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https://www.readbyqxmd.com/read/29145656/refining-operative-strategies-for-optic-nerve-decompression-a-morphometric-analysis-of-transcranial-and-endoscopic-endonasal-techniques-using-clinical-parameters
#1
Steven L Gogela, Lee A Zimmer, Jeffrey T Keller, Norberto Andaluz
BACKGROUND: Various approaches can be considered for decompression of the intracanalicular optic nerve. Although clinical experience has been reported, no quantitative study has yet compared the extent of decompression achieved by an endoscopic endonasal versus transcranial approach. OBJECTIVE: Toward this aim, our morphometric analysis compared both approaches by quantifying the circumferential degree of optic canal decompression that is possible before any meningeal violation, which would result in cerebrospinal fluid (CSF) leak...
May 3, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29134171/endoscopic-endonasal-repair-of-internal-carotid-artery-injury-during-endoscopic-endonasal-surgery
#2
Irit Duek, Gill E Sviri, Moran Amit, Ziv Gil
Background  Injury to the cavernous portion of the internal carotid artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication that can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success. Objectives  We provide a detailed technical description of an operative technique for endoscopic management of carotid artery injury. Methods  A case of ICA injury during endoscopic skull base surgery is presented...
October 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29131823/prevalence-of-extracranial-carotid-artery-aneurysms-in-patients-with-an-intracranial-aneurysm
#3
V E C Pourier, C J H C M van Laarhoven, M D I Vergouwen, G J E Rinkel, Gert J de Borst
BACKGROUND AND PURPOSE: Aneurysms in various arterial beds have common risk- and genetic factors. Data on the correlation of extracranial carotid artery aneurysms (ECAA) with aneurysms in other vascular territories are lacking. We aimed to investigate the prevalence of ECAA in patients with an intracranial aneurysm (IA). METHODS: We used prospectively collected databases of consecutive patients registered at the University Medical Center Utrecht with an unruptured intracranial aneurysm (UIA) or aneurysmal Subarachnoid hemorrhage (SAH)...
2017: PloS One
https://www.readbyqxmd.com/read/29119070/superior-ophthalmic-vein-access-for-embolization-of-an-indirect-carotid-cavernous-fistula
#4
Ali S Haider, Prabhat Garg, Dean Leonard, Tijani Osumah, Umair Khan, Steven Vayalumkal, Lyndon K Lee, Phu Nguyen, Grant Gilliland, Kennith F Layton
Carotid cavernous fistulae (CCF) are defined as abnormal connections between the carotid circulation and cavernous sinus. CCFs can be categorized as being direct or indirect. Direct CCFs are usually associated with trauma, whereas indirect CCFs are associated with revascularization following cavernous sinus thrombosis. We present a case of a 53-year-old male who presented with tinnitus, proptosis, conjunctivitis, and blurry vision. The patient had a recent endovascular transvenous embolization that was only partially successful, with a residual carotid cavernous fistula draining to the left superior ophthalmic vein and multiple cortical veins...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29114317/agenesis-of-the-internal-carotid-artery-with-transcavernous-anastomosis-associated-with-anterior-communicating-artery-aneurysms
#5
Kosuke Kumagai, Satoru Takeuchi, Naoki Otani, Masaki Komiyama, Kentaro Mori
Agenesis of the internal carotid artery (ICA) is a rare congenital anomaly. Recently, several cases of ICA agenesis have been associated with cerebral aneurysms. We present the seventh case of ICA agenesis with transcavernous anastomosis associated with cerebral aneurysms. A 47-year-old man presented with transient numbness of his left hand. Magnetic resonance angiography indicated the presence of anterior communicating artery (ACoA) aneurysms. Digital subtraction angiography revealed two ACoA aneurysms, absence of the left ICA, and an anomalous collateral vessel connecting the cavernous portions of both internal carotid arteries, which was considered to be a transcavernous anastomosis...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29103480/risk-factors-analysis-of-mirror-aneurysms-a-multi-center-retrospective-study-based-on-clinical-and-demographic-profile-of-patients
#6
Zhong-Qing Huang, Xin-Wei Zhou, Zhong-Jun Hou, Sui-Qiao Huang, Zhi-Hua Meng, Xian-Long Wang, Hao Yu, Lv-Jin Feng, Qiu-Jing Wang, Ping-An Li, Zhi-Bo Wen
As a special subgroup of multiple intracranial aneurysms, mirror aneurysms are located bilaterally on the corresponding intracranial arteries. The current study sought to compare the clinical and demographic features of patients harboring mirror aneurysm, and to elucidate the corresponding risk factors. We performed a retrospective cohort study of 2641 intracranial aneurysms patients, who were admitted to our hospitals between January 2005 and June 2014. Patients were subdivided into three groups based on the inclusion criteria: (i) single (n=2250); (ii) non-mirror multiple (n=285); and (iii) mirror aneurysms (n=106)...
November 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29099499/carotid-cavernous-fistula-current-concepts-in-aetiology-investigation-and-management
#7
A D Henderson, N R Miller
A carotid-cavernous fistula (CCF) is an abnormal communication between arteries and veins within the cavernous sinus and may be classified as either direct or dural. Direct CCFs are characterized by a direct connection between the internal carotid artery (ICA) and the cavernous sinus, whereas dural CCFs result from an indirect connection involving cavernous arterial branches and the cavernous sinus. Direct CCFs frequently are traumatic in origin and also may be caused by rupture of an ICA aneurysm within the cavernous sinus, Ehlers-Danlos syndrome type IV, or iatrogenic intervention...
November 3, 2017: Eye
https://www.readbyqxmd.com/read/29098418/bilateral-carotid-cavernous-sinus-fistula-a-case-report-and-review-of-the-literature
#8
REVIEW
Gavin Docherty, Maryam Eslami, Kailun Jiang, Jason S Barton
Carotid cavernous fistula (CCF) is an abnormal vascular shunt from the carotid artery to the cavernous sinus. They are commonly classified based on hemodynamics, etiology or anatomically. Hemodynamic classification refers to whether the fistula is high or low flow. Etiology is commonly secondary to trauma or can occur spontaneously in the setting of aneurysm or medical conditions predisposing to arterial wall defects. Bilateral carotid cavernous fistulas are rare. We present a case of bilateral CCF secondary to trauma...
November 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29097132/cavernous-carotid-stenosis-following-stereotactic-radiosurgery-for-cushing-s-disease-a-rare-complication-and-review-of-the-literature
#9
Mohana Rao Patibandla, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
Intracranial carotid stenosis or occlusion after SRS is an extraordinarily rare event. Because of the rarity of this event, increased awareness within the neurosurgical community is required. For those with post-radiosurgical carotid stenosis who are asymptomatic, longitudinal follow up is recommended. Management depends on whether the patient is symptomatic or asymptomatic. Those who are symptomatic may require balloon angioplasty, stenting, or bypass surgery.
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29054956/indirect-carotid-cavernous-fistula-mimicking-ocular-myasthenia
#10
Lakshmi Leishangthem, Sudhakar Reddy Satti
71-year-old woman with progressive left-sided, monocular diplopia and ptosis. Her symptoms mimicked ocular myasthenia, but she had an indirect carotid cavernous fistula (CCF). She was diagnosed with monocular myasthenia gravis (negative acetylcholinesterase antibody) after a positive ice test and started on Mestinon and underwent a thymectomy complicated by a brachial plexus injury. Months later, she developed left-sided proptosis and ocular bruit. She was urgently referred to neuro-interventional surgery and was diagnosed with an indirect high-flow left CCF, which was treated with Onyx liquid and platinum coil embolisation...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29043093/anatomical-study-of-petrous-and-cavernous-parts-of-internal-carotid-artery
#11
Manisha Vijaywargiya, Rashmi Deopujari, Sunita Arvind Athavale
The petrous and cavernous parts of internal carotid artery (ICA) are obscure and are not readily accessible to observation/imaging. These parts have broad biological and medical interest because of their peculiar shape. Given the their clinical importance and the scarce data available based mostly on imaging, the present study was aimed at studying these parts of ICA by dissection. The study was carried out on 56 ICAs obtained from embalmed adult cadavers and 10 ICAs from five fetuses. The foetal ICAs were studied in situ...
September 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/29042328/ruptured-persistent-trigeminal-artery-causing-direct-cavernous-sinus-fistula-treated-with-pipeline-embolization-and-minimal-coiling
#12
Nam K Yoon, Al-Wala Awad, James M Gee, Philipp Taussky
BACKGROUND: Rupture of a persistent trigeminal artery associated with development of a cavernous sinus fistula in a traumatic setting is rare. They are typically treated with coil embolization of the cavernous sinus. CASE DESCRIPTION: We present the case of a 42-year-old woman who developed a direct cavernous carotid fistula after a motor-vehicle accident. Angiographic imaging revealed a rupture point of a persistent trigeminal artery as it connected with the cavernous segment of the internal carotid artery (ICA), causing a cavernous sinus fistula...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29040718/the-mcconnell-s-capsular-arteries-and-their-relevance-in-endoscopic-endonasal-approach-to-the-sellar-region
#13
Cristian Ferrareze Nunes, André Beer-Furlan, Francesco Doglietto, Ricardo Luis Carrau, Daniel Monte-Serrat Prevedello
BACKGROUND: The McConnell's capsular arteries (MCCA) were first described in 1953. They consist of medial branches of the cavernous internal carotid artery (ICA) and are divided in anterior and inferior capsular arteries. OBJECTIVE: To highlight the anatomy of the MCCA and its importance in the surgical treatment of tuberculum sellae and planum sphenoidale tumors through an endoscopic endonasal approach. METHODS: Ten cadaveric specimens fixed in formalin and perfused with colored silicone were dissected...
October 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29026931/imaging-patterns-of-rhino-orbital-cerebral-mucormycosis-in-immunocompromised-patients-when-to-suspect-complicated-mucormycosis
#14
Peter Raab, Ludwig Sedlacek, Stefanie Buchholz, Stefan Stolle, H Lanfermann
PURPOSE: The aim of this study was to describe radiological imaging findings of a complicated sinusitis, which should raise the suspicion of rhino-orbital-cerebral mucormycosis as being the underlying cause. METHODS: In this retrospective analysis, we describe the cases and imaging findings of 8 patients with proven mucormycosis. These patients presented mostly with new facial or orbital swelling and were referred for imaging to our institution. Magnetic resonance imaging and computed tomography images were classified as abnormal or normal with respect to orbital, paranasal and cerebral signal results...
October 12, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29024673/not-the-usual-suspect
#15
Andrew G Lee, Jonathan D Shader, Aroucha Vickers, Orlando M Diaz, Jurij R Bilyk
An 82-year-old woman presented with right-sided proptosis, chemosis, and a supraorbital bruit. A dural carotid-cavernous fistula (CCF) was suspected, but catheter angiography revealed an intraorbital inferior ophthalmic vein arteriovenous fistula (AVF) supplied by the right ophthalmic artery and infraorbital branch of the internal maxillary artery. A primary orbital AVF can mimic the clinical and radiographic features of the more common CCF.
October 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29021314/augmented-3d-venous-navigation-for-neuroendovascular-procedures
#16
Raphaël Blanc, Robert Fahed, Pascal Roux, Stanislas Smajda, Gabriele Ciccio, Jean-Philippe Desilles, Hocine Redjem, Mikael Mazighi, Humain Baharvahdat, Michel Piotin
BACKGROUND: Endovascular venous access is increasingly used for the treatment of many cerebrovascular diseases. The quality of venous roadmapping through arterial injection can be problematic because of contrast media dilution, slow flow velocity, and unilateral opacification of the venous system. OBJECTIVE: To describe our experience with the VesselNavigator (Philips Healthcare, Best, The Netherlands) in performing live 3D roadmapping for intracranial venous procedures...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29021312/incompletely-obliterated-cranial-arteriovenous-fistulae-are-safely-and-effectively-treated-with-adjuvant-%C3%AE%C2%B5-aminocaproic-acid
#17
Brian M Howard, Jonathan A Grossberg, Adam Prater, C Michael Cawley, Jacques E Dion, Frank C Tong
BACKGROUND: Administration of ε-aminocaproic acid (εACA), as adjuvant therapy following incompletely embolized cranial dural arteriovenous (dAVFs) and direct carotid artery to cavernous sinus fistulae (CCFs), is a strategy to promote post-procedural thrombosis. However, the efficacy of εACA to treat incompletely obliterated dAVFs and CCFs has not been published. The purpose of this study was to determine if administration of εACA following incomplete embolization of cranial dAVFs or CCFs was associated with an increased likelihood of cure on follow-up imaging compared with patients not given adjuvant εACA...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29021309/recurrence-risk-factors-in-detachable-balloon-embolization-of-traumatic-direct-carotid-cavernous-fistulas-in-188-patients
#18
Bu-Lang Gao, Zi-Liang Wang, Tian-Xiao Li, Bin Xu
PURPOSE: To investigate the effects of detachable balloons in embolizing traumatic carotid cavernous fistulas (TCCFs) and the risk factors for recurrence after balloon embolization. MATERIALS AND METHODS: 188 patients with TCCFs were enrolled, and clinical, treatment, and follow-up data were analyzed for possible risk factors for recurrence after embolization. RESULTS: Among 188 patients, 182 (96.8%) had successful balloon embolization; 6 patients failed...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29018652/anastomotic-aneurysm-formation-after-high-flow-bypass-surgery-a-case-report-with-histopathological-study
#19
Tatsuya Uchida, Masanori Yoshino, Shinji Ito, Takayuki Hara
Bypass surgery is often used in the treatment of large and giant aneurysms. Major complications that often arise during the perioperative period include cranial nerve palsy, ischemic complications, and hyperperfusion. However, there have been a few reports about late onset complications such as anastomotic aneurysms. In particular, anastomotic aneurysm after high flow bypasses has never been reported. A 57-year-old woman who had been suffering from left eye pain was diagnosed with a large aneurysm of the left internal carotid artery (ICA) in the cavernous portion...
October 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28989047/delayed-complications-after-transsphenoidal-surgery-for-pituitary-adenomas
#20
REVIEW
Gmaan Alzhrani, Walavan Sivakumar, Min S Park, Phil Taussky, William T Couldwell
Perioperative complications after transsphenoidal surgery for pituitary adenomas have been well documented in the literature; however, some complications can occur in a delayed fashion postoperatively and reports are sparse about their occurrence, management, and outcome. Here, we describe delayed complications after transsphenoidal surgery and discuss the incidence, temporality from the surgery, and management of these complications based on the findings of studies that reported delayed postoperative epistaxis, delayed postoperative cavernous carotid pseudoaneurysm formation and rupture, vasospasm, delayed symptomatic hyponatremia (DSH), hypopituitarism, hydrocephalus, and sinonasal complications...
October 5, 2017: World Neurosurgery
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