Missed Cerebral Coil Found in Peripheral Circulation after Endovascular Embolization: A Rare Complication and Review

We report on the case of a huge varix that developed after the endovascular embolization of a cerebellar arteriovenous malformation (AVM) with a single drainer. A 21-year-old male presented with trigeminal neuralgia which was caused by the dilated drainer of the AVM. A varix was found at the basal vein of Rosenthal 2 months after an initial stage of embolization with polyvinyl alcohol particles; it diminished after the surgical extirpation of the AVM The varix formation might have been facilitated by the stenosis in the vein of Galen and by the dynamic changes that followed the embolization This rare complication should be kept in mind when embolization is performed for AVMs with impaired venous outlets

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Vertebral Arteriovenous Fistula: A Rare Complication Following Transpedicular Occipitocervical Fixation in a Patient with Atlantoaxial Dislocation

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1655771 ◽

2018 ◽

Vol 79 (06) ◽

pp. 533-535

Author(s):

Zhixiao Li ◽

Ming Li ◽

Rongjun Qian

Keyword(s):

Vertebral Artery ◽

Arteriovenous Fistula ◽

Rare Complication ◽

Preoperative Evaluation ◽

Endovascular Embolization ◽

Upper Cervical Spine ◽

Ethylene Vinyl Alcohol ◽

Occipitocervical Fixation ◽

Vertebral Arteriovenous Fistula ◽

Artery Embolism

AbstractVertebral arteriovenous fistula (AVF), a complication of a vertebral artery injury (VAI), is a rare but serious complication of upper cervical spine fixation surgery. We report a case of a 59-year-old female patient who had a vertebral AVF following transpedicular occipitocervical fixation surgery. Endovascular embolization of the AVF was successfully performed using ethylene vinyl alcohol. From this case we learned that preoperative evaluation of the course of the vertebral artery is necessary, and vertebral artery embolism is an effective and safe method to treat vertebral AVF after proof of a patent second vertebral artery.

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A Rare Complication of Endovascular Embolization: Extruded Onyx on Trigeminal Nerve

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1669972 ◽

2018 ◽

Vol 79 (S 05) ◽

pp. S422-S423 ◽

Cited By ~ 1

Author(s):

Pinar Eser Ocak ◽

Mustafa Başkaya

Keyword(s):

Brain Stem ◽

Trigeminal Nerve ◽

Rare Complication ◽

Cranial Nerves ◽

Endovascular Embolization ◽

University Hospital ◽

Preoperative Embolization ◽

Postoperative Mri ◽

Surgery Patient ◽

The Right

Objectives To demonstrate a rare complication of endovascular tumor embolization with onyx. Design Operative video. Setting Department of neurological surgery in a university hospital. Participants A 39-year-old male who was diagnosed with a right sided hemangioblastoma. Main Outcome Measures Surgical resection of the tumor, preservation of the cranial nerves and extruded embolization material on trigeminal nerve. Results The tumor was embolized with onyx the day before surgery. Patient woke up with no sensation in the right side of his face. Diffusion magnetic resonance imaging (MRI) showed a small restricted diffusion area within the right superior cerebellar vermis. Microsurgical resection of the tumor was uneventful and complete resection was achieved (Fig. 1). After the resection was completed, the trigeminal nerve was identified. Some of the capillaries overlying the nerve as well as the cerebellum and brain stem had extruded onyx-embolic material (Fig. 2). Some of the onyx over the cerebellum was removed; however, the ones on the trigeminal nerve and brain stem were not removed due to the risk of injury to the nerve. Postoperative MRI confirmed total resection. Patient made excellent recovery except he continued to have no sensation in the right side of his face. Conclusion Preoperative embolization is an important adjunct to resection of large hemangioblastomas in selected cases because it may facilitate circumferential dissection and debulking of the tumor. Although extrusion of the embolization material is relatively common, immediate extrusion of onyx and its transfixion on a cranial nerve has not been reported before. Judicial selection of preoperative embolization is required in hemangioblastomas.The link to the Video can be found at: https://youtu.be/s0DjD26Xkas.

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Facial Nerve Paralysis Following Endovascular Embolization: A Case Report and Review of the Literature

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420966611 ◽

2020 ◽

pp. 000348942096661

Author(s):

Austin Y. Feng ◽

Michael C. Jin ◽

Sandy Wong ◽

Jon-Paul Pepper ◽

Robert Jackler ◽

...

Keyword(s):

Case Report ◽

Facial Nerve ◽

Facial Palsy ◽

Rare Complication ◽

Relevant Literature ◽

Complete Recovery ◽

Endovascular Embolization ◽

Additional Treatment ◽

Facial Nerve Paralysis ◽

Nerve Paralysis

Objective: We report a case of facial nerve paralysis post-endovascular embolization of a sigmoid sinus dural arterio-venous fistula from initial presentation to current management and discuss the merits of observation versus decompression through a systematic review of relevant literature. Patient: 61 F with right facial palsy Intervention: Following a single intravenous dexamethasone injection with oral steroids over 2 months, patient was observed with no additional treatment other than Botox chemodenervation and facial rehabilitation. Outcome and Results: The patient initially presented with complete right facial palsy (HB 6/6). Post-op CT imaging indicated Onyx (ev3, Irvine, California, USA) particles present at the geniculate segment of the facial nerve. Observation was chosen over surgical intervention. At the most current follow up of 8 months, facial function has improved substantially (HB 2/6). Conclusion: Facial palsy is a serious, though rare, complication of transarterial endovascular embolization. With our case report and literature review, we highlight not only how conservative observation is the recommended treatment, but also that facial nerve recovery should be expected to reach near complete recovery, but not sooner than in 3 months.

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