scholarly journals Episodic hemilaryngopharyngeal spasm (HELPS) syndrome: case report of a surgically treatable novel neuropathy

2017 ◽  
Vol 126 (5) ◽  
pp. 1653-1656 ◽  
Author(s):  
Christopher R. Honey ◽  
Peter Gooderham ◽  
Murray Morrison ◽  
Zurab Ivanishvili
Keyword(s):  
Case Report ◽  
Botulinum Toxin ◽  
Respiratory Distress ◽  
Posterior Inferior Cerebellar Artery ◽  
Cranial Neuropathy ◽  
Neurovascular Conflict ◽  
Cerebellar Artery ◽  
Life Threatening ◽  
History Of ◽  
Botulinum Toxin Injections

The authors describe a novel cranial neuropathy manifesting with life-threatening episodic hemilaryngopharyngeal spasm (HELPS). A 50-year-old woman presented with a 4-year history of intermittent throat contractions, escalating to life-threatening respiratory distress. Botulinum toxin injections into her right vocal cord reduced the severity of her spasms, but the episodes continued to occur. MRI demonstrated a possible neurovascular conflict involving the cranial nerve IX–X complex and the posterior inferior cerebellar artery. Microvascular decompression of the upper rootlets of the vagal nerve eliminated her HELPS without complication. The authors propose a mechanism of HELPS implicating isolated involvement of the upper motor rootlets of the vagus nerve.

scholarly journals Lateral Medullary Syndrome (Wallenberg's Syndrome) - A Case Report

1970 ◽  
Vol 5 (1) ◽  
pp. 35-36 ◽  
Author(s):  
R Saha ◽  
S Alam ◽  
MA Hossain
Keyword(s):  
Case Report ◽  
Ischaemic Stroke ◽  
Posterior Inferior Cerebellar Artery ◽  
Sudden Onset ◽  
Appropriate Treatment ◽  
Cerebellar Artery ◽  
Lateral Medullary Syndrome ◽  
Great Vessels ◽  
History Of ◽  
The Brain

The Lateral medullary syndrome is not a very common stroke. Sometimes it is under diagnosed. Mr. Ibrahim Mollah, 50 years old male person, non diabetic, non hypertensive but smoker presented with the history of sudden onset of dysphagia, dysarthria and ataxia of the gait. He is clinically and radiologically diagnosed as a case of Lateral medullary syndrome (Ischaemic stroke). With treatment this patient improved significantly. It is commonly caused by occlusion of the cranial segment of the vertebral artery or the posterior inferior cerebellar artery. The occlusion may be due to thrombosis or embolism. The emboli are coming from the heart or the great vessels. We can diagnose Lateral medullary syndrome with expert clinical eye and CT/MRI of the brain. It should be managed with appropriate treatment and physiotherapy. DOI: 10.3329/fmcj.v5i1.6813Faridpur Med. Coll. J. 2010;5(1):35-36

Extended Retrosigmoid Craniotomy and Approach Through the Glossopharyngeal Cochlear Triangle for Clipping of a High-Riding Vertebral-Posterior Inferior Cerebellar Artery Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Geoffrey W Peitz ◽  
Ryan A McDermott ◽  
Jacob F Baranoski ◽  
Michael T Lawton ◽  
Justin R Mascitelli
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Artery Aneurysm ◽  
Cranial Neuropathy ◽  
Aneurysm Neck ◽  
Direct Exposure ◽  
Cerebellar Artery ◽  
Facial Spasm ◽  
History Of

Abstract The far lateral transcondylar (FL) craniotomy is the standard approach for posterior inferior cerebellar artery (PICA) aneurysm exposure through microsurgical dissection in the vagoaccessory triangle (VAT).1,2 However, the extended retrosigmoid (eRS) craniotomy and dissection through the glossopharyngeal-cochlear triangle (GCT) may be more appropriate when the patient has an aneurysm arising from a high-riding vertebral artery (VA)—PICA origin.3-5 We present a case of a 41-yr-old woman with hypertension presenting with left occipital pain and left-side hearing loss and past facial spasm and pain. Computed tomography angiography and digital subtraction angiography demonstrated an unruptured 8.4 × 9.0 × 10.2 mm saccular aneurysm at the left VA-PICA junction. Surgical clipping was chosen over endovascular therapy given the relationship of the PICA origin to the aneurysm neck as well as the history of cranial neuropathy. It was noted that the VA-PICA junction and aneurysm was high-riding at the level of the internal auditory canal. An eRS craniotomy was performed with dissection through the GCT, and the aneurysm was clipped as shown in the accompanying 2-dimensional operative video. Postoperative angiography demonstrated complete occlusion of the aneurysm and patency of the left VA and PICA without stenosis, and the patient had a favorable postoperative course although her left-sided hearing remained diminished. The eRS craniotomy allowed direct exposure via the GCT for clipping of the high-riding VA-PICA junction aneurysm and decompression of the cranial nerves. The traditional FL craniotomy and exposure through the VAT would likely have resulted in a less desirable inferior trajectory. The patient gave informed consent for the operation depicted in the video. Animation at 2:43 in video is used with permission from Barrow Neurological Institute, Phoenix, Arizona.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

scholarly journals Treating a Ruptured Fusiform Aneurysm of the Posterior Inferior Cerebellar Artery (PICA) using PICA-PICA Anastomosis combined with Trapping: A Case Report

2010 ◽  
Vol 19 (5) ◽  
pp. 420-424
Author(s):  
Kenta Aso ◽  
Yoshitaka Kubo ◽  
Shunsuke Kakino ◽  
Hiroshi Kashimura ◽  
Atsushi Sugawara ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Fusiform Aneurysm ◽  
Pica Pica ◽  
Cerebellar Artery

scholarly journals Dissecting Aneurysm of the Posterior Inferior Cerebellar Artery —Case Report—

1993 ◽  
Vol 33 (9) ◽  
pp. 634-637 ◽  
Author(s):  
Shoichiro KAWAGUCHI ◽  
Toshisuke SAKAKI ◽  
Kitaro KAMADA ◽  
Hideaki IWANAGA ◽  
Katsushige TAKEHASHI ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Cerebellar Artery

Arterial Thrombosis and Gangrene Secondary to Arachnidism

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 239-242
Author(s):  
Jan M. Eckermann ◽  
Theodore H. Teruya ◽  
Christian Bianchi ◽  
Ahmed M. Abou-Zamzam
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Vascular Disease ◽  
Tissue Damage ◽  
Arterial Thrombosis ◽  
Progressive Necrosis ◽  
Life Threatening ◽  
History Of ◽  
Spider Bites ◽  
Spider Bite

Spider bites can cause local tissue damage as well as life-threatening complications. This is a case report of a female with no history of lower extremity vascular disease who presented with a spider bite on the dorsum of her foot. She developed progressive necrosis and eventually suffered limb loss despite attempts at revascularization.

Double Origin of the Posterior Inferior Cerebellar Artery: Anatomic Case Report

2019 ◽  
Vol 124 ◽  
pp. 110-115 ◽  
Author(s):  
Ali Tayebi Meybodi ◽  
Leandro Borba Moreira ◽  
Xiaochun Zhao ◽  
Michael T. Lawton ◽  
Mark C. Preul
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Double Origin

scholarly journals Case Report: Bow Hunter's Syndrome Caused by Compression of Extracranially Originated Posterior Inferior Cerebellar Artery

2021 ◽  
Vol 12 ◽  
Author(s):  
Noriya Enomoto ◽  
Kenji Yagi ◽  
Shunji Matsubara ◽  
Masaaki Uno
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Head Rotation ◽  
Radiographic Examination ◽  
Posterior Decompression ◽  
First Case ◽  
Cerebellar Artery ◽  
Cervical Approach ◽  
The Right ◽  
Hunter's Syndrome

Bow hunter's syndrome (BHS) is most commonly caused by compression of the vertebral artery (VA). It has not been known to occur due to an extracranially originated posterior inferior cerebellar artery (PICA), the first case of which we present herein. A 71-year-old man presented with reproducible dizziness on leftward head rotation, indicative of BHS. On radiographic examination, the bilateral VAs merged into the basilar artery, and the left VA was predominant. The right PICA originated extracranially from the right VA at the atlas–axis level and ran vertically into the spinal canal. During the head rotation that induced dizziness, the right PICA was occluded, and a VA stenosis was revealed. Occlusion of the PICA was considered to be the primary cause of the dizziness. The patient underwent surgery to decompress the right PICA and VA via a posterior cervical approach. Following surgery, the patient's dizziness disappeared, and the stenotic change at the right VA and PICA improved. The PICA could be a causative artery for BHS when it originates extracranially at the atlas–axis level, and posterior decompression is an effective way to treat it.

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