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Cavernous Sinus

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1. Cavernous sinus thrombosis

Cavernous sinus thrombosis Cavernous sinus thrombosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cavernous sinus thrombosis Last reviewed: February 2019 Last updated: December 2017 Summary Thrombus formation within the cavernous sinus, which may be either septic or aseptic in origin. Infection can spread to the cavernous sinus either as an extension of thrombophlebitis or by septic emboli. The origin of aseptic (...) cavernous sinus thrombosis is usually through trauma or a prothrombotic condition. In the pre-antibiotic era, infections of the middle third of the face were responsible for the majority of cases. Currently, the most common cause is as a complication of acute sinusitis. Diagnosis is usually made through clinical evaluation together with imaging (CT or MRI). In the acute presentation, one eye is typically affected first, followed by the second eye within 48 hours of symptom onset. Must be differentiated

2017 BMJ Best Practice

2. Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection (Full text)

Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection Iatrogenic cavernous carotid pseudoaneurysms are a special group among other intracranial aneurysms. They can occur during the dissection phase of the surgery if the tumor encases a vessel. Complications of their rupture as hemorrhage or stroke are life threatening. Early recognition and treatment is mandatory to avoid catastrophic sequelae. We present the successful diagnosis and endovascular treatment (...) of a postoperative cavernous carotid pseudoaneurysm following radical cavernous sinus resection.

2016 Journal of neurological surgery reports PubMed

3. Hemangioma of the Cavernous Sinus: A Case Series (Full text)

Hemangioma of the Cavernous Sinus: A Case Series Introduction  Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are diagnosed with a combination of imaging and biopsy. We describe the clinical presentations, imaging findings, and management of two male patients with CSHs. Case Report  Case 1 describes a 57-year-old man who presented with vision changes and cranial nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m tagged red

2018 Journal of neurological surgery reports PubMed

4. Severe unilateral abducens nerve palsy from cavernous sinus carotid vascular ectasia (Full text)

Severe unilateral abducens nerve palsy from cavernous sinus carotid vascular ectasia Carotid cavernous sinus ectasia is a rare cause of abducens nerve palsy.We present a case of severe unilateral progressive esotropia resulting from cavernous sinus carotid vascular ectasia in a 67 y/o female. She had progressive esotropia over the years with no neuroimaging despite having regular ophthalmic care. Magnetic resonance imaging determined the etiology of her chronic severe esotropia.Carotid (...) cavernous sinus ectasia should be considered in the differential of severe progressive unilateral abducens nerve palsy. Magnetic resonance imaging with magnetic resonance angiography is important to determine etiology of severe progressive esotropia.

2018 American journal of ophthalmology case reports PubMed

5. Cavernous sinus syndrome associated with metastatic colorectal cancer and perineural spread along the trigeminal nerve (Full text)

Cavernous sinus syndrome associated with metastatic colorectal cancer and perineural spread along the trigeminal nerve We report the case of a patient with cavernous sinus syndrome associated with biopsy-confirmed metastasis from colorectal cancer.A patient known for laryngeal carcinoma and metastatic colorectal carcinoma presented with symptoms of left trigeminal neuralgia and progressive, near-complete ophthalmoplegia. Magnetic resonance imaging (MRI) revealed a mass in the left cavernous (...) sinus, extending into Meckel's cave with perineural spread along the mandibular branch of the left trigeminal nerve. A transsphenoidal biopsy was performed and demonstrated metastatic colon adenocarcinoma. We review the existing literature on colorectal cancer associated cavernous sinus syndrome.Cavernous sinus metastasis from colorectal cancer is exceedingly rare. We report the second case of this entity with histopathologic confirmation, and the first case with concurrent perineural spread

2017 American journal of ophthalmology case reports PubMed

6. Bilateral cavernous sinus thrombosis with septic lung lesions resulting from a nasal abscess (Full text)

Bilateral cavernous sinus thrombosis with septic lung lesions resulting from a nasal abscess 29260092 2019 02 26 2451-9936 7 2017 Sep American journal of ophthalmology case reports Am J Ophthalmol Case Rep Bilateral cavernous sinus thrombosis with septic lung lesions resulting from a nasal abscess. 113-114 10.1016/j.ajoc.2017.06.005 Schear Matthew J MJ Northwell Health Department of Ophthalmology, Hofstra Northwell School of Medicine, 600 Northern Blvd, Suite 214, Great Neck, NY 11021, United (...) States. Weiss Alexander A Northwell Health Department of Ophthalmology, Hofstra Northwell School of Medicine, 600 Northern Blvd, Suite 214, Great Neck, NY 11021, United States. Rodgers Rand R Northwell Health Department of Ophthalmology, Hofstra Northwell School of Medicine, 600 Northern Blvd, Suite 214, Great Neck, NY 11021, United States. eng Case Reports 2017 06 21 United States Am J Ophthalmol Case Rep 101679941 2451-9936 Cavernous sinus thrombosis Orbital infection 2016 12 31 2017 04 16 2017 06

2017 American journal of ophthalmology case reports PubMed

7. Traumatic Carotid Cavernous Fistula with a Connection between the Supraclinoid Internal Carotid Artery and Cavernous Sinus via a Pseudoaneurysm Presenting with Delayed Life-threatening Epistaxis (Full text)

Traumatic Carotid Cavernous Fistula with a Connection between the Supraclinoid Internal Carotid Artery and Cavernous Sinus via a Pseudoaneurysm Presenting with Delayed Life-threatening Epistaxis Traumatic carotid cavernous fistula (CCF) presents most commonly as a direct connection between the cavernous segment of internal carotid artery (ICA) and cavernous sinus (CS), and often accompanies basal skull fracture (BSF). The most frequently reported signs and symptoms are proptosis, chemosis

2017 NMC Case Report Journal PubMed

8. Venous outflow restriction as a predictor of cavernous sinus dural arteriovenous fistula obliteration after Gamma Knife surgery. (PubMed)

Venous outflow restriction as a predictor of cavernous sinus dural arteriovenous fistula obliteration after Gamma Knife surgery. OBJECTIVEGamma Knife surgery (GKS) obliterates 65%-87% of cavernous sinus dural arteriovenous fistulas (CSDAVFs). However, the hemodynamic effect on GKS outcomes is relatively unknown. The authors thus used the classification scheme developed by Suh et al. to explore this effect.METHODSThe authors retrospectively (1993-2016) included 123 patients with CSDAVFs who

2019 Journal of Neurosurgery

9. Cavernous sinus aneurysms: risk of growth over time and risk factors. (PubMed)

Cavernous sinus aneurysms: risk of growth over time and risk factors. OBJECTIVECavernous internal carotid artery (ICA) aneurysms are frequently diagnosed incidentally and the benign natural history of these lesions is well known, but there is limited information assessing the risk of growth in untreated patients. The authors sought to assess and analyze risk factors in patients with cavernous ICA aneurysms and compare them to those of patients with intracranial berry aneurysms in other (...) locations.METHODSData from consecutive patients who were diagnosed with a cavernous ICA aneurysm were retrospectively reviewed. The authors evaluated patients for the incidence of cavernous ICA aneurysm growth and rupture. In addition, the authors analyzed risk factors for cavernous ICA aneurysm growth and compared them to risk factors in a population of patients diagnosed with intracranial berry aneurysms in locations other than the cavernous ICA during the same period.RESULTSIn 194 patients with 208 cavernous ICA

2019 Journal of Neurosurgery

10. Outcomes of decompressive surgery for cavernous sinus meningiomas: long-term follow-up in 50 patients. (PubMed)

Outcomes of decompressive surgery for cavernous sinus meningiomas: long-term follow-up in 50 patients. OBJECTIVECavernous sinus meningiomas are complex tumors that offer a perpetual challenge to skull base surgeons. The senior author has employed a management strategy for these lesions aimed at maximizing tumor control while minimizing neurological morbidity. This approach emphasizes combining "safe" tumor resection and direct decompression of the roof and lateral wall of the cavernous sinus (...) as well as the optic nerve. Here, the authors review their experience with the application of this technique for the management of cavernous sinus meningiomas over the past 15 years.METHODSA retrospective analysis was performed for patients with cavernous sinus meningiomas treated over a 15-year period (2002-2017) with this approach. Patient outcomes, including cranial nerve function, tumor control, and surgical complications were recorded.RESULTSThe authors identified 50 patients who underwent

2019 Journal of Neurosurgery

11. Isolated third nerve palsy with pupillary involvement resulting from carotid-cavernous sinus fistula: A case report. (Full text)

Isolated third nerve palsy with pupillary involvement resulting from carotid-cavernous sinus fistula: A case report. Isolated third nerve palsy with pupillary involvement caused by a posterior drainage carotid-cavernous sinus fistula (CCF) is relatively rare. Diagnosis of a posterior drainage CCF can often be delayed due to its unapparent congestive signs.Here, we present the case of a young male patient with right-sided CCF, who presented with right-side headache and partial third nerve palsy

2019 Medicine PubMed

12. Cavernous sinus-orbital apex aspergillus infection in a diabetic patient: A case report. (Full text)

Cavernous sinus-orbital apex aspergillus infection in a diabetic patient: A case report. Cavernous sinus-orbital apex aspergillosis is a rare but serious complication of rhinosinusitis. Pathology results are scarce, and this condition is difficult to diagnose based on clinical and radiological results.A 64-year-old woman presented with cavernous sinus-orbital apex syndrome. Axial and sagittal T1 contrast-enhanced magnetic resonance imaging (MRI) showed a right orbital apex mass abutting (...) the right posterior ethmoid sinus, sphenoid sinus, and cavernous sinus.Cavernous sinus and orbital apex aspergillosis.Functional endoscopic sinus surgery was performed, and a biopsy of the lesion tissue was submitted for examination, which showed the presence of aspergillus.One year after surgical debridement, antifungal, and anticoagulation treatments, the patient is still asymptomatic without recurrence.Early surgical debridement is crucial to confirm the diagnosis of cavernous sinus-orbital apex

2019 Medicine PubMed

13. A case of meningioma originating from the lateral wall of the cavernous sinus. (PubMed)

A case of meningioma originating from the lateral wall of the cavernous sinus. Meningioma originating from the lateral wall of the cavernous sinus is rare with only two reported cases. A 67-year-old man presented with recent memory disturbance and partial seizure. Magnetic resonance imaging revealed a well-demarcated and homogeneously enhanced mass lesion originating from the lateral wall of the left cavernous sinus. Total tumor removal was performed through a combined epi- and intradural

2019 British Journal of Neurosurgery

14. Unique case of trigeminal neuralgia due to Epstein-Barr-virus-associated B-cell lymphomatoid granulomatosis of the Meckel's cave and cavernous sinus: Important clinical and therapeutic implications (Full text)

Unique case of trigeminal neuralgia due to Epstein-Barr-virus-associated B-cell lymphomatoid granulomatosis of the Meckel's cave and cavernous sinus: Important clinical and therapeutic implications Trigeminal neuralgia (TN) represents one of the most disabling pain syndromes. Several diseases have been described as etiological triggers of TN, vascular compression of the trigeminal nerve being the most frequent cause. Here, we describe for the first time a rare case of TN caused (...) by an infiltration of an isolated Epstein-Barr virus (EBV) B-cell lymphomatoid granulomatosis (LYG) mass into the Meckel's cave and cavernous sinus.A 51-year-old woman undergoing immunosuppressant treatment for Crohn's disease presented due to right-sided TN. Magnetic resonance imaging (MRI) scans revealed an isolated lesion affecting the right Meckel's cave and lateral wall of the cavernous sinus. We accomplished tumor resection through a subtemporal extradural approach and the patient recovered successfully

2018 Surgical neurology international PubMed

15. Prediction of cavernous sinus invasion in patients with Cushing's disease by magnetic resonance imaging. (PubMed)

Prediction of cavernous sinus invasion in patients with Cushing's disease by magnetic resonance imaging. OBJECTIVECavernous sinus invasion (CSI) in Cushing's disease (CD) negatively affects the probability of complete resection, biochemical cure, and need for adjuvant therapy. However, the prediction of CSI based on MRI findings has been inconsistent and variable. Among macroadenomas, the Knosp classification is the most widely utilized radiographic predictor of CSI, but its accuracy (...) in predicting CSI and the probability of gross-total resection is limited in the setting of microadenomas or Knosp grade 0-2 macroadenomas. The authors noticed that the presence of a triangular shape of adenomas adjacent to the cavernous sinus on coronal MR images is frequently associated with CSI. The authors aimed to determine the correlation of this radiographic finding ("sail sign" [SS]) with CSI.METHODSThe authors performed a retrospective review of all patients with a pituitary lesion < 20 mm

2018 Journal of Neurosurgery

16. Natural history of cavernous sinus meningiomas. (PubMed)

Natural history of cavernous sinus meningiomas. OBJECTIVEMeningiomas confined to the cavernous sinus (MCSs) are benign tumors. Due to the high risk of severe complications, the intracavernous surgical procedure was abandoned in favor of radiotherapy. However, the choice of treatment remains complicated due to the fact that the natural history of this lesion has not yet been described.METHODSThe authors studied the natural history of this lesion using a prospective series of 53 consecutive

2018 Journal of Neurosurgery

17. Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review. (Full text)

Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review. Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas.To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International

2018 Neurosurgery PubMed

18. Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas. (PubMed)

Superiority of constructive interference in steady-state MRI sequencing over T1-weighted MRI sequencing for evaluating cavernous sinus invasion by pituitary macroadenomas. OBJECTIVEPreoperatively determining the extent of parasellar invasion of pituitary macroadenomas is useful for surgical planning and patient counseling. Here, the authors compared constructive interference in steady state (CISS), a T2-weighted gradient-echo MRI sequence, to volume-interpolated breath-hold examination (VIBE (...) ), a T1-weighted gradient-echo MRI sequence, for evaluation of cavernous sinus invasion (CSI) by pituitary macroadenomas.METHODSVIBE and CISS images of 98 patients with pituitary macroadenoma were retrospectively analyzed and graded using the modified Knosp classification. The Knosp grades were correlated to surgical findings of CSI, which were determined intraoperatively using 0° and 30° endoscopes. The predictive accuracies for CSI according to the Knosp grades derived from the CISS and VIBE images

2018 Journal of Neurosurgery

19. Cavernous sinus involvement is not a risk factor for the primary tumor site treatment outcome of Sinonasal adenoid cystic carcinoma (Full text)

Cavernous sinus involvement is not a risk factor for the primary tumor site treatment outcome of Sinonasal adenoid cystic carcinoma Sinonasal adenoid cystic carcinoma is a rare malignancy of the head and neck. Cavernous sinus invasion from sinonasal adenoid cystic carcinoma and its related management have rarely been investigated. This study evaluated the relationship between treatment outcome and cavernous sinus involvement in addition to other parameters.A retrospective case series study (...) , and the absence of skull-base and infratemporal fossa invasion were associated with better overall survival (P = 0.033, P = 0.012, P = 0.011, and P = 0.040, respectively) and better disease-free survival (P = 0.019, P = 0.001, P = 0.017, and P = 0.029, respectively). Multivariate analysis identified primary surgery as the only independent prognostic factor for disease-free survival (P = 0.026). Cavernous sinus invasion by sinonasal adenoid cystic carcinoma was not associated with worse overall survival

2018 Journal of Otolaryngology - Head & Neck Surgery PubMed

20. Cavernous sinus involvement in human papillomavirus associated oropharyngeal squamous cell carcinoma: case report of an atypical site of distant metastasis (Full text)

Cavernous sinus involvement in human papillomavirus associated oropharyngeal squamous cell carcinoma: case report of an atypical site of distant metastasis HPV-associated OSCC (HPV-OSCC) has been determined to be a distinct disease entity from non-HPV associated OSCC. Patients affected by HPV-OSCC generally have a more favourable prognosis, with improved rates of locoregional control and survival compared with their non-HPV counterparts. Despite this, HPV-OSCC has a similar rate of distant (...) squamous cell carcinoma (cT4aN2c) was diagnosed, and he was treated with primary chemoradiation. Shortly after treatment, he presented with progressive bilateral cranial nerve palsies including left cranial nerve III and right cranial nerve VI involvement. Imaging identified masses in the left cavernous sinus with extension of tumor into the sella and in the right cavernous sinus at the level of Dorello's canal. Endoscopic Image Guided Transsphenoidal biopsy of the left sellar mass confirmed distant

2018 Journal of Otolaryngology - Head & Neck Surgery PubMed

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