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Ica child skull base

Sergey Spektor, Shlomo Dotan, Cezar José Mizrahi
BACKGROUND: Skull base drilling is a necessary and important element of skull base surgery; however, drilling around vulnerable neurovascular structures has certain risks. We aimed to assess the frequency of complications related to drilling the anterior skull base in the area of the optic nerve (ON) and internal carotid artery (ICA), in a large series of patients. METHODS: We included anterior skull base surgeries performed from 2000 to 2012 that demanded unroofing of the optic canal, with extra- or intradural clinoidectomy and/or drilling of the clinoidal process and lateral aspect of the tuberculum sella...
June 2013: Acta Neurochirurgica
M Yashar S Kalani, Samuel Kalb, Nikolay L Martirosyan, Salvatore C Lettieri, Robert F Spetzler, Randall W Porter, Iman Feiz-Erfan
OBJECT: Resection of cancer and the involved artery in the neck has been applied with some success, but the indications for such an aggressive approach at the skull base are less well defined. The authors therefore evaluated the outcomes of advanced skull base malignancies in patients who were treated with bypass and resection of the internal carotid artery (ICA). METHODS: The authors retrospectively reviewed the charts of all patients with advanced head and neck cancers who underwent ICA sacrifice with revascularization in which an extracranial-intracranial bypass was used between 1995 and 2010 at the Barrow Neurological Institute...
March 2013: Journal of Neurosurgery
Benedicto Oscar Colli, Carlos Gilberto Carlotti, João Alberto Assirati, Daniel Giansanti Abud, Marcelo Campos Moraes Amato, Roberto Alexandre Dezena
The term "paraclinoid aneurysms", has been used for aneurysms of the internal carotid artery (ICA) between the cavernous sinus and the posterior communicating artery. Due to their complex anatomical relationship at the skull base and because they are frequently large/giant, their surgical treatment remains a challenge. Ninety-five patients harboring 106 paraclinoid aneurysms underwent surgery (1990-2010). Age, 11-72 years old. Sex, 74:21 female/male. Follow-up; 1-192 months (mean = 51.7 months). Eighty-six patients had single and 9 had multiple paraclinoid aneurysms...
January 2013: Neurosurgical Review
Christine M Glastonbury, H Ric Harnsberger, Patricia A Hudgins, Karen L Salzman
INTRODUCTION: This study aimed to describe the lateralized petrous internal carotid artery (ICA), a rare variant of the intratemporal course of the ICA, and distinguish it from aberrant ICA. METHODS: A retrospective multi-institutional review of all patients diagnosed over a 10-year period with lateralized ICA was completed. Medical records were reviewed for demographic data as well as clinical information in all patients. Computerized tomography (CT) studies were reviewed in all patients...
September 2012: Neuroradiology
Arata Watanabe, Tomohiro Omata, Hidehito Koizumi, Shin Nakano, Nobuyasu Takeuchi, Hiroyuki Kinouchi
OBJECT: The natural history of moyamoya disease is not well known. We have observed that the bony carotid canal is hypoplastic in patients with adult onset moyamoya disease. Bony carotid canal development should represent internal carotid artery (ICA) development, and may stop with the beginning of ICA stenosis. The purpose of this study was to determine the onset of moyamoya disease by measuring the bony carotid canal. METHODS: The normal diameter of the bony carotid canal was evaluated on 4-mm thick bone window CT scans of the skull base in 60 Japanese patients aged 20-80 years, who had minor head trauma or headache considered to be unrelated to the skull base or arterial systems...
June 2010: Journal of Neurosurgery. Pediatrics
Yoshinobu Seo, Takehiko Sasaki, Hirohiko Nakamura
The cochlea is one of the most important organs to preserve during skull base surgery. However, no definite landmark for the cochlea has been identified during maximum drilling of the petrous apex such as anterior transpetrosal approach. The relationship between the cochlea and the petrous portion of the internal carotid artery (ICA) was assessed with computed tomography (CT) in 70 petrous bones of 35 patients, 16 males and 19 females aged 12-85 years (mean 48.6 years). After accumulation of volume data with multidetector CT, axial bone window images of 1-mm thickness were obtained to identify the cochlea and the horizontal petrous portion of the ICA...
2010: Neurologia Medico-chirurgica
Florian H Ebner, Verena Kuerschner, Klaus Dietz, Eva Bueltmann, Thomas Naegele, Juergen Honegger
BACKGROUND: The objective of this study is to evaluate the significance of reduced intercarotid artery distance in the C5 segment in acromegalic patients and the implications for transsphenoidal surgery. METHODS: The skull base with the carotid canal was examined with a helical CT scan in 45 patients with acromegaly and 45 age group-matched controls. The distances between the inner walls (IWs) of the carotid sulcus (CS), the outer walls (OWs) of the CS, and the diameter of the ICA at the C5 segment were assessed...
November 2009: Surgical Neurology
E Bryson, W Draf, E Hofmann, U Bockmühl
BACKGROUND: Occult malformations of the lateral skull base are rare anomalies, but can cause severe complications such as recurrent meningitis. Therefore, they need to be precisely delineated and sufficient surgical closure is mandatory. PATIENTS AND METHODS: Between 1986 and 2004 twenty patients (10 children and 10 adults) with occult malformations at the lateral skull base were treated surgically at the ENT-Department of the Hospital Fulda gAG. Of these 3 Mondini-malformations, 11 defects of the tegmen tympani or the mastoidal roof, 2 dural lesions to the posterior fossa and 4 malformations within the pyramidal apex have been found...
December 2005: Laryngo- Rhino- Otologie
Jason W Allen, Anthony J G Alastra, Peter K Nelson
OBJECT: The aim of this study was to determine the prevalence of angiographically identifiable skull base arterial branches that potentially serve as collateral conduits during a balloon occlusion test (BOT) of the internal carotid artery (ICA). The authors posited that neurological deficits in patients who had previously tolerated the occlusion test may be attributable to an unrecognized collateral support through these channels (operant during proximal ICA BOT) when permanent ICA occlusion was performed more distally...
January 2005: Journal of Neurosurgery
Jan Gralla, Caspar Brekenfeld, Juerg Schmidli, Marco Caversaccio, Dai-Do Do, Gerhard Schroth
PURPOSE: To describe the management of a pediatric patient with recurrent, life-threatening nasopharyngeal hemorrhages due to a pseudoaneurysm of the internal carotid artery (ICA), most likely caused by deep neck infection following peritonsillar abscess. CASE REPORT: An 11-year-old boy presented with lymphadenopathy of the neck, torticollis, and difficulty swallowing that had persisted for some weeks. After sneezing, the patient suffered massive recurrent nasopharyngeal hemorrhages leading to anemia...
December 2004: Journal of Endovascular Therapy
N P McIvor, R A Willinsky, K G TerBrugge, J A Rutka, J L Freeman
Twenty-nine patients with lesions of the neck, skull base, and cavernous sinus had test balloon occlusions of the internal carotid artery (ICA) to determine the feasibility of sacrifice of the artery. Only one patient (3.4%) showed evidence of cerebrovascular compromise. Sixteen patients who tolerated test occlusions went on to ICA sacrifice. Ten patients had permanent balloon occlusion (PBO) of the ICA for cavernous aneurysms or to "trap" carotid-cavernous fistulae (CCF). Complications occurred in three patients (30%) with permanent morbidity in one patient (10%)...
January 1994: Head & Neck
E J de Vries, L N Sekhar, J A Horton, D E Eibling, I P Janecka, V L Schramm, H Yonas
A patent internal carotid artery (ICA) is essential in most patients. Management of skull base lesions often requires translocation, balloon embolization, or resection of this vessel. Preoperative tests to assess the availability of collateral flow have not been uniformly accurate. A new test that significantly increases the safety of surgical removal of the ICA is described. One hundred thirty-six patients were studied with temporary balloon occlusion (TBO) of the ICA and determination of stable xenon-enhanced computed tomography cerebral blood flow (Xe/CT CBF) measurements...
January 1990: Laryngoscope
D J Quint, R Silbergleit, W C Young
Congenital absence of one or both internal carotid arteries (ICAs) has a high association with circle of Willis aneurysm formation. Since the carotid canals in the skull base form secondary to the presence of the embryonic ICA, absence or hypoplasia of a carotid canal on a computed tomographic (CT) scan through the skull base should suggest a congenital ICA abnormality and prompt a search for associated intracranial vascular abnormalities. Of four patients with carotid canal underdevelopment evident at CT, two had associated circle of Willis aneurysms and a third had an extensive skull base rete mirabile supplying an abnormal tangle of vessels in the basal cisterns...
February 1992: Radiology
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