scholarly journals III cranial nerve cavernous malformation: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 452
Author(s):  
Giuseppe Di Perna ◽  
Fabio Cofano ◽  
Roberto Altieri ◽  
Bianca Maria Baldassarre ◽  
Luca Bertero ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Cavernous Malformation ◽  
Cranial Nerves ◽  
Brain Parenchyma ◽  
Nerve Sparing ◽  
Review Of The Literature ◽  
Total Resection ◽  
Cavernous Malformations ◽  
And Function

Background: Cavernous malformations generally occur in brain parenchyma but rarely these lesions arise from cranial nerves (CNs). Case Description: This paper described a case of a woman presented with III CN dysfunction due to the presence of a right III CN cavernoma. Surgical treatment with nerve sparing gross total resection was performed. A 3-month follow-up was documented. Conclusion: Only few cases of CNs cavernomas have been described in the literature. These lesions have been described to show a more aggressive behavior compared to intraparenchymal cavernomas, especially in symptomatic patients. Differential diagnosis and surgical treatment could be challenging, especially trying to preserve nerve integrity and function.

scholarly journals Cavernous Malformation of the Hypoglossal Nerve: Case Report and Review of the Literature

2002 ◽  
Vol 29 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Michael Chow ◽  
Bassam Addas ◽  
Virgilio Sangalang ◽  
Renn Holness
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Cavernous Malformation ◽  
Cranial Nerves ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Cavernous Malformations

Abstract:Objective:To describe a patient who presented with a hypoglossal nerve palsy caused by a cavernous malformation, review the literature on cavernous malformations associated with cranial nerves and the differential diagnosis of hypoglossal palsy.Results:Partial resection of the lesion was achieved and the diagnosis of cavernous malformation proven histologically.Conclusions:Involvement of a cranial nerve by a cavernous malformation is very uncommon and the facial nerve is the example most frequently reported. This case report adds another possible site for this rare occurrence.

Functional outcome after surgical treatment of cavernous malformation involving ocular motor cranial nerves: A systematic review

2020 ◽  
Author(s):  
Kyoung Su Sung ◽  
Jaejoon Lim ◽  
So Jung Hwang ◽  
Duk-Hee Chun ◽  
KYUNGGI CHO
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Cavernous Malformation ◽  
Cranial Nerves ◽  
Ocular Motor ◽  
Cavernous Malformations ◽  
Functional Changes ◽  
Preservation Method ◽  
Surgical Methods ◽  
Functional Preservation

Abstract Background: Cavernous malformations (CMs) of cranial nerves (CN) III, IV, and VI are extremely rare, and limited studies have assessed the functional outcomes after treatment. This systematic review investigated the clinical features of CMs in ocular motor CNs, including treatment results, and compared different surgical methods for functional preservation of ocular motor CNs. Methods: ‘PubMed’, ‘SCOPUS’, ‘Web of Science’, and ‘Google Scholar’ databases were searched to identify case reports and studies published between January 1980 and December 2018. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results: Twenty-seven patients were identified (median age, 46 years; range, 3 months-71 years). CN III was involved in 17 patients (63.0%), CN IV in 8 (29.6%), and CN VI in 2 (7.4%). Treatments included gross total resection (GTR) and nerve transection in 6 patients (22.2%), GTR and nerve continuity preservation in 7 (25.9%), subtotal resection (STR) and nerve continuity preservation in 4 (14.8%), GTR and end-to-end anastomosis in 5 (18.5%), and conservative care in 3 (11.1%), while the treatment method for 2 (7.4%) patients was not described in the literature. In 22 patients who underwent surgical treatment, functional changes included improvement in 9 patients (40.9%), no change in 10 (45.5%), and worsening symptoms in 3 (13.6%). Functional preservation was achieved in 12 (54.5%) of the 22 patients; the nerve continuity preservation method conferred significant advantage for functional preservation compared with other surgical methods ( p =0.004). Conclusion: Functional preservation of ocular motor CNs can be achieved by nerve continuity preservation. Key Words: cavernous malformation; cranial nerve; treatment outcome

scholarly journals Odontogenic Myxoma: Follow-Up of 13 cases after conservative surgical treatment and review of the literature

2021 ◽  
pp. 0-0
Author(s):  
H. Martins ◽  
E. Vieira ◽  
A. Gondim ◽  
H. Osório-Júnior ◽  
J. da Silva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Review Of The Literature ◽  
Odontogenic Myxoma

scholarly journals Expanded Transsphenoidal Trans-Lamina Terminalis Approach to Tumors Extending Into the Third Ventricle: Technique Notes and a Single Institute Experience

2021 ◽  
Vol 11 ◽  
Author(s):  
Lei Cao ◽  
Wentao Wu ◽  
Jie Kang ◽  
Hui Qiao ◽  
Xiaocui Yang ◽  
...  
Keyword(s):  
Cavernous Malformation ◽  
Third Ventricle ◽  
Radical Resection ◽  
Lamina Terminalis ◽  
Total Resection ◽  
The Third ◽  
Cerebrospinal Fluid Leaks ◽  
Ventricular Tumors ◽  
New Onset

ObjectThe trans lamina terminalis approach (TLTA) has been described as a way to remove third ventricular tumors. The aim of this paper was to analyze the feasible outcomes of TLTA applied to tumors extending into the third ventricle in our institute.MethodsSuprasellar tumors (n = 149) were treated by the extended endonasal approach from September 2019 to December 2020 in Beijing Tiantan Hospital. Eleven of the tumors were treated by TLTA or TLTA via the trans-chiasm-pituitary corridor (TCPC). The surgical technique notes of TLTA were described and indications and outcomes of the approach were analyzed.ResultsThere were 11 patients enrolled in the study, six with papillary craniopharyngiomas, two with adamantinomatous craniopharyngiomas, one with a germinal cell tumor (GCT), one with cavernous malformation and one with chordoid glioma. Four of the patients received a radical resection by TLTA alone, while seven of them received TLTA via the TCPC. Gross total resection was achieved in eight patients (72.7%), and partial resection in three patients (27.3%). Visual function was improved in four of the 11 patients (36.4%), was unchanged in five patients (45.5%), and deteriorated in two patients (18.2%). New-onset hypopituitarism occurred in seven patients (63.3%) and new-onset diabetes insipidus occurred in two patients (18.2%). Electrocyte imbalance were observed in six patients (54.5%) at post-operative week 2. There were no surgery-related deaths or cerebrospinal fluid leaks. Postoperative intracranial infection was observed in one patient (9.1%), and during the follow-up period, tumor recurrence occurred in one patient (9.1%).ConclusionThe expanded TLTA provides a feasible suprachiasm corridor to remove tumors extending into the third ventricle, especially for craniopharyngiomas. Sound understanding of the major strengths and limitations of this approach, as well as strategies for complication avoidance, is necessary for its safe and effective application.

Endoscopic Resection of Hemorrhaged Third Ventricle Cavernous Malformation: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. E51-E51
Author(s):  
Giorgio Palandri ◽  
Thomas Sorenson ◽  
Mino Zucchelli ◽  
Nicola Acciarri ◽  
Paolo Mantovani ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intraventricular Hemorrhage ◽  
Cavernous Malformation ◽  
Third Ventricle ◽  
Gross Total Resection ◽  
Vascular Lesions ◽  
Total Resection ◽  
Cavernous Malformations ◽  
The Third

Abstract Cavernous malformations of the third ventricle are uncommon vascular lesions. Evidence suggests that cavernous malformations in this location might have a more aggressive natural history due to their risk of intraventricular hemorrhage and hydrocephalus.1 The gold standard of treatment is considered to be microsurgical gross total resection of the lesion. However, with progressive improvement in endoscopic capabilities, several authors have recently advocated for the role of minimally-invasive neuroendoscopy for resecting intraventricular cavernous malformations.2-4 In this timely intraoperative video, we demonstrate the gross total resection of a third ventricle cavernous malformation that presented with hemorrhage via a right-sided trans-frontal neuroendoscopic approach.

scholarly journals Intracranial nonvestibular neurinomas: Young neurosurgeons’ experience

2014 ◽  
Vol 05 (03) ◽  
pp. 231-243
Author(s):  
Forhad Hossain Chowdhury ◽  
Mohammod R. Haque ◽  
Khandkar A. Kawsar ◽  
Mainul H. Sarker ◽  
Mahmudul Hasan ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Craniovertebral Junction ◽  
Jugular Foramen ◽  
Clinical Profile ◽  
Clinical Feature ◽  
Subtotal Resection ◽  
Total Resection

ABSTRACT Background and Objectives: Neurinoma arising from other than nonvestibular cranial nerves is less prevalent. Here we present our experiences regarding the clinical profile, investigations, microneurosurgical management, and the outcome of nonvestibular cranial nerve neurinomas. Materials and Methods: From January 2005 to December 2011, the recorded documents of operated nonvestibular intracranial neurinomas were retrospectively studied for clinical profile, investigations, microneurosurgical management, complications, follow-up, and outcomes. Results: The average follow-up was 24.5 months. Total number of cases was 30, with age ranging from 9 to 60 years. Sixteen cases were males and 14 were females. Nonvestibular cranial nerve schwannomas most commonly originated from trigeminal nerve followed by glossopharyngeal+/vagus nerve. There were three abducent nerve schwannomas that are very rare. There was no trochlear nerve schwannoma. Two glossopharyngeal+/vagus nerve schwannomas extended into the neck through jugular foramen and one extended into the upper cervical spinal canal. Involved nerve dysfunction was a common clinical feature except in trigeminal neurinomas where facial pain was a common feature. Aiming for no new neurodeficit, total resection of the tumor was done in 24 cases, and near-total resection or gross total resection or subtotal resection was done in 6 cases. Preoperative symptoms improved or disappeared in 25 cases. New persistent deficit occurred in 3 cases. Two patients died postoperatively. There was no recurrence of tumor till the last follow-up. Conclusion: Nonvestibular schwannomas are far less common, but curable benign lesions. Surgical approach to the skull base and craniovertebral junction is a often complex and lengthy procedure associated with chances of significant morbidity. But early diagnosis, proper investigations, and evaluation, along with appropriate decision making and surgical planning with microsurgical techniques are the essential factors that can result in optimum outcome.

scholarly journals Grisel’s Syndrome in Children: Two Case Reports and Systematic Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Nicole Pini ◽  
Martina Ceccoli ◽  
Patrizia Bergonzini ◽  
Lorenzo Iughetti
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Early Diagnosis ◽  
Head And Neck ◽  
Case Reports ◽  
Atlantoaxial Joint ◽  
Review Of The Literature ◽  
Grisel’S Syndrome

Background and Objective. Grisel’s syndrome is a rare syndrome characterized by nontraumatic rotatory subluxation of the atlantoaxial joint. It usually affects children and typically presents with torticollis after ear, nose, and throat (ENT) surgery or head and neck infections. In the pediatric literature, there is only a small amount of available data; moreover, no systematic review has been previously done with focus on the pediatric population. We report our experience of two cases, and we provide a systematic review on Grisel’s syndrome in children in order to offer a deeper insight about its clinical presentation, its current diagnosis, and principles of treatment. Case Reports and Review. We describe two boys of 9 and 8 years old, who developed atlantoaxial subluxation after adenoidectomy. Considering the early diagnosis, a conservative treatment was chosen, with no recurrence and no sequelae at follow-up. We identified 114 case reports, of which 90 describe children, for a total of 171 pediatric patients. Of the 154 cases in which cause was reported, 59.7% presented a head and neck infection and 35.7% had previous head and neck surgery. There is no sex prevalence (49.7% males versus 50.2% females). Mean delay in diagnosis is 33 days. Eight % of the patients had neurological impairment of the 165 cases which mentioned treatment, 96% underwent a conservative treatment, of whom the 8.8% recurred with the need of surgery. As a whole, 12% underwent surgery as a first- or second-line treatment. 3 6% of the patients whose follow-up was reported developed a sequela, minor limitation of neck movement being the most frequent. Conclusion. Grisel’s syndrome should be suspected in children with painful unresponsive torticollis following ENT procedures or head and neck inflammation. CT scan with 3D reconstruction is the gold standard for diagnosis, allowing the identification of the subluxation and the classification according to the Fielding–Hawkins grading system. Surgical treatment is indicated in case of high-grade instability or failure of conservative treatment. Review of the literature shows how early diagnosis based on clinical and radiological evaluation is crucial in order to avoid surgical treatment and neurologic sequelae.

Advances in the Treatment and Outcome of Brainstem Cavernous Malformation Surgery

Neurosurgery ◽  
2011 ◽  
Vol 68 (2) ◽  
pp. 403-415 ◽  
Author(s):  
Adib A. Abla ◽  
Gregory P. Lekovic ◽  
Jay D. Turner ◽  
Jean G. de Oliveira ◽  
Randall Porter ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Patient Outcomes ◽  
Perioperative Complications ◽  
Low Flow ◽  
Tube Placement ◽  
Cerebrospinal Fluid Leakage ◽  
Cavernous Malformations ◽  
Study Population ◽  
The Mean

Abstract BACKGROUND: Brainstem cavernous malformations (BSCMs) are relatively uncommon, low-flow vascular lesions. Because of their relative rarity, relatively little data on their natural history and on the efficacy and durability of their treatment. OBJECTIVE: To evaluate the long-term durability of surgical treatment of BSCMs and to document patient outcomes and clinical complications. METHODS: The charts of all patients undergoing surgical treatment of BSCM between 1985 and 2009 were reviewed retrospectively. The study population consisted of 300 patients who had surgery for BSCM. Forty patients were under 19 years of age at surgery; pediatric BSCMs have been reported separately. Patient demographics, lesion characteristics, surgical approaches, and patient outcomes were examined. RESULTS: The study population consisted of 260 adult patients with a female-to-male ratio of 1.5 and mean age of 41.8 years. Of the 260 patients, 252 presented with a clinical or radiographic history of hemorrhage. The mean follow-up in 240 patients was 51 months. The mean Glasgow Outcome Scale on admission, at discharge, and at last follow-up was 4.4, 4.2, and 4.6. Postoperatively, 137 patients (53%) developed new or worsening neurological symptoms. Permanent new deficits remained in 93 patients 3(36%). There were perioperative complications in 74 patients (28%); tracheostomy, feeding tube placement, and cerebrospinal fluid leakage were most common. Eighteen patients (6.9%) experienced 20 rehemorrhages. Twelve patients required reoperation for residual/recurrent BSCM. The overall annual risk of postoperative rehemorrhage was 2%/patient. CONCLUSION: Although BSCM surgery has significant associated risks, including perioperative complications, new neurological deficits, and death, most patients have favorable outcomes. Overall, surgery markedly improved the risk of rehemorrhage and related symptoms and should be considered in patients with accessible lesions.

Surgical Treatment of Childhood Inflammatory Myofibroblastic Tumors

2016 ◽  
Vol 27 (04) ◽  
pp. 319-323 ◽  
Author(s):  
Beril Talim ◽  
İbrahim Karnak ◽  
Saniye Ekinci ◽  
Fatih Andiran ◽  
Arbay Çiftçi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Lobe ◽  
Diagnostic Methods ◽  
Incomplete Resection ◽  
Total Resection ◽  
Presenting Symptoms ◽  
Inflammatory Myofibroblastic Tumors ◽  
The Mean

Aim A retrospective study was performed to evaluate the clinical features, diagnostic methods, and treatment alternatives of childhood inflammatory myofibroblastic tumors (IMTs). Patients and Methods Patients who underwent surgical treatment for IMT between 2000 and 2015 were evaluated for age, sex, presenting symptoms, physical examination findings, diagnostic methods, treatment modalities, histopathologic findings, and results of surgical treatment during long-term follow-up. Results Eleven patients who underwent surgical treatment were included in the study. Male:female ratio was 7:4 and the mean age of the patients was 6.09 years (1–10 years). Presenting symptoms were respiratory difficulty, cough (n = 7, 63.3%), abdominal pain, vomiting (n = 2, 18.8%), loss of body weight (n = 1, 9.09%), palpable mass (n = 1, 9.09%), and rectal bleeding (n = 1, 9.09%). Ultrasonography (n = 4, 36.3%) and computed tomography (n = 9, 81.1%) were used for diagnosis. Localizations of tumors were lungs (n = 5, 45.4%), mediastinum (n = 2, 18.1%), spleen (n = 1, 9.09%), neck (n = 1, 9.09%), colon (n = 1, 9.09%), and rectum (n = 1, 9.09%). The mean size of mass was 6.6 cm (2–12 cm) and six patients were diagnosed with preoperative biopsy. Lung lobectomy (right lower lobe; n = 3, right middle and lower lobe; n = 2), total resection of mass with adjacent bowel (n = 2), partial splenectomy (n = 1), total resection of neck mass (n = 1), and incomplete resection (n = 2) were the choice of surgical treatment. Incomplete resection was performed in masses closely adjacent to atrium and mediastinal structures. In histopathologic evaluation, surgical margins were free of tumor in four cases, positive in six cases, and were not reported in one case. Anaplastic lymphoma kinase (ALK) positivity was detected in six cases, negative in two cases, and was not evaluated in three cases. Two cases who had residual mass with positive ALK received chemotherapy. Mean follow-up time was 68.2 months (5 months to 12 years). During follow-up, there was no recurrence or distant metastasis. Ten patients survived and one patient was lost to follow-up. Conclusion IMT is a rare tumor of childhood with a spectrum of clinical findings because of variable localization. Surgical treatment is the first choice of treatment. Patients with residual mass and ALK positivity may require medical treatment. In our series, long-term survival of patients was favorable in patients with total resection.

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