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Cavernous Sinus

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121. Nasal Cavity and Paranasal Sinus Cancers

extend to involve the adjacent maxillary sinus. The sphenoid sinus is a midline structure and cancers arising here often extend laterally to involve the adjacent cavernous sinus or orbital apex. The occult nature of these tumors often results in intracranial extension. The frontal sinus resides within the anterior skull and is bounded by the anterior cranial fossa and the tissues of the forehead. The pneumatization pattern is quite variable, even side-to-side in the same patient, and may extend (...) Nasal Cavity and Paranasal Sinus Cancers Date of origin: 2016 ACR Appropriateness Criteria ® 1 Nasal Cavity and Paranasal Sinus Cancers American College of Radiology ACR Appropriateness Criteria ® NASAL CAVITY AND PARANASAL SINUS CANCERS Expert Panel on Radiation Oncology–Head & Neck Cancer: Farzan Siddiqui, MD, PhD 1 ; Richard V. Smith, MD 2 ; Sue S. Yom, MD, PhD 3 ; Jonathan J. Beitler, MD, MBA 4 ; Paul M. Busse, MD, PhD 5 ; Jay S. Cooper, MD 6 ; Ehab Y. Hanna, MD 7 ; Christopher U. Jones, MD

2016 American College of Radiology

122. Treatment of a carotid cavernous fistula via direct transovale cavernous sinus puncture. (PubMed)

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

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2013 Journal of Neurosurgery

123. Balloon-Assisted Coiling of the Cavernous Sinus to Treat Direct Carotid Cavernous Fistula: A Single Center Experience of 13 Consecutive Patients (PubMed)

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

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2013 Interventional Neuroradiology

124. IMAGES IN CLINICAL MEDICINE: Carotid–Cavernous Sinus Fistula (PubMed)

IMAGES IN CLINICAL MEDICINE: Carotid–Cavernous Sinus Fistula 21345097 2011 03 04 2016 11 25 1533-4406 364 8 2011 Feb 24 The New England journal of medicine N. Engl. J. Med. Images in clinical medicine. Carotid-cavernous sinus fistula. e15 10.1056/NEJMicm1006035 Korn Bobby S BS University of California, San Diego, La Jolla, CA, USA. Zhang Kang K eng R01 EY018660 EY NEI NIH HHS United States R01 EY021374 EY NEI NIH HHS United States Case Reports Journal Article United States N Engl J Med (...) 0255562 0028-4793 AIM IM Carotid-Cavernous Sinus Fistula diagnostic imaging pathology therapy Embolization, Therapeutic Eye blood supply Female Humans Hypertension complications Middle Aged Tomography, X-Ray Computed 2011 2 25 6 0 2011 2 25 6 0 2011 3 5 6 0 ppublish 21345097 10.1056/NEJMicm1006035 PMC3805040 NIHMS515360

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2011 NEJM

125. Cavernous Sinus Syndromes (Diagnosis)

Cavernous Sinus Syndromes (Diagnosis) Cavernous Sinus Syndromes: Overview, Clinical Presentation, Diagnostic Workup Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2MTcxMC1vdmVydmlldw== processing > Cavernous (...) Sinus Syndromes Updated: Jan 16, 2019 Author: Ryszard M Pluta, MD, PhD; Chief Editor: Robert A Egan, MD Share Email Print Feedback Close Sections Sections Cavernous Sinus Syndromes Overview Overview Background Cavernous sinus syndrome describes symptoms comprising ophthalmoplegia, chemosis, proptosis, Horner syndrome, and/or trigeminal sensory loss evoked by vascular, inflammatory, traumatic, congenital, or neoplastic processes affecting the cavernous sinus near the midline of the frontotemporal

2014 eMedicine.com

126. Cavernous Sinus Syndromes (Treatment)

Cavernous Sinus Syndromes (Treatment) Cavernous Sinus Syndromes: Overview, Clinical Presentation, Diagnostic Workup Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2MTcxMC1vdmVydmlldw== processing > Cavernous (...) Sinus Syndromes Updated: Jan 16, 2019 Author: Ryszard M Pluta, MD, PhD; Chief Editor: Robert A Egan, MD Share Email Print Feedback Close Sections Sections Cavernous Sinus Syndromes Overview Overview Background Cavernous sinus syndrome describes symptoms comprising ophthalmoplegia, chemosis, proptosis, Horner syndrome, and/or trigeminal sensory loss evoked by vascular, inflammatory, traumatic, congenital, or neoplastic processes affecting the cavernous sinus near the midline of the frontotemporal

2014 eMedicine.com

127. Cavernous Sinus Syndromes (Overview)

Cavernous Sinus Syndromes (Overview) Cavernous Sinus Syndromes: Overview, Clinical Presentation, Diagnostic Workup Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2MTcxMC1vdmVydmlldw== processing > Cavernous (...) Sinus Syndromes Updated: Jan 16, 2019 Author: Ryszard M Pluta, MD, PhD; Chief Editor: Robert A Egan, MD Share Email Print Feedback Close Sections Sections Cavernous Sinus Syndromes Overview Overview Background Cavernous sinus syndrome describes symptoms comprising ophthalmoplegia, chemosis, proptosis, Horner syndrome, and/or trigeminal sensory loss evoked by vascular, inflammatory, traumatic, congenital, or neoplastic processes affecting the cavernous sinus near the midline of the frontotemporal

2014 eMedicine.com

128. Cavernous Sinus Syndromes (Follow-up)

Cavernous Sinus Syndromes (Follow-up) Cavernous Sinus Syndromes: Overview, Clinical Presentation, Diagnostic Workup Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2MTcxMC1vdmVydmlldw== processing > Cavernous (...) Sinus Syndromes Updated: Jan 16, 2019 Author: Ryszard M Pluta, MD, PhD; Chief Editor: Robert A Egan, MD Share Email Print Feedback Close Sections Sections Cavernous Sinus Syndromes Overview Overview Background Cavernous sinus syndrome describes symptoms comprising ophthalmoplegia, chemosis, proptosis, Horner syndrome, and/or trigeminal sensory loss evoked by vascular, inflammatory, traumatic, congenital, or neoplastic processes affecting the cavernous sinus near the midline of the frontotemporal

2014 eMedicine.com

129. Cavernous Sinus Thrombosis (Follow-up)

Cavernous Sinus Thrombosis (Follow-up) Cavernous Sinus Thrombosis Follow-up: Further Inpatient Care, Deterrence/Prevention, Complications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzkxNzA0LWZvbGxvd3Vw (...) processing > Cavernous Sinus Thrombosis Follow-up Updated: Jul 17, 2018 Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP Share Email Print Feedback Close Sections Sections Cavernous Sinus Thrombosis Follow-up Further Inpatient Care Admission to intensive care unit is indicated. Next: Deterrence/Prevention Patients should be educated that furuncles or abscesses (pimples) in the central portion of the face should not be manipulated without prior antibiotic coverage

2014 eMedicine Emergency Medicine

130. Cavernous Sinus Thrombosis (Overview)

Cavernous Sinus Thrombosis (Overview) Cavernous Sinus Thrombosis: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzkxNzA0LW92ZXJ2aWV3 processing > Cavernous Sinus (...) Thrombosis Updated: Jul 17, 2018 Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP Share Email Print Feedback Close Sections Sections Cavernous Sinus Thrombosis Overview Background Cavernous sinus thrombosis (CST) was initially described by Bright in 1831 as a complication of epidural and subdural infections. The dural sinuses are grouped into the sagittal, lateral (including the transverse, sigmoid, and petrosal sinuses), and cavernous sinuses. Because of its complex

2014 eMedicine Emergency Medicine

131. Cavernous Sinus Thrombosis (Treatment)

Cavernous Sinus Thrombosis (Treatment) Cavernous Sinus Thrombosis Treatment & Management: Emergency Department Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzkxNzA0LXRyZWF0bWVudA== processing (...) > Cavernous Sinus Thrombosis Treatment & Management Updated: Jul 17, 2018 Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP Share Email Print Feedback Close Sections Sections Cavernous Sinus Thrombosis Treatment Emergency Department Care The mainstay of therapy for cavernous sinus thrombosis is early and aggressive antibiotic administration. Although S aureus is the usual cause, broad-spectrum coverage for gram-positive, gram-negative, and anaerobic organisms should

2014 eMedicine Emergency Medicine

132. Cavernous Sinus Thrombosis (Diagnosis)

Cavernous Sinus Thrombosis (Diagnosis) Cavernous Sinus Thrombosis: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzkxNzA0LW92ZXJ2aWV3 processing > Cavernous Sinus (...) Thrombosis Updated: Jul 17, 2018 Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP Share Email Print Feedback Close Sections Sections Cavernous Sinus Thrombosis Overview Background Cavernous sinus thrombosis (CST) was initially described by Bright in 1831 as a complication of epidural and subdural infections. The dural sinuses are grouped into the sagittal, lateral (including the transverse, sigmoid, and petrosal sinuses), and cavernous sinuses. Because of its complex

2014 eMedicine Emergency Medicine

133. Post-traumatic Cavernous Carotid Pseudoaneurysm with Delayed Epistaxis (PubMed)

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

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2018 Cureus

134. An Eye with a Heartbeat: Carotid Cavernous Fistula-a Case Report. (PubMed)

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

135. Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report. (PubMed)

(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.

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2018 BMC Ophthalmology

136. A Case of Right-Sided Direct Carotid Cavernous Fistula: A Diagnostic Challenge (PubMed)

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

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2018 The American journal of case reports

137. Pathophysiology of carotid-cavernous fistulas in vascular Ehlers-Danlos syndrome: a retrospective cohort and comprehensive review (PubMed)

-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

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2018 Orphanet journal of rare diseases

138. A giant solid cavernous hemangioma mimicking sphenoid wing meningioma in an adolescent: A case report. (PubMed)

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

139. Fractionated External-beam Radiation Therapy For Incompletely Resected Intracranial Extra-axial Cavernous Haemangioma: A Case Report (PubMed)

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

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2018 Cureus

140. 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 (PubMed)

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

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2013 Interventional Neuroradiology

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