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https://www.readbyqxmd.com/read/29775151/selection-of-endoscopic-or-transcranial-surgery-for-tuberculum-sellae-meningiomas-according-to-specific-anatomical-features-a-retrospective-multicenter-analysis-kosen-002
#1
Doo-Sik Kong, Chang-Ki Hong, Sang Duk Hong, Do-Hyun Nam, Jung-Il Lee, Ho Jun Seol, Jiwoong Oh, Dong Gyu Kim, Yong Hwy Kim
OBJECTIVE The endoscopic endonasal approach (EEA) and the transcranial approach (TCA) are good options for the treatment of tuberculum sellae (TS) meningiomas. The objective of this study was to identify the key anatomical features in TS meningiomas and compare the two surgical approaches. METHODS The authors retrospectively reviewed clinical data in 178 patients with TS meningiomas treated at 3 institutions between January 2010 and July 2016. Patients with tumors encasing the internal carotid artery or anterior cerebral artery or involving the anterior clinoid process or cavernous sinus were excluded...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29754515/spontaneous-direct-carotid-cavernous-sinus-fistula-secondary-to-a-persistent-primitive-trigeminal-artery-treated-by-trans-venous-coil-embolisation
#2
Andrew Imrie, Kendal Redmond, David Leggett
A healthy 51-year-old female presented with a spontaneous direct carotid-cavernous sinus fistula associated with a persistent primitive trigeminal artery. She had no history of connective tissue or cerebrovascular disorders or significant head trauma. This is a rare lesion with only 18 previously reported cases. It had similar clinical presentation and imaging appearance to a high-flow direct carotid-cavernous fistula and was uncovered after successful trans-venous coil embolisation of the fistula. It therefore needs to be considered in cases of direct carotid-cavernous fistula without history of trauma...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29744017/spontaneous-recanalization-after-carotid-artery-dissection-the-case-for-an-ultrasound-only-monitoring-strategy
#3
Sarah Lumsden, Gabor Rosta, Jean Bismuth, Alan B Lumsden, Zsolt Garami
Dissection of the internal carotid artery (ICA) accounts for 5% to 25% of ischemic strokes in young adults. We report a case of spontaneous recanalization of a traumatic ICA dissection in which carotid duplex (CDU) and transcranial color-coded duplex ultrasound (TCCD) were used. A 47-year-old male presented with intermittent episodes of headache, blurry vision, anisocoria, and loss of taste sensation following a whiplash injury while body surfing. Magnetic resonance angiogram (MRA) of the neck revealed absent flow in the cavernous ICA and a clot at the skull base...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29730106/imaging-evaluation-of-the-location-and-fenestration-of-sellar-floor-during-endonasal-transsphenoidal-surgery-in-patients-with-pituitary-adenomas
#4
Shousen Wang, Yong Qin, Deyong Xiao, Zhifeng Wu, Liangfeng Wei
To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29730099/may-the-inferior-petrosal-sinus-recanalization-during-endovascular-treatment-for-carotid-cavernous-fistulas-increase-the-risk-of-sixth-nerve-palsy
#5
Thomas Robert, Daniele Valsecchi, Philippe Sylvestre, Raphaël Blanc, Gabriele Ciccio, Stanislas Smajda, Hocine Redjem, Michel Piotin
INTRODUCTION: Sixth nerve palsy is a common complication of endovascular treatment for carotid-cavernous fistulas (CCF). Two hypotheses are evoked: the spontaneous venous congestion into the cavernous sinus (CS), and the direct compression of the nerve by the embolic agent into the CS. Nevertheless, the evidence is still uncertain. Knowing the vicinity of the sixth nerve with the inferior petrosal sinus (IPS) in the Dorello's canal, we hypothesized that the recanalization of the IPS increased the risk of nerve damage...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29726776/the-25th-anniversary-of-the-retrograde-suction-decompression-technique-dallas-technique-for-the-surgical-management-of-paraclinoid-aneurysms-historical-background-systematic-review-and-pooled-analysis-of-the-literature
#6
Bruno C Flores, Jonathan A White, H Hunt Batjer, Duke S Samson
OBJECTIVE Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29726765/aneurysms-with-persistent-filling-after-failed-treatment-with-the-pipeline-embolization-device
#7
Badih Daou, Elias Atallah, Nohra Chalouhi, Robert M Starke, Jeffrey Oliver, Maria Montano, Pascal Jabbour, Robert H Rosenwasser, Stavropoula I Tjoumakaris
OBJECTIVE The Pipeline embolization device (PED) has become a valuable tool in the treatment of cerebral aneurysms. Although failures with PED treatment have been reported, the characteristics and course of these aneurysms remain a topic of uncertainty. METHODS Electronic medical records and imaging studies were reviewed for all patients treated with the PED between July 2010 and March 2015 to identify characteristics of patients and aneurysms with residual filling after PED treatment. RESULTS Of 316 cases treated at a single institution, 281 patients had a long-term follow-up...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29719553/47-consecutive-cases-of-pipeline-flex-flow-diversion-utilizing-a-novel-large-bore-intracranial-intermediate-catheter-nuances-and-institutional-experience-with-the-syphontrak
#8
Li-Mei Lin, Bowen Jiang, Matthew T Bender, Erick M Westbroek, Jessica K Campos, Rafael J Tamargo, Judy Huang, Alexander L Coon, Geoffrey P Colby
Background: The increasing complexity of modern neurointerventions has necessitated a shift in intracranial access techniques towards more robust distal support platforms. Here we present our experience with the Syphontrak Support Catheter (Codman Neuro, Raynham, MA, USA) in the triaxial platform for the implantation of the second-generation Pipeline Flex embolization device (PED Flex; Medtronic Neurovascular, Irvine, CA, USA). Methods: We retrospectively identified patients who underwent PED Flex treatment utilizing the Syphontrak at a single institution...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29710055/tied-pipeline-a-case-of-rare-complication
#9
Shigeru Miyachi, Hiroyuki Ohnishi, Ryo Hiramatsu, Ryokichi Yagi, Toshihiko Kuroiwa
A 48-year-old female with a symptomatic giant carotid cavernous aneurysm underwent endovascular treatment with multiple Pipeline Flex embolic devices (PED). The delivery catheter had to take a complicated course of multiple turns to cross the aneurysm, and its loop was tied in the aneurysm. When the catheter was to be withdrawn, it was apparent that the tied catheter had made a tight knot that bound the tail of the previous PED together. We successfully retrieved all of the system including the tied PED, and we used telescoping stents with five PEDs in the next operation...
May 1, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29707473/hemangioma-of-the-cavernous-sinus-a-case-series
#10
Dylan A Noblett, Jennifer Chang, Atrin Toussi, Arthur Dublin, Kiarash Shahlaie
Introduction  Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are diagnosed with a combination of imaging and biopsy. We describe the clinical presentations, imaging findings, and management of two male patients with CSHs. Case Report  Case 1 describes a 57-year-old man who presented with vision changes and cranial nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m tagged red blood cell (RBC) imaging supported CSH diagnosis. He was treated with surgical resection and radiotherapy...
April 2018: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29698879/use-of-pipeline%C3%A2-embolization-device-for-the-treatment-of-traumatic-intracranial-pseudoaneurysms-case-series-and-review-of-cases-from-literature
#11
Mairaj T Sami, Domenico A Gattozzi, Hesham M Soliman, Alan R Reeves, Christopher J Moran, Paul J Camarata, Koji C Ebersole
OBJECTIVE: Intracranial traumatic pseudoaneurysms (PSA) are a rare but dangerous subtype of cerebral aneurysm. Reports documenting use of flow-diverting stents to treat traumatic intracranial PSAs are few and lack long-term follow-up. To our knowledge, this is the largest case-series to date demonstrating use of Pipeline Endovascular Device (PED) for traumatic intracranial PSAs. PATIENTS AND METHODS: Retrospective review of 8 intracranial traumatic PSAs in 7 patients treated using only PED placement...
June 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29685413/a-cavernous-sinus-lesion-clinically-responsive-to-steroids
#12
M W Ruff, I D Carabenciov, D R Johnson, B E Pollock, J E Parisi, J P Klaas
Tolosa Hunt syndrome (THS) is characterized by painful ophthalmoplegia secondary to idiopathic granulomatous inflammation of the cavernous sinus. The characteristic finding on MRI is an enhancing T1 isointense and T2 hypo- or hyperintense cavernous sinus mass lesion, which may result in focal narrowing of the ipsilateral internal carotid artery. Although the incidence is quite rare, it is a common diagnostic consideration in cases that present with multiple cranial neuropathies. However, the differential diagnosis for a unilateral cavernous sinus lesion in adults is broad and includes neoplastic, inflammatory (such as sarcoidosis and immunoglobulin G4-related disease [IgG4-RD]), infectious etiologies (such as syphilis and leprosy), as well as vascular lesions...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29628938/spontaneous-resolution-of-post-traumatic-direct-carotid-cavernous-fistula
#13
Varun Naragum, Glenn Barest, Mohamad AbdalKader, Katharine M Cronk, Thanh N Nguyen
Post-traumatic carotid-cavernous fistulas are due to a tear in the wall of the cavernous carotid artery, leading to shunting of blood into the cavernous sinus. These are generally high-flow fistula and rarely resolve spontaneously. Most cases require endovascular embolization. We report a case of Barrow type A carotid-cavernous fistula which resolved spontaneously.
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29627790/embolization-of-a-cavernous-carotid-fistula-through-the-vein-of-labb%C3%A3-a-new-alternative-transvenous-access-route
#14
Angelos Aristeidis Konstas, Alice Song, Julia Song, Aristomenis Thanos, Ian B Ross
Endovascular treatment of carotid cavernous fistulas (CCFs) via a transvenous approach is standard, but in rare cases this approach is challenging due to absence or thrombosis of the commonly used venous routes. A 61-year-old woman presented with a symptomatic CCF with all but one of the venous access routes to the CCF thrombosed, leaving an engorged superficial middle cerebral vein (SMCV) as the only venous outflow from the cavernous sinus. Access to the CCF was made possible after careful navigation of the sigmoid sinus, the vein of Labbé and the SMCV, bypassing the need for surgical access to the SMCV or for a direct transorbital puncture...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29620651/treatment-of-giant-cavernous-aneurysm-in-an-elderly-patient-via-extracranial-intracranial-saphenous-vein-bypass-graft-in-a-hybrid-operating-room-a-case-report
#15
Can Xin, Jianjian Zhang, Zhengwei Li, Zhongwei Xiong, Bangkun Yang, Xiaolin Wu, Hao Wang, Yichun Zou, Rongqing Wu, Wenyuan Zhao, Jincao Chen
RATIONALE: Extracranial-intracranial saphenous vein bypass (EC-IC SVB) remains indispensable for treating giant cavernous aneurysms. We report an unusual case of a giant cavernous aneurysm in an elderly patient treated with EC-IC SVB in a hybrid operating room. Immediately following proximal ligation of the internal carotid artery (ICA), she suffered an acute intraoperative encephalocele. PATIENT CONCERNS: A 71-year-old woman had suffered from severe headache and double vision for 4 months...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29608473/cavernous-sinus-aneurysm-associated-with-cerebellar-hemangioblastoma-in-an-adult-with-von-hippel-lindau-disease
#16
Hui Zhou, Shuo Sun, Hui Shi, Kui Ma
A case of cerebellar hemangioblastoma with von Hippel-Lindau disease and an aneurysm of the cavernous sinus segment of the internal carotid artery is presented here. A 60-year-old woman presented with a cerebellar solid tumor manifesting as headache of 4 months, progressive vomiting, and ataxia of half a month. Four-vessel angiography revealed a high stain mass tumor located in the posterior fossa; an aneurysm on the cavernous sinus segment of the internal carotid artery was demonstrated at the same time. The ipsilateral anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) branches were the main feeding vessels of the hemangioblastoma...
March 30, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29574221/endoscopic-endonasal-clipping-of-anterior-circulation-aneurysm-surgical-techniques-and-results
#17
Li-Min Xiao, Bin Tang, Shen-Hao Xie, Guan-Lin Huang, Zhi-Gang Wang, Er-Ming Zeng, Tao Hong
OBJECTIVE: Endoscopic endonasal clipping of intracranial aneurysms may utilize the microsurgical techniques as an alternative to the transcranial approach. The aim of this manuscript is to report a series of patients who underwent endoscopic endonasal approach(EEA) for microsurgical clipping of anterior circulation aneurysms. METHOD: A retrospective chart review was conducted. All the patients who underwent standard binostril EEA for aneurysm clipping were included...
March 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29554063/high-flow-extracranial-intracranial-bypass-for-giant-cavernous-carotid-aneurysm
#18
Junhui Chen, Chunlei Zhang, Peipei Li, Lei Chen, Yuhai Wang
Giant intracranial aneurysms have always been remain the most difficult cerebrovascular lesions to treat, especially for giant cavernous carotid aneurysm (CCA). The treatment of giant CCA is a greatest challenge for neurosurgeons. Surgical clipping morbidity and mortality rates are relatively high, and endovascular embolization also have a high complication. The authors reported a special 74-year-old female patient who presented with blurred vision and double vision for 3 years, a giant CCA was found by digital subtraction angiography and computed tomography angiography...
March 16, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29535902/delayed-endovascular-coil-extrusion-presenting-as-a-foreign-body-of-the-throat-a-case-report
#19
Anup Singh, Kapil Sikka, Nishchint Jain, Leve Joseph Devarajan
Endovascular treatment is a standard mode of treatment for traumatic cavernous internal carotid artery (ICA) pseudoaneurysms with good results and relatively low rates of complications. We describe a case of an unusual, potentially fatal, delayed postoperative event happening in a case of post-traumatic pseudoaneurysm of ICA, which had been previously managed with endovascular coiling.
March 2018: Neurointervention
https://www.readbyqxmd.com/read/29527388/enlargement-of-an-incidental-internal-carotid-artery-aneurysm-embedded-in-pituitary-adenoma-associated-with-medical-shrinkage-of-the-tumor-case-report
#20
Tigran Khachatryan, Marina Khachatryan, Ruben Fanarjyan, Mikayel Grigoryan, Arthur Grigorian
Background: Currently, transsphenoidal surgery (TSS) is the preferred method for surgical treatment of intrasellar pituitary adenomas. However, it carries some risk of intraoperative arterial injuries, which is mainly attributed to direct iatrogenic rupture of the internal carotid artery (ICA). There is anecdotal evidence suggesting that intracranial aneurysms are coincidentally found significantly more frequently in the setting of pituitary adenomas than when the incidence is compared to other intracranial neoplasms...
2018: Surgical Neurology International
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