Arteriovenous malformation of the conus supplied by the artery of Desproges-Gotteron

2011 ◽  
Vol 14 (4) ◽  
pp. 529-531 ◽  
Author(s):  
R. Shane Tubbs ◽  
Martin M. Mortazavi ◽  
Andrew J. Denardo ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Arteriovenous Malformation ◽  
Transarterial Embolization ◽  
Conus Medullaris ◽  
Treatment Interventions ◽  
First Case ◽  
Plantar Aspect ◽  
Repeat Angiography ◽  
The Right ◽  
Spinal Avm

The artery of Desproges-Gotteron is rarely mentioned in the literature and is unfamiliar to most neurosurgeons. The authors report a unique case of an arteriovenous malformation (AVM) of the conus in an adult woman, which received blood supply from an artery of Desproges-Gotteron. The patient presented with intermittent pain radiating down the right posterior thigh and foot and transient bladder incontinence. On examination, there was weakness of the right lower limb with hypalgesia of the plantar aspect of the right foot. Magnetic resonance imaging revealed a mass near the anterior aspect of the conus medullaris and angiography confirmed a spinal AVM at the L-1 level and a shunt located at the inferior L-3 level. The patient underwent transarterial embolization, and at 2-year follow-up, repeat angiography demonstrated no evidence of residual or recurrent spinal AVM, intermittent and tolerable pain without treatment interventions, and a normal neurological examination. The artery of Desproges-Gotteron appears to be a rare arterial variation. Moreover, the authors believe this to be the first case of a conal AVM supplied by such an artery. The anatomy and implications of such an arterial variant are discussed.

scholarly journals Contralateral De Novo Intraosseous Arteriovenous Malformation in a Child with Arteriovenous Malformation of Mandible Treated by Endovascular Embolotherapy

2012 ◽  
Vol 18 (4) ◽  
pp. 484-489 ◽  
Author(s):  
C-H Yeh ◽  
Y-M Wu ◽  
Y-L Chen ◽  
H-F Wong
Keyword(s):  
Arteriovenous Malformation ◽  
De Novo ◽  
Transarterial Embolization ◽  
Subsequent Development ◽  
Cyanoacrylate Glue ◽  
Direct Puncture ◽  
Life Threatening ◽  
Detachable Coils ◽  
The Right

We describe our experience of the development of contralateral de novo intraosseous AVMs in a ten-year-old girl with AVMs of the mandible who underwent endovascular embolotherapy. She initially presented with intermittent oral bleeding. Computed tomography and digital subtraction angiography demonstrated intraosseous AVMs within the right mandible. The AVMs were treated by transosseous direct-puncture and transarterial embolization with Guglielmi detachable coils and n-butyl cyanoacrylate glue. However, de novo intraosseous AVMs developed within the previously healthy contralateral mandible and resulted in dangerous oral bleeding. Therefore, we suggest regular follow-up and prompt retreatment of any residual mandibular AVMs in patients undergoing endovascular or surgical treatment to prevent subsequent development of “secondary” AVMs and life-threatening oral bleeding.

Perimedullary Arteriovenous Fistula of the Filum Terminale

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. E219-E220 ◽  
Author(s):  
Yong Jun Jin ◽  
Ki-Jeong Kim ◽  
O Ki Kwon ◽  
Sang Ki Chung
Keyword(s):  
Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Conus Medullaris ◽  
Leg Pain ◽  
Anterior Spinal Artery ◽  
Filum Terminale ◽  
Segmental Artery ◽  
First Case ◽  
History Of ◽  
The Right

Abstract OBJECTIVE Although a dural or intramedullary arteriovenous fistula involving the conus medullaris and fed by the lateral sacral artery has been reported, a case of perimedullary fistula arising from an artery in the filum terminale has not been described in the literature. The authors report the first case of perimedullary arteriovenous fistula located in the filum terminale. CLINICAL PRESENTATION A 61-year-old man presented with a 10-year history of leg pain. Thoracolumbar magnetic resonance imaging scans revealed multiple perimedullary signal voids from T10 to L3. Angiography showed engorged perimedullary veins and a fistula fed by the anterior spinal artery from the right ninth segmental artery and by 2 branches of the left lateral sacral artery. The anterior spinal artery was also regarded as the artery of the filum terminale. INTERVENTION Transarterial embolization was performed to occlude the feeders from the left lateral sacral artery, and an L5 total laminectomy was subsequently performed to obliterate residual fistulous material from the artery of the filum terminale. The thickened, yellowish filum, surrounded by tortuous, engorged veins, was coagulated and resected. Postoperatively, the patient's symptoms gradually resolved and were not aggravated during long periods of walking. CONCLUSION It must be noted that a fistula can be located in the filum terminale and can be successfully treated using multidisciplinary approaches.

scholarly journals Unusual intramuscular locations as a first presentation of hydatid cyst disease in children: a report of two cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruba A. Khasawneh ◽  
Ziyad M. Mohaidat ◽  
Rawand A. Khasawneh ◽  
Sohaib B. Zoghoul ◽  
Yousef M. Henawi
Keyword(s):  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Rectus Femoris ◽  
Mri Imaging ◽  
Palpable Lump ◽  
First Case ◽  
Endemic Areas ◽  
Wbc Count ◽  
The Right

Abstract Background Hydatid disease is an endemic disease in many countries of the world including the Middle East. It mainly affects the liver and lungs. Intramuscular hydatid disease is rarely reported in children. Such uncommon localization of hydatid cyst may pose difficulties in the clinical and radiological diagnosis; hence affecting patient’s management and outcome even in endemic areas. Case presentation We herein describe intramuscular hydatid cysts in 2 different children. The first case is a 5-year-old boy who presented with a painless palpable lump over the right lumbar paraspinal region. His history was remarkable for sheep contact. His laboratory results revealed a mild increase in white blood cell (WBC) count and C-reactive protein. The lesion showed typical features of a hydatid cyst on ultrasound. Further imaging including ultrasound of the abdomen and CT of the chest, abdomen, and pelvis showed infestation of the liver and lung as well. The lesions were resected surgically without complications. The patient received Albendazole preoperatively and after surgery for 3 months. No evidence of recurrence was seen during follow-up. The second case is a 6-year-old girl who presented with an incidental palpable lump in her left thigh during her hospital admission for recurrent meningitis. Ultrasound and MRI imaging were performed demonstrating a unilocular cystic lesion in the left proximal rectus femoris muscle. A provisional diagnosis of hematoma vs. myxoma was given. Biopsy was performed and yielded blood products only. The lesion was resected surgically with a postoperative diagnosis of hydatid cyst. Blood tests performed afterward showed a positive titer for Echinococcus. The patient received Albendazole for 3 months. No evidence of recurrence was seen during follow-up. Conclusions Despite its rarity; skeletal muscle hydatid cyst should always be considered in the differential diagnosis of cystic muscle lesions in children in endemic areas even if imaging studies did not show any of the typical signs. This will improve patient outcome by preventing unnecessary cystic puncture which might lead to serious complications, such as anaphylaxis and local dissemination.

scholarly journals Renal adenocarcinoma associated with hypertrophic osteopathy in a cat

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692096243
Author(s):  
Sarah Elhamiani Khatat ◽  
Rosario Vallefuoco ◽  
Meryem El Mrini ◽  
Morgane Canonne-Guibert ◽  
Dan Rosenberg
Keyword(s):  
Abdominal Mass ◽  
New Bone Formation ◽  
Abdominal Ultrasonography ◽  
Radiographic Findings ◽  
Renal Adenocarcinoma ◽  
First Case ◽  
Primary Neoplasm ◽  
The Right ◽  
Radiographic Changes

Case summary A 10-year-old neutered male domestic shorthair cat was diagnosed with renal adenocarcinoma associated with hypertrophic osteopathy. The cat was referred for chronic ambulation difficulties. The physical examination showed a painful thickening of all four limbs, a right cranial abdominal mass and a conjunctival hyperaemia. Radiographic findings were consistent with extensive periosteal new bone formation involving not only the diaphyses of the fore- and hindlimbs, but also of the pelvis, tarsus and carpus. Abdominal ultrasonography and CT revealed a mass within the right kidney and a primary neoplasm was suspected. A ureteronephrectomy of the right kidney was performed and histopathology confirmed the diagnosis of renal adenocarcinoma. Although clinical improvement of the lameness occurred after surgery, no radiographic changes of hypertrophic osteopathy lesions were observed at the 9-month follow-up. Relevance and novel information Feline cases of hypertrophic osteopathy are rarely reported in the literature and only a few of them were associated with abdominal neoplastic diseases. To our knowledge, this is the first case of renal adenocarcinoma associated with hypertrophic osteopathy in a cat.

scholarly journals Periocular Cutaneous Mucormycosis Caused by Saksenaea erythrospora

2017 ◽  
Vol 14 (04) ◽  
pp. 209-212
Author(s):  
Bunyada Putthirangsiwong ◽  
Pornchai Mahaisavariya ◽  
Weerawan Chokthaweesak ◽  
Dinesh Selva
Keyword(s):  
Complete Recovery ◽  
Molecular Techniques ◽  
First Case ◽  
Chronic Dacryocystitis ◽  
Oral Itraconazole ◽  
Periocular Region ◽  
Cutaneous Mucormycosis ◽  
The Right

Abstract Saksenaea erythrospora is a rare pathogen in humans. Ten adult cases have been previously reported, eight manifested with cutaneous infection, and two presented with invasive rhinosinusitis infection. The authors present a 16-month-old boy with progressive painful mass at the right medial canthus and upper cheek that was unresponsive to broad-spectrum antibiotics. He underwent an anterior orbitotomy and biopsy. Histopathology revealed broad nonseptate sterile hyphae and grew S. erythrospora, which was confirmed by molecular techniques. The patient was treated with intravenous liposomal amphotericin B and oral itraconazole combined with aggressive surgical debridement. The patient made a complete recovery without long-term complications at 4 months of follow-up. Primary cutaneous mucormycosis caused by S. erythrospora may rarely involve the periocular region and mimic chronic dacryocystitis. We report the first case of pediatric periocular cutaneous mucormycosis caused by S. erythrospora.

scholarly journals Accelerated corneal endothelial cell loss in two patients with granulomatosis with polyangiitis following phacoemulsification

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Hung-Ta Chen ◽  
Kuan-Jen Chen ◽  
Yi-Jen Hsueh ◽  
Yaa-Jyuhn James Meir ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Cataract Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Corneal Edema ◽  
Cell Loss ◽  
Multiple Organs ◽  
First Case ◽  
Before And After ◽  
The Right

Abstract Background Generally, the loss rate of human endothelial cells (HCEC) in routine cataract surgery is 8.5%. When the corneal endothelial cells density (ECD) drops, the HCEC may decompensate to keep cornea dehydration which leads to corneal edema. Granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disease involving multiple organs including eyes such as conjunctivitis, scleritis, uveitis, and corneal ulcer. In this study, we report two cases of GPA whose corneal ECD decreased significantly after phacoemulsification cataract surgery. Case presentation In the first case of 69-year-old male with GPA, the ECD dropped 39.6% (OD) four months after phacoemulsification and 38.1% (OS) six months postoperatively respectively. At the final follow-up, the residual ECD was only 55% in the right eye in the 49th month, and 56% remained in the left eye in the 39th month. In the second case of 54-year old female, left ECD dropped 63.9% at the 4th month after surgery and 69.6% ECD remained at the 15th month postoperatively while similar ECD of right eye before and after left eye surgery. Conclusion Extensive preoperative ophthalmic evaluation and meticulous postoperative inflammation control should be applied to prevent severe loss of HCEC in GPA patients.

scholarly journals Mandibular Tori Limiting Treatment of Carcinoma of the Upper Aerodigestive Tract

2019 ◽  
Vol 12 ◽  
pp. 117954761985659
Author(s):  
Christopher M Low ◽  
Daniel L Price ◽  
Jan L Kasperbauer
Keyword(s):  
Anterior Commissure ◽  
Aerodigestive Tract ◽  
Surgical Removal ◽  
Robotic Assistance ◽  
Direct Visualization ◽  
Upper Aerodigestive Tract ◽  
First Case ◽  
Mandibular Tori ◽  
The Right

Background: Mandibular tori are a rare cause of difficult direct visualization of the upper aerodigestive tract. In the setting of aerodigestive tract pathology necessitating direct visualization, removal of mandibular tori may be required to facilitate treatment. Methods: In the first case, large bilateral symmetric mandibular tori were removed to facilitate access to the anterior commissure and removal of a T1 glottic squamous cell carcinoma (SCC). In the second case, large bilateral mandibular tori were removed to access a markedly exophytic SCC in the right vallecula. Subsequently, the tumor was removed with robotic assistance with excellent exposure. Results: Both patients were free of recurrence at last follow-up. Conclusion: Mandibular tori are an uncommon cause of difficult direct laryngoscopy. In situations that require direct visualization of the anterior commissure or base of tongue for diagnosis and management of lesions, surgical removal of the tori may be required as in the cases presented here.

scholarly journals The first case of gland inclusion in an intrapulmonary lymph node: a mimic of metastasis

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chenglong Wang ◽  
Yijia Cao ◽  
Min Zeng ◽  
Lijuan Wang ◽  
Xiaojing Cao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
The Body ◽  
Case Presentation ◽  
Ectopic Tissue ◽  
First Case ◽  
Primary Lung Adenocarcinoma ◽  
The Right

Abstract Background Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma. Case presentation A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication. Conclusions It is very important to correctly diagnose a lymph node inclusion for proper clinical management.

Two cases of nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation

2013 ◽  
Vol 127 (6) ◽  
pp. 614-618 ◽  
Author(s):  
Y W Kim ◽  
M-J Baek ◽  
K H Jung ◽  
S K Park
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Literature Review ◽  
Sleep Apnoea ◽  
Invasive Technique ◽  
Branchial Cleft Cyst ◽  
First Case ◽  
Branchial Cleft ◽  
The Right

AbstractObjective:We report two extremely rare cases of symptomatic nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation.Methods:Case report and literature review concerning nasopharyngeal branchial cleft cyst and surgical treatment methods.Results:The first case was a two-year-old boy with a 1 × 2 cm, cystic, oropharyngeal mass, who also had severe snoring and sleep apnoea. The second case was a 56-year-old man with right nasal obstruction and a sensation of fullness in the right ear. In both cases, we performed endoscopic marsupialisation using a powered instrument. There was no recurrence in either case over two years of follow up.Conclusion:Powered instrument marsupialisation is a simple, effective and less invasive technique for the treatment of nasopharyngeal branchial cleft cyst.

Adenosine-Induced Cardiac Arrest for Transvenous Embolization of Midbrain Arteriovenous Malformation

2019 ◽  
Vol 18 (6) ◽  
pp. E184-E190 ◽  
Author(s):  
Jaims Lim ◽  
Hussain Shallwani ◽  
Kunal Vakharia ◽  
Adnan H Siddiqui
Keyword(s):  
Arteriovenous Malformation ◽  
Transarterial Embolization ◽  
Posterior Wall ◽  
Sudden Onset ◽  
High Flow ◽  
Neurological Deficits ◽  
Transvenous Embolization ◽  
Blurred Vision ◽  
Systemic Hypotension ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE Few studies describe the use of adenosine-induced cardiac systole for treatment of cerebrovascular pathologies. We describe a midbrain arteriovenous malformation (AVM) treated with transvenous embolization using adenosine-induced asystole to achieve transient systemic hypotension with the purpose of furthering discussion on the technique and operative considerations for adenosine use in endovascular AVM treatments. CLINICAL PRESENTATION A 29-yr-old man presented with sudden onset of severe bilateral headache, blurred vision, and numbness on the right side of his face and tongue. Noncontrast head computed tomography revealed fourth ventricle hemorrhage. Diagnostic cerebral angiography revealed a high-flow midbrain AVM with a posterior wall perforator from the basilar artery terminus and a draining vein into the straight sinus. Transarterial AVM embolization was successful. The patient was discharged with no residual neurological deficits but returned 1 wk later with slurred speech and left-sided dysmetria. Repeat angiography revealed partial AVM filling. Attempts at transarterial embolization were unsuccessful. Thus, transvenous AVM embolization with adenosine-induced cardiac asystole and systemic hypotension was performed. A total of 60 mg of adenosine was administered, followed by 2 additional doses of 60 and 40 mg; and complete cardiac asystole with a mean arterial pressure of 40 mmHg was maintained, resulting in successful embolization of the AVM. No residual filling was visualized on postembolization arterial angiography runs. The patient was neurologically stable and discharged on postoperative day 2. CONCLUSION With appropriate and safe dosing, adenosine-induced asystole and systemic hypotension may be a feasible, safe option to reduce flow and assist endovascular transvenous embolization of high-flow AVMs.

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