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Cavernous Sinus

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101. Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature Full Text available with Trip Pro

Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review (...) for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA). DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS) may be used as alternatives

2015 Case reports in otolaryngology

102. Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children. (Abstract)

Ophthalmic manifestations and outcomes after cavernous sinus thrombosis in children. To review the causes, treatment, and outcomes of cavernous sinus thrombosis (CST) in children.The medical records of children (<18 years of age) diagnosed with thrombophlebitis of an intracranial venous sinus were reviewed to identify cases of CST presenting to Children's Hospital Colorado from January 2000 through January 2013. Cases were evaluated for etiology, symptoms, imaging characteristics, treatment (...) , and outcomes.A total of 110 children with a venous thrombus of an intracranial sinus were included. Of these, 9 had a CST. All cases were confirmed by magnetic resonance imaging. All 9 had sinusitis, 4 had orbital involvement, and 1 resulted from a nasal septal abscess. Eight cases presented with ophthalmoplegia, and 5 presented with decreased vision. Every patient underwent sinus surgery: 4 underwent orbitotomy for abscess drainage, and 1 required bilateral exenteration. Cultures were inconclusive in 2

2015 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

103. Dopamine Agonists Withdrawal Study of Invasive Prolactinomas Involving the Cavernous Sinus

Dopamine Agonists Withdrawal Study of Invasive Prolactinomas Involving the Cavernous Sinus Dopamine Agonists Withdrawal Study of Invasive Prolactinomas Involving the Cavernous Sinus - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Dopamine Agonists Withdrawal Study of Invasive Prolactinomas Involving the Cavernous Sinus The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT02536261 Recruitment Status : Recruiting First Posted

2015 Clinical Trials

104. Gamma Knife radiosurgery for the treatment of cavernous sinus hemangiomas Full Text available with Trip Pro

Gamma Knife radiosurgery for the treatment of cavernous sinus hemangiomas The present retrospective study aimed to analyze the outcome of patients with cavernous sinus hemangioma (CSH) treated with Gamma Knife radiosurgery (GKS). Between August 2011 and April 2014, 7 patients with CSHs underwent GKS. GKS was performed as the sole treatment option in 5 patients, whilst partial resection had been performed previously in 1 patient and biopsy had been performed in 1 patient. The mean volume

2015 Oncology letters

105. Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. Full Text available with Trip Pro

Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. OBJECT An important prognostic factor for the surgical outcome and recurrence of a pituitary adenoma is its invasiveness into parasellar tissue, particularly into the space of the cavernous sinus (CS). The aims of this study were to reevaluate the existing parasellar classifications using an endoscopic technique and to evaluate the clinical and radiological

2015 Journal of Neurosurgery

106. Septic cavernous sinus thrombosis secondary to acute bacterial sinusitis: a retrospective study of seven cases. (Abstract)

Septic cavernous sinus thrombosis secondary to acute bacterial sinusitis: a retrospective study of seven cases. Septic cavernous sinus thrombosis (SCST) is a rare but severe complication of acute bacterial sinusitis. Evaluations of advances in imaging techniques as well as in medical and surgical treatment are hampered by the lack of recent studies.We aim to report our experience in the management of SCST in patients with acute bacterial sphenoid sinusitis over the past 10 years and to discuss (...) the initial work-up and treatment strategies.We performed a retrospective study of patients admitted for SCST related to acute sinusitis at a tertiary care center between 2003 and 2013. Clinical charts were reviewed for demographics, clinical presentations, imaging and microbiologic findings, medical and surgical treatments, and outcomes.Seven patients were treated for SCST. Sphenoid sinus was involved in all cases. The most frequent presenting signs included headache (100%), cranial nerve impairment (86

2015 American journal of rhinology & allergy

107. A Ruptured Dermoid Cyst of the Cavernous Sinus Extending into the Posterior Fossa Full Text available with Trip Pro

A Ruptured Dermoid Cyst of the Cavernous Sinus Extending into the Posterior Fossa Supratentorial dermoid cysts are uncommon to develop in the cavernous sinus. We present a ruptured dermoid cyst of the cavernous sinus extending into the posterior fossa. The patient was a 32-year-old female who complained occipital headache, blurred vision, and tinnitus over 4 years. Brain magnetic resonance (MR) imaging revealed an enhanced tumor in the right cavernous sinus extending into the right temporal (...) base and the posterior fossa with findings of ruptured cyst. Surgical resection was performed, and pathological findings were confirmed to be a dermoid cyst. We report a second case with ruptured dermoid cyst of the cavernous sinus extending into the posterior fossa.

2015 Journal of Korean Neurosurgical Society

108. Conservative management of cavernous sinus cavernous hemangioma in pregnancy. Full Text available with Trip Pro

Conservative management of cavernous sinus cavernous hemangioma in pregnancy. Cavernous sinus cavernous hemangiomas in pregnancy are extremely rare lesions. The precise management of these lesions remains unknown. The authors present a case of a cavernous hemangioma in pregnancy, centered within the cavernous sinus that underwent postpartum involution without surgical intervention. A 34-year-old pregnant patient (gravida 1, para 0) presented to an otolaryngologist with persistent headache (...) and left-sided facial pain and numbness in the V1 distribution. While being treated for sinusitis, her symptoms progressed to include a left-sided oculomotor palsy and abducens palsy. Magnetic resonance imaging without contrast revealed an expansile mass within the left cavernous sinus consistent with a cavernous hemangioma. The patient was evaluated by a neurosurgeon who recommended close follow-up and postpartum imaging without surgical intervention. Although the lesion enlarged during pregnancy

2014 Journal of Neurosurgery

109. Sclerosing cavernous hemangioma of the cavernous sinus mimicking congenital fibrosis of the extraocular muscles. Full Text available with Trip Pro

Sclerosing cavernous hemangioma of the cavernous sinus mimicking congenital fibrosis of the extraocular muscles. A girl with a clinical presentation suggestive of unilateral congenital fibrosis of the extraocular muscles type 3 at 2 years of age years later developed progressive ophthalmoplegia and an afferent pupillary defect. Reimaging revealed a lesion diagnosed as a sclerosing cavernous sinus hemangioma with focal calcification. Cavernous sinus hemangioma is a rare, benign vascular

2014 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

110. Gamma knife radiosurgery as an alternative treatment of Barrow type B carotid cavernous fistulas: A case report. Full Text available with Trip Pro

Gamma knife radiosurgery as an alternative treatment of Barrow type B carotid cavernous fistulas: A case report. Barrow type B carotid-cavernous fistulas are dural shunts between the meningeal branches of the internal carotid artery and the cavernous sinus; these types of dural fistulas can produce specific patterns of symptoms based on the pattern of venous drainage.A 67-year-old man came to our hospital presenting with acute left orbital pain and double vision in the left eye. The diagnosis (...) was carotid-cavernous fistula fed by the meningohypophyseal trunk and drained to the left superior ophthalmic vein.We planned gamma knife radiosurgery for the left cavernous sinus including fistula point as an alternative treatment. The orbital pain disappeared in 2 weeks, and all signs and symptoms in the left eye completely improved within 2 months.Gamma knife radiosurgery may be an alternative treatment for carotid cavernous fistula. Furthermore, in patients with poor vascular access and no fatal

2019 Medicine

111. Post-traumatic Cavernous Carotid Pseudoaneurysm with Delayed Epistaxis Full Text available with Trip Pro

Post-traumatic Cavernous Carotid Pseudoaneurysm with Delayed Epistaxis Cavernous carotid aneurysms (CCAs) pose considerable dilemmas in management. Delayed post-traumatic epistaxis is a rare presentation of CCA. Clinically, the symptomatic triad of unilateral blindness, orbital fractures, and massive epistaxis is pathognomonic for internal carotid artery (ICA) pseudoaneurysm. The epistaxis is usually profound, intermittent, and life-threatening in nature. As most of these cases are initially (...) seen by a physician, a high index of suspicion is essential during its early identification. Traumatic aneurysms are pseudoaneurysms with a fibrous wall that rupture and cause massive epistaxis resulting from disruption through the sphenoid sinus wall. We report a young adult who presented with the triad and severe anemia four months following head injury. He was treated with ligation of the carotid artery and a high-flow extracranial-intracranial (EC-IC) bypass. In the era of endovascular coiling

2018 Cureus

112. A Case of Right-Sided Direct Carotid Cavernous Fistula: A Diagnostic Challenge Full Text available with Trip Pro

A Case of Right-Sided Direct Carotid Cavernous Fistula: A Diagnostic Challenge BACKGROUND Carotid cavernous fistulas (CCFs) are rare potentially sight-threatening abnormal connections between carotid artery and cavernous sinus. CASE REPORT We report a case of CCF in an 83-year-old female, who presented with swollen and painful right eye. The patient was initially treated with empiric antibiotics for suspected peri-orbital cellulitis, as noted clinically and in computed tomography (CT) orbits

2018 The American journal of case reports

113. Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report. Full Text available with Trip Pro

(PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention.Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V1) and maxillary (V2) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should (...) be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral posterior circulation cerebral infarction (i.e., occipital lobe infarction) can occur in CCA patients, presumably as a result of distal embolization through an ipsilateral, prominent PCOM. Spontaneous clinical improvement with stable radiographic support may occur.

2018 BMC Ophthalmology

114. A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report. Full Text available with Trip Pro

tumor was completely removed with 2 sessions of Gamma Knife radiotherapy after surgery.We were confronted with excessive bleeding during surgery so we attained subtotal resection. However, the patient recovered well with no recurrence of the tumor.Our case shows that space occupying lesions involving the cavernous sinus and sphenoid ridged could be easily misdiagnosed as sphenoid wing meningiomas in children and adolescents and even adults therefore great care must be exercised when confronted (...) A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report. Central nervous system (CNS) solid cavernous hemangiomas are rare extra-axial anomalies that may sometimes resemble meningiomas. Due to their complex vascular nature, accurate preoperative diagnosis is important to avoid disastrous hemorrhage during operation. To the best of our knowledge this is the first case in an adolescent since all middle cranial fossa hemangioma cases reported

2018 Medicine

115. Fractionated External-beam Radiation Therapy For Incompletely Resected Intracranial Extra-axial Cavernous Haemangioma: A Case Report Full Text available with Trip Pro

Fractionated External-beam Radiation Therapy For Incompletely Resected Intracranial Extra-axial Cavernous Haemangioma: A Case Report We report a case of a cavernous haemangioma arising from the left trigeminal nerve causing mass effect, midline shift and hydrocephalus. Surgical resection was attempted after immediate insertion of bilateral extra-ventricular drains, but complete resection was not achieved, with residual disease at the superior orbital fissure and cavernous sinus. Stereotactic

2018 Cureus

116. Pathophysiology of carotid-cavernous fistulas in vascular Ehlers-Danlos syndrome: a retrospective cohort and comprehensive review Full Text available with Trip Pro

-39.0]). Increased carotid circumferential wall stress, higher carotid distensibility and lower carotid intima-media thickness could contribute to a higher risk for direct sCCF in vEDS. There is no predictive factor for the occurrence of sCCF apart from female sex in vEDS.In vEDS, anatomical and pathophysiological features of the intra-cavernous internal carotid artery make it prone to shunting in the cavernous sinus, due either to a spontaneous rupture or to a spontaneous dissection (...) Pathophysiology of carotid-cavernous fistulas in vascular Ehlers-Danlos syndrome: a retrospective cohort and comprehensive review Vascular Ehlers-Danlos syndrome (vEDS) is a rare condition characterized by connective tissue fragility. Direct spontaneous carotid-cavernous fistula (sCCF) is reportedly pathognomonic of vEDS. We conducted this study to understand the possible mechanisms of occurrence of sCCF in this subset of patients.We conducted a retrospective analysis of a monocentric vEDS

2018 Orphanet journal of rare diseases

117. An Eye with a Heartbeat: Carotid Cavernous Fistula-a Case Report. (Abstract)

An Eye with a Heartbeat: Carotid Cavernous Fistula-a Case Report. A carotid cavernous fistula is a rare type of arteriovenous (AV) fistula due to an abnormal communication between the cavernous sinus and the carotid arterial system. Normal venous return to the cavernous sinus is impeded as high-pressure arterial blood enters the cavernous sinus. The classical triad of symptoms is characterized by pulsating exophthalmos, ocular bruit, and conjunctival chemosis. However, it is important to note (...) was appreciated over the affected eye, prompting further diagnostic testing. The patient was admitted for urgent cerebral angiography and definitive endovascular neurosurgical intervention to preserve his eyesight. We discuss the clinical presentation, pathophysiology, and diagnostic modalities important to the management of this rare and potentially devastating cause of vision loss. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: A carotid cavernous fistula is a rare and easily misdiagnosed cause

2018 Journal of Emergency Medicine

118. Treatment of a carotid cavernous fistula via direct transovale cavernous sinus puncture. Full Text available with Trip Pro

Treatment of a carotid cavernous fistula via direct transovale cavernous sinus puncture. Endovascular treatment is the treatment of choice for indirect carotid cavernous fistulas (CCFs). Direct surgical obliteration of CCFs is recommended in highly symptomatic patients or in those with an aggressive pattern of venous drainage. However, this is a technically challenging approach associated with significant procedural morbidity. The authors present a case in which they decided to attempt a novel (...) access to the cavernous sinus through the foramen ovale before recommending surgery for an otherwise untreatable dural CCF. This 52-year-old man with an indirect CCF and neurological deficit had undergone several attempts to embolize the shunt by means of the standard approaches. Ultimately direct cavernous sinus access was obtained through the foramen ovale, resulting in complete obliteration of the shunt. The occlusion was radiographically stable at the 6-month follow-up evaluation, and the patient

2013 Journal of Neurosurgery

119. Balloon-Assisted Coiling of the Cavernous Sinus to Treat Direct Carotid Cavernous Fistula: A Single Center Experience of 13 Consecutive Patients Full Text available with Trip Pro

Balloon-Assisted Coiling of the Cavernous Sinus to Treat Direct Carotid Cavernous Fistula: A Single Center Experience of 13 Consecutive Patients This study evaluated clinical and neuroradiological results in 13 consecutive patients with spontaneous and traumatic direct carotid cavernous fistulas treated at our center between January 2006 and September 2012. All patients were treated by coiling of the cavernous sinus. Coiling was always performed while a semi-compliant non-detachable balloon (...) , 54%) and a resolution of symptoms in eight patients (8/12, 67%). Radiological follow-up showed complete occlusion of the fistula in all patients (9/9, 100%) and clinical follow-up showed a resolution of symptoms in eight patients (8/9, 89%) and persistent symptoms in one (1/9, 11%). No procedure-related complications occurred. Balloon-assisted coiling of the cavernous sinus for the treatment of direct carotid cavernous fistulas proved an effective and safe technique, both in angiographic

2013 Interventional Neuroradiology

120. Resolution of Clinical Symptoms after Reopening of an Occluded Inferior Petrosal Sinus in a Patient with a Cavernous Sinus Dural Arteriovenous Fistula: A Case Report Full Text available with Trip Pro

Resolution of Clinical Symptoms after Reopening of an Occluded Inferior Petrosal Sinus in a Patient with a Cavernous Sinus Dural Arteriovenous Fistula: A Case Report We describe a rare case with a cavernous sinus (CS) dural arteriovenous fistula (DAVF) in which the clinical symptoms disappeared after the patient underwent reopening of an occluded inferior petrosal sinus (IPS). A 66-year-old woman presented with increased intraocular pressure, chemosis, and proptosis on the left side (...) . Angiography demonstrated a left CS DAVF supplied by the dural branches of bilateral internal carotid arteries. The shunt flow was directed to the superior and inferior ophthalmic veins, while the bilateral IPSs were not opacified. Accordingly, a transvenous embolization of the fistula was attempted. Although the microcatheter was navigated to the cavernous sinus through the occluded left IPS, obliteration of the fistula was unsuccessful because of the failure of superselective catheterization

2013 Interventional Neuroradiology

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