INTRACAVERNOUS TRIGEMINAL GANGLION AMYLOIDOMA

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. E574-E574 ◽  
Author(s):  
Markus J. Bookland ◽  
Carlos A. Bagley ◽  
Jacob Schwarz ◽  
Peter C. Burger ◽  
Henry Brem
Keyword(s):  
New York ◽  
Nervous System ◽  
Trigeminal Neuralgia ◽  
Cavernous Sinus ◽  
Trigeminal Ganglion ◽  
Brain Magnetic Resonance Imaging ◽  
Gasserian Ganglion ◽  
Resected Tumor ◽  
Facial Numbness ◽  
The Right

Abstract OBJECTIVE Isolated amyloidomas rarely manifest in nervous system tissues. To the authors' knowledge, there have been 52 documented cases of primary amyloid tumors of the central nervous system and closely associated structures. The authors present a case of a woman with a history of presumptive trigeminal neuralgia who was found to have an amyloidoma of the trigeminal ganglion. CLINICAL PRESENTATION A 32-year-old Caucasian patient presented with a chief complaint of severe numbness and pain throughout the right side of her face. Her symptoms had been progressive over the previous 3 years. Medical management of her presumptive diseases with Zoloft (Pfizer Inc., New York, NY) and Neurontin (Pfizer Inc.) failed to improve or halt her right facial numbness and pain. Brain magnetic resonance imaging was acquired, demonstrating abnormal contrast enhancement and enlargement of the right trigeminal ganglion. The lesion abutted and indented the right internal carotid artery and extended from Meckel's cave into the inferior cavernous sinus and distally to the foramen ovale. INTERVENTION The patient underwent a right frontotemporal craniotomy for resection of the gasserian ganglion lesion. A delicate incision was made in the wall of the cavernous sinus, allowing confirmatory biopsy of the lesion. With the site of the tumor within the cavernous sinus verified by pathology, the remainder of the tumor was removed. A final pathological review of the resected tumor confirmed a diagnosis of amyloidoma of the trigeminal ganglion. CONCLUSION We present the case of a patient with a rare trigeminal ganglion amyloidoma that closely mimicked idiopathic trigeminal neuralgia. Even in the absence of systemic signs of amyloidosis, this benign protein deposition disease should be considered in the differential for atypical dysesthesias of the trigeminal dermatomes. Furthermore, central and peripheral nervous system amyloidomas respond well to surgical resection and rarely recur.

scholarly journals Cerebral hemispheres – cerebellum – kidney interaction in patients with acute cerebral ischemia

2021 ◽  
Vol 26 (1) ◽  
pp. 90-98
Author(s):  
O.M. Kononets ◽  
O.V. Tkachenko ◽  
O.O. Kamenetska
Keyword(s):  
Nervous System ◽  
Ischemic Stroke ◽  
Brain Magnetic Resonance Imaging ◽  
Environmental Parameters ◽  
The Body ◽  
Electrolyte Balance ◽  
Vector Correlation ◽  
Vertebrobasilar System ◽  
Acute Cerebral Ischemia ◽  
The Right

The nervous system, in particular the autonomic one, is well known to constantly regulate the internal functioning of the body, adapting it to changeable external and internal environmental parameters. In particular, there is a close multiple-vector correlation between the nervous system and the kidneys. The aim of this study was to specify the mechanisms, clinical and paraclinical characteristics of the concomitant lesions of the nervous system and the kidneys in patients with acute stroke. This paper presents the case report of 215 patients, aged 70 ± 8.44, who suffered from ischemic stroke. Among them, we examined 144 women and 71 men. The patients underwent a comprehensive examination, including a detailed clinical and neurological check-up (evaluating the patients’ condition severity with the National Institutes of Health Stroke Scale (NIHSS) and the Barthel index on admission and on the 21st day of the disease), laboratory analysis (electrolyte balance, nitrogen metabolism (on admission and on the 21st day of the disease) and instrumental examination (CT scan of the brain, the follow-up brain magnetic resonance imaging). The statistical methods were used to analyze the data. In the 1st day of the disease, all the surveyed patients with right hemispheric carotid stroke and the overwhelming majority of the patients with left hemispheric carotid stroke and ischemic stroke in the vertebrobasilar system had cerebral renal syndrome, represented by renal concentration-filtration dysfunction, accompanied by the reduced glomerular filtration rate. A reliable relationship was found between the renal concentration and filtration function and the right hemispheric ischemic focus in patients with ischemic stroke, the characteristics are to be specified.

Microsurgical Resection of Recurrent Cavernous Sinus Hemangioma by Superior and Lateral Approach: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E165-E166
Author(s):  
Qazi Zeeshan ◽  
Juan P Carrasco Hernandez ◽  
Michael K Moore ◽  
Laligam N Sekhar
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Cavernous Sinus ◽  
Tumor Resection ◽  
Cranial Nerves ◽  
Brain Magnetic Resonance Imaging ◽  
Mass Effect ◽  
Lateral Approach ◽  
Microsurgical Resection ◽  
The Right

Abstract This video shows the technical nuances of microsurgical resection of recurrent cavernous sinus (CS) hemangioma by superior and lateral approach.  A 77-yr-old woman presented with headache and difficulty in vision in right eye for 6 mo. She had previously undergone attempted resection of a right CS tumor in another hospital with partial removal, and the tumor had grown significantly. Neurological examination revealed proptosis, cranial nerve 3 palsy, and loss of vision in right eye (20/200). Left side visual acuity was 20/20.  Brain magnetic resonance imaging (MRI) demonstrated a large CS mass with homogeneous enhancement, measuring 3.3 × 3.3 × 2.6 cm, extending into the suprasellar cistern with mass effect on the right optic nerve. It extended anteriorly to the region of the right orbital apex and abuted the basilar artery posteriorly.  She underwent right frontotemporal craniotomy, posterolateral orbitotomy and anterior clinoidectomy as well as optic nerve decompression, and the CS tumor was removed by superior and lateral approach. An incision was made into the superior wall of the CS medial to the third nerve. On lateral aspect the tumor had extended outside the CS through the Parkinson's triangle. Posteriorly it extended through the clival dura. Anteriorly tumor encased the carotid artery and it was gradually dissected away. At the end of the operation, all of the cranial nerves were intact.  Postoperative MRI showed near complete tumor resection with preservation of the internal carotid artery. At 6 mo follow-up her modified Rankin Scale was 1 and vision in left eye was normal.  Informed consent was obtained from the patient prior to the surgery that included videotaping of the procedure and its distribution for educational purposes. All relevant patient identifiers have also been removed from the video and accompanying radiology slides.

scholarly journals Trigeminal ganglion involvement in sarcoidosis

2018 ◽  
Vol 20 (4) ◽  
pp. 439-441
Author(s):  
Jairo Silva Dos Ângelos ◽  
Guilherme Brasileiro De Aguiar ◽  
Edgar Manuel Garcete Fariña ◽  
Maud Parise ◽  
Alexandre Martins Cunha ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Magnetic Resonance ◽  
Parietal Cortex ◽  
Central Nervous System Involvement ◽  
Corticosteroid Treatment ◽  
Unknown Etiology ◽  
Histopathological Study ◽  
Gasserian Ganglion ◽  
The Right

Sarcoidosis is a disease of unknown etiology presenting as noncaseating granulomatous infiltration in tissues. Central Nervous system is rarely affected , usually as dissemination from other organs, mainly lungs. We report on a case in which the patient had only central nervous system involvement, presenting with a mass in the right gasserian ganglion and another lesion in right parietal cortex, observed in magnetic resonance. Diagnosis was given by histopathological study of the lesion and the patient improved with corticosteroid treatment.

scholarly journals Trigeminal Neuralgia associated with Wallenberg Syndrome, a case report

2021 ◽  
Author(s):  
Matheus Goncalves Maia ◽  
Vivian Dias Baptista Gagliardi ◽  
Francisco Tomaz Meneses Oliveira ◽  
Eduardo dos Santos Sousa ◽  
Marina Trombin Marques ◽  
...  
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Vascular Compression ◽  
Gasserian Ganglion ◽  
Entry Zone ◽  
Root Entry Zone ◽  
Initial Event ◽  
The Right ◽  
The Brain

Context: Trigeminal neuralgia is typically associated with structural lesions that affect the brainstem, pre-ganglionic roots, gasserian ganglion and the trigeminal nerve. The association of trigeminal neuralgia with infarction of the dorsolateral medulla is rare, being more associated with pontine lesions, in the context of brainstem infarction. Methods: Report the case of a 55-year-old male patient, who presented with a left dorsolateral bulbar infarction, and developed a ipsilateral trigeminal neuralgia afterwards. Case report: A 55-year-old man attended to the emergency room referring sudden incoordination of the left limbs, associated with numbness of the contralateral limbs. The neurological examination showed nystagmus, numbness of the left face, ataxia of the left limbs and numbness of the right limbs. The Magnetic Resonance of the Brain revealed an area of recent infarction in the left posterolateral aspect of the medulla. He underwent thrombolysis, evolving with complete resolution of symptoms. In the week after the initial event, he returned to the outpatient clinic, reporting paroxysms of excruciating pain in the upper lip, nose and left zygomatic region, being diagnosed with neuralgia of the maxillary segment of the trigeminal nerve, improving with introduction of Gabapentin. Conclusion: Although most cases of trigeminal neuralgia are determined by vascular compression of the trigeminal nerve root entry zone, other causes must be considered. The association of this condition with dorsolateral medulla infarction is rare, with only 4 cases reported in the last 10 years.

A Rare Case of Steroid-Resistant Neurosarcoidosis of the Cavernous Sinus With Optic Neuropathy: A Case Report

2021 ◽  
pp. 194187442199364
Author(s):  
Shiva Barforoshi ◽  
Nikhil A. Patel ◽  
Alvin P. Singh ◽  
Terrence Li ◽  
Benjamin Mba
Keyword(s):  
Nervous System ◽  
Combination Therapy ◽  
Cavernous Sinus ◽  
Optic Neuropathy ◽  
Vision Loss ◽  
Clinical Manifestations ◽  
Mediastinal Lymphadenopathy ◽  
Mri Findings ◽  
History Of ◽  
The Right

Sarcoidosis is an inflammatory disease that presents with nervous system involvement in 5-10% of cases, commonly known as neurosarcoidosis.1 While there are no randomized controlled trials for the treatment of neurosarcoidosis, expert opinion supports initial treatment with corticosteroids and the use of steroid-sparing or anti-TNF agents in refractory or severe cases. We report a case of a 48-year-old African American male with a past medical history of biopsy-proven hepatic and renal sarcoidosis and progressive headache, dizziness, and blurry vision for 5 months, presenting with an acute exacerbation of right-sided vision loss over one day. MRI of the brain revealed a dural-based mass extending into the right cavernous sinus and compressing the right optic nerve. Given the pathological confirmation of systemic granulomatous disease consistent with sarcoidosis, clinical manifestations, bilateral hilar and mediastinal lymphadenopathy, MRI findings typical of central nervous system inflammation, and exclusion of other possible etiologies, the patient was diagnosed with probable neurosarcoidosis. Corticosteroids initially resolved his symptoms; however, he suffered an acute relapse. Combination therapy with corticosteroids plus mycophenolate mofetil (MMF) led to the eventual resolution of his symptoms. Only 8 cases of neurosarcoidosis involving the cavernous sinus have been reported. Our patient represents the only reported case of probable neurosarcoidosis of the cavernous sinus with optic neuropathy successfully treated with corticosteroid plus MMF combination therapy. We highlight the need to consider early, aggressive treatment in cases of neurosarcoidosis with optic neuropathy and to develop criteria to guide treatment strategy based on neurolocalization and the degree of neurological disability.

Giant Cavernous Sinus Teratoma: A Clinical Example of a Rare Entity: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 48 (6) ◽  
pp. 1367-1371 ◽  
Author(s):  
Samuel Tobias ◽  
Javier Valarezo ◽  
Karen Meir ◽  
Felix Umansky
Keyword(s):  
Cavernous Sinus ◽  
Bone Erosion ◽  
Mature Teratoma ◽  
Benign Tumors ◽  
Gasserian Ganglion ◽  
Middle Fossa ◽  
Presumptive Diagnosis ◽  
Large Tumor ◽  
The Right ◽  
Different Tissues

Abstract OBJECTIVE AND IMPORTANCE Teratomas represent 0.5% of all intracranial tumors. These benign tumors have tissue representative of the three germinal layers: ectoderm, mesoderm, and endoderm. Most teratomas are midline tumors located predominantly in the sellar and pineal regions. Cavernous sinus location is very rare; only two purely intracavernous teratomas have been reported. CLINICAL PRESENTATION A 14-year-old boy presented with a history of progressive right eye proptosis and visual acuity impairment, headaches, and a neuralgia-like facial pain in the right V1 distribution. A head computed tomographic scan and magnetic resonance imaging disclosed a large tumor filling the right cavernous sinus and extending into the ipsilateral middle fossa. These scans also demonstrated mixed signals derived from different tissues conforming to the tumor (fat, cartilage, muscle strands, bone, and a primordial tooth). Heterogeneous enhancement was seen after infusion of contrast medium. Significant bone erosion and remodeling was evident in the middle fossa floor and right orbit, with secondary proptosis. A presumptive diagnosis of mature teratoma was made. INTERVENTION With the use of a right frontotemporal interfascial approach, a combined extra- and intradural dissection of the tumor was performed. The lesion entirely occupied the cavernous sinus, laterally displacing the Gasserian ganglion and trigeminal branches (predominantly V1 and V2). The internal carotid artery and Cranial Nerve VI were medially displaced by the tumor mass. The lesion was composed of different tissues, including hair, fat, cartilage, muscle, nerve-like tissue, bone, and a primordial tooth. The tumor was removed completely, and the pathological report confirmed the diagnosis of a mature teratoma. There was no evidence of recurrence at the 8-month follow-up examination. CONCLUSION Because of the lesion's location in the lateral wall of the cavernous sinus, a total removal was achieved with the use of standard microsurgical techniques. Knowledge of the microanatomy is essential in treating intracavernous pathology. We present the third reported case of a giant mature teratoma of the cavernous sinus.

scholarly journals Orbital apex syndrome due to aspergillosis: case report

2001 ◽  
Vol 59 (3B) ◽  
pp. 806-808 ◽  
Author(s):  
Yvens B. Fernandes ◽  
Ricardo Ramina ◽  
Guilherme Borges ◽  
Luciano S. Queiroz ◽  
Marcos V.C. Maldaun ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Renal Failure ◽  
Nervous System ◽  
Rare Case ◽  
Visual Loss ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Facial Numbness ◽  
The Central Nervous System ◽  
The Right

We report the case of a 73-year-old female who presented facial numbness and pain in the first division of the trigeminal nerve, ptosis, diplopia and visual loss on the right side for the previous four months. The neurological, radiological and histological examination demonstrated a rare case of invasive fungal aspergillosis of the central nervous system, causing orbital apex syndrome, later transformed in temporal brain abscess. She died ten months later due to respiratory and renal failure in spite of specific antimycotic therapy.

PENYALAHGUNAAN HAK KEKEBALAN DIPLOMATIK DITINJAU DARI KONVENSI WINA 1961 (STUDI KASUS PENYELUNDUPAN EMAS OLEH PEJABAT DIPLOMATIK KOREA UTARA DI BANGLADESH)

2019 ◽  
Vol 1 (1) ◽  
pp. 81-94
Author(s):  
Komang Sukaniasa
Keyword(s):  
New York ◽  
North Korea ◽  
Vienna Convention ◽  
Diplomatic Relations ◽  
Special Power ◽  
New York Convention ◽  
Diplomatic Immunity ◽  
The Right ◽  
State Representatives

Diplomatic officials are state representatives in developing diplomatic relations with other countries where it is accredited. Diplomatic officials have the rights of immunity and privileges granted by the sending country. Besides enjoying these rights, diplomatic officials also have obligations. As a diplomatic official from North Korea, Son Young Nam is obliged to obey the rules contained in the 1961 Vienna Convention, the 1969 New York Convention, and to respect the national law of the country of Bangladesh which is the country where he was accredited. Son Young Nam's smuggling of gold into Bangladesh was a form of abuse of diplomatic immunity. The act violated Articles 27 and 41 (1) of the 1961 Vienna Convention and Article 25b of The Special Power Act of Bangladesh. Although they have the right to immunity, these rights are not absolute. Immune rights can be breached in the event of gross violations committed by diplomatic officials.

Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery

2002 ◽  
Vol 97 ◽  
pp. 533-535 ◽  
Author(s):  
Jin Woo Chang ◽  
Jae Young Choi ◽  
Young Sul Yoon ◽  
Yong Gou Park ◽  
Sang Sup Chung
Keyword(s):  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Fourth Ventricle ◽  
Gamma Knife Radiosurgery ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Segmental Demyelination ◽  
Content Type ◽  
Clinical Responses ◽  
Fine Print

✓ The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.

ASSESSMENT OF PHYSIOLOGICAL PARAMETERS OF THE TRIGEMINAL AND COCHLEOVESTIBULAR SYSTEMS IN TEMPOROMANDIBULAR JOINT PAIN DYSFUNCTION

2020 ◽  
Vol 17 (2) ◽  
pp. 110-120
Author(s):  
N.D. Sorokina ◽  
◽  
L.R. Shahalieva ◽  
S.S. Pertsov ◽  
L.V. Polma ◽  
...  
Keyword(s):  
Nervous System ◽  
Evoked Potentials ◽  
Temporomandibular Joint ◽  
Differential Diagnostics ◽  
Autonomous Nervous System ◽  
Dental Diseases ◽  
Grade Ii ◽  
The Right ◽  
Distal Occlusion ◽  
The Brain

One of the most common causes of chronic pain in the facial region, including in the trigeminal nerve link, which is not associated with dental diseases, is pain dysfunction of the temporomandibular joint. At the same time, there is evidence in the literature that there are relationships between pain dysfunction of the temporomandibular joint, abnormal occlusion, cervical-muscular tonic phenomena, postural disorders, dysfunction of the Autonomous nervous system and cochleovestibular manifestations. At the same time, neurophysiological indicators of functional disorders in the maxillofacial region and intersystem interactions in pain dysfunction of the temporomandibular joint are insufficiently studied.Goal. The aim of the work is to evaluate the neurophysiological features of trigeminal afferentation in terms of trigeminal somatosensory evoked potentials (TSWP) and the auditory conducting system of the brain in terms of acoustic stem evoked potentials (ASVP) in distal occlusion of the dentition with pain dysfunction of the temporomandibular joint (TMJ) in comparison with physiological occlusion in students 18-21 years old. Material and methods. The main study included 41 students with distal occlusion (21 girls and 20 boys), (grade II Engl, symmetrically right and left in 14 people, and grade II Engl on the left and grade I on the right in 12 people, grade I on the left and grade II on the right in 15 people). All respondents with distal occlusion and who were practically healthy signed an informed consent to participate in the study. We used complex orthodontic methods of examination, subjective degree of severity and intensity of pain in the TMJ, assessment of the Autonomous nervous system (samples and tests), and neurophysiological methods for assessing TSVP and ASVP. Results. Significant differences in ASEP parameters were found in the group of respondents with distal occlusion in the form of a decrease in the latency period of peak I, III, and V compared to physiological occlusion, that correlated with the subjective assessment (in points) of cochleovestibular disorders. According to the TSVP study, a decrease in the duration of latent periods was found, which indicates an increased excitability of non-specific brain stem structures at the medullo-ponto-mesencephalic level compared to the control group. Conclusions. The results obtained are supposed to be used for differential diagnostics, including such dental diseases as TMJ pain dysfunction, occlusion abnormalities accompanied by pain syndrome. Additional functional diagnostics of multi-modal VP of the brain (acoustic evoked potentials, trigeminal evoked potentials) can be performed in conjunction with indicators of autonomic nervous system dysfunction, with parameters of severity of clinical symptoms of cochleovestibular disorders, musculoskeletal dysfunction the maxillofacial area, with indicators of pain, which will determine the tactics and effectiveness of subsequent treatment.

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