Recurrent subarachnoid hemorrhage complicating cerebral arterial ectasia

1981 ◽  
Vol 55 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Steven J. Goldstein ◽  
Phillip A. Tibbs
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cranial Nerve ◽  
Review Of The Literature ◽  
Radiographic Findings ◽  
Content Type ◽  
Clinical Complications ◽  
Cranial Nerve Palsies ◽  
Arterial Ectasia ◽  
Fine Print

✓ A case of subarachnoid hemorrhage (SAH) complicating cerebral arterial ectasia is reported. While ischemia and cranial nerve palsies are commonly associated with this condition, review of the literature reveals that SAH is exceedingly rare. The pathogenesis, radiographic findings, and clinical complications of cerebral arterial ectasia are discussed.

Transsphenoidal approach to infrasellar tumors involving the cavernous sinus

1990 ◽  
Vol 73 (4) ◽  
pp. 513-517 ◽  
Author(s):  
Nobuo Hashimoto ◽  
Haruhiko Kikuchi
Keyword(s):  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Transsphenoidal Approach ◽  
Skull Base Tumors ◽  
Content Type ◽  
Operating Field ◽  
Cranial Nerve Palsies ◽  
Operative Complications ◽  
Fine Print

✓ The authors review their 2-year experience with a rhinoseptal transsphenoidal approach to skull-base tumors of various pathologies involving both the sphenoid and cavernous sinuses. Eight patients with cranial nerve palsies attributable to compression of the contents of the cavernous sinus and/or optic canal are included in this report. Among these patients, a total of 17 cranial nerves were affected. Postoperative normalization was achieved in eight nerves, significant improvement in seven nerves, and no improvement in two nerves. There were no operative complications of aggravation of cranial nerve palsies in this series. In spite of the limited operating field, the results demonstrate the effectiveness and safety of this approach. The authors recommend that this approach be considered before more aggressive surgery is undertaken.

Multiple intracranial aneurysms in sickle cell anemia

1985 ◽  
Vol 62 (3) ◽  
pp. 430-434 ◽  
Author(s):  
M. Chris Overby ◽  
Allen S. Rothman
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Intracranial Aneurysms ◽  
Neurological Complications ◽  
Review Of The Literature ◽  
Hemoglobin S ◽  
Content Type ◽  
Multiple Intracranial Aneurysms ◽  
Fine Print

✓ Neurological complications of sickle cell anemia occur in 18% to 29% of patients with homozygous hemoglobin S disease. A review of the literature yielded reports of two cases, both treated conservatively, of multiple intracranial aneurysms occurring in patients with sickle cell anemia. The authors report two cases of subarachnoid hemorrhage secondary to multiple intracranial aneurysms in patients with sickle cell anemia. One of the two patients underwent three craniotomies for ablation of six intracranial aneurysms. The techniques used in the treatment of these patients are presented.

Complications of halo-pelvic traction

1976 ◽  
Vol 45 (6) ◽  
pp. 716-718 ◽  
Author(s):  
Rodney A. Rozario ◽  
Bennett M. Stein
Keyword(s):  
Blood Supply ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Rapid Rate ◽  
Content Type ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ When halo-pelvic traction is applied at a rapid rate it may induce cranial nerve palsies. The sixth, ninth, and tenth cranial nerves appear to be the most vulnerable. A proposed etiology is the stretching of these nerves resulting in a compromised blood supply with a consequent temporary paralysis which usually improves within 8 to 10 weeks.

Transverse fracture of the clivus

1973 ◽  
Vol 39 (5) ◽  
pp. 610-614 ◽  
Author(s):  
Bob B. Sanders ◽  
Gary D. Vanderark
Keyword(s):  
Cranial Nerve ◽  
Young Patients ◽  
Clinical Findings ◽  
Horner’S Syndrome ◽  
Transverse Fracture ◽  
Radiological Findings ◽  
Horner's Syndrome ◽  
Content Type ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ Three young patients with transverse fracture of the clivus exhibited clinical findings of progressive cranial nerve palsies associated with a Horner's syndrome. Clinical and radiological findings of this syndrome are described.

Multiple false localizing signs in intracranial tumor

1974 ◽  
Vol 40 (2) ◽  
pp. 264-266 ◽  
Author(s):  
Andrew R. Turnbull
Keyword(s):  
Cranial Nerve ◽  
Intracranial Tumor ◽  
Content Type ◽  
Cerebellar Hemangioblastoma ◽  
Mode Of Presentation ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ A case of cerebellar hemangioblastoma is presented in which multiple false localizing signs caused difficulty in the clinical localization of the lesion. The mode of presentation and pathogenesis of these signs are briefly discussed, and the observation made that the ninth and tenth cranial nerve palsies recorded in this case rarely lead to false localization.

Meningiomas of the clivus and apical petrous bone

1986 ◽  
Vol 65 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Marc R. Mayberg ◽  
Lindsay Symon
Keyword(s):  
Cranial Nerve ◽  
Clinical Status ◽  
Surgical Techniques ◽  
Petrous Bone ◽  
External Carotid ◽  
Total Resection ◽  
Content Type ◽  
Presenting Symptoms ◽  
Cranial Nerve Palsies ◽  
Fine Print

✓ Between March, 1966, and June, 1985, 23 women and 12 men underwent partial or total resection of apical petrous or clivus meningiomas at The National Hospital for Nervous Diseases. Presenting symptoms were typically of long duration (mean 29 months) and consisted primarily of gait disturbance, headache, hearing loss, and facial pain. Cranial nerve deficits, especially affecting the fifth, seventh, and eighth nerves, were observed in nearly every patient. Tumor size, but not location, was generally associated with degree of preoperative disability. Plain skull films were usually unremarkable, but computerized tomography (CT) proved highly accurate in determining tumor location and size. A characteristic pattern of vascular displacement was seen on vertebral angiograms, although blood supply to the tumors was derived primarily from branches of the internal and external carotid arteries. Subtotal or total resection was undertaken in all cases; nine patients required adjunctive cerebrospinal fluid shunting procedures. Although surgical techniques evolved during the course of the 20-year study, a combined supra- and infratentorial approach proved a relatively safe and effective means of surgical treatment. New or worsened postoperative deficits, especially cranial nerve palsies, and complications in the immediate postoperative period frequently resulted in temporary deterioration of the clinical status during this period; the total operative mortality rate was 9%. Follow-up periods ranged up to 9 years; 70% of patients resumed an independent existence, and none is known to have required subsequent tumor surgery. The size of the lesion was the only significant factor in determining outcome. These data suggest that meningiomas of the clivus and apical petrous bone can be accurately diagnosed by CT and three-vessel angiography, and effectively treated by microsurgical resection.

Acoustic neurinoma presenting as subarachnoid hemorrhage

1974 ◽  
Vol 41 (3) ◽  
pp. 391-393 ◽  
Author(s):  
Kevin McCoyd ◽  
Kevin D. Barron ◽  
Robert J. Cassidy
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cranial Nerve ◽  
Acoustic Neurinoma ◽  
Eighth Cranial Nerve ◽  
Content Type ◽  
Acute Subarachnoid Hemorrhage ◽  
Fine Print

✓An acute subarachnoid hemorrhage arising from a neurinoma of the eighth cranial nerve is reported.

Multiple cranial nerve palsies due to a hyperextension injury to the cervical spine

1984 ◽  
Vol 61 (1) ◽  
pp. 172-173 ◽  
Author(s):  
Louis Rosa ◽  
Mark Carol ◽  
Roberto Bellegarrigue ◽  
Thomas B. Ducker
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Cranial Nerve ◽  
Content Type ◽  
Hyperextension Injury ◽  
Cranial Nerve Palsies ◽  
Multiple Cranial Nerve ◽  
Fine Print

✓ The case of a patient with multiple bilateral cranial nerve palsies and spinal cord sparing secondary to a stable hyperextension injury to C-1 is presented.

Stereotactic radiotherapy for the treatment of acoustic neuromas

2004 ◽  
Vol 101 (Supplement3) ◽  
pp. 362-372 ◽  
Author(s):  
Michael T. Selch ◽  
Alessandro Pedroso ◽  
Steve P. Lee ◽  
Timothy D. Solberg ◽  
Nzhde Agazaryan ◽  
...  
Keyword(s):  
Stereotactic Radiotherapy ◽  
Tumor Size ◽  
Cranial Nerve ◽  
Target Volume ◽  
Tumor Control ◽  
Content Type ◽  
Seventh Cranial Nerve ◽  
Acoustic Neuromas ◽  
Fine Print

Object. The authors sought to assess the safety and efficacy of stereotactic radiotherapy when using a linear accelerator equipped with a micromultileaf collimator for the treatment of patients with acoustic neuromas. Methods. Fifty patients harboring acoustic neuromas were treated with stereotactic radiotherapy between September 1997 and June 2003. Two patients were lost to follow-up review. Patient age ranged from 20 to 76 years (median 59 years), and none had neurofibromatosis. Forty-two patients had useful hearing prior to stereotactic radiotherapy. The fifth and seventh cranial nerve functions were normal in 44 and 46 patients, respectively. Tumor volume ranged from 0.3 to 19.25 ml (median 2.51 ml). The largest tumor dimension varied from 0.6 to 4 cm (median 2.2 cm). Treatment planning in all patients included computerized tomography and magnetic resonance image fusion and beam shaping by using a micromultileaf collimator. The planning target volume included the contrast-enhancing tumor mass and a margin of normal tissue varying from 1 to 3 mm (median 2 mm). All tumors were treated with 6-MV photons and received 54 Gy prescribed at the 90% isodose line encompassing the planning target volume. A sustained increase greater than 2 mm in any tumor dimension was defined as local relapse. The follow-up duration varied from 6 to 74 months (median 36 months). The local tumor control rate in the 48 patients available for follow up was 100%. Central tumor hypodensity occurred in 32 patients (67%) at a median of 6 months following stereotactic radiotherapy. In 12 patients (25%), tumor size increased 1 to 2 mm at a median of 6 months following stereotactic radiotherapy. Increased tumor size in six of these patients was transient. In 13 patients (27%), tumor size decreased 1 to 14 mm at a median of 6 months after treatment. Useful hearing was preserved in 39 patients (93%). New facial numbness occurred in one patient (2.2%) with normal fifth cranial nerve function prior to stereotactic radiotherapy. New facial palsy occurred in one patient (2.1%) with normal seventh cranial nerve function prior to treatment. No patient's pretreatment dysfunction of the fifth or seventh cranial nerve worsened after stereotactic radiotherapy. Tinnitus improved in six patients and worsened in two. Conclusions. Stereotactic radiotherapy using field shaping for the treatment of acoustic neuromas achieves high rates of tumor control and preservation of useful hearing. The technique produces low rates of damage to the fifth and seventh cranial nerves. Long-term follow-up studies are necessary to confirm these findings.

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.

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