Retrograde suction decompression of giant paraclinoid aneurysms using a No. 7 French balloon–containing guide catheter

2006 ◽  
Vol 105 (3) ◽  
pp. 479-481 ◽  
Author(s):  
Richard J. Parkinson ◽  
Bernard R. Bendok ◽  
Christopher C. Getch ◽  
Parham Yashar ◽  
Ali Shaibani ◽  
...  
Keyword(s):  
Visual Loss ◽  
Modified Technique ◽  
Parent Vessel ◽  
Guide Catheter ◽  
Paraclinoid Aneurysms ◽  
History Of ◽  
The Right ◽  
Neck Diameter ◽  
Temporary Clip ◽  
Endovascular Devices

✓ The treatment of large and giant paraclinoid carotid artery (CA) aneurysms often requires the use of suction decompression for safe and effective occlusion. Both open and endovascular suction decompression techniques have been described previously. In this article the authors describe a revised endovascular suction decompression technique that provides several advantages in the treatment of large and giant paraclinoid and CA aneurysms. A 51-year-old woman presented with a relatively brief history of progressive visual loss in the right eye, nonspecific headache, and an afferent pupillary defect. After angiography studies had been obtained, it was determined that she had a giant right paraclinoid internal CA aneurysm with a dome size of approximately 26 mm on the right and a neck diameter of 10 mm. A modified technique was performed in which suction decompression was used. With the aid of a No. 7 French Concentric balloon guide catheter (Concentric Medical, Inc., Mountain View, CA) and application of a temporary clip distal to the aneurysm, the aneurysm was trapped and decompressed using retrograde suction through the guide catheter when the balloon was inflated. After satisfactory placement of three permanent clips, an intraoperative angiogram obtained through the same guide catheter confirmed CA patency. The aneurysm was then punctured and aspirated, ensuring complete occlusion of the aneurysm sac and reconstruction of the parent vessel. The patient made an excellent recovery and did not suffer any complications. She did not experience worsening in her vision. This technical modification to endovascular suction decompression allows several potential advantages, including higher volume decompression and the ability to deliver endovascular devices to distal arterial locations.

scholarly journals Brachiocephalic Vein Stenosis in Association with Ipsilateral Hyperdynamic Brachio-Basilic Fistula Causing Ipsilateral Facial Swelling and Contralateral Papillodema and Visual Loss

2010 ◽  
Vol 16 (3) ◽  
pp. 322-325 ◽  
Author(s):  
P. Eames ◽  
L. Senthil ◽  
A. Thomas ◽  
P. Riley ◽  
M.A. Burdon
Keyword(s):  
Visual Loss ◽  
Jugular Vein ◽  
Brachiocephalic Vein ◽  
Facial Swelling ◽  
The Face ◽  
Dialysis Fistula ◽  
History Of ◽  
Hypertensive Woman ◽  
The Right ◽  
Vein Stenosis

A 69-year-old hypertensive woman with a hyperdynamic, left brachio-basilic dialysis fistula presented with a long history of throbbing in her head, swelling of the left side of the face and two months of right visual loss with gross swelling of the right optic disc. Tight stenosis of left brachiocephalic vein was found to be causing retrograde flow into the left jugular vein which normalised after dilatation and stenting with resolution of the papillodema.

scholarly journals A case of recurring Amaurosis Fugax

2019 ◽  
pp. 85-87
Author(s):  
Y. Suthahar ◽  
J. Blackwell ◽  
G. Zachariah ◽  
V. Umachandran
Keyword(s):  
Risk Factors ◽  
Visual Loss ◽  
Sudden Onset ◽  
Vascular Risk ◽  
Amaurosis Fugax ◽  
Anti Platelet Therapy ◽  
History Of ◽  
Ct Head ◽  
The Right ◽  
Hospital Manager

WW a 43 year old Caucasian Hospital Manager, first presented in July 08 complaining of transient mono-ocular visual loss in the right eye.  She described sudden onset loss of vision – ‘like a curtain coming across the vision’.  She then proceeded to have similar symptoms in the left eye.  There was no history of a subsequent headache. The episode would between 30 seconds and 10 minutes and could occur up to 10 times a day. At times, the attack was also associated with some left arm numbness.  She was initially reviewed by Dr Vu [ Stroke Consultant] who diagnosed Amaurosis Fugax and started her on standard anti-platelet therapy  [combination of Aspirin and Dypyridamole].  She had very little in terms of vascular risk factors [nil hypertensive, minimal alcohol and a life-long non-smoker with a fasting cholesterol 3.12]. Her PMH history consisted of Gilberts’ Syndrome and endometriosis. She also suffered a DVT following a hysterectomy. Her initial investigations of a CT head and carotid duplex were normal.

scholarly journals Visual Loss from Choroidal Melanoma Mimicking Neurological Syndromes

2017 ◽  
Vol 9 (1) ◽  
pp. 31-35
Author(s):  
Karim Hammamji ◽  
Ehud Reich ◽  
Amit Arora ◽  
Victoria M.L. Cohen ◽  
Mandeep S. Sagoo
Keyword(s):  
Optic Neuritis ◽  
Visual Loss ◽  
Vision Loss ◽  
White Male ◽  
Choroidal Melanoma ◽  
Proton Beam Radiotherapy ◽  
Pet Ct ◽  
Oral Steroids ◽  
History Of ◽  
The Right

Melanoma of the eye is rare, but can mimic a range of disorders. This report highlights 2 cases of choroidal melanoma with vision loss mimicking neurological diagnoses. The first patient is a 41-year-old white male with a known history of multiple sclerosis and a previous episode of optic neuritis in the right eye, who presented with a 6-month history of decreased vision in the same eye, and occasional photopsiae. He was treated with 2 courses of oral steroids for presumed recurrent optic neuritis. After a temporary improvement in his symptoms, his vision worsened, following which he had a head MRI, which revealed a solid intraocular mass. He was subsequently diagnosed with a choroidal melanoma for which he was treated successfully with ruthenium-106 plaque brachytherapy. The second patient is a 57-year-old female, who presented with a progressive cerebellar syndrome under investigation by the neurology service, as well as decreased vision in the right eye. Her visual acuity gradually deteriorated and her neurological assessment, which included a PET-CT, revealed uptake in the right eye. The diagnosis of a choroidal melanoma was made, and following conservative treatment with proton beam radiotherapy, she had an enucleation of the eye. Intraocular tumours can masquerade as many different entities. Unexplained unilateral visual loss, especially if it is atypical for a neurological syndrome, should prompt dilated fundoscopy and referral to an ophthalmologist.

scholarly journals Recurrent retinal artery ischemia as a presenting symptom of ophthalmic artery aneurysm

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Rao Muhammad Rashad Qamar ◽  
Qasim Mansoor ◽  
Majeed T
Keyword(s):  
Visual Loss ◽  
Ophthalmic Artery ◽  
Serum Cholesterol Level ◽  
Artery Aneurysm ◽  
Normal Serum ◽  
Slit Lamp ◽  
Magnetic Resonance Angiogram ◽  
History Of ◽  
Retinal Artery ◽  
The Right

An 81 years old woman presented with sudden painless greying of her vision in the right eye. This resolved within l-2 hours without any residual visual loss. She experienced similar symptoms twice in 4 months. The attacks lasted forty to sixty minutes. She had no history of hypertension, diabetes mellitus, migraine, ischemic heart disease and atrial fibrillation. Further neurological and systemic enquiry was negative On ocular examination, best visual acuity was 6/9 right eye and 6/60 in left eye. Slit lamp biomicroscopy, tonometry and discs appearances were normal. Right macula showed multiple drusens and dry type of ARMD.There was left disciform macular degeneration. The vascular pattern of both fundi was normal and did not reveal any embolus. Extraocular movements were normal. Cardiovascular examination, Carotid artery palpation and auscultation were all normal. Serum cholesterol level was normal. Thrombophilic screen was negative. Magnetic Resonance Angiogram showed aneurysm of right ophthalmic artery near the junction of carotid-ophthalmic artery. After neurosurgical consultation, she was advised to take Tab. Aspirin 75mg daily.

scholarly journals Terson's syndrome: neurosurgical considerations on the subject of a rare case with ophthalmological sequelae

2013 ◽  
Vol 32 (02) ◽  
pp. 114-117
Author(s):  
Bruno Lourenço Costa ◽  
Filipe Mira Ferreira ◽  
Augusto Barbosa ◽  
José Lozano Lopes ◽  
Armando Lopes
Keyword(s):  
Surgical Treatment ◽  
Visual Loss ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Vitreous Hemorrhage ◽  
Severe Visual Loss ◽  
Timely Review ◽  
History Of ◽  
Terson’S Syndrome ◽  
Terson's Syndrome ◽  
The Right

AbstractAccording to prospective studies, vitreous hemorrhage may be diagnosed in 8%-27% of the patients with aneurysmal subarachnoid hemorrhage (SAH) (Terson's syndrome) and has been associated with a bad neurological outcome. In spite of its incidence and prognostic value, vitreous hemorrhage is underdiagnosed. We describe the case of a 48 year-old woman who was diagnosed with a SAH due to the rupture of an aneurysm of the right middle cerebral artery bifurcation that was surgically treated with minimal neurological morbidity. However, due to vitreous hemorrhage in the right eye, the patient developed visual loss that did not recovered after proper surgical treatment. In the context of the present case we take a timely review of the literature, discussing the incidence, pathophysiology, treatment and prognosis of Terson's syndrome. The reported case stresses that the natural history of Terson's syndrome is not always synonymous with good outcome. Significant visual sequelae due to vitreous hemorrhage are very rare after proper conservative or surgical treatment. The severe visual loss of this patient emphasizes the need for a systematic, early and serial ophthalmological evaluation of all patients with aneurysmal SAH.

scholarly journals Acanthamoeba Keratitis and Acanthamoeba Conjunctivitis: A Case Report

2020 ◽  
Author(s):  
Oktay ALVER ◽  
Mehmet BAYKARA ◽  
Merve YÜRÜK ◽  
Nazmiye ÜLKÜ TÜZEMEN
Keyword(s):  
Visual Loss ◽  
Contact Lenses ◽  
Acanthamoeba Keratitis ◽  
Eyelid Edema ◽  
History Of ◽  
Laboratory Examinations ◽  
Acanthamoeba Species ◽  
Eye Infection ◽  
The Right ◽  
Microbial Agents

Acanthamoeba species are vision-threatening agents by causing cornea infections known as Acanthamoeba keratitis. A 5 year-old kid with the complaints of erythema, eyelid edema, inflammation, limitation of eye movements in the right eye, and having no history of wearing contact lenses or trauma, was diagnosed of Acanthamoeba conjunctivitis through laboratory examinations in the Ophthalmology clinic. The visual sharpness of the patient improved after the treatment. A 44 year-old female patient suffering from pain, stinging, irritation, and inability to see in the left eye with the history of wearing contact lenses or trauma was diagnosed of Acanthamoeba keratitis through laboratory examinations. The agent was isolated and identified as "A. castellani" in the Genotype "T2". Examination of the left eye on the 15th day of treatment indicated that all complaints disappeared except for the cataract originated visual loss. However, the first diagnosis of Acanthamoeba keratitis appeared in the literature on a case with no history of wearing contact lenses and trauma it is found to be attention grabbing. We think that Acanthamoeba should not be ignored among microbial agents that cause eye infection with or without trauma and contact lens usage history.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

ANALYSIS OF REGULATIONS REGARDING THE SETTLEMENT OF ISSUES ON THE REMOVAL AND RECOVERY OF PLANTATIONS IN THE RIGHT-OF-WAY OF PUBLIC ROADS

2020 ◽  
pp. 55-60
Author(s):  
Nataliia Kharytonova ◽  
Olha Mykolaienko ◽  
Tetyana Lozova
Keyword(s):  
Traffic Safety ◽  
Climatic Factors ◽  
Visual Orientation ◽  
Right Of Way ◽  
Adverse Weather ◽  
Overhead Power Lines ◽  
The Right ◽  
Neck Diameter ◽  
Proper Operation

Greening of roads contributes to the protection of roads and their elements from influence of adverse weather and climatic factors; it includes the measures for improvement and landscaping of roads, ensures the protection of roadside areas from transport pollution, provides visual orientation of drivers. The solution of these issues will ensure creation and maintenance of safe and comfortable conditions for travelers. Green plantings in the right-of-way road area include woody, bushy, flower and grass vegetation of natural and artificial origin. For proper operation of public roads and satisfaction of other needs of the industry, there may be the need in removing the greenery. The reason for the removal of greenery in the right-of-way road area may be due to the following factors: construction of the architectural object, widening of the motor road, repair works in the security zone of overhead power lines, water supply, drainage, heating, telecommunications facilities, cutting of hazardous, dry and fautal trees, as well as self-grown and brushwood trees with a root neck diameter not exceeding 5 cm, elimination of the consequences of natural disasters and emergencies. The removal of plantations in the right-of-way area is executed in order to ensure traffic safety conditions and to improve the quality of plantations composition and their protective properties. Nowadays, in Ukraine there is no clear procedure for issuing permits for removing of such plantations. In order to resolve this issue, there is a need in determining the list of regulations in the area of forest resources of Ukraine and, if needed, the list of regulatory acts that have to be improved; to prepare a draft of the regulatory legal act that would establish the procedure of plantations cutting, the methodology of their condition determination, recovery costs determination, the features of cutting. Keywords: plantations, cutting, right-of-way, woodcutting permit, order.

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