Use of N-butyl 2-cyanoacrylate (nBCA) for preoperative tumor embolization

2021 ◽  
pp. neurintsurg-2021-017400
Author(s):  
Rimal H Dossani ◽  
Muhammad Waqas ◽  
Hamid H Rai ◽  
Ammad A Baig ◽  
Justin M Cappuzzo ◽  
...  
Keyword(s):  
Target Location ◽  
Memory Loss ◽  
Middle Meningeal Artery ◽  
Content Type ◽  
Tumor Embolization ◽  
Postoperative Mri ◽  
Word Finding ◽  
Liquid Embolic ◽  
History Of ◽  
Video Player

N-butyl 2-cyanoacrylate (nBCA) is a fast-acting liquid adhesive that polymerizes when it comes in contact with blood anions. We present the principles of nBCA preparation and delivery for tumor embolization of a right convexity meningioma in a patient who presented with a 6-month history of word-finding difficulty and memory loss video 1. Angiography of the middle meningeal artery showed a hairpin turn that was not negotiable with a number of different microwires, including the Synchro-2, Chikai 014 and Balt hybrid 008 wire. Due to the tortuous hairpin turn, the microcatheter position was distal to the tumor blush for the convexity meningioma. Given the distal microcatheter position, we opted for nBCA as the liquid embolic of choice for tumor embolization. The time of polymerization for nBCA may be delayed using glacial acetic acid, which makes nBCA ideal when the microcatheter is in a distal position relative to the target location for embolization. The patient underwent successful embolization using nBCA and was taken for a right frontal craniotomy for resection of the meningioma the next day. The intraoperative blood loss was 100 mL and the postoperative MRI showed gross total resection. The patient had an uncomplicated hospital course and was discharged home on post-procedure day 3.Video 1

scholarly journals A Rare Case of Spontaneous Arachnoid Cyst Rupture Presenting as Right Hemiplegia and Expressive Aphasia in a Pediatric Patient

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 78
Author(s):  
Anne Bryden ◽  
Natalie Majors ◽  
Vinay Puri ◽  
Thomas Moriarty
Keyword(s):  
Cognitive Processing ◽  
Arachnoid Cyst ◽  
Memory Loss ◽  
Acute Onset ◽  
Word Finding ◽  
Outpatient Visits ◽  
The Family ◽  
History Of ◽  
Cyst Rupture ◽  
The Brain

This study examines an 11-year-old boy with a known history of a large previously asymptomatic arachnoid cyst (AC) presenting with acute onset of right facial droop, hemiplegia, and expressive aphasia. Shortly after arrival to the emergency department, the patient exhibited complete resolution of right-sided hemiplegia but developed headache and had persistent word-finding difficulties. Prior to symptom onset while in class at school, there was an absence of reported jerking movements, headache, photophobia, fever, or trauma. At the time of neurology consultation, the physical exam showed mildly delayed cognitive processing but was otherwise unremarkable. The patient underwent MRI scanning of the brain, which revealed left convexity subdural hematohygroma and perirolandic cortex edema resulting from ruptured left frontoparietal AC. He was evaluated by neurosurgery and managed expectantly. He recovered uneventfully and was discharged two days after presentation remaining asymptomatic on subsequent outpatient visits. The family express concerns regarding increased anxiety and mild memory loss since hospitalization.

Symptomatic solitary xanthogranuloma occupying the cavernous sinus

2001 ◽  
Vol 94 (2) ◽  
pp. 322-326 ◽  
Author(s):  
Kazumichi Yamada ◽  
Masaki Miura ◽  
Haruhiko Miyayama ◽  
Naohiko Furuyoshi ◽  
Jun Matsumoto ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Middle Meningeal Artery ◽  
Magnetic Resonance Images ◽  
Superior Orbital Fissure ◽  
Content Type ◽  
First Case ◽  
History Of ◽  
Mixed Pattern ◽  
The Right ◽  
Field Defect

✓ The authors report the first case of a solitary xanthogranuloma of the cavernous sinus without systemic manifestation. A 43-year-old woman experienced decreased visual acuity on the right side in association with papilledema and a visual field defect. She was alert and no other neurological sign was observed. She had no family history of hyperlipoproteinemia and no cutaneous and/or systemic xanthomatous lesions. Skull x-ray films showed an enlarged right superior orbital fissure. Computerized tomography revealed a low-density oval mass 2 × 3 cm in diameter in the right cavernous region that was compressing the right optic nerve in the lateral to medial direction. This mass exhibited isointensity on T1-weighted and mixed-pattern hyperintensity on T2-weighted magnetic resonance images with diffuse contrast enhancement. Cerebral angiography demonstrated fine staining in the margin, originating from the right middle meningeal artery. These neuroimaging findings closely mimicked those associated with trigeminal neuroma. The lesion was partially removed via a right-sided zygomatic approach, and her symptoms improved. Clinical characteristics and histopathological features of this rare case are discussed.

scholarly journals Onyx injection by direct puncture for presurgical embolization of a C2 hypervascular metastasis from a thyroid cancer

2021 ◽  
pp. neurintsurg-2020-017180
Author(s):  
Frédéric Clarençon ◽  
Pierre-Emmanuel Moreau ◽  
Jonathan Cortese ◽  
Gauthier Eloy ◽  
Frédéric Deschamps ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Neurological Complications ◽  
Embolic Agent ◽  
Direct Puncture ◽  
Content Type ◽  
Massive Blood Loss ◽  
Spinal Lesion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Video Player

Surgery for spinal hypervascular lesions, such as hemangioma or metastases from thyroid or renal cancer, may be challenging because of the risk of massive blood loss.1 To overcome this limitation, presurgical embolization has gained acceptance to reduce this risk.2 However, some configurations, such as the origin of a radiculomedullary artery close to the vessels feeding the lesion or when the lesion is supplied by vessels feeding an eloquent territory, may limit the possibility of presurgical embolization, especially with microparticles.3 Direct percutaneous puncture of the spinal lesion and subsequent embolization with liquid embolic agent may be a valuable option in such challenging cases.4We present a case of presurgical embolization of a C2 metastasis from a thyroid cancer using Onyx-18 injected by direct puncture (video 1). In this technical video, we stress the technical aspects of the direct puncture technique and the safety rules to avoid neurological complications.Video 1

Use of Walrus balloon-guide catheter through sheathless radial approach for mechanical thrombectomy of right middle cerebral artery occlusion

2021 ◽  
pp. neurintsurg-2021-017985
Author(s):  
Rimal H Dossani ◽  
Muhammad Waqas ◽  
Hamid H Rai ◽  
Andre Monteiro ◽  
Faisal Almayman ◽  
...  
Keyword(s):  
Radial Artery ◽  
Mechanical Thrombectomy ◽  
Artery Occlusion ◽  
Femoral Access ◽  
Content Type ◽  
Radial Approach ◽  
Guide Catheter ◽  
Ct Angiogram ◽  
History Of ◽  
Video Player

The literature demonstrates a favorable first pass effect with balloon-guide catheter (BGC) for mechanical thrombectomy. An 8F BGC is routinely used with femoral access. We present the first video report of 8F BGC advanced through the radial artery using a sheathless technique (video 1). An approximately 70-year-old patient presented with left-sided hemiplegia, neglect, and dysarthria. A CT angiogram demonstrated right M1 occlusion, and the patient underwent urgent mechanical thrombectomy. Radial approach was preferred owing to patient history of anticoagulation. A 6F Sim Select intermediate catheter was used to minimize the step off as the 8F BGC was advanced into the radial artery over an 035 exchange-length Advantage Glidewire. A skin nick over the Glidewire Advantage facilitated the introduction of the 8F BGC into the radial artery. Standard mechanical thrombectomy using a combination of stent retriever and aspiration catheter (Solumbra technique) was performed, and thrombolysis in cerebral infarction 3 recanalization was achieved after a single pass. The National Institutes of Health Scale score improved from 12 to 4, with mild left facial droop, dysarthria, and decreased speech fluency. The patient was discharged from the hospital on postoperative day 2. Ultrasound should be used for immediate assessment of radial artery size and conversion to femoral access without delay if the radial artery is less than 2.5 mm.Video 1

A tribute to Gwen Leighty

2006 ◽  
Vol 19 (2) ◽  
pp. 84-86
Author(s):  
Jennifer Paustenbaugh
Keyword(s):  
Web Sites ◽  
Academic Libraries ◽  
Design Methodology ◽  
Fund Raising ◽  
Personal Knowledge ◽  
Valuable Contribution ◽  
Content Type ◽  
History Of ◽  
Development Network ◽  
Fund Raiser

PurposeThe purpose of the paper is to provide a tribute to the life and work of library fund‐raiser Gwen Leighty.Design/methodology/approachThe paper uses personal knowledge and references to Academic Libraries Advancement and Development Network (ALADN) and LIBDEV web sites.FindingsThe paper finds that fundraising is connecting with people and the journey that each development officer must make while raising funds for their library.Originality/valueThe paper presents a brief history of ALADN and the valuable contribution one person made to the cause of library fund‐raising.

The sediment of the Hostivar Reservoir (Prague, Czech Republic) as a memory of 45 years of pollution

2017 ◽  
Vol 28 (2) ◽  
pp. 204-213
Author(s):  
Lucie Soucková ◽  
Dana Kominkova
Keyword(s):  
Czech Republic ◽  
Design Methodology ◽  
Polyaromatic Hydrocarbons ◽  
Reservoir Sediment ◽  
Terrestrial Environment ◽  
Content Type ◽  
Sediment Extraction ◽  
History Of ◽  
Us Epa ◽  
Practical Implications

Purpose The purpose of this paper is to evaluate the historical pollution of the Hostivar Reservoir (largest reservoir in Prague) sediment by metals, polyaromatic hydrocarbons (PAH) and polychlorinated biphenyls (PCB) and identify the trends in pollution of aquatic environment. Design/methodology/approach Core samples, 140 cm long, recording the 45-year history of the reservoir, were separated to 5 cm width subsamples (approximately 1.5 years of sedimentation) and analyzed for metals (Cd, Pb, Cu, Zn, Cr, Ni, Al), PAH and PCB. Following methods were used: US EPA 3051 for metals, US EPA 505 and US EPA 8082 A for PCB, and ISO 18287:2006 for PAH. Findings Most of the contaminants had the highest concentration at the beginning of the existence of the reservoir, suggesting that the contamination results from construction activities. Significant decrease of Pb occurred in the second half of the 1990s. It was caused by termination of the addition of lead as a detonation suppressant to the gasoline. Most concentrations of PAHs, PCBs and metals, except copper do not present eco-toxicological risk. Practical implications The results show the volume of priority pollutants removed from the reservoir by sediment extraction, and point risk to the terrestrial environment due to application of the sediment in the construction of a noise protecting wall. Originality/value The paper presents unique data about historical contamination of the largest reservoir in Prague, the capital of Czech Republic. It shows how the watershed and the construction phase of the dam cause a pollution of the reservoir sediment and possible environmental risk for aquatic biota.

A brief history of small business in Australia, 1970-2010

2014 ◽  
Vol 3 (2) ◽  
pp. 222-236 ◽  
Author(s):  
Michael T. Schaper
Keyword(s):  
Small Business ◽  
Small Firms ◽  
Formal Education ◽  
Extensive Literature ◽  
Business Sector ◽  
Role Of Government ◽  
Content Type ◽  
Support Tools ◽  
History Of ◽  
Training And Research

Purpose – The purpose of this paper is to provide an overview of the development of the SME sector in Australia, concentrating on a number of key areas: small business definitions and numbers; the role of government; the emergence of key industry groups; and the evolution of education, training and research services. Design/methodology/approach – The study is a result of extensive literature reviews, desk research and the recollections of various participants in the field. Findings – There have been major changes to the Australian small business sector over the last 40 years. In 1983-1984 there were an estimated 550,000 small firms, and by 2010 this had grown to almost two million. Government involvement in, and support for, SMEs was virtually non-existent before 1970. Following the delivery of the Wiltshire report (1971), however, both state and federal governments responded by developing specialist advisory services, funding programmes and other support tools. Virtually non-existent before the 1970s, several peak industry associations were formed between 1977 and the 1990s. At the same time, formal education and teaching in the area expanded in the 1970s and 1980s and is now widespread. Practical implications – Development of the small business sector in Australia has often paralleled similar trends in other OECD nations. State and territory governments have often (but not always) been the principal drivers of policy change. Originality/value – There has been no little, if any, prior documentation of the evolution of the small business sector in Australia in the last 40 years.

Haunted by the past: transformations and daily challenges of China's prosthetics

2020 ◽  
Vol 10 (1) ◽  
pp. 115-124
Author(s):  
Chunchun Wang
Keyword(s):  
Design Methodology ◽  
Cross Cultural ◽  
Future Research ◽  
Institutional Pressures ◽  
Rehabilitation Center ◽  
Content Type ◽  
The Past ◽  
Daily Experiences ◽  
History Of ◽  
Depth Interviews

PurposeThe purpose of this paper is to examine the transformations of prosthetic practices in China, as well as the daily experiences and dilemmas arising from the everchanging practices since 1949. On the basis of materials, this paper explores an everyday perspective to review the history of technology.Design/methodology/approachEthnography was collected with the application of participant observations, informal interviews and in-depth interviews during a 13-months study at a rehabilitation center in Chengdu, China. The literature on prosthetic manufacturing was also reviewed for this paper.FindingsChina's prosthetic technology seems to evolve from traditional to modern. However, this progressive narrative – innovation-based timeline (Edgerton, 2006, xi) – has been challenged by daily practices. Due to institutional pressures, prosthetists are in a dilemma of selectively using their knowledge to create one kind of device for all prosthesis users with a certain kind of disability, thereby regulating the physical and social experiences of prosthesis users. Besides, prosthesis users are accustomed to prostheses made with old techniques, and must correct themselves from old experiences to the daily practices recognized by the selected techniques.Originality/valueThis paper provides a cross-cultural case to reexamine Edgerton's criticism of the progressive and orderly innovation-centric technological narrative. More importantly, it reviews the history and practices of China's prosthetics from daily experiences rather than Edgerton's concentration on technology; therefore, it provides an everyday perspective for future research on technological transformations.

Political radicalization and fragmentation of the democratic blocs and the legislative council elections in the Hong Kong Special Administrative Region

2017 ◽  
Vol 6 (4) ◽  
pp. 372-384
Author(s):  
Chung Fun Steven Hung
Keyword(s):  
Hong Kong ◽  
Political Parties ◽  
Special Administrative Region ◽  
Content Type ◽  
Legislative Council ◽  
Administrative Region ◽  
Two Systems ◽  
History Of ◽  
One Country Two Systems ◽  
Historical Comparative

Purpose After direct elections were instituted in Hong Kong and the sovereignty was transferred from Britain to China, politicization inevitably followed democratization. The purpose of this paper is to evaluate the pro-democratic political parties’ politics in Hong Kong in recent history. Design/methodology/approach The research was conducted through a historical comparative analysis, within the context of Hong Kong after the sovereignty handover and the interim period of crucial democratization. Findings With the implementation of “One country, Two systems,” political democratization was hindered in Hong Kong’s transformation. The democratic forces have no alternative but to seek more radicalized politics, which has caused a decisive and ineluctable fragmentation of the local political parties. Originality/value This paper explores and evaluates the political history of the Hong Kong Special Administrative Region under “One country, Two systems” and the ways in which the limited democratization hinders the progress of Hong Kong’s transformation.

Economic thought in the 17th and 18th centuries: a linguistic approach

2015 ◽  
Vol 23 (3) ◽  
pp. 260-270
Author(s):  
Iara Vigo de Lima
Keyword(s):  
Economic Thought ◽  
Point Of View ◽  
Content Type ◽  
Front Position ◽  
History Of ◽  
Epistemological Model ◽  
Theory Of Language ◽  
Theory Of Value ◽  
Linguistic Approach ◽  
Practical Implications

Purpose – The purpose of this paper is to analyse Michel Foucault’s new epistemological model regarding an analogy between the theory of language and economic thought in the seventeenth and eighteenth centuries. Design/methodology/approach – Through the scrutiny of language, Foucault intended to demonstrate that some analogies, among different branches of knowledge (interdiscursive practice), allow us to apprehend the underlying configuration of thought regarding ontological and epistemological conditions that have historically determined knowledge. He draws a parallel between four theoretical segments borrowed from general grammar (Attribution, Articulation, Designation and Derivation) and economic thought on wealth. Findings – One of the most remarkable propositions of this approach is that the theory of language and economic thought were epistemologically isomorphic in that context. What the theory of language stated in relation to “attribution” and “articulation” corresponded to the “theory of value” in economic thought. What grammar investigated regarding “designation” and “derivation” was analogous to the “theory of money and trade” in economic thought. The relationships that were – directly and diagonally – identified between and among them led to the conclusion that there was ‘a circular and surface causality’ in economic thought insofar as “circulation” preceded “production”. It was “superficial” because it could not find an explanation for the cause of “wealth”, which was only possible when “production” was placed in the front position of theories. Practical implications – Such an epistemological point of view can inspire other studies in the history of economic thought. Originality/value – This paper offers a perspective on how to think about the history of ontological and epistemological conditions of economic thought.

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