1/76. Transcatheter occlusion of the arterial supply to arteriovenous fistulas with Gianturco coils.Transcatheter occlusive therapy is finding widespread clinical application. Numerous types of occlusive devices have been described. This report details the first three cases of occlusion of the arterial supply to arteriovenous fistulas with Gianturco stainless steel coils. patients benefiting from this approach include those who refuse or cannot tolerate surgery, those in whom previous surgery failed, and those with chronic fistulas in whom surgery is likely to fail. The angiographer should make sure the coil is completely within the desired vessel, the feeding vessel is smaller than the coil to prevent passage through the fistula, and there is adequate collateral flow to distal organs to prevent infarction after occlusion of a major artery. This technique is useful as a nonsurgical treatment for a variety of arteriovenous fistulas and is within the capability of any experienced angiographer.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/76. Deterioration of ocular motor dysfunction after transvenous embolization of dural arteriovenous fistula involving the cavernous sinus.We treated 9 patients with the dural arteriovenous fistula involving the cavernous sinus by transvenous embolization. Two patients experienced deterioration of oculo-motor dysfunction after transvenous embolization. We can speculate about two different kind of causes by which patients symptoms deteriorated according to the result of intrasinus pressure recorded during the embolization [1]: high intrasinus pressure caused by the obliteration of the drainage pathway resulted in cranial nerve palsy in one case [2]; implanted coils directly compressed the cranial nerve in another case. Fortunately our cases recovered, but some kind of preventative measures may be needed in similar cases.- - - - - - - - - - ranking = 33.218079960051keywords = nerve (Clic here for more details about this article) |
3/76. Stereotactic radiosurgery and particulate embolization for cavernous sinus dural arteriovenous fistulae.OBJECTIVE: To evaluate the safety and efficacy of stereotactic radiosurgery, either with or without transarterial embolization, in the treatment of patients with dural arteriovenous fistulae (DAVFs) of the cavernous sinus. methods: We reviewed the findings, from a prospectively established database, for 20 patients with cavernous sinus DAVFs who were treated with either radiosurgery alone (n = 7) or radiosurgery and transarterial embolization (n = 13) in a 7-year period. The median follow-up period after radiosurgery was 36 months (range, 4-59 mo). RESULTS: Nineteen of 20 patients (95%) experienced improvement of their clinical symptoms. Fourteen of 15 patients (93%) experienced either total (n = 13) or nearly total (n = 1) obliteration of their DAVFs, as documented by angiography performed a median of 12 months after radiosurgery. No patient experienced a recurrence of symptoms after angiography showed DAVF obliteration. Two patients developed new neurological deficits after embolization procedures. One patient exhibited temporary aphasia secondary to a venous infarction; another patient exhibited permanent VIth cranial nerve weakness related to acute cavernous sinus thrombosis. Two patients experienced recurrent symptoms and underwent repeat transarterial embolization at 7 and 12 months; both patients achieved clinical and angiographic cures (5 and 10 mo later, respectively). One patient experienced recurrent visual symptoms and underwent transvenous embolization 4 months after radiosurgery. CONCLUSION: Staged radiosurgery and transarterial embolization provided both rapid symptom relief and long-term cures for patients with cavernous sinus DAVFs. radiosurgery alone was effective for patients with DAVFs whose arterial supply was not accessible via a transarterial approach, although the time course of symptom improvement was longer, compared with patients who also underwent embolization.- - - - - - - - - - ranking = 16.609039980026keywords = nerve (Clic here for more details about this article) |
4/76. brachial plexus and supraclavicular nerve injury caused by manual carotid compression for spontaneous carotid-cavernous sinus fistula.BACKGROUND: Manual carotid compression is an established treatment for a spontaneous carotid-cavernous sinus fistula unless emergency treatment is required for it. CASE REPORT: A 63-year-old woman presented with a spontaneous carotid-cavernous sinus fistula. Manual carotid compression of 5 minutes duration, twice a day, for 10 days resulted in injury to the upper trunk (C 5-6) of the brachial plexus and the supraclavicular nerve (C 3-4), which subsequently resolved within a month after cessation of the procedure. CONCLUSION: It is important to know the possible neurological complications of manual carotid compression.- - - - - - - - - - ranking = 83.045199900128keywords = nerve (Clic here for more details about this article) |
5/76. Spontaneous vertebral arteriovenous fistula--case report.A 57-year-old male presented with a rare case of spontaneous vertebral arteriovenous fistula manifesting as radiculopathy of the right arm, subsequently associated with pulsating tinnitus and vascular bruit in the nape. He had a past history of chiropractic-induced vertebrobasilar infarction. angiography showed a simple and direct fistula between the third segment of the right vertebral artery and the epidural veins at the C-1 level, where the artery runs backward above the arch of the C-1 just proximal to the penetration of the dura. The fistula was successfully obliterated by coil embolization, resulting in rapid improvement of the signs and symptoms. Mechanical compression to the nerve roots by the engorged epidural veins with arterial pressure was considered to be the major cause of radiculopathy. vertebral artery dissection induced by chiropractic manipulation is most likely responsible for the development of the fistula.- - - - - - - - - - ranking = 16.609039980026keywords = nerve (Clic here for more details about this article) |
6/76. arteriovenous fistula induced by a peribulbar nerve block.arteriovenous fistula (AVF) of the head and neck region is an uncommon clinical condition that can be of congenital or acquired etiology. We report a case of AVF of the left supraorbital vessels that developed after a peribulbar nerve block was given for cataract surgery.- - - - - - - - - - ranking = 83.045199900128keywords = nerve (Clic here for more details about this article) |
7/76. Transvenous occlusion of dural cavernous sinus fistulas through the thrombosed inferior petrosal sinus: report of four cases and review of the literature.BACKGROUND: The aim of this study is to describe the technique and results of the endovascular approach through the thrombosed inferior petrosal sinus (IPS) for occlusion of dural cavernous sinus fistulas (DCSFs). methods: In four patients presenting with clinically symptomatic DCSFs, the angiogram did not show opacification of the IPS, indicating that it neither drained the arteriovenous fistula nor the cerebral venous outflow. A large volume biplane phlebogram of the jugular bulb was obtained to identify a thrombosed remnant of the IPS. We were able to navigate small hydrophilic catheters and microguide wires through the thrombosed IPS into the ipsi- or contralateral CS. After reaching the fistula site the CS was packed with detachable platinum coils. RESULTS: We were able to reach the fistula site and to achieve a dense packing of coils within the arteriovenous shunting zone in all of the patients. The final angiogram showed subtotal or complete occlusion of the arteriovenous fistula. All four patients recovered completely and showed disappearance of the fistula on follow-up arteriograms. One patient developed a transient sixth nerve palsy. No complications related to the approach were observed. CONCLUSIONS: For endovascular treatment, transvenous occlusion of DCSFs via the IPS is a feasible approach, even when this sinus is partially or completely thrombosed. Gentle handling of recently available, improved hydrophilic microguide wires and microcatheters allows effective and safe catheter navigation into the CS. A phlebogram of the jugular bulb is very useful for identification of a thrombosed IPS.- - - - - - - - - - ranking = 16.609039980026keywords = nerve (Clic here for more details about this article) |
8/76. Idiopathic hypertrophic cranial pachymeningitis associated with a dural arteriovenous fistula involving the straight sinus: case report.OBJECTIVE AND IMPORTANCE: Reports of idiopathic hypertrophic cranial pachymeningitis have increased as a result of advances in magnetic resonance imaging. This is the first documented case of idiopathic hypertrophic cranial pachymeningitis associated with a dural arteriovenous fistula involving the straight sinus. We discuss possible causes of the association and the treatment options. CLINICAL PRESENTATION: A 64-year-old man presented with a headache and visual disturbance. gadolinium-enhanced T1-weighted magnetic resonance imaging demonstrated homogeneously stained meninges and prominent enhancement of the tentorium and falx. Angiograms demonstrated a dural arteriovenous fistula of the straight sinus. INTERVENTION: Although surgical excision of the straight sinus and subsequent corticosteroid therapy failed to relieve the patient's visual symptoms, subsequent surgical decompression of the optic nerve resulted in improvement and stabilization. CONCLUSION: Narrowing or occlusion of the tentorial sinuses and narrowing of the straight sinus by extensive dural fibrosis of the tentorium and falx, attributable in turn to idiopathic hypertrophic cranial pachymeningitis, may have resulted in the development of a dural arteriovenous fistula. We propose surgical decompression of the optic nerve as an alternative treatment during the active phase of the disease in patients who exhibit resistance to corticosteroid therapy.- - - - - - - - - - ranking = 33.218079960051keywords = nerve (Clic here for more details about this article) |
9/76. Rehabilitating patients with hepatopulmonary syndrome using living-related orthotopic liver transplant: a case report.The objective of this study was to rehabilitate a patient with hepatopulmonary syndrome (HPS) who underwent living-related orthotopic liver transplantation (LT). HPS is rare; it presents severe complication in patients with liver disease. A 17-year-old woman with HPS developed portal hypertension after undergoing Kasai's surgery for congenital biliary atresia and underwent a living-related orthotopic LT. After LT, her allograft functioned well, but she continued to have hypoxemia and orthodeoxia. She was referred for rehabilitation for disuse atrophy, contracture of hip and shoulder joints, left common peroneal nerve palsy, and rehabilitation for respiratory dysfunction. By day 106 after LT, her orthodeoxia and disuse atrophy had improved because of daily exercise training and active joint range of motion exercises. patients with HPS have orthodeoxia and poor responsiveness to oxygen therapy, and correction of hypoxemia after LT may be delayed. Therefore, rehabilitation approaches for patients with HPS should be based on the pathophysiology and characteristics of HPS.- - - - - - - - - - ranking = 16.609039980026keywords = nerve (Clic here for more details about this article) |
10/76. Multiple dural arteriovenous fistulae involving the cavernous and sphenoparietal sinuses.A 72-year-old woman who presented with a unilateral oculomotor nerve palsy was shown to have a very rare condition: multiple dural arteriovenous fistulae (DAVF) involving the cavernous and sphenoparietal sinuses. The sphenoparietal DAVF was cured completely by transarterial embolisation. Symptomatic relief was accomplished by this procedure. The cavernous sinus DAVF progressed to acquire cortical venous drainage, and was obliterated completely by transvenous embolisation.- - - - - - - - - - ranking = 16.609039980026keywords = nerve (Clic here for more details about this article) |
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