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Cavernous Sinus

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161. Operative surgical nuances of modified extradural temporopolar approach with mini-peeling of dura propria based on cadaveric anatomical study of lateral cavernous structures (PubMed)

consecutive cadaveric specimens, we performed an extradural anterior clinoidectomy with mini-peeling of the dura propria to expose the anterior clinoid process entirely. We also investigated the histological characteristics of the lateral cavernous sinus (CS) between the dura propria and periosteal dura at the SOF, foramen rotundum (FR), and foramen ovale (FO) levels, and of each trigeminal nerve division.Coronal histological examination of the lateral wall of the CS showed invagination of the dura (...) Operative surgical nuances of modified extradural temporopolar approach with mini-peeling of dura propria based on cadaveric anatomical study of lateral cavernous structures Extradural temporopolar approach (ETA) has been modified as less invasive manner and named as trans-superior orbital fissure (SOF) approach with mini-peeling technique. The present study discusses the operative nuances of this modified technique on the basis of cadaveric study of lateral cavernous structures.In five

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2016 Surgical neurology international

162. Bilateral Carotid-Cavernous Fistulas: An Uncommon Cause of Pituitary Enlargement and Hypopituitarism (PubMed)

Bilateral Carotid-Cavernous Fistulas: An Uncommon Cause of Pituitary Enlargement and Hypopituitarism Carotid-cavernous fistulas (CCFs) are rare, pathologic communications of the carotid artery and the venous plexus of the cavernous sinus. They can develop spontaneously in certain at risk individuals or following traumatic head injury. Typical clinical manifestations include headache, proptosis, orbital pain, and diplopia. We report a case of bilateral carotid-cavernous fistulas associated (...) with these symptoms and also with pituitary enlargement and hypopituitarism, which improved following surgical intervention. Arterialization of the cavernous sinus and elevated portal pressure may interfere with normal venous drainage and the conveyance of inhibiting and releasing hormones from the hypothalamus, resulting in pituitary enlargement and hypopituitarism. This condition should be considered in the differential diagnosis of hypopituitarism associated with anterior pituitary enlargement.

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2016 Case reports in endocrinology

163. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula (PubMed)

Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many

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2016 Polish Journal of Radiology

164. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae (PubMed)

Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic (...) symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages.We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous

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2016 Diagnostic and Interventional Radiology

165. Endovascular treatment of carotico-cavernous fistulas with acrylic glue: a series of nine cases (PubMed)

Endovascular treatment of carotico-cavernous fistulas with acrylic glue: a series of nine cases Injuries to the internal carotid artery close to the cavernous sinus may result in a fistulous connection between the artery and the venous sinus. Symptoms include pulsatile tinnitus, intracranial bruit, ophthalmological symptoms, and risk of intracerebral hematoma in cases of cortical venous reflux. Previous treatment strategies have included detachable latex balloons, coils, covered stents

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2016 Neuroradiology

166. A brief history of carotid-cavernous fistula. (PubMed)

A brief history of carotid-cavernous fistula. Carotid-cavernous fistula was one of the first intracranial vascular lesions to be recognized. This paper focuses on the historical progression of our understanding of the condition and its symptomatology-from the initial hypothesis of ophthalmic artery aneurysm as the cause of pulsating exophthalmos to the recognition and acceptance of fistulas between the carotid arterial system and cavernous sinus as the true etiology. The authors also discuss

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2016 Journal of Neurosurgery

167. Traumatic posterior communicating artery-cavernous fistula, angioarchitecture, and possible pathogenesis: a case report and literature review (PubMed)

Traumatic posterior communicating artery-cavernous fistula, angioarchitecture, and possible pathogenesis: a case report and literature review Carotid-cavernous fistulas (CCFs) are an abnormal vascular shunt between the carotid artery and the cavernous sinus, and were traditionally classified into four subtypes based on the detailed fistulas anatomy and arterial supply. CCFs are frequently encountered in patients with traumatic skull base fractures. In this report, we present one such case

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2016 Neuropsychiatric disease and treatment

168. Posttraumatic carotid-cavernous fistula: Pathogenetic mechanisms, diagnostic management and proper treatment. A case report (PubMed)

Posttraumatic carotid-cavernous fistula: Pathogenetic mechanisms, diagnostic management and proper treatment. A case report Carotid-cavernous fistulas are an uncommon diseases characterized by abnormal communications between arteries and veins located in the cavernous sinus. According with Barrow´s classification they could be divided in two groups: direct and indirect. The typical symptoms showed by theses pathologies are: pulsating exophthalmos and orbital blow. The present study describes (...) a case of direct posttraumatic carotid-cavernous fistula in a 26 years old man. Furthermore, we present the images that we used to make the diagnosis. In this light, we decided to treat this case with endovascular approach after considering several therapeutic options. The aim of the present report is twofold. First, we examine the importance of the proper management of the direct posttraumatic carotid-cavernous fistula. Second, we describe this rare syndrome with the goal of proposing suitable

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2016 Journal of clinical and experimental dentistry

169. Postpartum Regression of a Presumed Cavernous Meningioma (PubMed)

Postpartum Regression of a Presumed Cavernous Meningioma Meningiomas are known to be more common in females than males. They are also known in rare cases to grow in size during pregnancy, which can complicate its management. We describe a 31-year-old Caucasian woman who presented with blurring of her vision and diplopia during the third trimester of her pregnancy. Magnetic resonance imaging (MRI) showed a small left cavernous sinus meningioma. The patient was treated conservatively until her

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2016 Case reports in oncological medicine

170. Progression of unilateral moyamoya disease resulted in spontaneous occlusion of ipsilateral cavernous dural arteriovenous fistula: Case report (PubMed)

Progression of unilateral moyamoya disease resulted in spontaneous occlusion of ipsilateral cavernous dural arteriovenous fistula: Case report The pathogenic association between cavernous dural arteriovenous fistula (CDAVF) and moyamoya disease remains unclear. This unusual case is the first report of a progression of unilateral moyamoya disease resulting in the spontaneous occlusion of ipsilateral CDAVF. A 52-year-old woman presented with two-week spontaneous exophthalmos, chemosis (...) and tinnitus, and cerebral angiography showed a right CDAVF coexisting with ipsilateral moyamoya disease. Transvenous approaches through the inferior petrosal sinus and facial vein were attempted but failed. However, a progression of the moyamoya disease and disappearance of the CDAVF were observed on one month follow-up angiogram in accordance with the resolution of clinical symptoms. This extremely rare coincidental presentation may have deeper pathogenic implications. This case report may give a clue

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2016 Interventional Neuroradiology

171. Orbital approaches for treatment of carotid cavernous fistulas: A systematic review. (PubMed)

Orbital approaches for treatment of carotid cavernous fistulas: A systematic review. Carotid cavernous fistulas (CCFs) are abnormal connections between the carotid arteries and the cavernous sinus. CCFs often present with double vision, reduced visual acuity, and conjunctivitis. Deteriorating ocular symptoms caused by abnormal fistula drainage can cause permanent blindness, and so urgent interventional treatment is necessary. Transvenous embolization of the fistula is the primary treatment (...) option for most patients with symptomatic CCFs. Orbital approaches are considered to be risky compared with the traditional approach via the inferior petrosal sinus and are thus used as a secondary option. These approaches include embolization via the superior ophthalmic vein, inferior ophthalmic vein, and medial ophthalmic vein and direct transorbital puncture. This study aims to assess the merits and risks of orbital approaches in transvenous embolization of CCFs.A systematic review of 30 studies

2016 World neurosurgery

172. Interesting case of base of skull mass infiltrating cavernous sinuses (PubMed)

cavernous sinuses and sphenoid sinus with bony erosions. Biopsy of the nasopharyngeal mass revealed pathological features which are characteristic of IgG4 disease. His serum IgG4 levels and acute inflammatory markers were also elevated. The patient was started on oral corticosteroid therapy. Fever, headache and earache resolved early and there was gradual improvement in the vision of the left eye. After 6 months, visual acuity in the left eye was 6/9, but right eye visual acuity had no change. Follow-up (...) Interesting case of base of skull mass infiltrating cavernous sinuses A man aged 35 years presented with chronic headache and earache of 1-year duration. He had progressive vision loss and diplopia since last 9 months. He also had pain over the face and episodic profuse epistaxis. On examination, perception of light was absent in the right eye and hand movements were detected at 4 m distance in the left eye. Imaging revealed a lobulated mass in the nasopharynx extending into the bilateral

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2016 BMJ case reports

173. Endoscopic Management of Cavernous Carotid Surgical Complications: Evaluation of a Simulated Perfusion Model (PubMed)

Endoscopic Management of Cavernous Carotid Surgical Complications: Evaluation of a Simulated Perfusion Model Endoscopic surgical treatment of pituitary tumors, lateral invading tumors, or aneurysms requires surgeons to operate adjacent to the cavernous sinus. During these endoscopic endonasal procedures, the carotid artery is vulnerable to surgical injury at its genu. The objective of this simulation model was to evaluate trainees regarding management of a potentially life-threatening vascular

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2016 World neurosurgery

174. Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer (PubMed)

hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes (...) for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.

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2016 Journal of Korean Neurosurgical Society

175. Glaucoma Management in Carotid Cavernous Fistula (PubMed)

Glaucoma Management in Carotid Cavernous Fistula Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP

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2016 Case reports in ophthalmology

176. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment (PubMed)

or other skull base lesions adjacent to the cavernous sinus. 2016 BMJ Publishing Group Ltd. (...) Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm

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2016 BMJ case reports

177. Dual Endoscopic Endonasal Transsphenoidal and Precaruncular Transorbital Approaches for Clipping of the Cavernous Carotid Artery: A Cadaveric Simulation (PubMed)

as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach. Results The dual approach minimized the "coning down" and instrument "sword fighting" that occurs as the rod lens endoscope and instruments are used laterally and posterior toward the clivus and brainstem (...) Dual Endoscopic Endonasal Transsphenoidal and Precaruncular Transorbital Approaches for Clipping of the Cavernous Carotid Artery: A Cadaveric Simulation Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA

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2016 Journal of neurological surgery. Part B, Skull base

178. Direct carotid-cavernous fistula: A complication of, and treatment with, flow diversion (PubMed)

. Endovascular treatment of such direct fistulas typically involves either transarterial obliteration of the fistulous site or transvenous embolization of the cavernous sinus. Our case was successfully treated with further immediate flow diversion without additional transvenous intervention. There are few reports on the use of flow diversion for treatment of such direct CCFs, and in all but one of these cases, flow diversion was combined with concomitant transvenous embolization. Thus, the presented case (...) Direct carotid-cavernous fistula: A complication of, and treatment with, flow diversion Direct carotid-cavernous fistulas (CCFs) are rare complications of flow diversion and have typically been documented in a subacute time frame after treatment. We present the first reported case of an intraprocedural direct CCF that developed immediately after flow diversion for treatment of a symptomatic paraclinoid right internal carotid artery aneurysm with a neck involving the cavernous segment

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2016 Interventional Neuroradiology

179. Sustained trigeminocardiac reflex following balloon embolization of carotico-cavernous fistula (PubMed)

Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India. Swaminathan Aarthi A Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India. eng Journal Article 2016 06 24 United States Interv Neuroradiol 9602695 1591-0199 IM Balloon Occlusion Carotid-Cavernous Sinus Fistula therapy Humans Male Middle Aged Reflex, Trigeminocardiac 2016 6 26 6 0 2016 6 28 6 0 2017 6 14 6 0 ppublish 27341858 (...) Sustained trigeminocardiac reflex following balloon embolization of carotico-cavernous fistula 27341858 2017 06 13 2018 11 13 2385-2011 22 5 2016 Oct Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences Interv Neuroradiol Sustained trigeminocardiac reflex following balloon embolization of carotico-cavernous fistula. 577-8 10.1177/1591019916654140 Varadharajan Shriram S Department of Neuroimaging and Interventional Radiology

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2016 Interventional Neuroradiology

180. A note on the relationship of the human maxillary nerve to the cavernous sinus and to an emissary sinus passing through the foramen ovale. (PubMed)

A note on the relationship of the human maxillary nerve to the cavernous sinus and to an emissary sinus passing through the foramen ovale. 5969985 1967 09 02 2018 11 13 0021-8782 100 Pt 4 1966 Oct Journal of anatomy J. Anat. A note on the relationship of the human maxillary nerve to the cavernous sinus and to an emissary sinus passing through the foramen ovale. 905-8 Henderson W R WR eng Journal Article England J Anat 0137162 0021-8782 IM Cavernous Sinus anatomy & histology Cranial Sinuses

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1966 Journal of anatomy

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