Symptomatic solitary xanthogranuloma occupying the cavernous sinus

2001 ◽  
Vol 94 (2) ◽  
pp. 322-326 ◽  
Author(s):  
Kazumichi Yamada ◽  
Masaki Miura ◽  
Haruhiko Miyayama ◽  
Naohiko Furuyoshi ◽  
Jun Matsumoto ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Middle Meningeal Artery ◽  
Magnetic Resonance Images ◽  
Superior Orbital Fissure ◽  
Content Type ◽  
First Case ◽  
History Of ◽  
Mixed Pattern ◽  
The Right ◽  
Field Defect

✓ The authors report the first case of a solitary xanthogranuloma of the cavernous sinus without systemic manifestation. A 43-year-old woman experienced decreased visual acuity on the right side in association with papilledema and a visual field defect. She was alert and no other neurological sign was observed. She had no family history of hyperlipoproteinemia and no cutaneous and/or systemic xanthomatous lesions. Skull x-ray films showed an enlarged right superior orbital fissure. Computerized tomography revealed a low-density oval mass 2 × 3 cm in diameter in the right cavernous region that was compressing the right optic nerve in the lateral to medial direction. This mass exhibited isointensity on T1-weighted and mixed-pattern hyperintensity on T2-weighted magnetic resonance images with diffuse contrast enhancement. Cerebral angiography demonstrated fine staining in the margin, originating from the right middle meningeal artery. These neuroimaging findings closely mimicked those associated with trigeminal neuroma. The lesion was partially removed via a right-sided zygomatic approach, and her symptoms improved. Clinical characteristics and histopathological features of this rare case are discussed.

Spontaneous craniocervical osseous fusion caused by cervical dystonia

2001 ◽  
Vol 95 (1) ◽  
pp. 115-118 ◽  
Author(s):  
Ralf Weigel ◽  
Michael Rittmann ◽  
Joachim K. Krauss
Keyword(s):  
Cervical Dystonia ◽  
Three Dimensional ◽  
Sternocleidomastoid Muscle ◽  
Facet Joints ◽  
Content Type ◽  
History Of ◽  
Posterior Neck ◽  
Atlantoaxial Rotatory Fixation ◽  
The Right ◽  
Rotatory Fixation

✓ The authors report on a 31-year-old man with spontaneous craniocervical osseous fusion secondary to cervical dystonia (CD). After an 8-year history of severe CD, the patient developed a fixed rotation of his head to the right. Three-dimensional computerized tomography reconstructions revealed rotation and fixation of the occiput and C-1 relative to C-2, which was similar to that seen in atlantoaxial rotatory fixation. There was abnormal ossification of the odontoid facet joints and ligaments. Additional ossification was observed in the cervical soft tissue bridging the lateral mass of C-1 and the occiput. The patient underwent partial myectomy of the dystonic left sternocleidomastoid muscle and selective posterior ramisectomy of the right posterior neck muscles; postoperatively he experienced relief of his neck pain. In patients with CD refractory to conservative treatment, the appropriate timing of surgical treatment is important.

scholarly journals Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Valsalva Manoeuvre ◽  
First Case ◽  
Orbital Emphysema ◽  
History Of ◽  
Nerve Dysfunction ◽  
The Right ◽  
Needle Decompression

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.

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 Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Pouya Nazari ◽  
Pedram Golnari ◽  
Madhav Sukumaran ◽  
Ali Shaibani ◽  
Michael C Hurley ◽  
...  
Keyword(s):  
Unusual Case ◽  
Middle Meningeal Artery ◽  
Complete Healing ◽  
Spontaneous Thrombosis ◽  
Pseudoaneurysm Formation ◽  
Arteriovenous Fistulas ◽  
History Of ◽  
The Right ◽  
Repeat Imaging

ABSTRACT BACKGROUND AND IMPORTANCE Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results. CLINICAL PRESENTATION A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm. CONCLUSION Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.

Vascular decompression of a vertebral artery loop producing cervical radiculopathy

1998 ◽  
Vol 89 (3) ◽  
pp. 485-488 ◽  
Author(s):  
Paul W. Detwiler ◽  
Randall W. Porter ◽  
Timothy R. Harrington ◽  
Volker K. H. Sonntag ◽  
Robert F. Spetzler
Keyword(s):  
Vertebral Artery ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Vascular Structure ◽  
Loop Formation ◽  
Content Type ◽  
History Of ◽  
Radicular Symptoms ◽  
The Right ◽  
Vascular Decompression

✓ Vertebral artery tortuosity and loop formation are rare causes of cervical radiculopathy. The authors present the case of a 70-year-old man with 9 years of progressive right-sided cervical and scapular pain but no history of trauma. Computerized tomography myelography and magnetic resonance imaging revealed an ovoid mass in the right C3–4 intervertebral foramen. The patient underwent a right C-3 and C-4 hemilaminectomy and a complete C3–4 facetectomy. A pulsatile vascular structure was found compressing the right C-4 nerve root. The bone overlying the vascular structure was removed, producing decompression of the nerve root. Immediate postoperative angiography showed that this lesion was a focal vertebral artery loop. The patient's symptoms resolved after surgery, supporting the use of vascular decompression of a cervical nerve root compressed by a vertebral artery loop for the relief of radicular symptoms.

scholarly journals Aorta–bal kamra tunnel sikeres sebészi kezelése modern noninvazív képalkotó diagnosztika alapján

2015 ◽  
Vol 156 (28) ◽  
pp. 1140-1143
Author(s):  
István Hartyánszky ◽  
Márta Katona ◽  
Krisztina Kádár ◽  
Asztrid Apor ◽  
Sándor Varga ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Postoperative Management ◽  
Left Ventricular ◽  
Aortic Sinus ◽  
First Case ◽  
History Of ◽  
Dimensional Echocardiography ◽  
Aortic Orifice ◽  
Three Dimensional Echocardiography ◽  
The Right

Aortico-left ventricular tunnel is a rare congenital cardiac defect, which bypasses the aortic valve via the paravalvar connection from the aorta to the left ventricle. The authors report the history of a 14-year-old boy with aortico-left ventricular tunnel in whom the aortic orifice arose from the right aortic sinus and was closed by a pericardial patch. The diagnosis was confirmed by combined two-dimensional and real time three-dimensional echocardiogram and magnetic resonance imaging. This is the first case, in which these complex diagnostic imaging methods have been used in the pre- and postoperative management of this defect. Optimally the new transthoratic three-dimensional echocardiography would be needed to define the anatomy and functional consequences of the aortico-left ventricular tunnel and in the postoperative follow-up. Orv. Hetil., 2015, 156(28), 1140–1143.

Spontaneous spinal subdural hematoma associated with low-molecular-weight heparin

2005 ◽  
Vol 2 (5) ◽  
pp. 612-613 ◽  
Author(s):  
Yoon-Hee Cha ◽  
John H. Chi ◽  
Nicholas M. Barbaro
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Spinal Instrumentation ◽  
Cord Compression ◽  
Low Molecular Weight ◽  
Content Type ◽  
First Case ◽  
Spinal Subdural Hematoma ◽  
History Of ◽  
Fine Print

✓ Spinal subdural hematomas (SDHs) are a rare cause of cord compression and typically occur in the setting of spinal instrumentation or coagulopathy. The authors report the first case of a spontaneous spinal SDH occurring in conjunction with low-molecular-weight heparin use in a patient with a history of spinal radiotherapy.

scholarly journals Mesothelioma in two sheep with pericardial effusion and ascites

2020 ◽  
Vol 8 (1) ◽  
pp. e001031
Author(s):  
Nicola Fletcher ◽  
Camilla Brena ◽  
Amanda Carson ◽  
Mark Wessels ◽  
Tobias Floyd
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Domestic Animals ◽  
Diagnostic Pathology ◽  
First Case ◽  
Clinical Presentations ◽  
Rare Tumours ◽  
Microscopic Features ◽  
History Of ◽  
The Right

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in two sheep submitted to Animal and Plant Health Agency’s diagnostic pathology service with diverse clinical presentations. The first case was a 2-year-old ewe with a history of sudden death that had a nodular mass in the wall of the right auricle and marked pericardial effusion and ascites. The second case was a 3-year-old ewe with a history of recumbency which had a papillary mass in the peritoneal cavity and marked ascites. A diagnosis of mesothelioma in both cases was confirmed by immunohistochemistry for cytokeratin and vimentin. These cases highlight the diverse presenting signs that can be present with mesothelioma, and this tumour should be considered as a differential diagnosis in sheep with peritoneal, pericardial or pleural effusion at gross postmortem.

An unusual pterygopalatine meningocele associated with neurofibromatosis Type 1

2000 ◽  
Vol 93 (3) ◽  
pp. 480-483 ◽  
Author(s):  
Paul H. Chapman ◽  
Hugh D. Curtin ◽  
Michael J. Cunningham
Keyword(s):  
Cavernous Sinus ◽  
Neurofibromatosis Type 1 ◽  
Lateral Wall ◽  
Neurofibromatosis Type ◽  
Middle Fossa ◽  
Recurrent Meningitis ◽  
Superior Orbital Fissure ◽  
Content Type ◽  
Middle Fossa Approach

✓ The authors describe an unusual meningocele of the lateral wall of the cavernous sinus and the anterior skull base in a young patient with typical stigmata of neurofibromatosis Type 1 (NF1). This lesion was discovered during evaluation for recurrent meningitis. It represented an anterior continuation of Meckel's cave into a large cerebrospinal fluid space within the lateral wall of the cavernous sinus, extending extracranially through an enlarged superior orbital fissure into the pterygopalatine fossa adjacent to the nasal cavity. It was successfully obliterated, via an intradural middle fossa approach, with fat packing and fenestration into the subarachnoid space. This meningocele most likely represents a variant of cranial nerve dural ectasia occasionally seen in individuals with NF1. It has as its basis the same mesodermal defect responsible for the more common sphenoid wing dysplasia and spinal dural ectasias identified with this condition. Involvement of the trigeminal nerve with expansion of the lateral wall of cavernous sinus has not been reported previously. The authors surmise, however, that it may be present in some cases of orbital meningocele associated with sphenoid wing dysplasia.

Cerebral mycotic aneurysm of fungal origin

1978 ◽  
Vol 49 (1) ◽  
pp. 0107-0110 ◽  
Author(s):  
Gulshan K. Ahuja ◽  
Neeraj Jain ◽  
Malini Vijayaraghavan ◽  
Subimal Roy
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mycotic Aneurysm ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Content Type ◽  
History Of ◽  
The Right ◽  
Internal Carotid Arteries ◽  
Fine Print

✓ A young man who had a long history of sinusitis developed subarachnoid hemorrhage and died. Autopsy showed a mycotic aneurysm of fungal origin at the junction of the right posterior cerebral and internal carotid arteries. Four of five reported cases of fungal aneurysm were due to Aspergillus infection.

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