scholarly journals Intracisternal papaverine toxicity in anterior circulation aneurysm clipping surgery

2020 ◽  
pp. 386-390
Author(s):  
Zahraa F. Al-Sharshahi ◽  
Samer S. Hoz ◽  
Mustafa E. Almurayati ◽  
Zahraa M. Kareem ◽  
Zahraa Ameen
Keyword(s):  
Side Effects ◽  
Nerve Palsy ◽  
English Language ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Cochrane Library ◽  
Close Monitoring ◽  
Aneurysm Surgery ◽  
Anterior Circulation ◽  
Aneurysm Clipping

Introduction. Cerebral vasospasm is a major cause of mortality in patients with subarachnoid haemorrhage. Irrigation of intracisternal papaverine has been adopted as a strategy to reduce the incidence of aneurysm-surgery-associated vasospasm. Aim. The aim of this literature review is to summarize the reported complications associated with intracisternal papaverine administration. Patients and Methods. We searched the following databases: PubMed, Google Scholar, Cochrane Library, Clinical Key, Embase, Emerald, Health Business Elite, MEDLINE at OVID, EBM Reviews and Research Gate. The following keywords were used: Intracisternal papaverine, topical papaverine, direct papaverine, a vasodilator for aneurysm surgery, papaverine in aneurysm clipping, papaverine complications and papaverine side effects. The search criteria included all articles published between 1980-2019, in the English language. Results. Our search yielded a total of 19 articles describing 43 cases. The most common reported complication was ipsilateral oculomotor nerve palsy. Other local complications included: Bilateral oculomotor nerve palsy, ipsilateral facial nerve palsy, and monocular blindness. Although less common, reports pointing to papaverine systemic toxicity did exist. Examples of such complications included: Profound hypotension, bradycardia, hypertension and tachycardia, hyperthermia and metabolic acidosis, cardiac arrest and even death. Conclusion. Intracisternal papaverine irrigation is an effective strategy in reducing peri-operative vasospasm associated with aneurysm surgery. Although uncommon, both local and systemic side effects have been linked to papaverine use, calling for careful dosing and close monitoring to enhance its safety profile.

Oculomotor Nerve Palsy Due To Posterior Communicating Artery Aneurysm: Clipping vs Coiling

2021 ◽  
Author(s):  
Alexandrina S. Nikova ◽  
Georgios S Sioutas ◽  
Katerina Sfyrlida ◽  
Grigorios Tripsianis ◽  
Michael Karanikas ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Aneurysm Clipping ◽  
Posterior Communicating Artery Aneurysm

Bevacizumab-induced isolated oculomotor nerve palsy in glioblastoma multiforme

2021 ◽  
pp. 107815522110668
Author(s):  
Ezgi Değerli ◽  
Gülin Alkan ◽  
Nihan Şentürk Öztaş ◽  
Şahin Bedir ◽  
Sümeyra Derin ◽  
...  
Keyword(s):  
Side Effects ◽  
Glioblastoma Multiforme ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Growth Factor Receptor ◽  
Recurrent Glioblastoma ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Recurrent Glioblastoma Multiforme ◽  
Systemic Side Effects

Introduction: Bevacizumab, a monoclonal antibody against the vascular endothelial growth factor receptor, is the standard treatment of recurrent glioblastoma multiforme. In addition to common systemic side effects of bevacizumab, there are rare cases of cranial nerve palsy. Case report: We report a case of transient oculomotor nerve palsy after systemic administration of bevacizumab. Twenty-four hours after the systemic infusion of bevacizumab, transient oculomotor nerve palsy developed in a 49-year-old male patient. In the cranial MRI, there was no malignancy-related progression. Management and outcome: Bevacizumab treatment was discontinued. Methylprednisolone was started considering that bevacizumab increased the inflammatory response. Oculomotor nerve palsy resolved in 14 days. Discussion: There are many side effects of bevacizumab whose mechanisms of action have not been fully explained. Cranial nerve involvement is rarely reported. Our case is the first reported case of bevacizumab-induced oculomotor nerve palsy.

scholarly journals Acupuncture for Oculomotor Nerve Palsy: a Systematic Review Protocol

2021 ◽  
Author(s):  
Xiaohui Zhang ◽  
Shumei Zheng ◽  
Yijiang Liu ◽  
Ruosang Du ◽  
Hongwen Yuan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Eye Movement ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Biomedical Literature ◽  
Current Evidence ◽  
Oculomotor Nerve Palsy ◽  
Cochrane Library ◽  
Safety And Efficacy

Abstract Background: Oculomotor nerve palsy(ONP) is a common clinical disease in neurology and ophthalmology which results in serious syndrome such as ptosis, diplopia, and limited eye movement. The major medications treating ONP usually make sense and side effects, while acupuncture is known as a safe and effective therapy for ONP. We aim to evaluate the safety and efficacy of acupuncture in the treatment of ONP.Methods: The following database will be required from PubMed, Cochrane Library, Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang data, Chinese Scientific Journal Database, including studies and published systematic review in the reference list and grey. Three reviewers will search these databases, select data and evaluate the quality of studies separately. The methodological quality will be measured by the Cochrane risk of bias tool. The Review Manager 5.3 will be used to synthesize collected data.Results: The systematic review will evaluate the safety and efficacy based on current evidence of acupuncture for ONP. The primary outcomes are the therapeutic efficiency, the sizes of palpebral fissure and pupil, the range of eye movement and scores of diplopia. Quality of life, and adverse effects will be assessed as secondary outcomes. Conclusion: The study will provide high-quality recently evidence for evaluating the efficacy of acupuncture for patients with ONP. PROSPERO registration number: CRD42020162140.

Mobilization of the Transcavernous Oculomotor Nerve During Basilar Aneurysm Surgery: Biomechanical Bases for Better Outcome

2013 ◽  
Vol 10 (1) ◽  
pp. 106-115 ◽  
Author(s):  
Jaafar Basma ◽  
Mats Ryttlefors ◽  
Francesco Latini ◽  
Svetlana Pravdenkova ◽  
Ali Krisht
Keyword(s):  
Nerve Palsy ◽  
Postoperative Outcome ◽  
Complete Recovery ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Modified Rankin Scale ◽  
Aneurysm Surgery ◽  
Superior Orbital Fissure ◽  
Before And After ◽  
Pulling Force

Abstract BACKGROUND: The transcavernous approach adds a significant exposure advantage in basilar aneurysm surgery. However, one of its frequently reported side effects is postoperative oculomotor nerve palsy. OBJECTIVE: To present the technique of mobilizing the oculomotor nerve throughout its intracranial course and to analyze its consequences on the nerve tension and clinical outcome. METHODS: The oculomotor nerve is mobilized from its mesencephalic origin to the superior orbital fissure. Its degree of mobility, related to the imposed pulling force, was measured in 11 cadaveric nerves. Tension was mathematically deduced and compared before and after mobilizing of the cavernous segment. One hundred four patients treated for basilar aneurysms with the orbitozygomatic pretemporal transcavernous approach were followed up for a 1-year period and evaluated for postoperative oculomotor nerve palsy. RESULTS: Releasing the transcavernous segment compared to cisternal mobilization alone resulted in a significant increase in freedom of mobility from 4 to 7.9 mm (P < .001) and in a significant decrease in tension from 0.8 to 0.5 N (P = .006). Ninety-nine percent of aneurysms treated with this technique were amenable to neck clipping, and a total of 84% of patients had a good postoperative outcome (modified Rankin Scale score, 0-2). All patients showed direct postoperative palsy; however, 97% had a complete recovery by 9 months. Only 3 patients had a persistent diplopia on medial gaze, which was corrected with prism glasses. CONCLUSION: Mobilization of the transcavernous oculomotor nerve results in better maneuverability and less tension on the nerve, which lead to successful surgical treatment and favorable oculomotor outcome.

Pituitary Apoplexy Presenting as Isolated Oculomotor Nerve Palsy

2007 ◽  
Vol 41 (4) ◽  
pp. 246
Author(s):  
Moon Seok Yang ◽  
Won Ho Cho ◽  
Seung Heon Cha
Keyword(s):  
Nerve Palsy ◽  
Pituitary Apoplexy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V19
Author(s):  
Hussam Abou-Al-Shaar ◽  
Timothy G. White ◽  
Ivo Peto ◽  
Amir R. Dehdashti
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Entry Zone ◽  
Third Nerve Palsy ◽  
History Of ◽  
Tectal Plate ◽  
The Right ◽  
Transtentorial Approach ◽  
Third Nerve

A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.The video can be found here: https://youtu.be/ofj8zFWNUGU.

scholarly journals T cell acute lymphoblastic leukaemia presenting with sudden onset right oculomotor nerve palsy with normal neuroradiography and cerebrospinal fluid studies

2012 ◽  
Vol 2012 (mar26 1) ◽  
pp. bcr0120125685-bcr0120125685
Author(s):  
V. R. Bhatt ◽  
M. Naqi ◽  
R. Bartaula ◽  
S. Murukutla ◽  
S. Misra ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
T Cell ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Nerve Palsy ◽  
Sudden Onset ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy
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