Persistent Enlarged Occipital Sinus with Absent Unilateral Transverse Sinus

AbstractThe occipital sinus may occasionally remain patent, but the incidence is extremely low and observed in less than 10% of cases. A persistent patent occipital sinus (POS) may be associated with other venous sinus abnormality. The absence of transverse sinus in association with POS is an extremely rare condition and not reported yet. The neuroradiologist, neurosurgeons, otolaryngologist, and neurologist must be aware of the possible existence of POS and other associated venous sinus anomaly, as its warrants very crucial modification of surgical planning, selection of appropriate approaches, and, additionally, may also critically limit the extent of surgical exposure of target, and may hinder intended extent of surgical excision of tumor and associated possibility of injury to POS, which may produce catastrophic hemorrhage, brain swelling, and neurosurgical morbidity. The authors report a 35-year-old male who underwent suboccipital craniotomy for right-side giant acoustic schwannoma. Following the raising bone flap, a markedly prominent, turgid, occipital sinus was observed, not placed exactly in the midline but deviated to the right side, causing further restraining of dural opening. Surgical nuances and intraoperative difficulty encountered along with pertinent literature is reviewed briefly.

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Rheology of right ventricular outflow tract obstruction: sub-pulmonary membrane developing months after primary intervention to treat pulmonary atresia with intact interventricular septum

Cardiology in the Young ◽

10.1017/s1047951121001591 ◽

2021 ◽

pp. 1-4

Author(s):

Baher M. Hanna ◽

Wesam E. El-Mozy ◽

Sonia A. El-Saiedi

Keyword(s):

Right Ventricular ◽

Interventricular Septum ◽

Pulmonary Atresia ◽

Right Ventricular Outflow Tract ◽

Rare Condition ◽

Surgical Excision ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Ventricular Outflow Tract Obstruction ◽

The Right

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.

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RECONSTRUCTIVE TREATMENT USING A STENT GRAFT FOR A DURAL ARTERIOVENOUS FISTULA OF THE TRANSVERSE SINUS IN THE CASE OF HYPOPLASIA OF THE CONTRALATERAL VENOUS SINUSES

Neurosurgery ◽

10.1227/01.neu.0000351772.45417.92 ◽

2009 ◽

Vol 65 (5) ◽

pp. E994-E996 ◽

Cited By ~ 19

Author(s):

Beom Jin Choi ◽

Tae Hong Lee ◽

Chang Won Kim ◽

Chang Hwa Choi

Keyword(s):

Stent Graft ◽

Coil Embolization ◽

Transarterial Embolization ◽

Transverse Sinus ◽

Balloon Occlusion ◽

Sigmoid Sinus ◽

Venous Sinus ◽

Venous Sinuses ◽

Balloon Occlusion Test ◽

The Right

Abstract OBJECTIVE Transvenous coil embolization for transverse sinus (TS) and sigmoid sinus dural arteriovenous fistulae (DAVFs) is now recognized as one of the most effective treatment modalities. However, in the case of hypoplasia of the contralateral venous sinuses and internal jugular vein, complete occlusion of the ipsilateral sinus may cause fatal consequences. We describe a case of combined intravenous graft stent placement and transarterial coil embolization for DAVFs that involved the dominant right TS in a patient with hypoplasia of the contralateral venous sinuses. CLINICAL PRESENTATION A 50-year-old man presented with headache, left hand tremor, and pulsatile right tinnitus. A cerebral angiogram demonstrated a right TS DAVF that was supplied by tentorial branches of both internal carotid arteries, multiple branches of the right external carotid artery, and branches of the left occipital artery. Unfortunately, left TS and sigmoid sinus hypoplasia were observed. INTERVENTION A right TS balloon occlusion test revealed contrast stagnation of the cortical veins and of the right TS and superior sagittal sinus. In this case, the use of transvenous stent graft placement with or without transarterial embolization is safer and more effective than sacrifice of the right TS. We therefore performed balloon-expandable stent graft deployment at the right TS, and the remnant DAVF flow between the stent graft and venous sinus was treated with transarterial coil embolization. Postprocedural angiograms showed patent right TS outflow with disappearance of retrograde cortical venous drainage as well as complete eradication of the fistulous connections. CONCLUSION In a DAVF involving the dominant TS or sigmoid sinus in a patient with hypoplasia of the contralateral venous sinuses and an intolerable balloon occlusion test for the ipsilateral venous sinuses, the complete occlusion of the diseased venous sinus may cause hazardous consequences. In this situation, the use of a stent graft with or without transarterial embolization to preserve venous sinus flow can be an effective treatment.

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Management of a Persistent Oblique Occipital Sinus with Staged Ligation in a Case of Medulloblastoma: A Case Report

Pediatric Neurosurgery ◽

10.1159/000517214 ◽

2021 ◽

pp. 1-5

Author(s):

Gaurav Tyagi ◽

Gyani Jail Singh ◽

Manish Beniwal ◽

Dwarakanath Srinivas

Keyword(s):

Case Report ◽

Posterior Fossa ◽

Tumor Resection ◽

Female Child ◽

Transverse Sinus ◽

Venous Hypertension ◽

Venous Outflow ◽

Excessive Bleeding ◽

Occipital Sinus ◽

Suboccipital Craniotomy

Introduction: A patent persistent occipital sinus (OS) can be seen in 10% of adults. The presence of such a dominant draining OS can present as a challenge for posterior fossa surgeries. Occlusion or division of the sinus can cause venous hypertension, causing a cerebellar bulge or increased intra-op bleeding. Case report: A 3-and-a-half-year-old female child presented with a vermian medulloblastoma with hydrocephalus. MR venography (MRV) revealed a large patent OS draining from the torcula to the right sigmoid sinus. She underwent a left Frazier’s point VP shunt followed by a midline suboccipital craniotomy for the lesion. The OS was divided during a “Y”-shaped durotomy. Following the sinus ligation, there was a significant cerebellar bulge and excessive bleeding from the lesion. We released cisternal CSF and punctured the tumor cysts to allow the brain bulge to settle. Hemostasis was secured, and surgery was deferred, an augmented duroplasty was done, and bone flap was removed to allow for intracranial pressure decompression. The patient was electively ventilated for 24 h and weaned off gradually. A repeat MRV at 7 days showed the reorganization of the venous outflow at the torcula. Reexploration with tumor resection was done on post-op day 10. The patient recovered well from the surgery and was referred for adjuvant therapy. Conclusion: Surgeons should carefully analyze venous anatomy before posterior fossa surgeries. The persistent dominant OS, when present, should be taken care of while planning the durotomy. A hypoplastic but persistent transverse sinus allowed us to ligate and divide the OS. By doing a staged division of the sinus, reorganization of the venous outflow from the torcula can be allowed to occur, and the lesion can be resected.

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Elastofibroma Dorsi, a Rare Condition, with Challenging Diagnosis. Case Report and Literature Review

Medicina ◽

10.3390/medicina57040370 ◽

2021 ◽

Vol 57 (4) ◽

pp. 370

Author(s):

Octavian Neagoe ◽

Cosmin Ioan Faur ◽

Mihaela Ionică ◽

Flavia Baderca ◽

Roxana Folescu ◽

...

Keyword(s):

Postoperative Complications ◽

Histopathological Examination ◽

Rare Condition ◽

Surgical Excision ◽

High Rate ◽

Biological Entity ◽

Fatty Tissue ◽

Oncologic Surgery ◽

Elastofibroma Dorsi ◽

The Right

Elastofibroma dorsi (ED) is known as a particular clinical and biological entity. We report a case of a bilateral elastofibroma dorsi (ED) in a 65-year-old female who presented to the Department of General and Oncologic Surgery of Emergency Clinical Municipal Hospital Timisoara, Romania. The patient was symptomatic on the right side, presenting pain in the interscapulothoracic region associated with a variable tumoral mass, dependent on the position of the right arm. Imaging studies revealed a well-defined, bilateral tumoral mass with alternation of the muscular and fatty tissue. The initial diagnosis of lipoma was taken into consideration based on the CT scan and clinical findings. Surgical excision of the right subscapular tumor was performed without any postoperative complications. Microscopic examination of hematoxylin and eosin, Masson’s trichrome, and orcein stained slides revealed the diagnosis of ED. Considering the high rate of reported postoperative complications and the asymptomatic presentation of the contralateral subscapular mass, the patient underwent clinical and imagistic monitoring for the contralateral tumor. Due to its rare nature, ED is a difficult preoperative diagnosis that can, however, be suggested by its specific location and may require an accurate histopathological examination for a final diagnosis.

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Diagnosis and treatment of headache probably attributed to cerebral venous sinus thrombosis

Clinical Management Issues ◽

10.7175/cmi.v8i4.966 ◽

2014 ◽

Vol 8 (4) ◽

pp. 97-101

Author(s):

Rosario Iannacchero ◽

Amerigo Costa ◽

Antonio Sergi ◽

Aida Squillace ◽

Giuseppe Vescio ◽

...

Keyword(s):

Chronic Migraine ◽

Sinus Thrombosis ◽

Rare Condition ◽

Transverse Sinus ◽

Cerebral Venous Sinus Thrombosis ◽

Warning Signs ◽

Venous Sinus ◽

Diagnosis And Treatment ◽

Secondary Headache ◽

Venous Sinus Thrombosis

Cerebral venous sinus thrombosis (CVST) is a rare condition whose most common and sometimes only symptom is headache. Alas, diagnosis and treatment of CVST is often delayed or overlooked because of its high clinical variability. Using guidelines advices in detecting warning signs or symptoms of secondary headaches might ease the diagnosis of CVST.The article presents the case of a woman who is in treatment for chronic migraine and assessed for secondary headache in a multidisciplinary outpatient headache program. Alert symptoms like sudden worsening headache presentation, along with anamnestic cues, prompted neuroimaging that detected left transverse sinus thrombosis whose onset was difficult to date.

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A rare case of unilateral breast filariasis mimicking chronic mastitis

International Surgery Journal ◽

10.18203/2349-2902.isj20212744 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2228

Author(s):

Varsha A. Sharma ◽

Manmohan M. Kamat ◽

Jeena K. Sathyan ◽

Seema Barman ◽

Shravani Shetye

Keyword(s):

Benign Lesion ◽

Rare Condition ◽

Surgical Excision ◽

Axillary Lymph Nodes ◽

Excision Biopsy ◽

Axillary Lymph ◽

Presumptive Diagnosis ◽

Lower Quadrant ◽

History Of ◽

The Right

Filariasis of the breast is a very rare condition. In India, largest number (around 600 million) of people live in endemic areas. Despite the huge number, it is quite rare to find microfilaria in routine smears and body fluids and it is even more rare to find it in breasts. A 40 years old female, presented with a history of lump in the right breast approximately 3x3 cm in size in the right lower quadrant. Findings were confirmed by clinical examination which did not reveal any palpable ipsilateral or contralateral axillary lymph nodes. FNAC showed it as a benign lesion. After local excision, histopathology revealed a filarial worm. Filariasis of the breast is a rare disease. The presence of microfilaria in breasts using FNAC has been reported at times but the presence of the filarial worms can only be confirmed on histopathology, hence a core biopsy or an excision biopsy is a must in all the cases. A presumptive diagnosis of filariasis can be made on sonography if the worms are alive and active, the typical presentation on USG is the filarial dance. Surgical excision of the lump followed by DEC therapy is the treatment of choice for filarial lump of the breast.

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Venous Sinus Stenting using Transcranial Access for the Treatment of Idiopathic Intracranial Hypertension in a Pediatric Patient

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_135_17 ◽

2017 ◽

Vol 08 (04) ◽

pp. 672-675 ◽

Cited By ~ 6

Author(s):

Thomas J. Buell ◽

Robert M. Starke ◽

Dale Ding ◽

Harry R. Hixson ◽

Daniel M. S. Raper ◽

...

Keyword(s):

Intracranial Hypertension ◽

Transverse Sinus ◽

Jugular Bulb ◽

Venous Sinus ◽

Direct Access ◽

Endovascular Stenting ◽

Stent Deployment ◽

Surgical Access ◽

The Right

ABSTRACTA 4-year-old male with headaches, papilledema, intracranial hypertension, and bilateral transverse sinus (TS) stenosis underwent attempted percutaneous placement of a right TS stent. Stent deployment was not technically feasible due to the stiffness of the stent and tortuosity of the patient's jugular bulb. Therefore, the patient underwent hybrid endovascular stenting of the right TS using neuronavigation and direct access of the TS following a single burr hole craniectomy. Two Express 8 mm × 17 mm balloon-mounted stents were deployed into the right TS, which resulted in obliteration of the preexisting trans-stenosis pressure gradient and decreased intracranial parenchymal pressure as monitored through an intracranial pressure bolt. The patient's headaches and papilledema resolved, and follow-up imaging demonstrated no in-stent or stent-adjacent stenosis. This case demonstrates the feasibility of combining minimally invasive open surgical access to allow direct cannulation for venous sinus stenting.

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Primary extramedullary plasmacytoma of the parotid gland: a case report and review of the literature

The Journal of Laryngology & Otology ◽

10.1017/s0022215100140253 ◽

1998 ◽

Vol 112 (2) ◽

pp. 179-181 ◽

Cited By ~ 7

Author(s):

J. Gonzalez-Garcia ◽

K. Ghufoor ◽

G. Sandhu ◽

P. A. Thorpe ◽

J. Hadley

Keyword(s):

Parotid Gland ◽

Rare Condition ◽

Surgical Excision ◽

Good Prognosis ◽

Extramedullary Plasmacytoma ◽

Treatment Modalities ◽

Malignant Neoplasms ◽

Upper Respiratory Tract ◽

Review Of The Literature ◽

The Right

AbstractSolitary extramedullary plasmacytomas are uncommon malignant neoplasms with a great predilection for the upper respiratory tract. Extramedullary plasmacytoma involving the parotid gland is an extremely rare condition. This report describes the case of a primary extramedullary plasmacytoma arising in the right parotid gland of a 63-year-old man. A review of the literature reveals that this disease has generally a good prognosis, provided that multiple myeloma has been excluded. The treatment of choice should be surgical excision followed by radiotherapy, although from this study there is insufficient evidence to suggest that this is more effective than surgery alone. All patients must have regular long-term follow-up to monitor for recurrence or dissemination, in which event chemotherapy may be considered in addition to the other treatment modalities.

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http://medcraveonline.com/JNSK/case-on-venous-sinus-thrombosis-the-unexpected-should-be-expected.html

Journal of Neurology & Stroke ◽

10.15406/jnsk.2020.10.00411 ◽

2020 ◽

Vol 10 (1) ◽

pp. 58-59

Author(s):

Rafael Ferreira Nascimento ◽

Fabiana Gouveia ◽

João Miguel Freitas ◽

João Patrício Freitas ◽

Rafael Rafael Freitas

Keyword(s):

Ct Scan ◽

Sinus Thrombosis ◽

Vascular Diseases ◽

Duplex Ultrasound ◽

Transverse Sinus ◽

The Body ◽

Venous Sinus ◽

Venous Sinus Thrombosis ◽

Neurological Exam ◽

The Right

ntroduction: The authors present a venous sinus thrombosis that started in a woman 10 days after labour. Case Report: A 34-year old woman, who had gone into labor 10 days before her admission, presented to the emergency department with paresthesia on the right side of the body and dysarthria which started that day. The neurological exam showed predominant right brachial paresis associated with a diminished sensitivity in the right arm and leg. The CT-Scan revealed a venous thrombosis that reached the straight, superior and transverse sinus, with a greater extension on the right side involving multiple tributary veins. The admission in the cerebral vascular diseases unit was followed by heparin perfusion. Ten days after the onset of the episode the patient was submitted to another CT-Scan that showed resolution of the thrombosis. Goldman campimetry was considered normal. The patient was discharged from the unit and started an etiologic search, which pointed to the pregnancy as the main reason for the event. The echocardiogram and cervical duplex ultrasound were normal. Currently, the patient does not show any sequels and maintains follow-up in the cerebrovascular disease consult. Conclusion: The authors highlight the role of the physician in the diagnosis of a rare entity in a woman, 10 days after labour, without any relevant past medical history.

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Tarsal villonodular tenosynovitis (giant cell tumor of tendon sheath) in a dog

Ciência Rural ◽

10.1590/0103-8478cr20200786 ◽

2021 ◽

Vol 51 (11) ◽

Author(s):

Yasmin Daoualibi ◽

Camila Blanco Pohl ◽

Regina Tose Kemper ◽

Kahena Morais Rolemberg ◽

Stéphanie Christine Demeulemeester ◽

...

Keyword(s):

Animal Species ◽

Rare Condition ◽

Surgical Excision ◽

Tendon Sheath ◽

Giant Cells ◽

Serous Fluid ◽

Mixed Breed ◽

Pelvic Limb ◽

The Right ◽

Pigmented Villonodular

ABSTRACT: A 12-year-old female mixed-breed dog presented with lameness, pain, and an enlarged, non-ulcerated, nodular mass in the region proximal to the tarsal joint of the right pelvic limb. Surgical excision was performed, revealing a 6.5 cm mass adherent to the deep flexor tendon and adjacent tissues. The cut section had cysts filled with blackened clotted material, which exuded reddish serous fluid. Microscopically, the cysts were filled with red blood cells and were either denuded or covered by synoviocytes. In addition, the mass was characterized by marked fibrovascular connective tissue associated with siderophages and multinucleated giant cells. These findings were consistent with those of pigmented villonodular tenosynovitis, a rare condition affecting several animal species and humans.

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