Different clinical presentations of dural arteriovenous fistulae of the hypoglossal canal: Report on three cases and discussion of the treatment approach

Neurocirugía ◽  
2020 ◽  
Author(s):  
Sebastián Baldi ◽  
Ana Fernandez ◽  
Alberto Gil ◽  
Santiago Rosati
Keyword(s):  
Treatment Approach ◽  
Arteriovenous Fistulae ◽  
Hypoglossal Canal ◽  
Clinical Presentations

scholarly journals Left temporal craniotomy and direct microcatheterization of the middle meningeal artery for treatment of a complex temporal dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V8
Author(s):  
Daniel M. S. Raper ◽  
Nasser Mohammed ◽  
M. Yashar S. Kalani ◽  
Min S. Park
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Treatment Approach ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Intraoperative Angiography ◽  
Arteriovenous Fistulae ◽  
Posterior Division ◽  
Technical Considerations ◽  
Meningeal Artery

The preferred method for treating complex dural arteriovenous fistulae of the transverse and sigmoid sinuses is via endovascular, transarterial embolization using liquid embolysate. However, this treatment approach mandates access to distal dural feeding arteries that can be technically challenging by standard endovascular approaches. This video describes a left temporal craniotomy for direct stick microcatheterization of an endovascularly inaccessible distal posterior division of the middle meningeal artery for embolization of a complex left temporal dural arteriovenous fistula. The case was performed in the hybrid operative suite with biplane intraoperative angiography. Technical considerations, operative nuances, and outcomes are reviewed.The video can be found here: https://youtu.be/Dnd4yHgaKcQ.

Acute heart failure: early pharmacological therapy

2018 ◽  
Author(s):  
Jonathan R Dalzell ◽  
Colette E Jackson ◽  
Roy Gardner ◽  
John JV McMurray
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Mechanical Circulatory Support ◽  
De Novo ◽  
Treatment Approach ◽  
Pharmacological Therapy ◽  
Current Therapy ◽  
Circulatory Support ◽  
Clinical Presentations

Acute heart failure syndromes consist of a spectrum of clinical presentations due to an impairment of some aspect of the cardiac function. They represent a final common pathway for a vast array of pathologies and may be either a de novo presentation or, more commonly, a decompensation of pre-existing chronic heart failure. Despite being one of the most common medical presentations, there are no definitively proven prognosis-modifying treatments. The mainstay of current therapy is oxygen and intravenous diuretics. However, within this spectrum of presentations, there is a crucial dichotomy which governs the ultimate treatment approach, i.e. the presence, or absence, of cardiogenic shock. Patients without cardiogenic shock may receive vasodilators, whilst shocked patients should be considered for treatment with inotropic therapy or mechanical circulatory support, when appropriate and where available.

Microsurgical ligation of spinal arteriovenous fistulae: techniques

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video11
Author(s):  
Chad A. Tuchek ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Natural History ◽  
Lower Extremity ◽  
Vascular Malformation ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula ◽  
Arteriovenous Fistulae ◽  
Lower Extremity Weakness ◽  
Clinical Presentations ◽  
Wide Range ◽  
Microsurgical Techniques

Spinal dural arteriovenous fistula (dAVF) is an acquired abnormal arterial-to-venous connection within the spinal dura with a wide range of clinical presentations and natural history. Spinal dAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dura of the nerve root sleeve. Spinal dAVFs are the most common vascular malformation of the spine.The authors present a patient who presented with sudden temporary lower extremity weakness secondary to an L-1 spinal dAVF. The details of microsurgical techniques to disconnect the fistula are discussed in this video.The video can be found here: http://youtu.be/F9Kiffs3s6A.

scholarly journals Far Lateral Approaches: Dural Arteriovenous Fistulae at the Hypoglossal Canal: 3-Dimensional Operative Video

2021 ◽  
Vol 22 (1) ◽  
pp. e50-e50
Author(s):  
Karol P. Budohoski ◽  
Damiano G. Barone ◽  
Saniya Mediratta ◽  
Matthew Ross ◽  
Ramez W. Kirollos ◽  
...  
Keyword(s):  
Arteriovenous Fistulae ◽  
3 Dimensional ◽  
Hypoglossal Canal ◽  
Far Lateral

scholarly journals Sex Differences in Inflammation During Venous Remodeling of Arteriovenous Fistulae

2021 ◽  
Vol 8 ◽  
Author(s):  
Shin Mei Chan ◽  
Gabe Weininger ◽  
John Langford ◽  
Daniel Jane-Wit ◽  
Alan Dardik
Keyword(s):  
Sex Differences ◽  
Animal Models ◽  
Clinical Studies ◽  
Vascular Remodeling ◽  
Cardiovascular Events ◽  
Wall Thickening ◽  
Arterial Remodeling ◽  
Arteriovenous Fistulae ◽  
Clinical Presentations ◽  
Menopausal Women

Vascular disorders frequently have differing clinical presentations among women and men. Sex differences exist in vascular access for hemodialysis; women have reduced rates of arteriovenous fistula (AVF) maturation as well as fistula utilization compared with men. Inflammation is increasingly implicated in both clinical studies and animal models as a potent mechanism driving AVF maturation, especially in vessel dilation and wall thickening, that allows venous remodeling to the fistula environment to support hemodialysis. Sex differences have long been recognized in arterial remodeling and diseases, with men having increased cardiovascular events compared with pre-menopausal women. Many of these arterial diseases are driven by inflammation that is similar to the inflammation during AVF maturation. Improved understanding of sex differences in inflammation during vascular remodeling may suggest sex-specific vascular therapies to improve AVF success.

Acute heart failure: early pharmacological therapy

2015 ◽  
Author(s):  
Jonathan R Dalzell ◽  
Colette E Jackson ◽  
Roy Gardner ◽  
John JV McMurray
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Mechanical Circulatory Support ◽  
De Novo ◽  
Treatment Approach ◽  
Pharmacological Therapy ◽  
Current Therapy ◽  
Circulatory Support ◽  
Clinical Presentations

Acute heart failure syndromes consist of a spectrum of clinical presentations due to an impairment of some aspect of the cardiac function. They represent a final common pathway for a vast array of pathologies and may be either a de novo presentation or, more commonly, a decompensation of pre-existing chronic heart failure. Despite being one of the most common medical presentations, there are no definitively proven prognosis-modifying treatments. The mainstay of current therapy is oxygen and intravenous diuretics. However, within this spectrum of presentations, there is a crucial dichotomy which governs the ultimate treatment approach, i.e. the presence, or absence, of cardiogenic shock. Patients without cardiogenic shock may receive vasodilators, whilst shocked patients should be considered for treatment with inotropic therapy or mechanical circulatory support, when appropriate and where available.

Jealousy in Couple Relationships

2004 ◽  
Vol 21 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Padmal de Silva
Keyword(s):  
Treatment Approach ◽  
Clinical Treatment ◽  
Couple Relationships ◽  
Relationship Enhancement ◽  
Clinical Presentations

AbstractThis article discusses the problem of jealousy in couple relationships. The clinical presentations are summarised, and the question of what is morbid jealousy is addressed. Issues in the assessment of jealousy in couples are discussed, with suggestions for the areas to be covered. A framework for the formulation of the problem is proposed. Finally, the clinical treatment of morbid jealousy is reviewed. A treatment approach is described, which includes relationship enhancement work and a range of specific techniques.

scholarly journals Iron-deficiency anemia: a view of hematologist and gynecologist. Optimizing diagnostic and treatment approach

2020 ◽  
Vol 3 (4) ◽  
pp. 248-253
Author(s):  
E.A. Lukina ◽  
◽  
A.V. Ledina ◽  
S.I. Rogovskaya ◽  
◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Overload ◽  
Iron Deficiency Anemia ◽  
Treatment Approach ◽  
Deficiency Anemia ◽  
Gynecological Disorders ◽  
Clinical Presentations ◽  
Latent Iron Deficiency ◽  
Parenteral Iron ◽  
Social Importance

Iron-deficiency anemia (IDA) is an acquired disease characterized by the reduced levels of iron in the serum, tissues, and bone marrow that mainly result from hemorrhages (e.g., nasal, gastrointestinal etc.). Women are at risk for IDA due to the physiological monthly loss of blood, childbearing, and breastfeeding but also due to various gynecological disorders leading to iron depletion and anemia. The paper describes the pathogenic mechanisms, diagnostic criteria, and clinical presentations of IDA and the potential consequences of iron overload. Considering a high medical and social importance of anemia in pregnancy, the data on IDA prevalence in this cohort as well as the potential complications both for the mother and the child are addressed. Current therapeutic approaches for anemia using peroral and parenteral iron preparations and their indications are highlighted. The prevention of iron deficiency and the effective options of its correction are viable tasks which allow for improving the health and quality of women’s life. KEYWORDS: anemia, iron-deficiency anemia, diagnosis, pregnancy, latent iron deficiency, iron overload, treatment, iron (II) fumarate. FOR CITATION: Lukina E.A., Ledina A.V., Rogovskaya S.I. Iron-deficiency anemia: a view of hematologist and gynecologist. Optimizing diagnostic and treatment approach. Russian Journal of Woman and Child Health. 2020;3(4):248–253. DOI: 10.32364/2618-8430-2020-3-4-248-253.

Transvenous coil embolization with intra-operative cone beam CT assistance in the treatment of hypoglossal canal dural arteriovenous fistulae

2018 ◽  
Vol 11 (2) ◽  
pp. 179-183 ◽  
Author(s):  
Matthew Thomas Crockett ◽  
Albert Ho Yuen Chiu ◽  
Tejinder P Singh ◽  
William McAuliffe ◽  
Timothy John Phillips
Keyword(s):  
Coil Embolization ◽  
Low Dose ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Complication Rates ◽  
Effective Treatment Option ◽  
Arteriovenous Fistulae ◽  
Hypoglossal Canal ◽  
Patient Cohort ◽  
Entire Patient Cohort

BackgroundHypoglossal canal dural arteriovenous fistulae (HC-dAVF) are a rare subtype of skull base fistulae involving the anterior condylar confluence or anterior condular vein within the hypoglossal canal. Transvenous coil embolization is a preferred treatment strategy, however delineation of fistula angio-architecture during workup and localization of microcatheter tip during embolization remain challenging on planar DSA. For this reason, our group have utilized intra-operative cone beam CT (CBCT) and selective cone beam CT angiography (sCBCTA) as adjuncts to planar DSA during workup and treatment. The purpose of this article is to present our experience in the treatment of HC-dAVF using transvenous coil embolization (TVCE) with cone beam CT assistance, describing our technique as well as presenting our angiographic and clinical outcomes.MethodsTen patients with symptomatic HC-dAVF were treated using TVCE with intra-operative cone beam CT assistance. Prospectively collected data regarding clinical and angiographic results and complication rates was recorded and reviewed.ResultsComplication-free fistula occlusion was achieved in our entire patient cohort. The dominant symptom of pulsatile tinnitus resolved in all 10 patients.ConclusionsThis study demonstrates that TVCE with CBCT assistance is a highly effective treatment option for HC-dAVF, achieving complication-free fistula occlusion in our entire patient cohort. We have found low-dose sCBCTA and CBCT to be an extremely useful adjunct to planar DSA imaging during both workup and treatment of these rare fistulae.

Bronchioloalveolar carcinoma.

1996 ◽  
Vol 14 (8) ◽  
pp. 2377-2386 ◽  
Author(s):  
J E Barkley ◽  
M R Green
Keyword(s):  
English Language ◽  
Treatment Approach ◽  
Bronchioloalveolar Carcinoma ◽  
Small Cell Lung ◽  
Cigarette Smokers ◽  
Medline Search ◽  
Adenocarcinoma Of The Lung ◽  
Clinical Presentations ◽  
Histologic Types ◽  
Extent Of Disease

PURPOSE To review bronchioloalveolar carcinoma (BAC). MATERIALS AND METHODS English language articles were identified through a Melvyl Medline Search (1966 to 1995) and through the bibliographies of selected articles. RESULTS An increase in BAC appears to be responsible for the observed rise in the incidence of adenocarcinoma of the lung. Patients with BAC tend to be younger at diagnosis, are more likely to be female, and less likely to be cigarette smokers when compared with other patients with non-small-cell lung cancer (NSCLC). The etiology of this disease is unclear, but multiple environmental insults have been implicated. There are three subtypes of BAC and the symptoms and prognosis of the disease depend on the subtype and extent of disease, but are generally similar to other histologic types of NSCLC. The radiographic differential diagnosis is broad and includes both benign and malignant diseases. The treatment approach to patients with BAC is similar to those with other types of NSCLC. CONCLUSION BAC appears to be increasing in incidence, especially in young, nonsmoking females. Three subtypes of the disease exist and are responsible for the variable clinical presentations. Further epidemiologic investigation is needed to elucidate the etiology and pathogenesis of this unique disease.

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