scholarly journals Decompression surgery for pure arterial malformations in a 15 year old with acute, progressive visual impairment: illustrative case

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Katsuma Iwaki ◽  
Koichi Arimura ◽  
Ataru Nishimura ◽  
Koji Iihara
Keyword(s):  
Surgical Treatment ◽  
Visual Field ◽  
Incidental Findings ◽  
Optic Tract ◽  
Decompression Surgery ◽  
Illustrative Case ◽  
Main Body ◽  
Microsurgical Clipping ◽  
First Case ◽  
Visual Field Impairment

BACKGROUNDThe authors document the first case of pure arterial malformations (PAMs) of the posterior communicating artery (PCoA), which were successfully treated with microsurgical clipping of the main body of the PAMs. PAMs are defined as dilated, overlapping, and tortuous arteries with a coil-like appearance and/or a mass of arterial loops without any associated venous component. Although PAMs usually have a benign history and are often incidental findings, this case presented with acute progression of visual field impairment.OBSERVATIONSBecause the patient’s right optic tract was affected by the loop of PAMs of the PCoA, the authors performed microsurgical clipping of the main body of the PAMs using endoscopy, which ceased the progression of symptoms without any complications.LESSONSThere have been several reports of PAMs receiving surgical treatment for accompanying lesions. However, in this case, the lesion to the main body of PAMs was the cause of visual field impairment and was successfully treated with microsurgical clipping.

scholarly journals Efficacy of Suboccipital Release and Stabilization Exercise Training in Type 1 Chiari Malformation Patient Undergoing Surgical Treatment: A Case Report

2021 ◽  
Vol 5 (1) ◽  
pp. 30-33
Author(s):  
Yasemin Özel Aslıyüce ◽  
◽  
Özlem Ülger ◽  
Keyword(s):  
Surgical Treatment ◽  
Exercise Training ◽  
Chiari Malformation ◽  
Pain Perception ◽  
Pinch Strength ◽  
Decompression Surgery ◽  
Stabilization Exercise ◽  
First Case ◽  
Gait Parameters

In Chiari malformation, some symptoms are known to recur after decompression surgery. To our knowledge, this is the first case for symptomatic outcome after suboccipital release and stabilization exercises the patient with type 1 Chiari malformation who has experienced surgery. The present study aims to investigate the efficacy of suboccipital release and stabilization exercise training in a patient with Type 1 Chiari Malformation undergoing surgical treatment. A 47- year-old female patient with Chiari malformation received suboccipital release and stabilization exercise training for 10 weeks. Her symptomatic parameters were evaluated, such as pain, grip and pinch strength, deep cervical flexor strength, balance and gait. After the treatment, there were improvements in pain perception, the score of performance index of deep cervical muscles, grip force, static balance and gait parameters. Suboccipital oscillation and stabilization exercises are thought to be safe and effective in patients with Chiari malformation undergoing decompression surgery

A role for the corpus callosum in visual area V4 of the macaque

1993 ◽  
Vol 10 (1) ◽  
pp. 159-171 ◽  
Author(s):  
Robert Desimone ◽  
Jeffrey Moran ◽  
Stanley J. Schein ◽  
Mortimer Mishkin
Keyword(s):  
Visual Field ◽  
Corpus Callosum ◽  
Anterior Commissure ◽  
Color Constancy ◽  
Receptive Fields ◽  
Optic Tract ◽  
Complete Suppression ◽  
Central Visual Field ◽  
Field Representation ◽  
Area V4

AbstractThe classically defined receptive fields of V4 cells are confined almost entirely to the contralateral visual field. However, these receptive fields are often surrounded by large, silent suppressive regions, and stimulating the surrounds can cause a complete suppression of response to a simultaneously presented stimulus within the receptive field. We investigated whether the suppressive surrounds might extend across the midline into the ipsilateral visual field and, if so, whether the surrounds were dependent on the corpus callosum, which has a widespread distribution in V4. We found that the surrounds of more than half of the cells tested in the central visual field representation of V4 crossed into the ipsilateral visual field, with some extending up to at least 16 deg from the vertical meridian. Much of this suppression from the ipsilateral field was mediated by the corpus callosum, as section of the callosum dramatically reduced both the strength and extent of the surrounds. There remained, however, some residual suppression that was not further reduced by addition of an anterior commissure lesion. Because the residual ipsilateral suppression was similar in magnitude and extent to that found following section of the optic tract contralateral to the V4 recording, we concluded that it was retinal in origin. Using the same techniques employed in V4, we also mapped the ipsilateral extent of surrounds in the foveal representation of VI in an intact monkey. Results were very similar to those in V4 following commissural or contralateral tract sections. The findings suggest that V4 is a central site for long-range interactions both within and across the two visual hemifields. Taken with previous work, the results are consistent with the notion that the large suppressive surrounds of V4 neurons contribute to the neural mechanisms of color constancy and figure-ground separation.

Arteriovenous malformations in the optic apparatus: systematic literature review and report of four cases

2021 ◽  
pp. 1-11
Author(s):  
Visish M. Srinivasan ◽  
Phiroz E. Tarapore ◽  
Stefan W. Koester ◽  
Joshua S. Catapano ◽  
Caleb Rutledge ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Visual Function ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Visual Fields ◽  
Optic Tract ◽  
Visual Disturbance ◽  
Visual Field Defects ◽  
Subtotal Resection

OBJECTIVE Rare arteriovenous malformations (AVMs) of the optic apparatus account for < 1% of all AVMs. The authors conducted a systematic review of the literature for cases of optic apparatus AVMs and present 4 cases from their institution. The literature is summarized to describe preoperative characteristics, surgical technique, and treatment outcomes for these lesions. METHODS A comprehensive search of the English-language literature was performed in accordance with established Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all published cases of AVM in the optic apparatus in the PubMed, Web of Science, and Cochrane databases. The authors also searched their prospective institutional database of vascular malformations for such cases. Data regarding the clinical and radiological presentation, visual acuity, visual fields, extent of resection, and postoperative outcomes were gathered. RESULTS Nine patients in the literature and 4 patients in the authors’ single-surgeon series who fit the inclusion criteria were identified. The median age at presentation was 29 years (range 8–39 years). Among these patients, 11 presented with visual disturbance, 9 with headache, and 1 with multiple prior subarachnoid hemorrhages; the AVM in 1 case was found incidentally. Four patients described prior symptoms of headache or visual disturbance consistent with sentinel events. Visual acuity was decreased from baseline in 10 patients, and 11 patients had visual field defects on formal visual field testing. The most common visual field defect was temporal hemianopia, found in one or both eyes in 7 patients. The optic chiasm was affected in 10 patients, the hypothalamus in 2 patients, the optic nerve (unilaterally) in 8 patients, and the optic tract in 2 patients. Six patients underwent gross-total resection; 6 patients underwent subtotal resection; and 1 patient underwent craniotomy, but no resection was attempted. Postoperatively, 9 of the patients had improved visual function, 1 had no change, and 3 had worse visual acuity. Eight patients demonstrated improved visual fields, 1 had no change, and 4 had narrowed fields. CONCLUSIONS AVMs of the optic apparatus are rare lesions. Although they reside in a highly eloquent region, surgical outcomes are generally good; the majority of patients will see improvement in their visual function postoperatively. Microsurgical technique is critical to the successful removal of these lesions, and preservation of function sometimes requires subtotal resection of the lesion.

scholarly journals Complete resolution of a giant multilocular prostatic cystadenoma following androgen deprivation therapy: an illustrative case report

2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Nikita Sushentsev ◽  
Yvonne Rimmer ◽  
Tristan Barrett
Keyword(s):  
Androgen Deprivation Therapy ◽  
Complete Resolution ◽  
External Beam Radiotherapy ◽  
Pelvic Mass ◽  
Androgen Deprivation ◽  
Illustrative Case ◽  
Imaging Features ◽  
First Case ◽  
Complete Surgical Resection ◽  
Risk Prostate Cancer

ABSTRACT Giant multilocular prostatic cystadenoma (GMPC) is a rare benign pelvic mass for which complete surgical resection is an accepted treatment of choice. This report presents the first case of complete resolution of GMPC following a 3-year course of luteinising hormone-releasing hormone agonist alongside external beam radiotherapy for the concurrent treatment of unfavorable intermediate-risk prostate cancer. In addition to illustrating the imaging features of the effect of androgen deprivation therapy (ADT) and radiotherapy on GMPC regression, this case provides evidence for considering ADT as an alternative, noninvasive GMPC treatment option in patients in whom surgical treatment is either contraindicated or can be made less invasive by reducing the size of GMPC prior to its removal.

Laparoscopic surgical approach for the treatment of piriformis syndrome: Intrapelvic decompression technique

2021 ◽  
pp. 228402652110456
Author(s):  
Ahmet Kale ◽  
Gülfem Başol ◽  
Elif Cansu Gündoğdu ◽  
Emre Mat ◽  
Gazi Yıldız ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Decompression Surgery ◽  
Piriformis Syndrome ◽  
First Case ◽  
Cutaneous Allodynia ◽  
Pelvic Nerves ◽  
Uncommon Disease ◽  
History Of ◽  
Vas Scores ◽  
The Right

Introduction: Piriformis syndrome is an uncommon disease resulting from the piriformis muscle’s compression of the sciatic nerve. Pain and numbness in the buttocks and down the leg are the most common symptoms. This study analyzes the laparoscopic surgical treatment of piriformis syndrome. Methods: We report three cases of piriformis syndrome diagnosed in our hospital. The first case was a 40 years old woman with a 7-year history of intermittent low back pain and sciatica on her right side. Hyperesthesia and cutaneous allodynia were observed in the right sciatic nerve dermatome. The second case was a 30 years old woman with a 2-year history of sciatica on her left side. The third case was a 30 years old woman with a 2-year history of sciatica on her right side. All the patients underwent laparoscopic decompression surgery, which was performed to release the sciatic nerve or sacral nerve roots. Results: The patients were reexamined at the postoperative 3rd and 6th months. Their visual analog scale (VAS) scores were found to be decreased from 10/10, 9/10, and 7/10 to 0/10, 1/10, and 0/10, respectively. Conclusion: Due to the very few cases in the literature, pelvic piriformis syndrome is an exclusively clinical diagnosis. If the sciatica is refractory to conservative treatments, laparoscopic exploration and decompression surgery of the pelvic nerves and piriformis muscle could be an option.

scholarly journals A case report and review of the literature of Bouveret syndrome

2020 ◽  
Vol 102 (1) ◽  
pp. e15-e19 ◽  
Author(s):  
G Singh ◽  
N Merali ◽  
S Shirol ◽  
P Drymousis ◽  
S Singh ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Rare Variant ◽  
Gastric Outlet Obstruction ◽  
Gallstone Ileus ◽  
Outlet Obstruction ◽  
Review Of The Literature ◽  
First Case ◽  
Bouveret Syndrome

Bouveret syndrome is a rare variant of gallstone ileus causing gastric outlet obstruction. It results from the formation of either a cholecystoduodenal or a cholecystogastric fistula and subsequent migration of gallstone into the duodenum or pylorus of stomach, causing obstruction. The first case was reported by Leon Bouveret in 1896. We report a case illustrating the rarity and severity of this condition, together with a review of the literature of the different methods of endoscopic and surgical treatment.

scholarly journals Clipping of a basilar tip aneurysm using hypothermia and circulatory arrest: a case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Ntenis Nerntengian ◽  
Grigorios Gkasdaris ◽  
Theodosios Birbilis
Keyword(s):  
Circulatory Arrest ◽  
Neurological Deficits ◽  
Safe Alternative ◽  
Complex Aneurysms ◽  
Microsurgical Clipping ◽  
First Case ◽  
Heart Lung Machine ◽  
Microsurgical Techniques ◽  
Basilar Tip Aneurysm ◽  
Lung Machine

Abstract Treatment of complex and giant aneurysms remains challenging despite modern endovascular and microsurgical techniques. We report the first case of microsurgical clipping of a complex basilar tip aneurysm under circulatory arrest and hypothermia performed in Greece. A 52-year-old patient presented with a Hunt and Hess Grade 4 subarachnoid hemorrhage. The digital subtraction angiography revealed a complex basilar tip aneurysm. Due to aneurysm complexity, we decided for microsurgical clipping under hypothermia and circulatory arrest. We performed a right pterional craniotomy with orbitozygomatic osteotomy. The patient was then put on heart–lung-machine. Following hypothermia and circulatory arrest, the aneurysm was clipped with its complete occlusion. The patient was discharged with no neurological deficits. Clipping of complex aneurysms under hypothermia and cardiac arrest performed by experienced team is a safe alternative when endovascular therapy or bypass technique is not feasible.

Central visual field impairment during and following cystoid macular oedema

2007 ◽  
Vol 92 (1) ◽  
pp. 84-88 ◽  
Author(s):  
C G Kiss ◽  
T Barisani-Asenbauer ◽  
C Simader ◽  
S Maca ◽  
U Schmidt-Erfurth
Keyword(s):  
Visual Field ◽  
Macular Oedema ◽  
Cystoid Macular Oedema ◽  
Central Visual Field ◽  
Visual Field Impairment

scholarly journals A rare anomalous origin of right vertebral artery with double branch: First case report

2017 ◽  
Vol 24 (2) ◽  
pp. 225-228 ◽  
Author(s):  
Ya-dong Liu ◽  
Zhi-qiang Li ◽  
Jing-jing Fu ◽  
Ya-jun E
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Vertebral Artery ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Incidental Findings ◽  
Aberrant Right Subclavian Artery ◽  
First Case ◽  
The Right ◽  
Double Origin

Vertebral artery origin anomalies are typically incidental findings during angiography. We present an extremely rare variant in which the right vertebral artery has a double origin from the right subclavian artery and right common carotid artery in association with an aberrant right subclavian artery, which has never been reported before.

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