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https://www.readbyqxmd.com/read/28321374/ectopic-pituitary-adenomas-presenting-as-sphenoid-or-clival-lesions-case-series-and-management-recommendations
#1
Bobby A Tajudeen, Edward C Kuan, Nithin D Adappa, Joseph K Han, Rakesh K Chandra, James N Palmer, David W Kennedy, Marilene B Wang, Jeffrey D Suh
Background An ectopic pituitary adenoma presenting as a clival or sphenoid mass is a rare clinical occurrence that may mislead the clinician and result in unnecessary interventions or potential medicolegal consequences. Here, we present one of the largest multi-institutional case series and review the literature with an emphasis on radiological findings and critical preoperative workup. Methods Retrospective chart review. Results Nine patients were identified with ectopic pituitary adenomas of the sphenoid or clivus...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28317564/odontogenic-infections
#2
REVIEW
Orrett E Ogle
The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and strict anaerobes. The dominant isolates are strictly anaerobic gram-negative rods and gram-positive cocci. The periapical infection is the most common form of odontogenic infection. Although odontogenic infections are usually confined to the alveolar ridge vicinity, they can spread into deep fascial spaces. Cavernous sinus thrombosis, brain abscess, airway obstruction, and mediastinitis are possible complications of dental infections...
April 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28314403/management-of-cavernous-sinus-involvement-in-sinonasal-and-ventral-skull-base-malignancies
#3
REVIEW
Amol Raheja, William T Couldwell
Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28301972/efficacy-of-transsphenoidal-surgery-in-achieving-biochemical-cure-of-growth-hormone-secreting-pituitary-adenomas-among-patients-with-cavernous-sinus-invasion-a-systematic-review-and-meta-analysis
#4
Vanessa Briceno, Hasan A Zaidi, Joanne A Doucette, Kaho B Onomichi, Amer Alreshidi, Rania A Mekary, Timothy R Smith
OBJECTIVES: Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature...
March 16, 2017: Neurological Research
https://www.readbyqxmd.com/read/28299013/tolosa-hunt-syndrome-demonstrated-by-constructive-interference-steady-state-magnetic-resonance-imaging
#5
Nisar A Wani, Majid Jehangir, Parveen A Lone
PURPOSE: To highlight the role of constructive interference steady state (CISS) magnetic resonance imaging (MRI) in the diagnosis of Tolosa-Hunt Syndrome (THS). CASE REPORT: We describe a case of THS in a 55-year-old woman presenting with left painful opthalmoplegia that was diagnosed by CISS MRI. Patient responded to steroid treatment and the lesion resolved. CONCLUSION: Imaging with MRI can help in making the diagnosis of THS by demonstrating an enhancing soft tissue lesion in the cavernous sinus and orbital apex resolving with steroids...
January 2017: Journal of Ophthalmic & Vision Research
https://www.readbyqxmd.com/read/28298046/hypofractionated-stereotactic-radiosurgery-a-new-treatment-strategy-for-giant-cavernous-sinus-hemangiomas
#6
Xin Wang, Huaguang Zhu, Jonathan Knisely, Guanghai Mei, Xiaoxia Liu, Jiazhong Dai, Ying Mao, Li Pan, Zhiyong Qin, Enmin Wang
OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare benign vascular tumors that arise from the dural venous sinuses lateral to the sella. Stereotactic radiosurgery (SRS) has emerged as a principal alternative to microresection for small- and medium-sized CSHs. Resection is a reasonable option for large (3-4 cm in diameter) and giant (> 4 cm in diameter) CSHs. However, management of giant CSHs remains a challenge for neurosurgeons because of the high rates of morbidity and even death that stem from uncontrollable and massive hemorrhage during surgery...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297690/-multiple-tentorial-dural-arteriovenous-fistulas-with-acquired-pial-arteriovenous-fistula-presented-with-unilateral-eye-symptoms-successfully-treated-by-transarterial-embolization-and-direct-surgery-a-case-report
#7
Hisato Minamide, Yutaka Hayashi, Naoyuki Uchiyama
A 58-year-old man presented with slowly progressive chemosis, exophthalmos, and blepharedema of the left eye. Digital subtraction angiography revealed multiple dural arteriovenous fistulas(dAVFs)involving the bilateral tentorium, superior sagittal sinus, and right frontal convexity. In addition, occlusion of the left cavernous sinus and left sigmoid sinus were observed, which could lead to venous hypertension and might be associated with the occurrence of multiple dAVFs. Along with the congestion of the left ophthalmic vein, increased intracranial pressure due to the left tentorial dAVF with cortical venous reflux could have caused the left eye symptoms; therefore, the tentorial lesion was treated first...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28291420/de-novo-formation-of-a-large-cavernoma-associated-with-a-congenital-torcular-dural-arteriovenous-fistula-case-report
#8
Waleed Brinjikji, Kelly D Flemming, Giuseppe Lanzino
The authors report a case of a developmentally normal child with a congenital complex torcular dural arteriovenous fistula (DAVF) who later, in his teenage years, developed several vermian cavernomas within a large cerebellar developmental venous anomaly (DVA). The patient had initially presented with an abnormally large head circumference but no neurological deficits. He underwent several partial embolization procedures in an attempt to decrease the blood supply of the fistula over the course of 8 years. Nine years following initial presentation, he presented with a fourth ventricular hemorrhage, due to development of a new vermian cavernoma adjacent to a previously known vermian DVA and suffered subsequent mild left-sided hemiataxia from which he later recovered...
February 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28286277/extent-of-resection-visual-and-endocrinological-outcomes-for-endoscopic-endonasal-surgery-for-recurrent-pituitary-adenomas
#9
Hyunwoo Do, Varun R Kshettry, Alan Siu, Irina Belinsky, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE: To assess outcomes after endoscopic endonasal surgery for recurrent or residual pituitary adenomas. METHODS: We retrospectively analyzed 61 patients from 2009 - 2016 that underwent endoscopic endonasal surgery for recurrent or residual pituitary adenomas after prior microscopic or endoscopic transphenoidal operation. RESULTS: Prior surgical approach was endoscopic endonasal in 55.7% and microscopic in 44.2%. The mean preoperative maximal tumor diameter was 2...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28286276/the-value-of-intraoperative-mri-in-endoscopic-and-microsurgical-transsphenoidal-pituitary-adenoma-resection
#10
Andrej Paľa, Andreas Knoll, Christine Brand, Gwendolin Etzrodt-Walter, Jan Coburger, Christian Rainer Wirtz, Michal Hlaváč
INTRODUCTION: The routine use of iMRI helps to achieve gross total resection in transsphenoidal pituitary surgery. We have compared the added value of iMRI for extent of resection in endoscopic versus microsurgical transsphenoidal adenomectomy. METHODS: A total of 96 patients with pituitary adenoma were included. 28 consecutive patients underwent endoscopic transsphenoidal tumor resection. For comparison, we used a historic cohort of 68 consecutive patients treated microsurgically...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28282443/the-bovine-paranasal-sinuses-bacterial-flora-epithelial-expression-of-nitric-oxide-and-potential-role-in-the-in-herd-persistence-of-respiratory-disease-pathogens
#11
Gerard M Murray, Rónan G O'Neill, Alison M Lee, Máire C McElroy, Simon J More, Aisling Monagle, Bernadette Earley, Joseph P Cassidy
The bovine paranasal sinuses are a group of complex cavernous air-filled spaces, lined by respiratory epithelium, the exact function of which is unclear. While lesions affecting these sinuses are occasionally reported in cattle, their microbial flora has not been defined. Furthermore, given that the various bacterial and viral pathogens causing bovine respiratory disease (BRD) persist within herds, we speculated that the paranasal sinuses may serve as a refuge for such infectious agents. The paranasal sinuses of clinically normal cattle (n = 99) and of cattle submitted for post-mortem examination (PME: n = 34) were examined by microbial culture, PCR and serology to include bacterial and viral pathogens typically associated with BRD: Mycoplasma bovis, Histophilus somni, Mannheimia haemolytica and Pasteurella multocida, bovine respiratory syncytial virus (BRSV) and bovine parainfluenza-3 virus (BPIV-3)...
2017: PloS One
https://www.readbyqxmd.com/read/28260625/cavernous-sinus-syndrome-a-prospective-study-of-73-cases-at-a-tertiary-care-centre-in-northern-india
#12
S Bhatkar, M K Goyal, A Takkar, K K Mukherjee, P Singh, R Singh, V Lal
OBJECTIVES: To study the clinical and etiological profile of patients with cavernous sinus syndrome (CSS) and identify factors which could determine the etiology and influence the outcome of these patients. PATIENTS AND METHODS: This prospective observational study included 73 consecutive patients satisfying the criteria of CSS (i.e. involvement of any 2 of the 3rd, 4th, 5th and 6th cranial nerves or any one of them with radiological evidence of cavernous sinus involvement)...
February 22, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28254595/does-low-field-intraoperative-magnetic-resonance-improve-the-results-of-endoscopic-pituitary-surgery-experience-of-the-implementation-of-a-new-device-in-a-referral-center
#13
Sergio García, Luis Reyes, Pedro Roldán, Jorge Torales, Irene Halperin, Felicia Hanzu, Cristobal Langdon, Isam Alobid, Joaquim Enseñat
OBJECTIVE: To assess the contribution of low field intraoperative magnetic resonance(iMRI) to endoscopic pituitary surgery. MATERIALS AND METHODS: The authors analyzed a prospective series of patients undergoing endoscopic endonasal surgery for pituitary macroadenomas assisted with a low field iMRI(PoleStarN30™Medtronic,0,15T). Clinical, radiological and surgical variables were analyzed and compared with our fully endoscopic historic cohort operated without iMRI assistance...
February 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28243891/igg4-related-disease-presenting-as-panuveitis-without-scleral-involvement
#14
REVIEW
Kinda Najem, Larissa Derzko-Dzulynsky, Edward A Margolin
BACKGROUND: The following case emphasizes the importance of including IgG4-related disease (RD) in the differential diagnosis of intraocular inflammation and multiple cranial nerve palsies. RESULTS: A 33-year-old man, with a history of idiopathic bilateral panuveitis, presented with a new right pupillary-sparing partial third nerve palsy, which spontaneously resolved in 2 weeks, but was followed 1 month later, by a right sixth nerve palsy, which also resolved within a few weeks...
December 2017: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28242132/abducens-nerve-palsy-due-to-inferior-petrosal-sinus-thrombosis
#15
Shivam Om Mittal, Junaid Siddiqui, Bashar Katirji
Isolated unilateral abducens nerve palsy is usually due to ischemia, trauma or neoplasm. Dorello's canal is the space between the petrous apex and superolateral portion of the clivus, bound superiorly by Gruber's ligament. The abducens nerve travels with inferior petrosal sinus (IPS) though the Dorello's canal before entering the cavernous sinus. A 31-year-old man presented with neck pain, and binocular horizontal diplopia, worse looking towards left and at distance. He had a history of intravenous drug abuse but no history of hypertension or diabetes...
February 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28236426/adenoid-cystic-carcinoma-of-maxillary-sinus-misdiagnosed-as-chronic-apical-periodontitis
#16
So-Young Park, Chien-Yun Pi, Euiseong Kim, Yoon Lee
Sometimes pain originating from a non-odontogenic pathologic condition is mistaken as endodontic illness, leading to misdiagnosis. The patient can misinterpret the pain as originating from a site different from the actual site, which is known as referred pain. However, the clinician managing pain in the orofacial region needs to be well-informed about the typical signs and symptoms of non-odontogenic diseases and to be able to make the correct referral when necessary for proper diagnosis and treatment. A 43-year-old man presented to the department of conservative dentistry complaining of dental pain...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28236049/analysis-of-the-venous-channel-within-the-clivus-using-multidetector-computed-tomography-digital-subtraction-venography
#17
Katsuhiro Mizutani, Masahiro Toda, Jun Kurasawa, Takenori Akiyama, Hirokazu Fujiwara, Masahiro Jinzaki, Kazunari Yoshida
PURPOSE: Although neuroradiologists and skull base neurosurgeons are aware of the existence of veins within the clivus, such vessels have seldom been described in the literature. The aim of the present study is to elucidate the detailed venous structure of the clivus. METHODS: Computed tomography digital subtraction venography (CT-DSV) images of 50 unruptured aneurysm cases were examined retrospectively. RESULTS: Eighteen emissary veins were identified in 14 (28...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28222415/young-adult-patient-with-headache-fever-and-blurred-vision
#18
Stavroula A Paschou, Konstantinos Tzioras, Vasiliki Trianti, Stavroula Lyra, Vasileios-Arsenios Lioutas, Andreas Seretis, Andromachi Vryonidou
BACKGROUND AND IMPORTANCE: This case highlights the fact that acute pituitary apoplexy may be misdiagnosed due to being confused with other entities exhibiting similar symptoms, such as meningitis or subarachnoid hemorrhage. CLINICAL PRESENTATION: A patient in his late 30s presented with sudden and severe frontal headache, fever, blurred vision, nausea, confusion, as well as oculomotor palsy (CN III) with partial ptosis of the left eyelid, dilated left pupil and left eye globe deviation inferiorly and laterally...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217399/delayed-and-isolated-oculomotor-nerve-palsy-following-minor-head-trauma
#19
Yu Nakagawa, Masahiro Toda, Shunsuke Shibao, Kazunari Yoshida
BACKGROUND: The purpose of this study was to consider the mechanism of isolated oculomotor nerve palsy after minor head trauma. CASE DESCRIPTION: We report a rare case of delayed and isolated oculomotor nerve palsy following minor head trauma. A 19-year-old boy complained of double vision 1 day after a minor head trauma. Neuro-ophthalmic examination showed isolated left oculomotor nerve palsy. Computed tomography and magnetic resonance imaging examination revealed no abnormal findings and steroid therapy was administered for a week...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28213639/prechiasmatic-sulcus-and-optic-strut-an-anatomic-study-in-dry-skulls
#20
Vasiliki Kanellopoulou, Evgenia Efthymiou, Vasiliki Thanopoulou, Dimitra Kozompoli, Dimitrios Mytilinaios, Maria Piagkou, Elizabeth O Johnson
BACKGROUND: Although safe surgical access to the cavernous sinus is related to understanding the anatomical and ethnic variants of the prechiasmatic sulcus and the optic strut, there remains a paucity of studies of the morphology and the bony relationships in the region. The present study provides a systematic morphological and morphometric analysis of the sulcal region and the optic strut anatomy and their relations in a Greek population. METHODS: The interoptic distance, length of planum sphenoidale, sulcal length and sulcal angle was determined in 96 Greek adult dry skulls...
February 17, 2017: Acta Neurochirurgica
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