scholarly journals Brain herniation into the right transverse dural sinuses

2021 ◽  
Author(s):  
Ali Alsmair
Keyword(s):  
Brain Herniation ◽  
Dural Sinuses ◽  
The Right

scholarly journals Acute paradoxical brain herniation after decompressive craniectomy for severe traumatic brain injury: A case report

2019 ◽  
Vol 10 ◽  
pp. 79
Author(s):  
Ryo Hiruta ◽  
Shinya Jinguji ◽  
Taku Sato ◽  
Yuta Murakami ◽  
Mudathir Bakhit ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Severe Traumatic Brain Injury ◽  
Skin Flap ◽  
Temporal Lobectomy ◽  
Acute Subdural Hematoma ◽  
Brain Herniation ◽  
Midline Shift ◽  
The Right

Background: Sinking skin flap syndrome or paradoxical brain herniation is an uncommon neurosurgical complication, which usually occurs in the chronic phase after decompressive craniectomy. We report a unique case presenting with these complications immediately after decompressive craniectomy for severe traumatic brain injury. Case Description: A 65-year-old man had a right acute subdural hematoma (SDH), contusion of the right temporal lobe, and diffuse traumatic subarachnoid hemorrhage with midline shift to the left side. He underwent an emergency evacuation of the right SDH with a right decompressive frontotemporal craniectomy. Immediately after the operation, his neurological and computed tomography (CT) findings had improved. However, within 1 h after the surgery, his neurological signs deteriorated. An additional follow-up CT showed a marked midline shift to the left, i.e., paradoxical brain herniation, and his skin flap overlying the decompressive site was markedly sunken. We immediately performed an urgent cranioplasty with the right temporal lobectomy. He responded well to the procedure. We suspected that a cerebrospinal fluid leak had caused this phenomenon. Conclusion: Decompressive craniectomy for severe traumatic brain injury can lead to sinking skin flap syndrome and/or paradoxical brain herniation even in the acute phase. We believe that immediate cranioplasty allows the reversal of such neurosurgical complications.

scholarly journals Eyelid Edema: A Rare Cause of a Common Sign

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Andreia Soares ◽  
Cristina Almeida ◽  
Cristina Freitas ◽  
Marco Sales-Sanz ◽  
Sara Ribeiro
Keyword(s):  
Csf Leak ◽  
Orbital Fracture ◽  
Minor Trauma ◽  
Ophthalmological Examination ◽  
Brain Herniation ◽  
Orbital Roof ◽  
Eyelid Edema ◽  
Eyelid Swelling ◽  
Common Sign ◽  
The Right

We report a 48-year-old female patient who presented to the emergency room with right eyelid edema, with 3 days of evolution. She had suffered minor trauma to this eye one week before. She reported episodes of right eyelid swelling of spontaneous resolution since the occurrence of a traumatic brain injury 5 years ago. Ophthalmological examination showed a soft and painless eyelid edema of the right eye. Brain computed tomography showed an area of bone discontinuity of the orbital roof with brain herniation and a CSF leak into the eyelid (blepharocele). Magnetic resonance confirmed the result of TC and revealed an area of frontal encephalomalacia. Ibuprofen (800 mg/day) was prescribed, with complete resolution within 20 days. She was evaluated by Neurosurgery with no indication of surgery due to the resolution of the edema and absence of symptoms. Blepharocele is a rare entity that should be considered in the differential diagnosis of unilateral eyelid edema. It can be secondary to an orbital fracture or congenital lesion.

Preoperative Onyx embolization of a giant cavernous malformation involving the dural sinuses

2009 ◽  
Vol 3 (4) ◽  
pp. 302-306 ◽  
Author(s):  
Shervin R. Dashti ◽  
David Fiorella ◽  
Robert F. Spetzler ◽  
Elisa Beres ◽  
Cameron G. McDougall ◽  
...  
Keyword(s):  
Blood Loss ◽  
Transarterial Embolization ◽  
Vascular Lesions ◽  
Preoperative Embolization ◽  
Cavernous Malformations ◽  
Dural Sinuses ◽  
Ideal Agent ◽  
Liquid Embolic ◽  
Feeding Vessels ◽  
The Right

Cavernous malformations (CMs) or hemangiomas arising from within the dural sinuses are rare entities that differ from their parenchymal counterparts in that they are highly vascular lesions. While parenchymal CMs are typically angiographically occult, intrasinus malformations may have large, dural-based arterial feeding vessels that are amenable to preoperative embolization. The novel liquid embolic Onyx (ev3, Inc.) is an ideal agent for the embolization of these lesions. The authors present the first known case of a giant intrasinus CM embolized with Onyx before gross-total resection. The authors report the case of a 9-year-old boy with brief apneic episodes in whom MR imaging revealed a giant CM arising from within the right transverse and sigmoid sinuses and infiltrating the right tentorium cerebelli. At another institution, the patient had undergone 1 prior embolization and 2 unsuccessful attempts at resection. Both surgeries had been complicated by massive blood loss and were aborted. Under the authors' care, the patient underwent preoperative transarterial embolization with Onyx during which a substantial volume of the mass lesion was filled with embolisate. Subsequently, complete circumferential excision of the mass from the tentorium was accomplished with minimal intraoperative blood loss.

The false fontanel

1984 ◽  
Vol 61 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Richard L. Saunders
Keyword(s):  
Cerebrospinal Fluid Leak ◽  
Illustrative Case ◽  
Anterior Fontanel ◽  
Brain Herniation ◽  
Content Type ◽  
Cranial Window ◽  
The Right ◽  
Fluid Leak ◽  
The Brain ◽  
Infants And Young Children

✓ In the neonate, palpation of the anterior fontanel is recognized as a simple and reliable means for estimating intracranial pressure. With closure of the fontanel this aspect of the clinical examination is lost. The authors report a series of 15 shunted infants and children in whom a false fontanel was created by making a 2-cm craniectomy in the right parietal region and excising the underlying internal pericranium. This produces a cranial opening which, like the anterior fontanel, can be used for palpation and real-time ultrasound imaging of the brain. By removing the internal pericranium, reossification of the defect is delayed by more than 12 months. Sparing the dura propria avoids the risks of cerebrospinal fluid leak or brain herniation into the cranial window. This procedure is reported to be simple, reliable, and of value in assessing shunt function in hydrocephalic infants and young children. An illustrative case report is presented.

scholarly journals Post-operative Temporal Lobe Encephalocele

2018 ◽  
Vol 33 (1) ◽  
pp. 56-57
Author(s):  
Ian C. Bickle ◽  
Fakrudin Salim
Keyword(s):  
High Resolution ◽  
Temporal Lobe ◽  
Middle Ear ◽  
Mastoid Cavity ◽  
Brain Herniation ◽  
Intracranial Abscess ◽  
Tegmen Tympani ◽  
The Right ◽  
Temporal Bones ◽  
The Brain

  This 24-year-old woman presented to ENT outpatients with an enlarging swelling in the right external auditory canal.  A radical mastoidectomy for chronic suppurative otitis media with cholesteatoma had previously been undertaken at another institution.  On clinical examination there was an otologic mass that was tender on probing. High resolution imaging of the temporal bones and a subsequent MRI brain confirmed the mass was a temporal lobe encephalocele. A temporal lobe encephalocele is where a segment of the temporal lobe invaginates through a defect in the tegmen tympani.  The brain is separated from the middle ear and mastoid process by an exceptionally thin layer of bone – the tegmen tympani. Damage to the tegmen compromises the barrier with the brain and may occur for a number of reasons.  This includes congenital, traumatic, post-infectious, malignant invasion, post-radiation therapy and post-surgical causes.1 When this occurs the brain may extrude through the defect resulting in a temporal lobe encephalocele.  A bony defect alone, whatever the cause, is insufficient to always result in an encephalocele.  Even with dehiscence of the tegmen the dura is capable of supporting the brain issue without herniation.  Only when the integrity of the dura is compromised does an encephalocele occur.2 This may be due to the underlying disease process (such as cholesteatoma causing an intracranial abscess) or both purposeful (opening dura to drain an adjacent intracranial abscess) /non-purposeful surgical intervention.  Mainstream microsurgical techniques however have lowered the incidence of dural violation.3 Historically, infection was a major cause, but with the ready availability of antibiotics and prompt management, the key contemporary cause is iatrogenic, following mastoid surgery.  However, the overall incidence is uncommon following otologic surgery.  In a review of 25 years of middle ear/mastoid encephalocele cases 77% were identified to be iatrogenic in origin.4 This patient presented with the finding of a mass observed in the external auditory canal.  Less common findings at attendance include tympanic perforation, cholesteatoma, otorrhoea and meningitis.4   The key to diagnosis hinges on cross-sectional imaging: combined imaging with CT to assess the osseous structures and MRI for soft tissue review.  The high-resolution CT (HRCT) of the temporal bones illustrates a large defect in the right tegmen tympani with a large soft tissue lesion occupying the post-surgical mastoid cavity abutting the tympanic membrane. (Figures 1A, B) The defect of 15mm in the tegmen was more than double the average of 7.2mm reported elsewhere.4 The MRI confirms the defect in the tegmen with the protrusion of a knuckle of the right temporal lobe and its overlying meninges through the defect into the mastoid cavity. The dumb-bell appearance is typical with the narrower neck at the site of the tegmental dehiscence. The extruded brain occupies the post-operative middle ear cavity. (Figures 2 A, B and C) The defect size and volume of herniated brain can be accurately assessed, both of which may be key determinates of the type of surgical procedure. Revision mastoidectomy with repair of the tegmen defect and dural integrity using a combined intracranial-mastoid approach is planned as a joint case with neurosurgical colleagues. References McMurphy AB, Oghalai JS. Repair of iatrogenic temporal lobe encephalocele after canal wall down mastoidectomy in the presence of active cholesteatoma.  Otol Neurotol. 2005 Jul;26(4):587-94. PMID:16015151   Neely JG, Kuhn JR. Diagnosis amd treatment of iatrogenic cerebrospinal fluid leak and brain herniation during or following mastoidectomy. Laryngoscope 1985 Nov;95(11):1299-300. PMID:4058205   Glasscock ME 3rd, Dickins JR, Jackson CG, Wiet RJ, Feenstra L.           Surgical management of brain tissue herniation into the middle ear and              mastoid. Laryngoscope. 1979 Nov;89(11):1743-54. DOI:10.1288/00005537-197911000-00005 PMID:502695   Jackson CG, Pappas DG Jr, Manolidis S, Glasscock ME 3rd, Von Doersten PG, Hampf CR, Williams JB, Storper IS. Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol. 1997 Mar;18(2):198-205. PMID:9093677  

Investor-State Dispute Settlement under NAFTA Chapter 11: The Shape of Things to Come?

1998 ◽  
Vol 35 ◽  
pp. 263-290
Author(s):  
J. Anthony VanDuzer
Keyword(s):  
Free Trade Agreement ◽  
Dispute Settlement ◽  
Trade Agreement ◽  
Minimum Standards ◽  
The North ◽  
State Behaviour ◽  
Nafta Chapter 11 ◽  
To Come ◽  
The Right

SummaryRecently, there has been a proliferation of international agreements imposing minimum standards on states in respect of their treatment of foreign investors and allowing investors to initiate dispute settlement proceedings where a state violates these standards. Of greatest significance to Canada is Chapter 11 of the North American Free Trade Agreement, which provides both standards for state behaviour and the right to initiate binding arbitration. Since 1996, four cases have been brought under Chapter 11. This note describes the Chapter 11 process and suggests some of the issues that may arise as it is increasingly resorted to by investors.

What face familiarity feelings say about the lateralization of specific entities within the core system

2019 ◽  
Vol 42 ◽  
Author(s):  
Guido Gainotti
Keyword(s):  
Temporal Lobe ◽  
Memory System ◽  
Core System ◽  
The Core ◽  
Memory Traces ◽  
Specific Memory ◽  
Target Article ◽  
Temporal Structures ◽  
The Right

Abstract The target article carefully describes the memory system, centered on the temporal lobe that builds specific memory traces. It does not, however, mention the laterality effects that exist within this system. This commentary briefly surveys evidence showing that clear asymmetries exist within the temporal lobe structures subserving the core system and that the right temporal structures mainly underpin face familiarity feelings.

Study of charge transfer in FeTi

1983 ◽  
Vol 41 ◽  
pp. 296-297
Author(s):  
J. Taft∅
Keyword(s):  
Charge Transfer ◽  
Charge Distribution ◽  
Electron Scattering ◽  
Periodic System ◽  
Electron Distribution ◽  
Scattering Amplitude ◽  
Transition Elements ◽  
Hartree Fock ◽  
Cscl Structure ◽  
The Right

It is well known that for reflections corresponding to large interplanar spacings (i.e., sin θ/λ small), the electron scattering amplitude, f, is sensitive to the ionicity and to the charge distribution around the atoms. We have used this in order to obtain information about the charge distribution in FeTi, which is a candidate for storage of hydrogen. Our goal is to study the changes in electron distribution in the presence of hydrogen, and also the ionicity of hydrogen in metals, but so far our study has been limited to pure FeTi. FeTi has the CsCl structure and thus Fe and Ti scatter with a phase difference of π into the 100-ref lections. Because Fe (Z = 26) is higher in the periodic system than Ti (Z = 22), an immediate “guess” would be that Fe has a larger scattering amplitude than Ti. However, relativistic Hartree-Fock calculations show that the opposite is the case for the 100-reflection. An explanation for this may be sought in the stronger localization of the d-electrons of the first row transition elements when moving to the right in the periodic table. The tabulated difference between fTi (100) and ffe (100) is small, however, and based on the values of the scattering amplitude for isolated atoms, the kinematical intensity of the 100-reflection is only 5.10-4 of the intensity of the 200-reflection.

New Dimensions in Freeze-Etching

1969 ◽  
Vol 27 ◽  
pp. 202-203 ◽  
Author(s):  
Russell L. Steere ◽  
Michael Moseley
Keyword(s):  
Fracture Surfaces ◽  
Aluminum Specimen ◽  
Specimen Holder ◽  
Freeze Etching ◽  
The Right

A redesigned specimen holder and cap have made possible the freeze-etching of both fracture surfaces of a frozen fractured specimen. In principal, the procedure involves freezing a specimen between two specimen holders (as shown in A, Fig. 1, and the left side of Fig. 2). The aluminum specimen holders and brass cap are constructed so that the upper specimen holder can be forced loose, turned over, and pressed down firmly against the specimen stage to a position represented by B, Fig. 1, and the right side of Fig. 2.

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