scholarly journals Treatment and Prognosis of Postoperative Acute Cerebral Venous Infarctions

2021 ◽  
Author(s):  
Qing Cai ◽  
Shoujie Wang ◽  
Jiahua Zhou ◽  
Huaizhou Qin ◽  
Dayun Feng
Keyword(s):  
Hemifacial Spasm ◽  
Lateral Ventricle ◽  
Surgical Intervention ◽  
Parietal Lobe ◽  
Neurological Dysfunction ◽  
Cerebral Vein ◽  
Cortical Vein ◽  
Vegetative Survival ◽  
Intracranial Lesions ◽  
Ct And Mri

Abstract IntroductionThe incidence of cerebral venous infarctions is not high, but this condition can cause serious complications. This paper summarizes the cases of serious complications after cerebral venous infarctions and proposes corresponding treatment strategies.MethodsA retrospective analysis was performed on 5 patients that had severe complications secondary to injury or sacrifice of related veins during the resection of different intracranial lesions (cerebellopontine angle, lateral ventricle, frontal lobe, falx parietal lobe, frontal parietal lobe). There were 2 males and 3 females, aged 34-58 years. Routine CT and MRI/MRV examinations were performed before the operation, and the diagnoses were a hemifacial spasm, a meningioma of the lateral ventricle, a hemangioma, a falx meningioma and a glioma. Postoperative CT examinations were performed to understand the intracranial conditions of the patients.ResultsFive cases had injuries to associated veins, which included the cerebellar cortical vein, internal cerebral vein, middle frontal vein, straight sinus, and postfrontal vein, during the operations. There were 2 cases of venous infarctions, 3 cases of hemorrhagic infarctions, 2 cases who had conservative treatment, 3 cases who had surgical treatment, 1 case who died (the hemifacial spasm), 1 case who had a vegetative survival (the lateral ventricular meningioma), and 3 cases with good recoveries (the hemangioma, falx meningioma, and glioma).ConclusionsSurgeons should pay more attention to intracranial vein injuries during procedures. Acute neurological dysfunction or even death may occur after these injuries. Surgeons should closely monitor the condition of the patient and proceed with surgical intervention if necessary. The prognosis is usually good for these surgery cases, but the prognosis can be poor if important veins are injured. The key to avoiding cerebral venous infarctions is to preserve the integrity of the veins to the greatest extent during the operation.

scholarly journals IMAGING OF INTRACRANIAL SPACE OCCUPYING LESIONS

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Saroj Kumari ◽  
Raghav Kumar
Keyword(s):  
Frontal Lobe ◽  
Parietal Lobe ◽  
Clinical Suspicion ◽  
Diverse Group ◽  
Resonance Imaging ◽  
Common Location ◽  
Intracranial Lesions ◽  
Anatomical Detail ◽  
Scanning Imaging ◽  
Clinical Departments

Introduction: With advanced MRI techniques such as perfusion, diffusion, and spectroscopy, it is now possible to differentiate between various intracranial lesions. Materials and Methods: This prospective cohort study was conducted on 50 patients referred by various clinical departments with clinical suspicion of intracranial space occupying lesions, evaluated by computed tomography & magnetic resonance imaging. Result: Solitary lesions were present in 35 patients (70%) & multiple lesions in 15 patients (30%). 68.00% lesions were Supratentorial & 32.00% infratentorial in location. Most common supratentorial location in adults was frontal lobe 40% followed by parietal lobe 30%. Most common supratentorial locations in children were frontal lobe. Infratentorially, cerebellum & posterior fossa were found to be most common location in adults & children respectively. Supratentorial lesions were most common both in adults & children. 60% lesions were intraaxial & 40 % extra axial in location. In adults, intraaxial lesions were more common than in children. Conclusion: Intracranial space occupying lesions comprise of a diverse group of lesions. With the introduction of CT & MRI scanning, imaging of lesions has acquired a new dimension whereby excellent anatomical detail in axial, sagittal & coronal planes as well as lesion characterization has become possible. Key words: Brain, CT, MRIs

scholarly journals LGG-40. NATURAL COURSE AND MANAGEMENT OF SMALL ASYMPTOMATIC LESION SUSPECTED OF LOW-GRADE GLIOMA IN CHILDREN

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii374-iii374
Author(s):  
Ai Muroi ◽  
Takao Tsurubuchi ◽  
Hidehiro Kohzuki ◽  
Ryoko Suzuki ◽  
Hiroko Fukushima ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Natural Course ◽  
Low Grade ◽  
Diffuse Astrocytoma ◽  
Mr Images ◽  
Initial Examination ◽  
Long Term Follow Up ◽  
Intracranial Lesions

Abstract OBJECTIVE The natural course of incidentally discovered small intracranial lesions has not been well discussed. Surgical intervention, including resection and biopsy, could be achieved if the lesion is growing. We present 13 cases with incidentally found, small non-enhancing lesions without related symptoms. METHODS We retrospectively reviewed a series of 13 children with T1 hypointense and T2 hyperintense intracranial lesions less than 20 mm in diameter without enhancement. We excluded the patients with NF-1 or Tuberous sclerosis. RESULTS Most patients underwent MRI for headache unrelated to the lesions. All cases were located supratentorially. The median age of the patients at the initial examination was 8.9 years (range, 2.2–14.6). Of these children, 2 patients (15.3%) underwent surgery because of progression on follow-up MR images. The pathological diagnosis was compatible with diffuse astrocytoma. Patients were followed for a median of 55 months (range, 11–87) and the overall survival rate was 100%. No patient experienced increase in size after 3 years of follow-up. CONCLUSIONS In most patients with small intracranial lesions, the lesions remained stable and conservative management was appropriate. However, in a few cases, the lesions changed in size or quality and surgical intervention was necessary. Long-term follow-up at least 3 years is mandatory.

Endoscopic-Assisted Microvascular Decompression

2018 ◽  
pp. 139-154
Author(s):  
M. Yashar S. Kalani ◽  
Michael R. Levitt ◽  
Celene B. Mulholland ◽  
Charles Teo ◽  
Peter Nakaji
Keyword(s):  
Trigeminal Neuralgia ◽  
Minimally Invasive ◽  
Effective Treatment ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Patient Population ◽  
Surgical Intervention ◽  
Cranial Nerves ◽  
Vascular Compression ◽  
Ephaptic Transmission

Diseases of ephaptic transmission are commonly caused by vascular compression of cranial nerves. The advent of microvascular decompression has allowed for surgical intervention for this patient population. This chapter highlights the technique of endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm. Endoscopy and keyhole techniques have resulted in a minimally invasive and effective treatment of symptoms for patients with neuralgia.

Lipomyelomeningocele: pathology, treatment, and outcomes

2012 ◽  
Vol 33 (4) ◽  
pp. E3 ◽  
Author(s):  
Christina E. Sarris ◽  
Krystal L. Tomei ◽  
Peter W. Carmel ◽  
Chirag D. Gandhi
Keyword(s):  
Spinal Cord ◽  
Neurological Disorder ◽  
Surgical Intervention ◽  
Neurological Deterioration ◽  
Neurological Dysfunction ◽  
Tethered Spinal Cord ◽  
Urodynamic Studies ◽  
Early Surgical Intervention

Lipomyelomeningocele represents a rare but complex neurological disorder that may present with neurological deterioration secondary to an inherent tethered spinal cord. Radiological testing is beneficial in determining the morphology of the malformation. Specialized testing such as urodynamic studies and neurophysiological testing may be beneficial in assessing for neurological dysfunction secondary to the lipomyelomeningocele. Early surgical intervention may be beneficial in preventing further neurological decline.

scholarly journals Prognostic Evaluation Based on Cortical Vein Score Difference in Stroke

Stroke ◽  
2013 ◽  
Vol 44 (10) ◽  
pp. 2748-2754 ◽  
Author(s):  
Rajsrinivas Parthasarathy ◽  
Mahesh Kate ◽  
Jeremy L. Rempel ◽  
David S. Liebeskind ◽  
Thomas Jeerakathil ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Odds Ratio ◽  
Arterial Occlusion ◽  
Venous Drainage ◽  
Cerebral Vein ◽  
Anterior Circulation ◽  
Prognostic Evaluation ◽  
Cortical Vein ◽  
Score Difference ◽  
Superficial Middle Cerebral Vein

Background and Purpose— Multimodal imaging in acute ischemic stroke defines the extent of arterial collaterals, resultant penumbra, and associated infarct core, yet limitations abound. We identified superficial and deep venous drainage patterns that predict outcomes in patients with a proximal arterial occlusion of the anterior circulation. Methods— An observational study that used computed tomography (CT) angiography to detail venous drainage in a consecutive series of patients with a proximal anterior circulation arterial occlusion. The principal veins that drain the cortex (superficial middle cerebral, vein of Trolard, vein of Labbé, and basal vein of Rosenthal) and deep structures were scored with a categorical scale on the basis of degree of contrast enhancement. The Prognostic Evaluation based on Cortical vein score difference In Stroke score encompassing the interhemispheric difference of the composite scores of the veins draining the cortices (superficial middle cerebral+vein of Trolard+vein of Labbé+basal vein of Rosenthal) was analyzed with respect to 90-day modified Rankin Scale outcomes. Results— Thirty-nine patients were included in the study. A Prognostic Evaluation based on Cortical vein score difference In Stroke score of 4 to 8 accurately predicted poor outcomes (modified Rankin Scale, 3–6; odds ratio, 20.53; P <0.001). On stepwise logistic regression analyses adjusted for CT Alberta stroke program early CT score, CT angiography collateral grading and National Institutes of Health Stroke Scale score, a Prognostic Evaluation based on Cortical vein score difference In Stroke score of 4 to 8 (odds ratio, 23.598; P =0.009) and an elevated admission National Institutes of Health Stroke Scale (odds ratio, 1.423; P =0.023) were independent predictors of poor outcome. Conclusions— The Prognostic Evaluation based on Cortical vein score difference In Stroke score, a novel measure of venous enhancement on CT angiography, accurately predicts clinical outcomes. Venous features on computed tomography angiography provide additional characterization of collateral perfusion and prognostication in acute ischemic stroke.

The role of computed and magnetic resonance imaging in assessment of the local advancement of malignant tumors of the hearing organ

2021 ◽  
Vol 11 (2) ◽  
pp. 10-17
Author(s):  
E. G. Khazarova ◽  
E. L. Dronova
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Skin Cancer ◽  
Temporal Bone ◽  
Surgical Intervention ◽  
Malignant Tumors ◽  
Locally Advanced ◽  
Resonance Imaging ◽  
Hearing Organ ◽  
Ct And Mri

Introduction. Сomputed tomography (СТ) and magnetic resonance imaging (MRI) are the main methods of radiological diagnostics, which makes it possible to objectively assess the local advancement of malignant tumors of the hearing organ and decide on the possibility of surgical intervention.The objective of this scientific research – to determine the main indications for surgical intervention, taking into account the radiological criteria for the lesion of the temporal bone (CT, MRI) in locally advanced outer ear skin cancer. Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in N. N. Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median – 12.0 months).Results. The prevalence of the tumor process in cancer of the skin of the external auditory canal in accordance with the staging system for lesions of the temporal bone structures (University of Pittsburgh, 1990), which takes into account CT and MRI signs of damage to the temporal bone and adjacent anatomical structures, is a factor that significantly affects the long-term results of treatment (for disease-free survival: hazard ratio (HR) 4.76, 95 % confidence interval (CI) 1.93–11.73, р = 0.00069; for tumor-specific survival: HR 4.25, 95 % CI 1.74–10.39, р = 0.0015; for overall survival: HR 1.96, 95 % CI 1.07–3.58, р = 0.029).Conclusion. CT and MRI are mandatory methods of radiological diagnosis of patients with skin cancer of the external auditory canal.

scholarly journals Infantile subdural empyema: The role of brain sonography and percutaneous subdural tapping in a resource-challenged region

2014 ◽  
Vol 05 (04) ◽  
pp. 355-359 ◽  
Author(s):  
Okezie Obasi Kanu ◽  
Chinenye Nnoli ◽  
Omodele Olowoyeye ◽  
Omotayo Ojo ◽  
Christopher Esezobor ◽  
...  
Keyword(s):  
Gold Standard ◽  
Subdural Empyema ◽  
Haemophilus Influenza ◽  
Level Of Consciousness ◽  
Intracranial Lesions ◽  
Brain Sonography ◽  
And Staphylococcus Aureus ◽  
Ct And Mri ◽  
Subdural Tapping

ABSTRACT Background This study explored the outcome of children with patent anterior fontanelles who were treated with trans-fontanelle ultrasound scan (TFUSS), which is more affordable and available than CT scan and MRI in the diagnosis of childhood intracranial pathologies and treatment of subdural empyema, in developing countries. Patients and Methods: Seventeen infants with post-meningitic subdural empyema, diagnosed using trans-fontanelle ultrasound alone and treated with subdural tapping over a 31-months period, were studied. Results: Eleven patients presented with grades II and III Bannister and William grading for level of consciousness in intracranial subdural empyema. Aspirate from 7 (41.2%) patients were sterile. The most common organisms isolated were Streptococcus faecalis 3 (17.6%), Haemophilus Influenza 2 (11.8) and Staphylococcus aureus 2 (11.8), multiple organisms were isolated in three of the patients. Ninety-four percent (94%) of the patients had good outcome. Five subjects developed hydrocephalus, one patient had a recurrence of subdural empyema, four patients had residual hemiparesis, two of the four patients had speech difficulties, while one patient (~6%) died. Conclusion: While CT and MRI remain the gold standard for investigating intracranial lesions, transfontanelle ultrasonography is adequate for diagnosis of infantile subdural empyema in resource-challenged areas. Percutaneous subdural tap is an affordable and effective therapy in such patients with financial challenges.

scholarly journals Neuroimaging studies in children aged 6 months to 16 years with new onset afebrile seizures

2019 ◽  
Vol 7 (1) ◽  
pp. 104
Author(s):  
Akula Satyanarayan ◽  
Gangina Sriram ◽  
Ganga Bhavani ◽  
T. Jaya Chandra
Keyword(s):  
Parietal Lobe ◽  
First Episode ◽  
Large Sample Size ◽  
Imaging Studies ◽  
Medical College ◽  
Generalized Seizures ◽  
Common Causes ◽  
Long Time ◽  
Ct And Mri ◽  
New Onset

Background: Seizures are the most common pediatric neurological disorder. With this a study was conducted to determine the frequency of abnormal neuroimaging in children aged between 6 months to 16 years with new onset afebrile seizures.Methods: Study was conducted in the department of pediatrics, GSL Medical College. Children aged six months to sixteen years, presented with the symptoms of first episode of afebrile seizures were included in the study. After through clinical examinations, findings were recorded, and all the participants underwent imaging studies such as CT and MRI. And the findings were recorded. p<0.05 was considered statistically significant.Results: Total of 80 participants were included in the study; in this, 22.5% (18) had simple partial, 41.3% (33) had complex partial and 5% (4) had partial seizures with 20 generalization and 31.3% (25) had generalized seizures. Seizures were more common among non-vegetarians (p<0.05). Bain CT shows localization to the parietal lobe in 54% of these cases.Conclusions: Neurocysticercosis and tuberculoma are common causes of seizures. Although cysticercosis incidence is greater in pork eaters, but vegetarians shouldn’t be excluded. Studies on large sample size for long time are recommended.

Acquired pial arteriovenous fistula secondary to cerebral cortical vein thrombosis: A case report and review of the literature

2021 ◽  
pp. 197140092110490
Author(s):  
Skander Sammoud ◽  
Nadia Hammami ◽  
Dhaker Turki ◽  
Fatma Nabli ◽  
Samia Ben Sassi ◽  
...  
Keyword(s):  
Low Flow ◽  
Left Middle Cerebral Artery ◽  
Cerebral Vein ◽  
Cortical Vein ◽  
Arteriovenous Fistulas ◽  
Vein Thrombosis ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
First Case ◽  
Cortical Vein Thrombosis

Pial arteriovenous fistulas (AVFs) are rare neurovascular malformations. They differ from arteriovenous malformations (AVMs) in that they involve single or multiple feeding arteries, draining directly into a dilated cortical vein with no intervening nidus. Pial and dural AVFs differ in blood supply, as the first originate from pial or cortical arteries and the latter from outside the dural leaflets. Unlike dural AVFs, most of the pial AVFs are supratentorial. The vast majority are congenital, manifesting during infancy. Acquired pial AVFs are significantly rarer and occur after vasculopathy, head trauma, brain surgery, or cerebral vein thrombosis. We describe a unique case of an acquired pial AVF in a 50-year-old man secondary to a cortical vein thrombosis manifesting as a focal-onset seizure with secondary generalization. A cerebral digital subtraction angiography revealed a low-flow pial AVF fed by a postcentral branch of the left middle cerebral artery draining to the superior sagittal sinus via a cortical vein. It also showed a collateral venous circulation adjacent to the previously thrombosed left parietal vein. There was no evidence of an associated dural AVF or venous varix. Endovascular treatment was scheduled three months later, but the angiogram preceding the embolization showed spontaneous and complete closure of the malformation. To our knowledge, this is the first case illustrating acquired pure pial AVF unaccompanied by a dural component following cortical vein thrombosis, eventually resulting in an unprompted closure.

Cerebral Blood Flow and Volume in Symptom-Free Migraineurs: a SPECT Study

1990 ◽  
Vol 29 (05) ◽  
pp. 210-214 ◽  
Author(s):  
G. L. Turco ◽  
G. Castellano ◽  
W. Liboni ◽  
V. Podio ◽  
G. Chianale ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gamma Camera ◽  
Parietal Lobe ◽  
Diagnostic Yield ◽  
Occipital Lobe ◽  
Occipital Cortex ◽  
Nuclear Data ◽  
The Right ◽  
Ct And Mri

Both CBF and CBV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT.

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