scholarly journals Pretemporal transcavernous transtentorial approach for right pontine cavernous malformation

2019 ◽  
Vol 1 (1) ◽  
pp. V5 ◽  
Author(s):  
Xavier T. J. Hsu ◽  
Chih-Hsiang Liao ◽  
Chun-Fu Lin ◽  
Sanford P. C. Hsu
Keyword(s):  
Mental Status ◽  
Cavernous Malformation ◽  
Vascular Lesion ◽  
Slow Flow ◽  
Total Removal ◽  
Posterior Clinoid Process ◽  
Acute Changes ◽  
The Right ◽  
Surgical Corridor ◽  
Transtentorial Approach

A 57-year-old man presented with acute changes in mental status. Brain CT showed a high-density lesion at the pons. Brain MRA revealed a very slow-flow vascular lesion at the right aspect of the pons, about 3.9 ⋅ 3.0 ⋅ 3.0 cm3, compatible with a pontine cavernous malformation (CM). Gross-total removal was achieved. In this approach, a wider surgical corridor was obtained by opening the Meckel’s cave and cutting the tentorium. For a midline attack point on the pons, additional removal of the posterior clinoid process can meet the goal. In the authors’ opinion, this approach is safe and effective in selected ventrolateral pontine CMs.The video can be found here: https://youtu.be/moHqEkp5eCA.

scholarly journals Posterior interhemispheric transtentorial approach for resection of a meningioma at the posteromedial tentorial incisura

2016 ◽  
Vol 40 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Sun Liyong ◽  
Yuhai Bao ◽  
Jiantao Liang ◽  
Mingchu Li ◽  
Jian Ren
Keyword(s):  
Third Ventricle ◽  
Symptomatic Improvement ◽  
Pineal Region ◽  
Increased Intracranial Pressure ◽  
Total Removal ◽  
Adjacent Structures ◽  
Patient Reported ◽  
Surgical Corridor ◽  
Tentorial Incisura ◽  
Transtentorial Approach

The posterior interhemispheric approach is a versatile approach to access lesions of the pineal region, posterior incisural space, posterior region of third ventricle, and adjacent structures. We demonstrate the case of a 26-year-old woman with symptoms of increased intracranial pressure and hydrocephalus caused by a meningioma at the posteromedial tentorial incisura. Gross-total removal of the tumor was successfully achieved via a posterior interhemispheric transtentorial approach. The patient reported an immediate and significant symptomatic improvement after surgery. The detailed operative technique and surgical nuances, including the surgical corridor, tentorium incision, tumor dissection and removal are illustrated in this video atlas.The video can be found here: https://youtu.be/nSNyjQKl7aE.

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V19
Author(s):  
Hussam Abou-Al-Shaar ◽  
Timothy G. White ◽  
Ivo Peto ◽  
Amir R. Dehdashti
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Entry Zone ◽  
Third Nerve Palsy ◽  
History Of ◽  
Tectal Plate ◽  
The Right ◽  
Transtentorial Approach ◽  
Third Nerve

A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.The video can be found here: https://youtu.be/ofj8zFWNUGU.

Blow/trauma to the chest and sudden cardiac death: Commotio cordis and contusio cordis are leading causes

2018 ◽  
Vol 58 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Lydia Krexi ◽  
Mary N Sheppard
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Traffic Accidents ◽  
Left Ventricular ◽  
Young Males ◽  
Contusio Cordis ◽  
Commotio Cordis ◽  
Forensic Practice ◽  
Acute Changes ◽  
The Right

Background In forensic practice, a blow to the chest can lead to sudden cardiac death (SCD). Commotio cordis and contusio cordis are leading causes. Methods From a database of 4678 patients who suffered from SCD, we found three patients with commotio cordis and two patients with contusio cordis. All the patients were examined macroscopically and microscopically and had negative toxicology screen. Results The three patients who died due to commotio cordis were young males (16, 23 and 38 years old). The circumstances of death were: a blow to the chest by a football, by a friend during a party and during an assault. The hearts were completely normal at autopsy. The two patients who had contusio cordis were older males (42 and 63 years old). Both patients died during traffic accidents. At autopsy, one had significant contusion over the left ventricle, and the second had contusion over the right ventricle. Conclusion This study indicates that a blow to the chest is very important to document in the circumstances of death, and a detailed history is vital. It raises the left ventricular intra-cavitary pressure, leading to commotio cordis with immediate death with a normal heart. Blunt chest trauma can cause direct myocardial lesions, with acute changes leading to contusio cordis.

scholarly journals Spontaneous resolution of a tentorial dural arteriovenous fistula fed by the artery of Wollschlaeger and Wollschlaeger after embolization of the main shunting point

2021 ◽  
Vol 12 ◽  
pp. 413
Author(s):  
Ryota Ishibashi ◽  
Yoshinori Maki ◽  
Hiroyuki Ikeda ◽  
Masaki Chin
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Vascular Lesion ◽  
Endovascular Embolization ◽  
Vascular Events ◽  
Residual Shunt ◽  
Inferior Surface ◽  
Type Iii ◽  
Meningeal Arteries ◽  
The Right

Background: Tentorial dural arteriovenous fistula (TDAVF) is a rare intracranial vascular shunt. A TDAVF can be supplied by the Artery of Wollschlaeger and Wollschlaeger (AWW). However, a limited number of cases of TDAVF fed by the AWW have been reported to date. Case Description: A 70-year-old woman complaining of the right motor weakness underwent magnetic resonance imaging. A vascular lesion beneath the cerebellar tentorium was incidentally found with chronic infarction of the left corona radiata. Angiographically, the vascular lesion was a TDAVF supplied by the bilateral posterior meningeal arteries. No other apparent feeders were detected. The TDAVF had a shunting point on the inferior surface of the cerebellar tentorium with venous retrograde flow (Borden type III, Cognard type III). To prevent vascular events, endovascular embolization was performed using n-butyl-2-cyanoacrylate. Following embolization of the shunting point, a residual shunt fed by the AWW was identified. The shunt supplied by the AWW was not observed preoperatively. Follow-up angiography performed 1 week later revealed spontaneous disappearance of the residual shunt. The patient was followed-up in our outpatient clinic, and no recurrence of the TDAVF was confirmed postoperatively. Conclusion: Detection of mild feeding from the AWW to a TDAVF can be elusive preoperatively. Following embolization of the main shunting point, residual shunting from the AWW can resolve spontaneously.

Contralateral supracerebellar-transtentorial approach for posterior medio-basal temporal cavernous malformation resection

2021 ◽  
Author(s):  
Fabio A. Frisoli ◽  
Jacob F. Baranoski ◽  
Joshua S. Catapano ◽  
Michael J. Lang ◽  
Michael T. Lawton
Keyword(s):  
Cavernous Malformation ◽  
Transtentorial Approach

Suboccipital transtentorial approach to remove a cerebellar cavernous malformation adjacent to cerebellomesencephalic fissure

2020 ◽  
Vol 162 (7) ◽  
pp. 1767-1770
Author(s):  
Peng Hu ◽  
Hong-Qi Zhang
Keyword(s):  
Cavernous Malformation ◽  
Transtentorial Approach

Altered Mental Status in the Emergency Department

2019 ◽  
Vol 39 (01) ◽  
pp. 005-019 ◽  
Author(s):  
Austin Smith ◽  
Jin Han
Keyword(s):  
Emergency Department ◽  
Mental Status ◽  
Altered Mental Status ◽  
Detailed History ◽  
Radiographic Testing ◽  
Life Threatening ◽  
Secondary Survey ◽  
Acute Changes ◽  
Department Evaluation ◽  
The Brain

AbstractAltered mental status is an umbrella term that covers a broad spectrum of disease processes that vary greatly in chronicity and severity. Causes can be a primary neurologic insult or a result of a systemic illness resulting in end-organ dysfunction of the brain. Acute changes in mental status are more likely than chronic changes to be immediately life-threatening and are therefore the focus of this review. Given the potential time-sensitive nature, acute changes in mental status must be addressed immediately and with urgency. We recommend a primary survey followed by a secondary survey with special attention to immediate life-threatening reversible causes. We then recommend a systems-based approach searching for any other life-threatening or reversible causes. Because the differential for altered mental status is broad, a comprehensive emergency department evaluation including a detailed history and physical exam as well as laboratory and radiographic testing is needed.

Effect of caval occlusion on the magnitude of unipolar atrial electrograms in dogs

1983 ◽  
Vol 245 (4) ◽  
pp. H580-H583
Author(s):  
R. A. Bedont ◽  
J. A. Abildskov ◽  
R. L. Lux ◽  
L. S. Green
Keyword(s):  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
P Wave ◽  
Radial Excitation ◽  
Heart Volume ◽  
Atrial Electrograms ◽  
Acute Changes ◽  
The Right ◽  
Brody Effect

Studies were done on eight mongrel dogs anesthetized with pentobarbital sodium to assess the effects of acute changes in heart volume on the magnitude of electrocardiographic potentials recorded from the right atrium. Following midsternotomy, acute changes in heart volume were produced by occlusion of the superior vena cava (SVC), inferior vena cava (IVC), or both vena cavae while heart rate was controlled by pacing the right atrium. P-wave area, defined by integrating absolute value of the P wave over time, increased by 8.2 +/- 7.4% during SVC occlusion, 13.3 +/- 8.5% during IVC occlusion, and 23.6 +/- 16.2% during occlusion of both vena cavae. Areas of ventricular complexes appearing in atrial electrograms decreased by 6.6 +/- 6.2% during SVC occlusion, 11.1 +/- 6.7% during IVC occlusion, and 15.2 +/- 9.2% during occlusion of both vena cavae. These results are compatible with predominately tangential activation of the atrium and radial excitation of the ventricle and provide experimental confirmation of the "Brody effect."

A Conjunctival Vascular Malformation as a Rare Presenting Sign of Wyburn–Mason Syndrome

2017 ◽  
Vol 16 (04) ◽  
pp. 239-242
Author(s):  
Gunnar Buyse ◽  
Lieven Lagae ◽  
Philippe Demaerel ◽  
Frank Kesteloot ◽  
Ingele Casteels ◽  
...  
Keyword(s):  
Vascular Malformation ◽  
Arteriovenous Malformations ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Vascular Lesion ◽  
Facial Skin ◽  
Sudden Appearance ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
The Brain

AbstractWyburn–Mason syndrome is a rare condition that is characterized by ipsilateral arteriovenous malformations affecting the eye, brain, and facial skin. A conjunctival vascular dilation can be a rare ocular presenting sign. We report a 6-year-old boy who attended the hospital because of the sudden appearance of a conjunctival vascular lesion in his right eye. Inspection of his facial skin showed a subtle discoloration along the right trigeminal nerve and a vascular structure of the conjunctiva. Fundoscopy showed dilated and tortuous retinal vessels. Brain magnetic resonance imaging (MRI) revealed a large arteriovenous malformation involving the thalamus and perimesencephalic area. Ophthalmologic and neuroradiologic findings were consistent with the diagnosis of Wyburn–Mason syndrome. The sudden emergence of a vascular malformation in the conjunctiva should alert the clinician to perform an ophthalmoscopy, and in our patient, this finding was the clue to diagnosis of Wyburn–Mason syndrome. Because of the association between retinal and intracranial arteriovenous malformations, an MRI of the brain is strongly recommended in all patients with ocular arteriovenous malformations.

Possible significance of juvenile oral venous angioma as marker of intracerebral vascular lesion

1983 ◽  
Vol 59 (2) ◽  
pp. 348-350 ◽  
Author(s):  
Henryk Majchrzak ◽  
Tadeusz Wencel ◽  
Grazyna Bierzyńska-Macyszyn ◽  
Janina Bielska
Keyword(s):  
Early Life ◽  
Parietal Lobe ◽  
Vascular Lesion ◽  
Venous Angioma ◽  
Lower Lip ◽  
Content Type ◽  
Arteriovenous Angioma ◽  
Cerebral Angioma ◽  
The Right ◽  
Fine Print

✓ This 10-year-old child suffered a hemorrhage into the right parietal lobe, the result of a ruptured arteriovenous angioma. From birth, the boy had a venous angioma of the mucous membrane of the cheek, lower lip, and hypoglossal area on the right side. The coexistence of these two vascular defects is most unusual, and venous angioma in early life may suggest the presence of cerebral angioma.

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