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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. Mobilization of the outer cavernous membrane decreases bleeding and improves resection in spheno-clinoidal meningiomas without cavernous sinus extension: A randomized controlled trial. (Abstract)

Mobilization of the outer cavernous membrane decreases bleeding and improves resection in spheno-clinoidal meningiomas without cavernous sinus extension: A randomized controlled trial. The aim of this study was to determine whether adding mobilization of the outer cavernous sinus membrane as a part of the approach, in large spheno-clinoidal meningiomas without cavernous sinus extension, would reduce bleeding and increase the extent of resection.This prospective randomized controlled trial (...) was held between February 2016 and April 2017 at Cairo University Hospitals. The study recruited 94 patients with spheno-clinoidal meningiomas without cavernous sinus involvement. Patients were randomly assigned (by a computer based randomization system) into two groups; the treatment group, in which the patients received mobilization of the outer layer of the lateral wall of the cavernous sinus, prior to opening of the dura; and, the control group, in which the patients were operated by a direct

2019 Neurology India Controlled trial quality: uncertain

3. Severe unilateral abducens nerve palsy from cavernous sinus carotid vascular ectasia Full Text available with Trip Pro

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

4. Hemangioma of the Cavernous Sinus: A Case Series Full Text available with Trip Pro

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

5. Cavernous sinus syndrome associated with metastatic colorectal cancer and perineural spread along the trigeminal nerve Full Text available with Trip Pro

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

6. Bilateral cavernous sinus thrombosis with septic lung lesions resulting from a nasal abscess Full Text available with Trip Pro

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

7. Cavernous sinus-orbital apex aspergillus infection in a diabetic patient: A case report. Full Text available with Trip Pro

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

8. A case of meningioma originating from the lateral wall of the cavernous sinus. (Abstract)

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

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

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

10. Cavernous sinus aneurysms: risk of growth over time and risk factors. (Abstract)

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

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

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

12. Isolated third nerve palsy with pupillary involvement resulting from carotid-cavernous sinus fistula: A case report. Full Text available with Trip Pro

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

13. Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection Full Text available with Trip Pro

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

14. 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 available with Trip Pro

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

15. The medial wall of the cavernous sinus. Part 2: Selective medial wall resection in 50 pituitary adenoma patients. (Abstract)

The medial wall of the cavernous sinus. Part 2: Selective medial wall resection in 50 pituitary adenoma patients. OBJECTIVEPituitary adenomas often invade the medial wall of the cavernous sinus (CS), but this structure is generally not surgically removed because of the risk of vascular and cranial nerve injury. The purpose of this study was to report the surgical outcomes in a large series of cases of invasive pituitary adenoma in which the medial wall of the CS was selectively removed

2018 Journal of Neurosurgery

16. The medial wall of the cavernous sinus. Part 1: Surgical anatomy, ligaments, and surgical technique for its mobilization and/or resection. (Abstract)

The medial wall of the cavernous sinus. Part 1: Surgical anatomy, ligaments, and surgical technique for its mobilization and/or resection. OBJECTIVEThe medial wall of the cavernous sinus (CS) is often invaded by pituitary adenomas. Surgical mobilization and/or removal of the medial wall remains a challenge.METHODSEndoscopic endonasal dissection was performed in 20 human cadaver heads. The configuration of the medial wall, its relationship to the internal carotid artery (ICA (...) ), and the ligamentous connections in between them were investigated in 40 CSs.RESULTSThe medial wall of the CS was confirmed to be an intact single layer of dura that is distinct from the capsule of the pituitary gland and the periosteal layer that forms the anterior wall of the CS. In 32.5% of hemispheres, the medial wall was indented by and/or well adhered to the cavernous ICA. The authors identified multiple ligamentous fibers that anchored the medial wall to other walls of the CS and/or to specific ICA segments

2018 Journal of Neurosurgery

17. Endoscopic Endonasal Approach to the Lateral Wall of the Cavernous Sinus: A Cadaveric Feasibility Study. (Abstract)

Endoscopic Endonasal Approach to the Lateral Wall of the Cavernous Sinus: A Cadaveric Feasibility Study. A transcranial extradural approach to the middle cranial fossa (MCF) requires separation of the dural layers of the lateral wall of the cavernous sinus. The authors tested the feasibility of an endonasal approach for this separation.A cadaveric feasibility study was conducted on the sides of 14 dry skulls and 10 fresh cadaveric heads. An endonasal, transsphenoidal, transpterygoid approach (...) was taken to the MCF. The maxillary struts and medial greater wing of the sphenoid below the superior orbital fissure were drilled with transposition of the maxillary nerve. The lateral cavernous dural layers were split at the maxillary nerve with separation of the temporal lobe dura and exposure of the MCF bony base. The integrity of the cranial nerves and inner and outer dural layers of the lateral cavernous wall was checked. Different measurements of bony landmarks were obtained.The integrity

2018 Rhinology and Laryngology

18. Prognosis of septic cavernous sinus thrombosis remarkably improved: a case series of 12 patients and literature review Full Text available with Trip Pro

Prognosis of septic cavernous sinus thrombosis remarkably improved: a case series of 12 patients and literature review Septic cavernous sinus thrombosis (CST) is a rare complication of infections in the head and neck area. CST is notorious for its bad prognosis, with high mortality and morbidity rates described in literature. However, these rates are based on old series. We question whether the prognosis of CST is currently still as devastating. The primary purpose of this study is to assess (...) the mortality and morbidity of CST.Using the databases of all relevant specialties in our tertiary referral hospital, we collected all the patients treated for CST in the period 2005-2017. In addition, a PubMed search, using the mesh term 'cavernous sinus thrombosis', was performed.We found 12 patients with CST in the study period. Of the 12 patients, 11 survived and 9 recovered without any permanent deficits. Seven patients were treated with anticoagulation, and in none of the patients we saw hemorrhagic

2018 European Archives of Oto-Rhino-Laryngology

19. Infantile Dermoid Cyst in the Lateral Wall of the Cavernous Sinus: A Case Report and Literature Review Full Text available with Trip Pro

Infantile Dermoid Cyst in the Lateral Wall of the Cavernous Sinus: A Case Report and Literature Review Dermoid tumors originating from the cavernous sinus are typically intradural, and thus, presentation with ophthalmoplegia is uncommon. Infantile dermoid tumors originating from the interdural space of the lateral wall of the cavernous sinus are also very rare. We herein present a 4-year-old infantile case of a dermoid cyst that was embedded in the lateral wall of the cavernous sinus (...) . The patient presented with oculomotor nerve palsy. Magnetic resonance image demonstrated a well-circumscribed oval lesion inside the lateral wall of the left cavernous sinus. The lesion had two solid components that were hyperintense on T1- and T2-weighted images and was associated with a cystic mass that included fluid with the same signal intensity as cerebrospinal fluid. Gross total removal via a frontotemporal approach was performed. The symptoms markedly recovered in the 6-month follow-up

2018 NMC Case Report Journal

20. 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 available with Trip Pro

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

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