Detachable balloon and calibrated-leak balloon techniques in the treatment of cerebral vascular lesions

1978 ◽  
Vol 49 (5) ◽  
pp. 635-649 ◽  
Author(s):  
Gérard Debrun ◽  
Pierre Lacour ◽  
Jean-Pierre Caron ◽  
Michel Hurth ◽  
Jean Comoy ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Vascular Lesions ◽  
Detachable Balloon ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Third Nerve ◽  
Fine Print ◽  
Cerebral Vascular

✓ Of the cerebral vascular lesions that can be treated with intravascular detachable balloon techniques, carotid-cavernous sinus fistulas and vertebro-vertebral fistulas have the best results. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The authors report 17 posttraumatic carotid-cavernous sinus fistulas successfully treated with preservation of the carotid blood flow in 12 cases. None of the patients died, and the morbidity was limited to one case of third nerve palsy. The treatment of aneurysms by this method is, however, much more difficult and dangerous. Of 14 cases treated, seven good results were obtained. Two patients died and two had a poor outcome. The embolization of certain brain angiomas with calibrated-leak balloons using bucrylate promises to be important in the future.

Aneurysm-induced third nerve palsy

1972 ◽  
Vol 36 (5) ◽  
pp. 548-551 ◽  
Author(s):  
Iftikhar A. Raja
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Functional Recovery ◽  
Poor Prognosis ◽  
Nerve Palsy ◽  
Nerve Function ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Carotid Ligation ◽  
Third Nerve ◽  
Fine Print

✓ Forty-two patients with aneurysm-induced third nerve palsy are described. After carotid ligation, 58% showed satisfactory and 42% unsatisfactory functional recovery. In some patients the deficit continued to increase even after carotid ligation. Early ligation provided a better chance of recovery of third nerve function. Patients in whom third nerve palsy began after subarachnoid hemorrhage had a poor prognosis. No relationship was noted between the size of the aneurysm and the recovery of third nerve function.

Symptoms of pituitary apoplexy rapidly reversed with bromocriptine

1996 ◽  
Vol 85 (6) ◽  
pp. 1153-1155 ◽  
Author(s):  
Michael H. Brisman ◽  
Gillian Katz ◽  
Kalmon D. Post
Keyword(s):  
Emergency Surgery ◽  
Visual Function ◽  
Prolactin Level ◽  
Nerve Palsy ◽  
Pituitary Apoplexy ◽  
Rapid Progression ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Third Nerve ◽  
Fine Print

✓ Macroprolactinomas rarely present with apoplexy. The authors describe a patient with a macroprolactinoma who presented with apoplexy and rapid progression of a third nerve palsy. The patient was managed expectantly with bromocriptine, and within 48 hours, the patient's third nerve palsy had completely resolved. The authors suggest that all patients who present with pituitary apoplexy in the presence of a pituitary tumor receive an immediate course of bromocriptine and steroid therapy until the prolactin level can be determined. Emergency surgery is indicated if visual function is abnormal and the tumor is not a prolactinoma.

Computerized tomography angiography in isolated third nerve palsies

1998 ◽  
Vol 88 (4) ◽  
pp. 679-684 ◽  
Author(s):  
Robert M. McFadzean ◽  
Evelyn M. Teasdale
Keyword(s):  
Cerebral Aneurysm ◽  
Ct Angiography ◽  
Computerized Tomography ◽  
Cerebral Angiography ◽  
Diagnostic Tool ◽  
Nerve Palsy ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Third Nerve ◽  
Fine Print

Object. The goal of this study was to assess the value of computerized tomography (CT) angiography as a diagnostic tool in isolated oculomotor nerve palsies. Methods. One hundred consecutive patients who presented with an isolated third nerve palsy were examined by CT angiography. This procedure was followed by conventional cerebral angiography in most patients in whom a vascular abnormality was noted on the CT angiography. Thus, all patients whose symptoms were caused by a compressive aneurysm were identified. The remaining patients were observed clinically to exclude the possibility that a missed cerebral aneurysm caused the isolated third nerve palsy. Eighteen patients harbored a cerebral aneurysm responsible for causing the isolated third nerve palsy. Most of the remaining patients experienced some degree of spontaneous recovery. There was no clinical evidence to indicate that a case of compressive cerebral aneurysm causing the isolated third nerve palsy had been missed on CT angiography. Conclusions. Computerized tomography angiography is a reliable diagnostic tool for use in the assessment of patients with an isolated third nerve palsy; it can identify the minority of patients in whom conventional cerebral angiography may be required.

Aberrant regeneration in idiopathic oculomotor nerve palsy

1980 ◽  
Vol 52 (6) ◽  
pp. 854-856 ◽  
Author(s):  
Jose F. Laguna ◽  
Michael S. Smith
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Aberrant Regeneration ◽  
Oculomotor Function ◽  
Third Nerve ◽  
Fine Print

✓ Aberrant regeneration of the oculomotor nerve usually follows injury to the nerve by posterior communicating artery aneurysms or trauma. A case of idiopathic third nerve palsy with pupillary involvement occurred in an otherwise healthy 38-year-old man. Follow-up examination 32 months later showed evidence of oculomotor function with aberrant regeneration.

Direct embolectomy of the basilar artery bifurcation

1992 ◽  
Vol 77 (3) ◽  
pp. 463-465 ◽  
Author(s):  
Michael K. Morgan ◽  
Michael T. Biggs
Keyword(s):  
Basilar Artery ◽  
Surgical Approach ◽  
Nerve Palsy ◽  
Therapeutic Embolization ◽  
Good Recovery ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Neurologically Normal ◽  
Third Nerve ◽  
Fine Print

✓ The case is presented of a 27-year-old man who developed a basilar artery bifurcation embolus encompassing Hilal microcoil as a complication following therapeutic embolization. An immediate direct surgical approach to the basilar artery bifurcation enabled the microcoil and associated thrombus to be removed and flow to be restored in the basilar artery and its distal branches. Postoperatively, the patient made a good recovery and on discharge was neurologically normal with the exception of a right third nerve palsy. This case suggests that in selected patients a direct surgical approach to the top of the basilar artery may be possible for treatment of emboli.

Management of carotid-cavernous fistulas by surgery combined with interventional radiology

1983 ◽  
Vol 59 (6) ◽  
pp. 1076-1081 ◽  
Author(s):  
Brian M. Tress ◽  
Kenneth R. Thomson ◽  
Geoffrey L. Klug ◽  
Roger R. B. Mee ◽  
Bruce Crawford
Keyword(s):  
Interventional Radiology ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Balloon Catheter ◽  
Superior Ophthalmic Vein ◽  
Detachable Balloon ◽  
Content Type ◽  
First Case ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ Two cases of carotid-cavernous fistulas were successfully treated by standard interventional radiology techniques after otherwise inaccessible vessels were surgically exposed. In the first case, an internal carotid artery (ICA), which had previously been ligated as part of an attempted surgical “entrapment” procedure, was recanalized to permit passage of a detachable balloon catheter to the fistula, resulting in its obliteration. In the second case, an enlarged superior ophthalmic vein was exposed and isolated to facilitate retrograde catheterization of the cavernous sinus and obliteration of a dural fistula between the ICA and the cavernous sinus by steel Gianturco coils. The methods and complications of both procedures are discussed.

Treatment of posttraumatic carotid-cavernous fistula using a detachable balloon catheter

1980 ◽  
Vol 53 (6) ◽  
pp. 784-786 ◽  
Author(s):  
Aldo Benati ◽  
Adriano Maschio ◽  
Stefano Perini ◽  
Alberto Beltramello
Keyword(s):  
Blood Flow ◽  
Internal Carotid ◽  
Balloon Catheter ◽  
Carotid Cavernous Fistula ◽  
Detachable Balloon ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Blood Flow ◽  
Fine Print

✓ Five cases of posttraumatic carotid-cavernous fistula are reported. The fistulas were occluded by intravascular detachable balloons, as described by Serbinenko and later modified by Debrun. The good results obtained in three of these patients illustrate the value of this procedure, as it allows a direct obliteration of the fistula with preservation of the internal carotid blood flow.

scholarly journals Cavernous sinus meningioma presenting as third nerve palsy in pregnancy

2018 ◽  
pp. bcr-2017-223152 ◽  
Author(s):  
Priya Nidamanuri ◽  
Dmitri Shastin ◽  
Ravindra Nannapaneni
Keyword(s):  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Third Nerve Palsy ◽  
Cavernous Sinus Meningioma ◽  
Third Nerve ◽  
In Pregnancy

A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus

1989 ◽  
Vol 71 (5) ◽  
pp. 699-704 ◽  
Author(s):  
Akira Hakuba ◽  
Kiyoaki Tanaka ◽  
Toshihisa Suzuki ◽  
Shuro Nishimura
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
The Other ◽  
Vascular Lesions ◽  
Content Type ◽  
Fine Print

✓ The authors present four cases of vascular lesions and 10 cases of tumors involving the cavernous sinus. They were operated on via a combined orbitozygomatic infratemporal epidural and subdural approach. With this approach, multisided exposure of the cavernous sinus can be achieved via the shortest possible distance with minimal retraction of the neural structures in and around the cavernous sinus. In one patient the carotid artery had been occluded previously, but in the other 13 patients it was preserved. There was no mortality, and all patients except one returned to work within 6 months after surgery.

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