WorldWideScience
 
 
1

Synovial cyst of the antecubital fossa mimicking a brachial artery pseudoaneurysm: report of a case.  

Science.gov (United States)

Pseudoaneurysms of the brachial artery are common following a percutaneous cardiac catheterization. Synovial cysts are a commonly identified entity in patients with rheumatic diseases as well. We present a rare case of a synovial cyst in the elbow masquerading as an iatrogenic pseudoaneurysm of the brachial artery. A 51-year-old female patient presented with a pulsatile and painful mass in the right antecubital fossa. The medical history revealed a recent diagnostic cardiac catheterization at the same site and rheumatoid arthritis under oral treatment. Imaging investigations were not fully diagnostic. Because of the clinical suspicion of a thrombosed pseudoaneurysm, exploratory surgery was indicated. The pathologic examination of the specimen confirmed the diagnosis of a synovial cyst. Ultrasonography and computed tomography imaging are valuable in the everyday clinical practice but they do not always exclude an iatrogenic pseudoaneurysm, especially when the medical history is suspicious. Surgical removal is the proper treatment and pathologic examination sets the final diagnosis in such cases of diagnostic difficulty. PMID:24517988

Filis, Konstantinos; Galyfos, George; Larentzakis, Andreas; Karanikola, Evridiki; Zarmakoupis, Constantinos

2014-07-01

2

Severe, traumatic soft-tissue loss in the antecubital fossa and proximal forearm associated with radial and/or median nerve palsy: nerve recovery after coverage with a pedicled latissimus dorsi muscle flap.  

Science.gov (United States)

A total of 6 patients with complex, traumatic wounds of the antecubital fossa and proximal forearm were included in this study. All patients presented with radial and/or median nerve palsies in addition to their soft-tissue defect. Except for 1 patient with a 15-cm defect of the radial nerve, all other traumatized nerves appeared in-continuity at the time of surgery. However, the nerve injury was severe enough to induce Wallerian degeneration (i.e., axonotmesis in traumatized nerves in-continuity). Three patients required brachial artery reconstruction with a reverse saphenous vein graft. Wound coverage was accomplished using a pedicled latissimus dorsi muscle flap, which was covered with a split-thickness skin graft. Successful reconstruction was obtained in all patients. Follow-up ranged from 2 to 6 years. The range of motion at the elbow and forearm was considered excellent in 5 patients and good in the remaining patient who had an intra-articular fracture. Motor recovery of traumatized nerves in-continuity was observed in all but 1 patient who had persistent partial anterior interosseous nerve palsy. The grip strength of the injured hand measured 70% to 85% of the contralateral uninjured hand. Median nerve sensory recovery was excellent in all patients. The versatility of the pedicled latissimus dorsi muscle flap for coverage of these complex wounds with traumatized neurovascular bundles around the elbow is discussed. PMID:11216605

Al-Qattan, M M

2001-02-01

3

Diaper Rash  

Science.gov (United States)

... that keep the Candida from growing. Preventing Diaper Rash The best way to prevent diaper rash is ... a cotton round moistened with water. Treating Diaper Rash Diaper rash usually can be cleared up by ...

4

Diaper rash  

Science.gov (United States)

... use cloth diapers: Do not put plastic or rubber pants over the diaper. They do not allow enough air to pass through. Do not use fabric softeners or dryer sheets. They may make the rash worse. When washing ...

5

Diaper Rash  

Science.gov (United States)

... diaper rash that does not improve with self-care measures, is getting worse, or involves the skin creases or any area that is not covered by the diaper. Treatments Your Physician May Prescribe The doctor may suggest the following: Mild topical corticosteroids to treat inflamed areas of skin. Be ...

6

Skin rash after triple vaccine.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Skin rash after triple vaccine is rare. We describe a child who developed a generalised asymptomatic rash after the second and third triple vaccine. Little information of the pathogenesis of the rash is available. We argue that the development of a rash is not a contraindication to future immunisation.

Denning, D. W.; Peet, L.; Poole, J.

1987-01-01

7

A Desert Rash  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 29-year-old man presented to the emergency department (ED) with a rash across his chest and abdomen. The rash began 2 hours before his arrival and was initially pruritic, but subsequently became painful. The patient also complained of acute onset of aching pain in both hips and his left arm. He denied associated chest pain or dyspnea, and had no paresthesias or disequilibrium. Routine laboratory studies and chest radiograph were normal. Earlier in the day, the patient had completed a div...

Bledsoe, Bryan E.; Matt Loptien; Berkeley, Ross P.

2011-01-01

8

A Desert Rash  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 29-year-old man presented to the emergency department (ED) with a rash across his chest and abdomen. The rash began 2 hours before his arrival and was initially pruritic, but subsequently became painful. The patient also complained of acute onset of aching pain in both hips and his left arm. He denied associated chest pain or dyspnea, and had no paresthesias or disequilibrium. Routine laboratory studies and chest radiograph were normal. Earlier in the day, the patient had completed a dive t...

Bledsoe, Bryan E.; Loptien, Matt; Berkeley, Ross P.

2011-01-01

9

Olmesartan: Induced maculopapular rash  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Olmesartan medoxomil is an angiotensin receptor blocker (ARB) which is shown to be effective and well tolerated in hypertensive patients. It is a frequently prescribed antihypertensive as it is considered safe. Here, we report the case of a patient who developed maculopapular rash during the course of the treatment with olmesartan medoxomil.

Bhushan, Aruna; Bhushan, S. T. Ved

2013-01-01

10

A Desert Rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 29-year-old man presented to the emergency department (ED with a rash across his chest and abdomen. The rash began 2 hours before his arrival and was initially pruritic, but subsequently became painful. The patient also complained of acute onset of aching pain in both hips and his left arm. He denied associated chest pain or dyspnea, and had no paresthesias or disequilibrium. Routine laboratory studies and chest radiograph were normal. Earlier in the day, the patient had completed a dive to 235 feet in depth in Lake Mead, Nevada, but reported a very controlled ascent with appropriate decompression stops. Two days earlier, he had completed a dive to 315 feet in Lake Mead without any problems. [West J Emerg Med. 2011;12(4:563–564.

Ross P. Berkeley

2011-05-01

11

A purpuric rash.  

Science.gov (United States)

Kelly is 28 years of age and a recreational sea swimmer and surfer. He presented with a rash on both arms of 6 months duration. Kelly said a similar eruption occurred 12 months previously and resolved in a few weeks with 1% hydrocortisone cream. He has no significant past history, is not on any medication, and there is no recent history of trauma or contact with insects or animals. Physical examination revealed multiple, flat, nonblanching dark red lesions on the medial aspect of both arms (Figure 1, 2). The rest of the physical examination was unremarkable. Full blood examination revealed normal levels of haemoglobin, white cells and platelets, and coagulation studies are normal. PMID:19893836

Aguayo-Leiva, Ingrid; Vano-Galvan, Sergio; Arrazola, Jose-Maria

2009-11-01

12

Vena cava filter placement via the antecubital access: a report of 6 cases  

International Nuclear Information System (INIS)

Objective: To study the methods and skill of vena cava filter placement via the antecubital access. Methods: Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF(Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results: The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions: vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access. (authors)

2008-08-01

13

Posterior fossa malformations.  

Science.gov (United States)

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

14

Posterior Fossa Epidural Hematomas  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4-7%. Seven cases of posttrau-matic posterior fossa epidural hematomas diagnosed by computed tomography (CT) are reported with radiological and clinical findings. This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospi...

Shakeri Bavil, M.

2008-01-01

15

Pyrazinamide-induced maculopapular rash  

Directory of Open Access Journals (Sweden)

Full Text Available Pyrazinamide is a commonly used first-line antitubercular drug. Gastric-related adverse drug reactions are common with pyrazinamide. Dermatological manifestations due to pyrazinamide are rare. This study aimed find out the dermatological manifestations/adverse drug reaction (ADR due to pyrazinamide. We reported a case of maculopapular rash caused by pyrazinamide in a patient on antituberculosis treatment using structured questionnaires. The patient developed maculopapular rashes on receiving combination antituberculosis treatment. The rashes disappeared after stopping the suspected drug. The patient was rechallenged with pyrazinamide, which led to reappearance of a similar type of rash. The causality, preventability, and severity were assessed using the Naranjo algorithm and Hartwig scale. Since pyrazinamide is a commonly used drug in tuberculosis and which is a common infectious disease in developing countries, with the similar reports, we can predict early case detection and can prevent the occurrence of similar reactions in future.

Khayyam Khalid

2010-01-01

16

A Chinese New Year rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 28-year-old man presented with a chief complaint of rashes all over his body. He had a history of a trip to Langkawi Island, a famous island resort off the west coast of Malaysia, over the Chinese New Year’s weekend. According to him, he had a lot of fun with a group of friends at the sunny beach and the beautiful sea. There were no untoward incidents and they were perfectly well when they returned home after a 2-day trip. On the evening of the second day after his return, he noticed rashes appearing over his body, notably on shoulders and trunk. These rashes were little painful in nature.

Keah SH

2013-10-01

17

Butterfly rash with periodontitis: A diagnostic dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Rashes can occur in any part of the body. But rash which appears on face has got both psychological and cosmetic effect on the patient. Rashes on face can sometimes be very challenging to physicians and dermatologists and those associated with oral manifestations pose a challenge to dentists. Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can al...

Aggarwal, Manvi; Mittal, Mudit; Dwivedi, Swati; Vashisth, Pallavi; Jaiswal, Deepesh

2012-01-01

18

Rocky Mountain spotted fever, petechial rash (image)  

Science.gov (United States)

... by ticks. This photograph shows the classical appearing rash which often begins on the wrists and ankles, ... rapidly towards the center of the body. The rash may also be present on the palms and ...

19

"Hot Tub Rash" and "Swimmer's Ear" (Pseudomonas)  

Science.gov (United States)

... Tub Rash” and “Swimmer’s Ear” (Pseudomonas) What is Pseudomonas and how can it affect me? Pseudomonas (sue- ... a health care provider for treatment. How is Pseudomonas spread? Hot tub rash can occur if contaminated ...

20

Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)  

Science.gov (United States)

... Protect Myself and My Family? "Hot Tub Rash" ( Pseudomonas Dermatitis / Folliculitis) Below are answers to the most ... de la bañera" y el "oído de nadador" ( Pseudomonas ) [PDF - 1 page] What Causes Hot Tub Rash? ...

 
 
 
 
21

Neurofibroma of infratemporal fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Neurogenic tumours form a very small percentage of all neoplastic Unions of head and neck region. The histological classifications of benign neurogenic tumours of head and neck include neurofibroma, schwannoma and neuromas. The purpose of this paper is to report a case of neurofibroma involving right infratemporal fossa, pterygopalatine fossa, nasopharynx which was treated surgically through a transmandibular approach.

2001-01-01

22

Severe skin rash associated with atazanavir  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Three cases of severe rash associated with the use of atazanavir are described. In all cases, the rash was maculopapular and pruritic. Rash onset occurred eight to 11 days after initiation of therapy, and resolved with atazanavir discontinuation. Clinicians prescribing atazanavir should be aware of this potential adverse effect.

Walkty, Andrew; Smith, Dick; Lopko, Bernie; Kasper, Ken

2009-01-01

23

Side Effects of HIV Medicines: HIV and Rash  

Science.gov (United States)

... medical attention. Why do people with HIV develop rash? A rash is an irritated area of the ... a serious, life-threatening condition. What are serious rash-related conditions? Rash can be a sign of ...

24

Rash associated with Pregabalin: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available A 48-year-old man with erythematous, maculopapularrash localized to his extremities and lumbar region thathe had been receiving oral pregabalin 300 mg per day for2 months to treat his neuropathy was applied. The Naranjoprobability scale indicates a probable relationship betweenthe development of rash and use of pregabalin byour patient. Pregabalin was discontinued and antihistaminictreatment, oral methyprednisolone and topical steroidcream were given to treat the rash. The rash almostcompletely resolved one week after pregabalin was discontinued.Pregabalin-induced rash was rarely reportedin Phase 3 clinical trials, and there is currently only oneavailable report on the development of a rash coincidingwith the use of pregabalin. No clear mechanisms reportedfor rash associated with pregabalin. It is usually recommendedto start pregabalin with low doses and slow increasesmight prevent the incidence of side effects. J ClinExp Invest 2013; 4 (1: 107-109Key words: pregabalin, rash, multiple myelom

Burak Uz

2013-03-01

25

Rash  

Science.gov (United States)

... by:. Medications, including antibiotics, seizure medications and diuretics Topical skin products, such as cosmetics, perfumes or skin creams ... you ate a new food, tried a new skin care product or took a new medication? Location and ...

26

Pathology Case Study: Maculopapular Rash  

Science.gov (United States)

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 38-year-old woman with a history of morbid obesity and gastric bypass surgery complains of fatigue, sore throat, and rash. Visitors are given the physical examination results and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in dermatologic pathology.

Flynn, Kevin J.; Malone, Mark

2007-11-21

27

Posterior Fossa Epidural Hematomas  

Directory of Open Access Journals (Sweden)

Full Text Available Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4-7%. Seven cases of posttrau-matic posterior fossa epidural hematomas diagnosed by computed tomography (CT are reported with radiological and clinical findings. This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospitalized in an 18-month period. The patients were evaluated regarding age, gender, type of trauma, cranial CT and Glasgow coma score in admittance, treatment and follow-up. Average age was 24.2 years and 85.7% of the cases were male. All cases had occipital fracture. Fifty-seven percent of the cases had only occipital fracture and posterior fossa epidural hematoma. All of the cases in this group were neurologically intact except for one who had a Glasgow coma score of 9 in admission. Two cases of this group were conservatively treated. In the others posterior fossa epidural hematomas got larger and they were treated surgically; these 2 cases recovered after surgery. Three of the 7 cases had the supratentorial region lesions; one of these cases died before operation. Two of them were treated surgically, one of them died and the other showed recovery after surgery.

2008-01-01

28

Heat Rash or Prickly Heat (Miliaria Rubra)  

Science.gov (United States)

newsletter | contact Share | Heat Rash or Prickly Heat (Miliaria Rubra) A parent's guide to condition and treatment information A A A This child with miliaria ... itchy bumps in area of redness. Overview Heat rash (miliaria rubra), also known as prickly heat, is ...

29

Drug-induced rash: nuisance or threat?  

Science.gov (United States)

Drug-induced rash is the most commonly reported drug reaction and occurs in a dizzying array of presentations. Changes in lean and fat body tissue, gastrointestinal acid and mucosal permeability, cardiac output, and renal and hepatic metabolism can affect drug absorption, distribution, metabolism, and elimination. Elders may develop cutaneous eruptions from drugs or biologics and be more sensitive to topical medications. Almost all medications have been associated with rash to some degree. Consultant pharmacists should be able to distinguish between the rashes that are uncomfortable from those that are potentially life-threatening. Some drug therapies tend to induce or aggravate "companion" rashes. With select medications, rash is a clinical indicator that the medication is working. Extensive or unusually painful drug-induced skin conditions are rare, but often require fast action by health care providers to direct the patient to life-saving help. Many of these rashes are associated with high mortality, severe complications, and potential chronic disability. Awareness of the drugs that are most likely to cause a rash can help consultant pharmacists work with the clinical team to arrange appropriate care. PMID:23462025

Wick, Jeannette Y

2013-03-01

30

Mysterious slapped face rash at holiday centre.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE--To discover the cause of an outbreak of facial rash in a holiday centre. DESIGN--Questionnaire survey of those with rash; analysis of samples of linen. SETTING--Holiday centre in south west England. PATIENTS--98 holiday-makers presenting to the first aid post with a facial rash. INTERVENTION--Replacement of bed linen with new linen in selected parts of the site. RESULTS--The attack rate was 7.0-14.2/1000 for most accommodation areas in the centre, but in one accommodation area the ...

1992-01-01

31

Skin rash during treatment with generic itraconazole  

Science.gov (United States)

Generic drugs have the same active substance, the same pharmaceutical form, the same therapeutic indications and a similar bioequivalence with the reference medicinal product (branded). Although a similar efficacy is postulated, some cases of clinical inefficacy during treatment with generic formulations have been reported. In this case, we describe a woman with onychomycosis that developed a skin rash during treatment with a generic formulation of itraconazole. Drug administration and its re-challenge confirmed the association between itraconazole and skin rash. Both Naranjo probability scale and World Health Organization causality assessment scale documented a probable association between generic-itraconazole and skin rash. The switch from generic formulation to brand one induced an improvement of symptoms. Since we are unable to evaluate the role of each excipient in the development of skin rash, we cannot rule out their involvement. However, more data are necessary to better define the similarities or differences between branded and generic formulations.

De Vuono, Antonio; Palleria, Caterina; Scicchitano, Francesca; Squillace, Aida; De Sarro, Giovambattista; Gallelli, Luca

2014-01-01

32

Drug Rash (Unclassified Drug Eruption) in Adults  

Science.gov (United States)

newsletter | contact Share | Drug Eruption, Unclassified Information for adults A A A Acute drug eruption with numerous red, raised lesions. Overview A drug rash (drug eruption), also known as a drug ...

33

Posterior fossa arachnoid cysts.  

Science.gov (United States)

Arachnoid cysts of the posterior fossa are rare lesions that are considered to be mostly congenital in origin. In this article, we retrospectively review 12 patients who underwent surgical treatment for their symptomatic posterior fossa arachnoid cysts. The most common presenting symptoms were gait disturbances and headache. The diagnosis was established on computed tomography or magnetic resonance imaging. Surgery consisted of cyst wall excision with fenestration in nine cases and shunting procedures in three cases. In all cases except one who-died, the postsurgical follow-up neuroradiological investigations showed that the cysts had decreased in size, the cerebellum had re-expanded, and if there was preoperative hydrocephalus, the ventricular size was decreased. The follow-up period ranged from 1 to 11 years. All surviving cases are free of symptoms and no arachnoid cysts recurred. The classification, pathophysiology, differential diagnosis and surgical treatment of infratentorial arachnoid cysts are discussed and the relevant literature is reviewed. PMID:10492679

Erdinçler, P; Kaynar, M Y; Bozkus, H; Ciplak, N

1999-02-01

34

Erythema Gyratum Repens: A Rare Paraneoplastic Rash  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Erythema gyratum repens (EGR) is a rare, and characteristic, paraneoplastic rash associated with a variety of malignancies, most notably lung, esophageal, and breast cancers. This case report details the appearance, epidemiology, diagnosis, and treatment of EGR. Prompt identification of EGR is essential, as the rash often precedes the diagnosis of malignancy by several months. Urgent patient referral to evaluate for malignancy is crucial, as this may lead to decreased morbidity and mortali...

Marina Gore; Winters, Michael E.

2011-01-01

35

Yardangs in Medusa Fossae  

Science.gov (United States)

[figure removed for brevity, see original site] (Released 29 July 2002) This THEMIS visible image covers a portion of the Medusa Fossae formation, near the equator of Mars. The most characteristic feature of the Medusa Fossae formation is the abundance of 'yardangs', which are erosional landforms carved by the wind. These features usually form in a linear fashion, and can be indicators of prevailing paleowind directions. On Earth, yardangs are typically found in rocks that are easily eroded, such as those that form from consolidated volcanic ash, dust-fall deposits or lake sediments. In this particular area of Medusa Fossae, the size, spacing, and orientation of the yardangs varies throughout the image. The largest form a stripe across the center of the image, while the smallest are found in the top half of the image (look closely). The small yardangs at the very top of the image are oriented NW-SE; however, the orientation changes to NE-SW near the bright ridge in the center of the image. The variation in size and orientation appears to correspond with topographic layers, and may be due either to differences in consolidation or changes in wind strength or direction as the yardangs were formed. Finally, the terrain in the lower third of the image appears etched or pitted, and was probably also formed by wind erosion.

2002-01-01

36

Approach to the Diseases with Rash  

Directory of Open Access Journals (Sweden)

Full Text Available The differential diagnosis for febrile patients with a rash is extensive. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion. Rashes can be categorized as maculopapular and diffusely erythematous, vesiculobullous, purpuric, or petechial. A thorough history and a careful physical examination are essential to making a correct diagnosis. Certain exanthemas have fairly characteristic morphology, but in many cases an accurate diagnosis cannot be made on the basis of morphology alone. Historical factors may be helpful when evaluating these patients, specifically their disease contacts, immunization record, previous exanthematous illnesses, and associated prodromal symptoms. Although laboratory studies can be useful in confirming the diagnosis, test results often are not available immediately. Because the severity of these illnesses can vary from minor (roseola infantum to life-threatening (meningococcemia, the physician must make prompt management decisions regarding empiric therapy.

Gönül Tan?r

2009-05-01

37

Ron Rash: One Foot in Eden  

DEFF Research Database (Denmark)

An analysis of Ron Rash's novel One Foot in Eden, focusing on his attachment to place and his depiction of the internal conflicts between farmers and townspeople in a small Appalachian community. Rash depicts the contemporary Southernerâ??s struggle to maintain his or her roots in a time of rapid homogenization. The inherent conflicts in his fiction are simultaneously a reminder of the necessity of living with oneâ??s past and a fierce attack on todayâ??s merciless industrialization. The novel ultimately resonates with the continuous changes of the South in the new millennium.

Bjerre, Thomas Ã?rvold

2010-01-01

38

Erythema Gyratum Repens: A Rare Paraneoplastic Rash  

Directory of Open Access Journals (Sweden)

Full Text Available Erythema gyratum repens (EGR is a rare, and characteristic, paraneoplastic rash associated with a variety of malignancies, most notably lung, esophageal, and breast cancers. This case report details the appearance, epidemiology, diagnosis, and treatment of EGR. Prompt identification of EGR is essential, as the rash often precedes the diagnosis of malignancy by several months. Urgent patient referral to evaluate for malignancy is crucial, as this may lead to decreased morbidity and mortality. [West J Emerg Med. 2011;12(4:556–558.

Michael E Winters

2011-05-01

39

Variations in the cubital fossa  

Directory of Open Access Journals (Sweden)

Full Text Available The median nerve crosses in front of the brachial artery at the middle of the arm from lateral to medial side, and passes along its medial side. They appear in cubital fossa beneath bicipital aponeurosis and rest on brachialis muscle. In cubital fossa, structures lying from lateral to medial are tendon of biceps brachii, brachial artery and median nerve (TAN. No literature is available stating median nerve to be lateral to the brachial artery in the cubital fossa. In the present case, we found bilateral variations in the course of median nerve and brachial artery in the cubital fossa. The nerve was lateral to the artery. Both the structures passed deep to an accessory slip of brachialis muscle in the lower arm. It is a rare variation. Compression neuropathy of median nerve, vascular compression and injury to the median nerve during brachial catheterization can occur in such a case.

Biswas S

2010-08-01

40

Clonazepam induced maculopapular rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Clonazepam is a benzodiazepine with prominent anticonvulsant action than other members of the group at equisedating doses. It especially blocks pentylenetetrazole-induced seizures. Other important actions include anxiolysis. Common adverse effects to Clonazepam include drowsiness and lethargy. In this submission we report a case of Clonazepam induced maculopapular rash in a 30 year old female treated for panic disorder. [Int J Basic Clin Pharmacol 2013; 2(5.000: 647-649

S. Mabu Shareef

2013-10-01

 
 
 
 
41

Leflunomide Induced Drug Rash And Hepatotoxicity  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 57 year old female presented with generalized erythematous scay plaques of 11/2 months duration and jaundice since 1 month. She was on leflunomide since 3 months for chronic rheumatoid arthritis. Investigations revealed positive ANA, rheumatoid factor and negative anti-DsDNA. Bilirubin and liver enzymes were markedly raised. Viral markers were negative. Direct immunoflourescence did not show lupus band. A diagnosis of drug induced hepatitis and skin rash was made. She was treated with chole...

Uppal Monica; Rai Reena; Srinivas C R

2004-01-01

42

Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.  

LENUS (Irish Health Repository)

We report on the case of a 2-year-old girl recently diagnosed with Methylenetetrahydrofolate reductase (MTHFR) deficiency who originally presented in the neonatal period with a distinctive rash. At 11 weeks of age she developed seizures, she had acquired microcephaly and developmental delay. The rash deteriorated dramatically following commencement of phenobarbitone; both rash and seizures abated following empiric introduction of pyridoxine and folinic acid as treatment of possible vitamin responsive seizures. We postulate that phenobarbitone in combination with MTHFR deficiency may have caused her rash to deteriorate and subsequent folinic acid was helpful in treating the rash and preventing further acute neurological decline as commonly associated with this condition.

Crushell, Ellen

2012-09-01

43

Medusae Fossae Yardangs  

Science.gov (United States)

[figure removed for brevity, see original site] Released 15 April 2003The Medusae Fossae formation is an enigmatic pile of eroding sediments that spans over 5000 km in discontinuous masses along the martian equator. The yardang ridges, formed from the scouring action of windblown sand, are a characteristic feature of this formation. In this image, there is evidence for a period of erosion when winds scoured the surface at nearly right angles to the prominent yardang direction.Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.Image information: VIS instrument. Latitude -5.1, Longitude 184.4 East (175.6 West). 19 meter/pixel resolution.

2003-01-01

44

Glioblastoma Located In Posterior Fossa  

Directory of Open Access Journals (Sweden)

Full Text Available A 63-year-old woman operated eight months ago for glioblastoma (GB located in posterior fossa was admitted to emergency room for stuporous, nausea, vomiting and headache. CT and MR showed recurrence of posterior fossa cysticnecrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF fistula from the incision was occurred and  contaminated by multidrug resistant Acinetobacter baumannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and children;and it appears as two different subsets: de novo (primary type and secondary  glioblastomas. Although our patient’s immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour wasde novo because of no other brain involvement, staining with GFAP, vimentin, and  nearly absent p53 mutation.

Bulent Bakar

2013-01-01

45

Pathology Case Study: Skin Rash and Proteinuria  

Science.gov (United States)

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 8-year-old boy has a history of skin rash with concurrent hematuria and proteinuria. Visitors are given the microscopic and gross descriptions, immunoflourescent and electron microscopy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in renal pathology.

Dickman, Paul S.; Horn, Kevin D.

2007-09-19

46

Leflunomide Induced Drug Rash And Hepatotoxicity  

Directory of Open Access Journals (Sweden)

Full Text Available A 57 year old female presented with generalized erythematous scay plaques of 11/2 months duration and jaundice since 1 month. She was on leflunomide since 3 months for chronic rheumatoid arthritis. Investigations revealed positive ANA, rheumatoid factor and negative anti-DsDNA. Bilirubin and liver enzymes were markedly raised. Viral markers were negative. Direct immunoflourescence did not show lupus band. A diagnosis of drug induced hepatitis and skin rash was made. She was treated with cholestyramine but she died after ten days of hospitalization.

Uppal Monica

2004-01-01

47

Rash in primary Epstein?Barr virus infection  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Rash can be one of the symptoms in acute infectious mononucleosis. According to the classical literature sources, drug-induced rash can be associated with synthetic penicillin and Epstein-Barr virus itself. Nowadays, a lot of case reports point to the development of rash after the administration of other groups of antimicrobials. Clinical and laboratory signs and the administration of antimicrobials in acute Epstein-Barr virus infection have been correlaed with the development of rash. Material and Methods. This retrospective-prospective study (2007-2010 included 243 patients hospitalized for acute infectious mononucleosis at the Department for Infectious Diseases, Clinical Center of Vojvodina, of whom 51 had rash and 192 were without it. Epstein-Barr virus infection was confirmed by ELISA IgM EBVVCA in all patients. Results. Student’s t-test did not show a significant difference between the age, gender, duration of symptoms, leucocytes count, absolute lymphocytes count, alanine aminotransferase, aspartate aminotransferase among patients with or without rash. ?2 test did not show a significant difference among the patients treated by synthetic or pure penicillin, macrolids and 1st and 2nd generation cephalosporins. However, if we compare all these antimicrobials, there is a significant difference between them and 3rd generation cephalosporins. Only two patients developed rash without antimicrobials. Conclusion. According to our results, rash developed independently of the clinical course of disease. Previous conclusion that synthetic penicillin produces rash seems to be not true, because there are many patients who were treated with them but did not develop rash. All antimicrobials can be associated with rash, but 3rd generation cephalosporins seem to produce rash less frequently than the others.

Lendak Dajana

2012-01-01

48

Piriformis fossa - an anatomical and orthopedics consideration.  

Science.gov (United States)

Introduction: Piriformis fossa is an important anatomical landmark having significant clinical value in orthopedic surgery; but its location and anatomical relationship with surrounding structures are not clearly defined. Hence it is necessary to clearly describe it in respect to anatomical and orthopedic aspect. Materials and Methods: Fifty Cadaveric dry femoral bones and Dissection of the four hip specimens were used to study the Piriformis fossa in respect to location and its relationship with surrounding structures. Clinical importance of piriformis fossa was determined in reference to antegrade femoral nail insertion. Observations: Piriformis muscle and so called piriformis fossa are unrelated entities. Piriformis fossa is anatomical site of insertion of obturator externus. In dry cadaveric femora; fossa was not always located in the direction of femoral shaft. It was located in the direction of femoral shaft in 24% cases only. In 68% cases femoral canal was aligned lateral and in 8% cases, it lies medial to the fossa. Conclusion: Piriformis fossa should be named as Trorchanteric fossa or Obturator fossa for better anatomical description. So called Piriformis fossa does not found to be universally corresponding to femoral shaft hence selection of entry site should be based on variable proximal femur and area on femur which corresponds to femoral shaft. PMID:24783092

Lakhwani, O P; Mittal, P S; Naik, D C

2014-03-01

49

RASH D - A mercury programme for neutron shielding calculations  

International Nuclear Information System (INIS)

An improved version of an earlier neutron shielding programme (RASH B) is described. The new programme is also written in Mercury Autocode and solves a set of multigroup diffusion equations in one dimension. It differs from RASH B in that distributed source terms may be introduced into all the groups if required. Some other improvements are also included. (author)

1962-01-01

50

Late presentation of sorafenib-associated rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Sorafenib, an oral multitargeted tyrosine kinase inhibitor, is licensed for the treatment of hepatocellular carcinoma. Rash is one of the most common side effects of its use, generally appearing within days to a few weeks of commencing treatment. We report the first case of rash appearing nine months after starting treatment with sorafenib. Case presentation A 75-year-old Caucasian man initially presented with asymptomatic transient jaundice. He was diagnosed with Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma after extensive investigation. He tolerated sorafenib 400 mg twice a day before presenting nine months later with a rash, confirmed to be drug-induced. Conclusions Sorafenib is a drug of choice in Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma. It can cause protracted rash quite late into treatment. Successful management of the rash could contribute to achieving stable disease in hepatocellular carcinoma over a significant period of time.

Ross Paul

2010-10-01

51

Giant tumour of the pterygopalatine fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Neurilemmomas are benign and slow growing tumours. Neurilemmomas of the pterygopalatine fossa are rare. In this paper we present a case of schwannoma arising in the pterygopalatine fossa with extension into infratemporal fossa and floor of the orbit. A transantral approach was used for excision of the tumor following which the defect in the floor of the orbit was reconstructed with the help of a temporoparietal flap.

2008-01-01

52

CT anatomy of the pterygopalatine fossa  

International Nuclear Information System (INIS)

The pterygopalatine fossa represents a central space in the depth of the facial skull. Acting as a mediator between neighbouring compartments it is traversed by numerous neurovascular structures. High resolution CT is possible not only to depict all those canals and openings but also the soft tissue contents of the fossa itself can be visualised by CT. This paper presents the radioanatomic prerequisites for assessment of the pterygopalatine fossa that may be affected by a variety of pathologic conditions. (orig.)

1989-01-01

53

rasH mutants deficient in GTP binding.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Single amino acid substitutions were introduced into a region of the rasH protein (residues 116, 117, and 119) homologous to a variety of diverse GTP-binding proteins. Each of the mutant p21 proteins displayed a significant reduction (10- to 5,000-fold) in GTP binding affinity. Activated rasH proteins deficient in GTP binding were unaltered in their ability to morphologically transform NIH 3T3 cells.

Der, C. J.; Pan, B. T.; Cooper, G. M.

1986-01-01

54

Late presentation of sorafenib-associated rash: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Introduction Sorafenib, an oral multitargeted tyrosine kinase inhibitor, is licensed for the treatment of hepatocellular carcinoma. Rash is one of the most common side effects of its use, generally appearing within days to a few weeks of commencing treatment. We report the first case of rash appearing nine months after starting treatment with sorafenib. Case presentation A 75-year-old Caucasian man initially presented with asymptomatic transient jaundic...

2010-01-01

55

Memnonia Fossae, Approximately Natural Color  

Science.gov (United States)

Tharsis-centered volcanic and tectonic activity resulted in the formation of radial grabens of Memnonia Fossae, which cut materials of the ancient cratered highlands and the relatively young, highland-embaying lava flows from the Tharsis volcanoes. Center of picture is at latitude 16 degrees S., longitude 142 degrees W. Natural color version shows albedo variations and uniform colors. The enhanced color version (PIA00151, following decorrelation stretch), however, reveals a diversity of subtle color variations; many of the color variations may be due to different lava flow units and variable amounts of weathering, possible alteration by water, and eolian redistributions. Viking Orbiter Picture Numbers 41B52 (green), 41b54 (red), and 41B56 (blue) at 198 m/pixel resolution. Picture width is 206 km. North is 119 degrees counter-clockwise from top.

1995-01-01

56

Computed tomography of posterior fossa tumor  

International Nuclear Information System (INIS)

58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

1980-06-01

57

Computed tomography of posterior fossa tumor  

Energy Technology Data Exchange (ETDEWEB)

58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

Suh, J. H.; Suh, C. O.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1980-06-15

58

Tuberculosis, fever and skin rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Hypersensitivity syndrome (HSS reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymphadenopathy, and internal organ involvement. The pathogenesis of HSS is not known, but an immune mechanism is suspected. So far, numerous drugs such as sulfonamides, Phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause this syndrome. We report a case in a 12-year-old female patient who diagnosed HSS depend on anti-tuberculosis drugs. She developed fever, rash, and eosinophilia 15 days after antituberculosis treatment with isoniazid, rifampin, pyrazinamide, and ethambutol was initiated. The patient had significant resolution of her fevers and rash with steroid therapy and did not relapse after steroid was tapered. This experience illustrates the potential of anti-tuberculosis treatment to cause hypersensitivity syndrome, a situation that could be misdiagnosed as an infectious process.

Emre Dincer

2009-06-01

59

Erlotinib-induced rash spares previously irradiated skin  

International Nuclear Information System (INIS)

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

2011-08-01

60

Erlotinib-induced rash spares previously irradiated skin  

Energy Technology Data Exchange (ETDEWEB)

Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

Lips, Irene M.; Vonk, Ernest J.A. [Radiotherapeutisch Instituut Stedendriehoek en Omstreken (RISO), Deventer (Netherlands). Dept. of Radiation Oncology; Koster, Mariska E.Y. [Deventer Hospital (Netherlands). Dept. of Lung Diseases; Houwing, Ronald H. [Deventer Hospital (Netherlands). Dept. of Dermatology

2011-08-15

 
 
 
 
61

Management of a pterygopalatine fossa hydatid cyst.  

Science.gov (United States)

Hydatid cyst disease is a rare parasitic infestation caused by larvae of Echinococcus granulosus. Although larval stage of this parasite can thrive in any part of the body, especially lungs and liver; head and neck involvement is rare. Pterygopalatine fossa involvement is reported in two cases in the literature. In this report we represent a case with solitary, secondary pterygopalatine fossa hydatid cyst extending in to the maxillary sinus, orbita, sphenoid sinus and skull base. PMID:22075139

Yumusakhuylu, Ali Cemal; Yilmaz, Asli Sahin; Devecioglu, Ibrahim; Oysu, Cagatay

2012-10-01

62

Posterior fossa subdural hematoma mimicking intracerebellar hemorrhage.  

Science.gov (United States)

Subdural hematomas of the posterior fossa are very rare and most cases are related to head injury. The influence of anticoagulation in cases of spontaneous development is well known. Although diagnosis is easily achieved by CT sean, atypical forms may lead to the wrong diagnosis of cerebellar hematoma. We present a case of a posterior fossa acute subdural hematoma occurring in an anticoagulated patient who was preoperatively misdiagnosed as an intracerebellar hemorrhage. PMID:14710308

Miranda, P; Alday, R; Lagares, A; Pérez, A; Lobato, R D

2003-12-01

63

Widespread skin rash following travel to South-East Asia.  

Science.gov (United States)

A 21-year-old man presented with a widespread, intensely pruritic skin rash, which developed acutely 5 days after returning from a backpacking holiday in Thailand. On initial presentation to his general practitioner, an erythematous, papular rash was noted in the upper right back, with smaller clusters of lesions on the buttocks and right arm. Based on the anatomical distribution of the lesions, a preliminary diagnosis of shingles was made. Over the following 2 weeks, the lesions failed to improve, and new snake-like lesions appeared. A dermatologist made the diagnosis of cutaneous larva migrans. The skin lesions rapidly resolved following oral albendazole therapy. PMID:24557477

Creamer, Andrew

2014-01-01

64

Zur kiefergelenkfunktionsabhängigen Knochendicke zwischen Fossa mandibularis des Os temporale und der Fossa cranii media  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Zur Untersuchung funktioneller Adaptationsvorgänge des Kiefergelenkes wurde die Stelle der dünnsten Knochendicke zwischen Fossa mandibularis und der Fossa cranii media (roofthickness) durch eine neue Methode, die auf CT basiert, vermessen und repräsentativ auf Abhängigkeiten überprüft. Das Patientenkollektiv enthielt 451 Kiefergelenke und wurde je nach Befund in drei Gruppen sclerosis, resorption und control eingeteilt. Korrelationen zeigte die roofthickness mit der Gelenkseite. Abhäng...

2008-01-01

65

Direct sagittal CT scanning in the diagnosis of pituitary fossa tumours and posterior fossa pathology  

Energy Technology Data Exchange (ETDEWEB)

Two independent methods are presented for multidirectional CT scanning of the brain using the Philips Tomoscan 300. The advantages in scanning pituitary fossa tumours and pathology of the posterior fossa are discussed. No additional software or modifications are required. Direct sagittal scanning is particularly advantageous for accurate assessment of the size of pituitary tumours and intrasellar lesions requiring surgical intervention or radiation therapy.

Podlas, H. (Department of Neuroradiology, Princess Nursing Home, Johannesburg, South Africa)

1981-01-01

66

Direct sagittal CT scanning in the diagnosis of pituitary fossa tumours and posterior fossa pathology  

International Nuclear Information System (INIS)

Two independent methods are presented for multidirectional CT scanning of the brain using the Philips Tomoscan 300. The advantages in scanning pituitary fossa tumours and pathology of the posterior fossa are discussed. No additional software or modifications are required. Direct sagittal scanning is particularly advantageous for accurate assessment of the size of pituitary tumours and intrasellar lesions requiring surgical intervention or radiation therapy. (Auth.)

1981-01-01

67

Extensive VZV Encephalomyelitis without Rash in an Elderly Man.  

Science.gov (United States)

Introduction. Varicella zoster virus (VZV) encephalomyelitis with cranial nerve involvement is rare. Characteristically it is preceded by a rash and primarily presents in the immunocompromised. The spectrum of VZV neurologic disease is extensive and it is not uncommon to present without rash. We report the case of an elderly otherwise immunocompetent patient who presented with diverse manifestations of VZV CNS infection all occurring without rash. Case Report. A 78-year-old man presented with 1 week of progressive paraparesis and sensory loss, malaise, and fevers. MRI of the neuraxis demonstrated numerous enhancing lesions: intramedullary, leptomeningeal, pachymeningeal, and cranial nerves. Cerebrospinal fluid (CSF) showed a white blood cell count of 420/ ? L with elevated protein (385?mg/dL). CSF VZV qualitative PCR was positive and CSF VZV immunofluorescence assay detected IgM antibody, confirming the diagnosis of VZV encephalomyelitis. Clinical and radiological improvement was observed after intravenous acyclovir treatment. Conclusion. This is a rare report of an immunocompetent patient with extensive VZV encephalomyelitis. We highlight the importance of considering this diagnosis even in the absence of the characteristic rash, and the potential risk of premature discontinuation of antiviral therapy once HSV has been excluded. Prompt recognition and treatment can dramatically reduce morbidity and mortality in patients. PMID:24864218

Lynch, Karen; Agarwal, Prakhar; Paranandi, Anu; Hadley, Susan; Vullaganti, Mithila

2014-01-01

68

The Measurement of Dispositions to Rash Action in Children  

Science.gov (United States)

Among adolescents and adults, there appear to be at least four different personality traits that dispose individuals to rash or ill-advised action: sensation seeking, negative urgency, lack of planning, and lack of perseverance. The four are only moderately correlated and they appear to play different roles in dysfunction. It is important to…

Zapolski, Tamika C. B.; Stairs, Agnes M.; Settles, Regan Fried; Combs, Jessica L.; Smith, Gregory T.

2010-01-01

69

Arachnoid cyst of the middle cranial fossa  

International Nuclear Information System (INIS)

The middle cranial fossa is the most common site for intracranial arachnoid cysts. Galassi and his associates have provided a useful classification of middle fossa arachnoid cysts based on their computed tomographic appearances. The Type I cyst is a small lenticular lesion. The Type II cyst is quadrangular in shape, reflecting a completely open insula. The Type III cyst appears as a large area of smoothly rounded lucency, with a significant compression of the brain. We report a 2-year-old boy with a middle fossa arachnoid cyst. This cyst differed from the type of Galassi's classification in its extension. Computerized tomograms showed low-density lesions of the bilateral middle cranial fossa and suprasellar area, which was not enhanced with contrast medium. Magnetic Resonance Imaging (MRI) showed a CSF-like pattern (Kjos) and revealed delicate anatomical structures in the surrounding brain. Arachnoid cysts are usually single lesions. However, not infrequently these cystic cavities may be divided by membranous septa into two or more compartments. Bilateral, more or less symmetrical arachnoid cysts in the middle cranial fossa as seen in this patient, however, seem to be very rare. Only a few such cases have been reported previously. MRI was superior to X-ray CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into Kjos's three groups on the basis of the intensity pattern of the cyst contents, thereby improving diagnostic specificity and patient management. (author)

1987-01-01

70

"'The Natural World Is the Most Universal of Languages' : An Interview with Ron Rash  

DEFF Research Database (Denmark)

Interview med den amerikanske forfatter Ron Rash. Rash taler bl.a. om de forskellige temaer i sine værker, om forholdet til naturen, og regionale fordomme i USA og om sine skrivevaner. Udgivelsesdato: Winter

Bjerre, Thomas Ã?rvold

2007-01-01

71

Topical use of human breast milk for diaper rash in infants  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose: Diaper rash is the most common irritant contact dermatitis, occurring in many of young children. In this study we have compared the effect of human breast milk (HBM) and zinc oxide ointment on diaper rash in hospitalized infants in Sanandaj. Methods: Subjects comprised infants less than two years of age with prematurity, sepsis, gastroenteritis and pneumonia who had diaper rash but did not have allergic causes of the rash. These 50 infants under two years ...

Susan Penjvini; Siroos Shahsawari; Farideh Gazerani; Sohaila Abdolkawand

2012-01-01

72

Allergic skin rash with lamotrigine and concomitant valproate therapy - Evidence for an increased risk  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting la...

Li, L. M.; Russo, M.; Odonoghue, M. F.; Duncan, J. S.; Sander, Jwas

1996-01-01

73

Trochanteric fossa or piriform fossa of the femur: time for standardised terminology?  

Science.gov (United States)

Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in this review study. The trochanteric fossa, a deep depression at the base of the femoral neck is indicated as 'piriform fossa' in the vast majority of the publications. Other publications indicate the insertion site of the tendon of the piriformis muscle on the greater trochanteric tip as 'piriform fossa'. As a result of recurrent terminology error and consistent reproductions of it, the recommended entry point in literature is confusing and seems to need standardisation. The piriform fossa does not appear to exist in the femoral region. The trochanteric fossa is the standard entry point which most surgeons recommend for facilitating a standard straight intramedullary nail, as is in line with the medullary canal. The greater trochanteric tip is the lateral entry point for intramedullary nails with a proximal lateral bend. PMID:23026115

Ansari Moein, C M S; Gerrits, P D; ten Duis, H J

2013-06-01

74

CT of perineural tumor extension: pterygopalatine fossa  

International Nuclear Information System (INIS)

Tumors of the oral cavity and paranasal sinuses can spread along nerves to areas apparently removed from the primary tumor. In tumors of the palate, sinuses, and face, this perineural spread usually involves the maxillary division of the trigeminal nerve. The pterygopalatine fossa is a pathway of the maxillary nerve and becomes a key landmark in the detection of neural metastasis by computed tomography (CT). Obliteration of the fat in the fossa suggests pathology. Case material illustrating neural extension is presented and the CT findings are described

1985-01-01

75

[Hydatid cyst of the posterior fossa].  

Science.gov (United States)

Hydatidosis is an endemic affection in Tunisia. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease. We report the case of a four-year-old child admitted for high intracranial pressure. Brain CT scan showed an extradural posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. She feels well six months later. PMID:17434701

Braham, E; Bellil, S; Bellil, K; Chelly, I; Mekni, A; Haouet, S; Kchir, N; Khaldi, M; Zitouna, M

2007-05-01

76

Poison Ivy Taking the Itch Out of the Rash  

Science.gov (United States)

A longstanding belief that has it roots in Native American folklore is that the crushed leaves of jewelweed (Impatiens capensis) relieve the skin's allergic reaction to the toxin of poison ivy (Toxicodendron radicans). This case was developed for an introductory majors or non-majors biology or plant class. It first examines students' conceptions about the rash of poison ivy, what in the plant causes the rash, and how the body responds to the toxin. Then students in small groups plan an experiment using the scientific method to test the ability of jewelweed to reduce the reaction. Following a comparison of experimental designs from different groups, data from a scientific paper is presented for interpretation and analysis. An important outcome of this case is that students recognize the need for evaluating myths and misconceptions using scientific evidence.

Ford, Rosemary H.

2011-01-01

77

Severe chronic diarrhea and maculopapular rash: A case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Systemic mastocytosis (SM) is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (MCs). We report a case of SM with multi-organ involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed muco...

Alessandra Elvevi; Federica Grifoni; Federica Branchi; Umberto Gianelli; Dario Conte

2011-01-01

78

[Meningiomas of the posterior cranial fossa].  

Science.gov (United States)

In a period of 3 years 12 patients with meningiomas of the posterior cranial fossa were treated surgically. The group included 2 cases of meningioma situated on the cerebellar convexity, 5 on the tentorium, 2 on the posterior aspect of the pyramid bone, 1 of Blumenbach clivus, 2 of foramen magnum. The neurological findings and pneumoencephylographic changes in cases of meningiomas of cerebellar convexity, tentorium and posterior aspect of the pyramid bone made possible the diagnosis of posterior fossa tumour and the diagnosis of meningioma was made possible by carotid and vertebral angiography. In the case of Blumenbach clivus meningioma and in foramen magnum meningiomas the neurological changes were characteristic of tumours at the craniovertebral junction. One meningioma growing through the tentorium was approached from the middle cranial fossa, the remaining ones from the posterior cranial fossa. The tumour could have been removed radically in 7 cases. In 5 cases only partial removal was possible. Three patients died, two after operations for tentorial meningioma and one after operation for Blumenbach clivus tumour. The results in the remaining cases were good. PMID:995226

Bromowicz, J; Wicentowicz, Z; Jedli?ska, M; Traczewski, W

1976-01-01

79

Otolaryngologic manifestations of posterior fossa arachnoid cysts.  

Science.gov (United States)

Posterior fossa arachnoid cysts are more common than previously reported. While they may present with symptoms of hearing loss, vertigo, and tinnitus, often they are associated with vague, nonspecific complaints such as headache, dizziness, or generalized unsteadiness. We present five cases of posterior fossa arachnoid cysts discovered in adult patients. Four of the five patients had nonlocalizing symptoms (three of those sought medical evaluations for persistent dizziness and/or headache). Two patients had prolonged symptoms despite medical evaluation and normal audiometric testing before the correct diagnosis was made. We describe the case of our senior author (C.P.D.) in detail and include computerized tomographic and nuclear magnetic resonance studies outlining his pathology. A review of the management of these lesions is included. Dizzy patients and those patients with nonspecific complaints referable to the inner ear or posterior fossa who have normal audiometric testing, and in whom the index of suspicion is high, should have high resolution computerized tomography of the posterior fossa. PMID:3999903

Hadley, M N; Grahm, T W; Daspit, C P; Spetzler, R F

1985-06-01

80

Chemical scoring by a rapid screening of hazard (RASH) method  

Energy Technology Data Exchange (ETDEWEB)

A rapid screening of hazard method (RASH) is presented for deriving relative potency estimates for hazardous substances. The method utilizes data from any available toxicological database such as the Registry of Toxic Effects of Chemical Substances (RTECS) or EPA's GENE-TOX database on genetic activity profiles. The method has been applied to derive relative potency values and permissible environmental concentrations for 278 chemicals. The derived values have been compared with recommendations of expert committees where possible, and substantial agreement is found.

Jones, T.D.; Walsh, P.J.; Watson, A.P.; Owen, B.A.; Barnthouse, L.W.; Sanders, D.A.

1988-03-01

 
 
 
 
81

Successful treatment of refractory rash in paraneoplastic amyopathic dermatomyositis.  

Science.gov (United States)

Skin involvement in dermatomyositis does not always parallel muscle disease and can be the most active or severe component of the disease, failing to respond to therapeutic interventions that are adequate for myositis and other systemic involvement. This case refers to a resistant paraneoplastic amyopathic dermatomyositis rash which readily resolved with intravenous immunoglobulin (IVIG), practically in the form of monotherapy. This observation gains particular significance considering that IVIG is still regarded as a second-line therapeutic regimen in the treatment of dermatomyositis despite its prevalence in matters of safety. PMID:16779504

Aslanidis, Spyros; Pyrpasopoulou, Athina; Kartali, Nikoleta; Zamboulis, Chryssanthos

2007-07-01

82

MR imaging of posterior fossa hemangloblastomas  

International Nuclear Information System (INIS)

The MR findings of 18 surgically proven posterior fossa hemangioblastomas (15 patients) were retrospectively analyzed, and correlated with CT (ten patients) and angiography (eight patients). MR imaging was performed at 1.5 T (ten patients) or 0.35 T (five patients) using both T1- and T2-weighted spin-echo sequences. Twelve tumors were located in the cerebellar hemispheres, four in the vermis, and two in the medulla. Three patients had von Hippel-Lindau disease. Seven lesions were solid, six solid with small cysts, and five cystic with small mural nodule. Tumor vessels were demonstrated in 13 lesions. Associated hemorrhage was present in four patients. MR demonstration of a posterior fossa mass with abnormal vessels should suggest the diagnosis of hemangioblastoma

1987-12-04

83

Posterior fossa hemorrhages in the newborn.  

Science.gov (United States)

Of 700 neonates examined by computed tomography (CT) in a 4 years period, 17 were found to have a posterior fossa hemorrhage. Eleven were born at term, and six were premature. Delivery was traumatic in 12 babies. The hematoma was in the subdural space in nine and within the cerebellum in eight. The CT diagnosis of extravasated blood in the posterior fossa is easy both in full-term neonates and prematures. The localization of the hematoma, however, may be difficult. While in the full-term neonates differentiation between subdural and intracerebellar location is relatively easy, in the premature the cerebellar hematoma frequently has a crescentic shape that resembles a subdural collection. Four patients with a subdural hematoma and four with a cerebellar hematoma were operated on. The general prognosis is poor: seven patients died; of the survivors, only three are normal at follow-up. PMID:7240500

Scotti, G; Flodmark, O; Harwood-Nash, D C; Humphries, R P

1981-02-01

84

Decompressive Craniectomy in Posterior Fossa Ischemic Stroke  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional ...

Luciano Santana-Cabrera; Guillermo Pérez-Acosta; Cristina Rodríguez-Escot; Rosa Lorenzo-Torrent; Manuel Sánchez-Palacios

2012-01-01

85

Posterior fossa arachnoid cysts: two case reports.  

Science.gov (United States)

2 cases of posterior fossa arachnoid cyst are discussed. In the first, it is likely that perinatal factors were responsible for the temporal lobe pathology and the formation of the cyst. Progressive dilatation of the temporal horn may have then been caused by obstruction from the cyst. In the second case, minor head trauma was a possible mechanism for the cyst production, although it seemed irrelevant to the mode of clinical presentation. PMID:756011

Purdie, G H; Rischbieth, R H

1978-01-01

86

Allergic skin rash with lamotrigine and concomitant valproate therapy: evidence for an increased risk Rash cutâneo com lamotrigina e concomitante uso de valproato: evidências de maior risco  

Directory of Open Access Journals (Sweden)

Full Text Available Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30% developed a rash, whilst of the 70 not taking valproate, only 6 (8% developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (pRash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina adicionada a seu tratamento. Dez dos 33 pacientes (30% que faziam uso de valproato e 6 (8% dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p<0,02.

L. M. Li

1996-03-01

87

Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa  

International Nuclear Information System (INIS)

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29- year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

2004-12-01

88

Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa  

Energy Technology Data Exchange (ETDEWEB)

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29- year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

Choi, Jin Woo; Heo, Min Suk; Lee, Jin Koo; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Chang Hyeon [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

2004-12-15

89

Mononucleosis-like drug rash: an interesting case presentation.  

Science.gov (United States)

Dapsone hypersensitivity syndrome (DHS) is a rare adverse effect of the commonly prescribed drug dapsone. We present a case of a 35-year-old male who was referred to us from the gastroenterologist with complaints of rash, nausea, vomiting, and jaundice since 2 days with a provisional differential diagnosis of infectious mononucleosis or viral exanthema. On enquiry patient gave history of taking dapsone a week prior for refractory urticaria. After thorough investigations we diagnosed him with DHS. This syndrome occurs in a relatively small proportion of patients, but it is associated with considerable morbidity and mortality. The reason for presenting this case is to remind physicians of the unpredictability and potential severity of this reaction which makes it a major concern in clinical practice. PMID:24791243

Vishnani, Reshma T; Malkani, Ram H; Topal, Afsha A; Desai, H G

2014-01-01

90

Emotion-Based Dispositions to Rash Action: Positive and Negative Urgency  

Science.gov (United States)

Under heightened emotional states, individuals are more inclined to engage in ill-considered or rash actions than at other times. The authors present evidence for the existence of 2 related traits called positive and negative urgency. The traits refer to individual differences in the disposition to engage in rash action when experiencing extreme…

Cyders, Melissa A.; Smith, Gregory T.

2008-01-01

91

Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background In recent years inhibitors directed against the epidermal growth factor receptor (EGFR have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI induced rashes have been published, data on systematic management studies are sparse. Methods Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes. Results Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin. Conclusions In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

Gerber Peter

2012-02-01

92

Thoracic empyema with scarlatiniform rash and acral desquamation: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 5 year old girl with thoracic empyema developed a scarlatiniform rash and acral desquamation. Cultures from blood, throat, and pleural fluid all grew Streptococcus pyogenes, a common etiologic agent of pediatric thoracic empyema. The presence of a scarlatiniform rash and acral desquamation in children with a thoracic empyema may help identify the causative organism.

Baird, John Scott; Sediva, Ivona

2009-01-01

93

Post-traumatic osteochondral ''loose body'' of the olecranon fossa  

International Nuclear Information System (INIS)

Three cases of intra-articular osteochondral bodies with the olecranon fossa are reported. All patients had had severe trauma to the elbow, and in each case an osteochondral fragment, nourished by the synovial fluid, became enlarged and finally lodged within the fossa. The radiological and pathological features and presumed pathogenesis are described

1981-01-01

94

Incidence and Determinants of Nevirapine and Efavirenz-Related Skin Rashes in West Africans: Nevirapine's Epitaph?  

Science.gov (United States)

Non-nucleoside reverse transcriptase inhibitor (NNRTI) associated rash is common and frequently leads to discontinuation of NNRTIs. This study assessed the risk of developing rashes and discontinuing NNRTIs and associated factors in a large clinic in central Ghana. In this retrospective cohort study, clinical data were obtained in patients starting efavirenz or nevirapine between 2004–2010. Factors associated with rashes were explored using a multivariate Cox proportional hazards regression model. Of 3,999 patients who started NNRTI-based ART, 281 (7.0%) experienced at least one episode of NNRTI-related rash with an incidence of 2.63 events/100 person-years, occurring in 10.2% and 5.6% of patients taking nevirapine and efavirenz respectively. Most rashes (94%) were grade 1 or 2 and were reported a median of 2 months following initiation of ART. In multivariate analysis developing a rash was associated with nevirapine use (aHR 1.67, 95% CI 1.28–2.10), female gender (aHR of 1.39, 95% CI 1.01–1.92) and lower baseline CD4 counts (aHR 0.88, 95% CI 0.82–0.95 per 50 cells/mm3 increment). Patients with nevirapine-associated rash were 11 times more likely to discontinue treatment as patients with efavirenz-associated rash. In contrast to findings in other studies, NNRTI-associated rashes in Ghanaians appear more common in patients with lower baseline CD4 counts. Given the increased frequency of rashes with nevirapine and subsequent discontinuations in many patients, along with other treatment-limiting toxicities, this provides further impetus for the replacement of nevirapine by efavirenz as the first-line NNRTI treatment of choice in Africa.

Sarfo, Fred Stephen; Sarfo, Maame Anima; Norman, Betty; Phillips, Richard; Chadwick, David

2014-01-01

95

Posterior fossa arachnoid cyst presenting with isolated sensorineural hearing loss.  

Science.gov (United States)

Arachnoid cysts are benign cysts occurring in the intra-arachnoid space and containing cerebrospinal fluid. They constitute approximately 1 per cent of all intracranial masses. They are uncommon in the posterior cranial fossa. Common presenting symptoms include headaches, seizures, focal neurologic signs and vague dizziness. Magnetic resonance imaging is the preferred method of investigation, and the treatment for symptomatic cysts is generally surgical drainage. We report the unusual presentation of a young patient with a posterior fossa arachnoid cyst that manifested in the form of isolated unilateral sensorineural hearing loss. The patient underwent posterior fossa craniotomy and marsupialization of the cyst. To our knowledge, posterior fossa arachnoid cyst presenting with isolated hearing loss alone has not been reported in the English literature. A review of the literature pertaining to posterior fossa arachnoid cysts, including the clinical features, diagnosis and management, is also presented. PMID:16848918

Thinakara-Rajan, T; Janjua, A; Srinivasan, V

2006-11-01

96

Surgical management of posterior cranial fossa meningiomas.  

Science.gov (United States)

Seventy-three patients with posterior fossa meningioma were operated upon between July 1975 and September 1992. The authors attempt a simple classification of these tumours. Fifty-five were women (average age: 48 years) and 18 were men (average age: 52 years). Frequently, there was gait disturbance except in tentorial meningioma where headache was the most common symptom. The most common physical finding was a cranial nerve deficit (77%). All patients underwent CT and angiography. More recently, MRI was used and found very helpful. Surgical approaches used were either a suboccipital craniectomy, a subtemporal craniotomy or a combined suboccipital-subtemporal approach. Tumour resection was complete in 57 (78%) cases. There were no operative deaths. Thirty-three per cent of patients were left with permanent deficits: mainly cranial nerve deficit (47%). Seventy-seven per cent of patients out of the 57 who could be followed up are functioning independently, 21% of these having no neurological deficit. With proper neuroradiological evaluation, good selection of patients and microneurosurgical techniques posterior fossa meningiomas can be completely excised with an acceptable complication rate. PMID:8161422

Symon, L; Pell, M; Singh, L

1993-01-01

97

3D CBCT anatomy of the pterygopalatine fossa.  

Science.gov (United States)

The anatomy of the pterygopalatine fossa keeps a traditional level and is viewed as constant, even though a series of structures neighboring the fossa are known to present individual variations. We aimed to evaluate on 3D volume renderizations the anatomical variables of the pterygopalatine fossa, as related to the variable pneumatization patterns of the bones surrounding the fossa. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 100 patients. The pterygopalatine fossa was divided into an upper (orbital) and a lower (pterygomaxillary) floor; the medial compartment of the orbital floor lodges the pterygopalatine ganglion. The pneumatization patterns of the pterygopalatine fossa orbital floor walls were variable: (a) the posterior wall pneumatization pattern was determined in 89.5 % by recesses of the sphenoidal sinus related to the maxillary nerve and pterygoid canals; (b) the upper continuation of the pterygopalatine fossa with the orbital apex was narrowed in 79.5 % by ethmoid air cells and/or a maxillary recess of the sphenoidal sinus; (c) according to its pneumatization pattern, the anterior wall of the pterygopalatine fossa was a maxillary (40.5 %), maxillo-ethmoidal (46.5 %), or maxillo-sphenoidal (13 %) wall. The logistic regression models showed that the maxillo-ethmoidal type of pterygopalatine fossa anterior wall was significantly associated with a sphenoidal sinus only expanded above the pterygoid canal and a spheno-ethmoidal upper wall. The pterygopalatine fossa viewed as an intersinus space is related to variable pneumatization patterns which can be accurately identified by CBCT and 3DVR studies, for anatomic and preoperatory purposes. PMID:22918475

Rusu, Mugurel Constantin; Didilescu, Andreea Cristiana; Jianu, Adelina Maria; P?duraru, Dumitru

2013-03-01

98

Skin rash associated with intravitreal bevacizumab in a patient with macular choroidal neovascularization  

Directory of Open Access Journals (Sweden)

Full Text Available Ioannis D Ladas, Marilita M Moschos, Thanos D Papakostas, Athanasios I Kotsolis, Ilias Georgalas, Michail ApostolopoulosDepartment of Ophthalmology, “G. Gennimatas” Hospital of Athens, University of Athens, Athens, GreecePurpose: The purpose of this observational case report is to describe a case of skin rash after intravitreal use of bevacizumab.Methods: A 50-year-old man with choroidal neovascularization in the right eye due to age-related macular degeneration was treated with three intravitreal injections of bevacizumab.Results: Twelve days after the first injection, the patient developed a maculopapular rash on his forehead and on both temporal regions around his eyes. The rash disappeared eight days after treatment with topical corticosteroids. A skin rash with the same distribution reappeared 14 days after the second and 10 days after the third injection. Similarly, it disappeared five and seven days after the use of the same treatment. The follow-up period was 15 months after the third injection. During the follow-up period the rash did not reappear.Conclusion: This case report may initiate further investigation of similar cases to support this observation, as there are a lack of reports of skin rash after intravitreal administration of bevacizumab.Keywords: skin rash, bevacizumab, age-related macular degeneration

Ioannis D Ladas

2008-12-01

99

Severe chronic diarrhea and maculopapular rash: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Systemic mastocytosis (SM is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (MCs. We report a case of SM with multi-organ involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal infiltration by large, spindle-shaped MCs with abnormal surface molecule expression (CD2 and CD25, a picture fully consistent with SM, according to the World Health Organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values < 20 ng/mL. The conclusive diagnosis was smouldering SM. There were no therapeutic indications except for treatment of symptoms. The patient was strictly followed up because of the risk of aggressive evolution.

Alessandra Elvevi

2011-01-01

100

Posterior fossa arachnoid cysts can mimic Meniere's disease.  

Science.gov (United States)

Arachnoid cysts constitute 1% of all intracranial space-occupying lesions. In the posterior fossa, they typically produce vague, nonspecific symptoms. However, a subset of these lesions can produce signs and symptoms indistinguishable from those of Meniere's disease. We discuss the clinical and laboratory features of 2 cases of posterior fossa arachnoid cysts mimicking Meniere's disease as well as the substantial resolution of symptoms in 1 patient after cysto-peritoneal shunt. Posterior fossa arachnoid cyst must be considered in the differential diagnosis of patients presenting with signs and symptoms of Meniere's disease. PMID:14608578

O'reilly, Robert C; Hallinan, Erin K

2003-01-01

 
 
 
 
101

Posterior fossa arachnoid cyst presenting as high cervical cord compression.  

Science.gov (United States)

We report a 16-year-old boy who presented with high cervical cord compression caused by a midline posterior fossa arachnoid cyst lying below the vermis. Cystoperitoneal shunting resulted in a dramatic improvement of neurological signs. PMID:11013694

Shukla, R; Sharma, A; Vatsal, D K

1998-06-01

102

Henoch-Schonlein purpura presenting sequentially as nodular rash, erythema nodosum, and palpable purpura  

Science.gov (United States)

We describe a 26-year-old woman who presented with a nodular rash on the elbows following an insect bite. Two days later, she developed erythema nodosum. Both these lesions were treated symptomatically. One week later, she had purpura, abdominal pain, hematuria, and arthralgias, following which steroids were administered. Her investigations revealed only microscopic hematuria that disappeared with therapy. This pattern of sequential appearance of rash and a nodular morphology are both unique features not previously reported.

Balamurugesan, Kandan; Viswanathan, Stalin

2014-01-01

103

Drug Rash with Eosinophilia and Systemic Symptoms: Two Emergency Department Cases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare, severe adverse drug event that appears with a generalized rash, fevers, and dysfunction of 1 or more organ systems. We describe 2 patients (1 adult and 1 pediatric) seen in the emergency department with DRESS, and review the clinical presentations, potential complications, and management of DRESS. Although rare, it can be associated with significant morbidity, including liver failure and death, and should be considered in...

Alina Tsyrulnik; Adam Landman

2011-01-01

104

Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance a...

Gerber Peter; Meller Stephan; Eames Tatiana; Buhren Bettina; Schrumpf Holger; Hetzer Sonja; Ehmann Laura; Budach Wilfried; Bölke Edwin; Matuschek Christiane; Wollenberg Andreas; Homey Bernhard

2012-01-01

105

Henoch-Schonlein purpura presenting sequentially as nodular rash, erythema nodosum, and palpable purpura.  

Science.gov (United States)

We describe a 26-year-old woman who presented with a nodular rash on the elbows following an insect bite. Two days later, she developed erythema nodosum. Both these lesions were treated symptomatically. One week later, she had purpura, abdominal pain, hematuria, and arthralgias, following which steroids were administered. Her investigations revealed only microscopic hematuria that disappeared with therapy. This pattern of sequential appearance of rash and a nodular morphology are both unique features not previously reported. PMID:24696039

Balamurugesan, Kandan; Viswanathan, Stalin

2014-01-01

106

Endoscopic evaluation of pterygopalatine fossa in adult Iranian cadavers  

Digital Repository Infrastructure Vision for European Research (DRIVER)

  Background : Our aim in this study was to recognize the endoscopic anatomy of the Pterygopalatine fossa (PPF) and the anatomic variations of the related neurovascular structures, to define the endoscopic endonasal approach to this region.   Methods: In a case series study 17 fresh adult cadavers were studied by endoscopic endonasal approach. To reach the pterygopalatine fossa endonasally, we performed the antrostomy and uncinectomy in all cadavers. The medial and posterior walls of the ma...

2013-01-01

107

Microsurgical Posterior Fossa Vestibular Neurectomy: An Evolution in Technique  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Between 1925 and 1945, Walter Dandy and Kenneth McKenzie performed more than 700 posterior fossa eighth nerve sections and vestibular neurectomies, treating the intractable vertigo accompanying Meniere's disease. During the past 10 years, using microsurgical techniques and reaching the posterior fossa through the temporal bone, vestibular neurectomy has enjoyed a resurgence of popularity. When hearing is to be preserved, vestibular neurectomy is the surgical treatment of choice, if the patien...

Silverstein, Herbert; Norrell, Horace; Wanamaker, Hayes; Flanzer, John

1991-01-01

108

Consideration of the operative indications for posterior fossa venous angiomas.  

Science.gov (United States)

The case of a patient with a venous angioma located in the midline of the posterior fossa and responsible for a cerebellar hemorrhage is reported. The patient had a good recovery after removal of the hematoma. We reviewed this and seven other cases of venous angioma in the posterior fossa reported in the literature. It appears that those venous angiomas that occur in the cerebellar hemisphere and produce a cerebellar hematoma can be successfully removed. PMID:3961660

Nishizaki, T; Tamaki, N; Matsumoto, S; Fujita, S

1986-05-01

109

Topical use of human breast milk for diaper rash in infants  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: Diaper rash is the most common irritant contact dermatitis, occurring in many of young children. In this study we have compared the effect of human breast milk (HBM and zinc oxide ointment on diaper rash in hospitalized infants in Sanandaj. Methods: Subjects comprised infants less than two years of age with prematurity, sepsis, gastroenteritis and pneumonia who had diaper rash but did not have allergic causes of the rash. These 50 infants under two years of age were randomly assigned to intervention and control groups (25 in each group .None of the children received or were receiving prior to the commencement of the study steroid and immunosuppressive drugs or topical medications. Results: There were   no significant differences between the two groups (HBM and zinc oxide ointment with respect to lesion size, inflammation and wound. But there were significant differences between before and after (two stages treatment by HBM and zinc oxide. Conclusions: Though not statistically significant, results favored use of topical breast milk to aid recovery of diaper rash. Therefore, recommend that topical breast milk is considered for treatment of diaper rash.

Susan Penjvini

2012-08-01

110

Transposition of the Pterygopalatine Fossa during Endoscopic Endonasal Transpterygoid Approaches.  

Science.gov (United States)

Introduction Complete or partial removal of the pterygoid process provides lateral extension of the endonasal corridor necessary to approach the Meckel cave, infrapetrous skull base, and medial infratemporal fossa. This paper provides the anatomical foundations for the endoscopic endonasal transpterygoid approach with preservation of all neurovascular structures inside the pterygopalatine fossa. Methods Eight endoscopic transpterygoid approaches were performed in fresh cadaveric specimens. In all dissections the vidian nerve and the periosteal sac enclosing the pterygopalatine fossa were preserved. Results We reliably transposed the pterygopalatine fossa to approach the Meckel cave, infrapetrous skull base, and medial infratemporal region, preserving the neurovascular structures inside the pterygopalatine fossa in all specimens. Conclusions The transposition of the pterygopalatine fossa neurovascular structures for endoscopic endonasal approaches to the skull base is an alternative technique that is both feasible and desirable. The transposition requires no additional technical skills but requires comprehensive knowledge of its anatomy. The anatomical preservation of the neurovascular structures is potentially beneficial to the quality of life of patients. Clinical studies are necessary to prove the real benefits of this technique. PMID:24436922

Pinheiro-Neto, Carlos D; Fernandez-Miranda, Juan C; Prevedello, Daniel M; Carrau, Ricardo L; Gardner, Paul A; Snyderman, Carl H

2013-10-01

111

Mineral Spectra from Nili Fossae, Mars  

Science.gov (United States)

Spectra collected by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) indicate the presence of three distinct minerals. The graphed information comes from an observation of terrain in the Nili Fossae area of northern Mars. CRISM is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Iron-magnesium smectite clay is formed through alteration of rocks by liquid water and is characterized by distinctive absorptions at 1.4, 1.9, and 2.3 micrometers due to water (H2O) and OH in the atomic structure of the mineral. Olivine is an iron magnesium silicate and primary igneous mineral, and water is not in its structure. Its spectrum is characterized by a strong and broad absorption at 1.0 micrometer due to ferrous iron (Fe2+). Carbonate is an alteration mineral identified by the distinctive paired absorptions at 2.3 and 2.5 micrometers. The precise band positions at 2.31 and 2.51 micrometers identify the carbonate at this location as magnesium carbonate. The broad 1.0 micrometer band indicates some small amount of ferrous iron is also present and the feature at 1.9 micrometers indicates the presence of water. CRISM researchers believe the magnesium carbonate found in the Nili Fossae region formed from alteration of olivine by water. The data come from a CRISM image catalogued as FRT00003E12. The spectra shown here are five-pixel-by-five-pixel averages of CRISM L-detector spectra taken from three different areas within the image that have then been ratioed to a five-pixel-by-five-pixel common denominator spectrum taken from a spectrally unremarkable area with no distinctive mineralogic signatures. This technique highlights the spectral contrasts between regions due to their unique mineralogy. The spectral wavelengths near 2.0 micrometers are affected by atmospheric absorptions and have been removed for clarity. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology, Pasadena, manages the Mars Reconnaissance Orbiter for the NASA Science Mission Directorate, Washington. Lockheed Martin Space Systems, Denver, is the prime contractor for the project and built the spacecraft. The Johns Hopkins University Applied Physics Laboratory led the effort to build the CRISM instrument and operates CRISM in coordination with an international team of researchers from universities, government and the private sector.

2008-01-01

112

A rare posterior cranial fossa tumor.  

Science.gov (United States)

Among tumors of the central nervous system, tumors of the mixed glioneuronal type form an important recognized subset. Some of the examples for mixed glioneuronal tumors include gangliocytoma, dysembryoplastic neuroepithelial tumor (DNT), ganglioglioma, anaplastic ganglioglioma, and central neurocytoma. The rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a new entity that has only slowly emerged in the literature due to its prior classification with other low-grade mixed glial and neuronal tumors. These tumors are relatively infrequent lesions, and therefore, they can be challenging to diagnose for the practicing pathologist. This is a rare biphasic tumor with clearly defined neurocytic and glial components. The tumor is found exclusively in the posterior fossa, where it arises in the midline, usually occupying a substantial fraction of the fourth ventricle, and it is observed by magnetic resonance imaging (MRI) as a circumscribed, solid mass with heterogeneous contrast enhancement. We describe here a case of RGNT occurring in a 22-year-old male. PMID:23361291

Nandeesh, Bevinahalli N; Chabra, Manmeet Singh; Babu, Manjaly K; Chand, Ashish K

2012-01-01

113

Malignant Fibrous Histiocytoma in the Infratemporal Fossa  

Energy Technology Data Exchange (ETDEWEB)

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

Lee, Kyung Hee; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1999-08-15

114

Malignant Fibrous Histiocytoma in the Infratemporal Fossa  

International Nuclear Information System (INIS)

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

1999-08-01

115

Preauricular transzygomatic anterior infratemporal fossa approach for tumors in or around infratemporal fossa lesions.  

Science.gov (United States)

Various surgical approaches to the infratemporal fossa (ITF) have been reported. Among them, the preauricular transzygomatic anterior ITF approach (anterior ITF approach) has been used for exposure of the antero-superior part of the ITF. The purpose of this article is to show anatomical dissections using the anterior ITF approach and to evaluate our surgical experience using this approach. An anatomical study of the anterior ITF approach was performed using six sides of three cadaveric heads. Clinical course was retrospectively reviewed for 34 patients who underwent microsurgical resection of tumor in or around the ITF using this approach. Medical, surgical, and neuroimaging records of these patients were evaluated. The key point of this approach was mobilization of the second and third divisions of the trigeminal nerve after drilling of the lateral loop between the foramina rotundum and ovale. After mobilization of the trigeminal nerve, the auditory tube, tensor veli palatini muscle, and pharyngobasilar membrane could be seen. Removal of the pterygoid muscles and plates allowed surgical access to the ITF, orbit, maxillary sinus, pterygopalatine fossa, and parapharyngeal space. We used this approach in 31 patients with skull base tumors between 1994 and 2007. Gross total removal was achieved in 27 of the 31 patients. No mortality or severe morbidity was encountered. Therefore, the anterior ITF approach provides easy access to the ITF and adjacent regions without destruction of important organs. PMID:22527629

Ohue, Shiro; Fukushima, Takanori; Kumon, Yoshiaki; Ohnishi, Takanori; Friedman, Allan H

2012-10-01

116

MRI of the fetal posterior fossa  

International Nuclear Information System (INIS)

MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)

2005-02-01

117

Bilateral chronic subdural hematomas of the posterior fossae.  

Science.gov (United States)

An 86-year-old female presented with rare bilateral chronic subdural hematomas (CSHs) of the posterior fossae which were successfully treated by surgical intervention. She had experienced mild head trauma one month before admission. She was transferred to our hospital because of consciousness disturbance and tetraparesis. Magnetic resonance (MR) imaging showed simultaneous occurrence of supratentorial and infratentorial CSHs. We tried to evacuate the CSHs of the bilateral posterior fossae because brainstem compression was markedly severe. Through bilateral burr-hole trepanations, chocolate-colored fluid, not containing clotted components, gushed out under great pressure. Postoperative course was uneventful. MR imaging revealed that the CSHs of the posterior fossae had completely disappeared and brainstem compression had also improved. The patient's neurological deficits were immediately improved after the operation. The patient was discharged one month after the operation for further rehabilitation. Trepanation and evacuation of the hematoma through the posterior fossa might be one of the therapeutic options for posterior fossa CSH, which is similar to supratentorial CSH. However, we considered that the emergency of this rare entity and the method of anesthesia were quite different from supratentorial CSH. PMID:23183077

Kurisu, Kota; Kawabori, Masahito; Niiya, Yoshimasa; Ohta, Yuzuru; Mabuchi, Shoji; Houkin, Kiyohiro

2012-01-01

118

Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

Tomomi Okamura

2011-04-01

119

Delayed skin rash following administration of technetium-99m diphosphonate: A case report  

International Nuclear Information System (INIS)

The authors report a case of a 48-yr-old woman who developed a delayed skin rash following intravenous (i.v.) administration of technetium-99m hydroxymethylene diphosphonate (99mTc-HDP). The rash was characterized by skin biopsy, and it was concluded that the reaction was due to the diphosphonate compound. The rash resolved spontaneously without treatment. With most 99mTc-based agents, adverse reactions are considered rare and are usually allergic in nature, but the delayed nature of this reaction is more common with diphosphonate compounds than with other radiopharmaceuticals. If a repeat examination is required, alternative agents (such as 99mTc-pyrosphosphate) or any other diagnostic modality (magnetic resonance imaging) may be considered. An intradermal skin test may be helpful to determine the safest alternative bone agent

1989-01-01

120

Delayed skin rash following administration of technetium-99m diphosphonate: A case report  

Energy Technology Data Exchange (ETDEWEB)

The authors report a case of a 48-yr-old woman who developed a delayed skin rash following intravenous (i.v.) administration of technetium-99m hydroxymethylene diphosphonate ({sup 99m}Tc-HDP). The rash was characterized by skin biopsy, and it was concluded that the reaction was due to the diphosphonate compound. The rash resolved spontaneously without treatment. With most {sup 99m}Tc-based agents, adverse reactions are considered rare and are usually allergic in nature, but the delayed nature of this reaction is more common with diphosphonate compounds than with other radiopharmaceuticals. If a repeat examination is required, alternative agents (such as {sup 99m}Tc-pyrosphosphate) or any other diagnostic modality (magnetic resonance imaging) may be considered. An intradermal skin test may be helpful to determine the safest alternative bone agent.

Hart, B.; Sorenson, J.F.; Eisenberg, B.; Glactz, G.; Owens, D.; Hladik, W.B. III.; Curry, M.C. (Univ. of New Mexico Medical Center, Albuquerque (USA))

1989-12-01

 
 
 
 
121

Squamous cell carcinoma of the pterygopalatine fossa (retroantral space).  

Science.gov (United States)

A patient developed sensory disturbance and pain in the distribution of the maxillary nerve several months after removal of a statedly benign cutaneous malar lesion. One year later, abducens palsy developed, and computed tomography showed a mass of the pterygopalatine fossa abutting on the superior nasopharynx. Results of examination and multiple biopsies of the nasopharynx were normal. Direct biopsy of the pterygopalatine fossa via a transmaxillary sinus approach revealed squamous cell carcinoma. Extension of malignancy from the adjacent nasopharynx (not detected on biopsy) or sphenoid sinus and perineural spread of an undiagnosed cutaneous squamous cell carcinoma along the maxillary nerve were considered as possibilities. The anatomy of the pterygopalatine fossa and its environs is reviewed with respect to clinical signs of second division trigeminal neuropathy, abducens palsy and diminished ipsilateral tearing. PMID:2947933

Slavin, M L; Abramson, A L

1986-12-01

122

Sulfasalazine-induced DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) Síndrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) induzida por sulfasalazina  

Digital Repository Infrastructure Vision for European Research (DRIVER)

CONTEXT: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a type of drug reaction commonly mistaken for a viral infection. It must be recognized promptly due to its high morbidity and 10% mortality rate. Few cases of DRESS syndrome induced by sulfasalazine have been reported in the literature. CASE REPORT: The case of a 47-year-old white Brazilian woman who developed DRESS syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthriti...

Renata Telles Rudge de Aquino; Carmen Silvia Vieitas Vergueiro; Maria Elisa Ruffolo Magliari; Thais Helena Proença de Freitas

2008-01-01

123

Subarachnoid pouches of the posterior fossa with syringomyelia  

International Nuclear Information System (INIS)

Three men are presented, all of whom were born with difficulty and later developed severe syringomyelia with collapsing cords on air myelography. Each had hydrocephalus and a sizable subarachnoid pouch in the posterior fossa. The clinical features and investigations are presented with a discussion of the aetiology and possible mechanisms concerned in pathogenesis and treatment. All three men had posterior fossa exploration over fifty years after birth, and the first two were also treated by valved ventriculo-atrial shunts. Each patient has improved a little since operation, but no certainly that this was due to surgery has been proved in any case; none has progressed since the last operation. (author)

1979-01-01

124

Discovery of Olivine in the Nili Fossae Region of Mars  

Science.gov (United States)

We have detected a 30,000-square-kilometer area rich in olivine in the Nili Fossae region of Mars. Nili Fossae has been interpreted as a complex of grabens and fractures related to the formation of the Isidis impact basin. We propose that post-impact faulting of this area has exposed subsurface layers rich in olivine. Linear mixture analysis of Thermal Emission Spectrometer spectra shows surface exposures of 30% olivine, where the composition of the olivine ranges from Fo30 to Fo70.

Hoefen, T. M.; Clark, R. N.; Bandfield, J. L.; Smith, M. D.; Pearl, J. C.; Christensen, P. R.

2003-01-01

125

Giant left middle fossa VII nerve schwannoma associated with amnesia.  

Science.gov (United States)

The facial nerve is the third most frequent location of intracranial schwannomas, with facial paresis the most common sign.(1,2) A 77-year-old woman presented with amnesia; the Mini-Mental State Examination score was 26, with normal cranial nerve function. A giant multicystic VII nerve schwannoma was identified in the left middle fossa, with components of the tumor in the temporal bone facial canal, geniculate ganglion, and internal auditory canal (figure). Compression of the hippocampus may have accounted for the clinical presentation. The middle fossa component of the tumor was resected for mass effect relief, with iatrogenic facial palsy. PMID:23918862

Cunha, André; Seixas, Daniela; Mascarenhas, Lino; Resende, Mário; Furtado, Antónia; Figueiredo Ribeiro, António Rui

2013-08-01

126

Neonatal posterior fossa haemorrhage associated with vacuum extractor.  

Science.gov (United States)

We report one case of posterior fossa intracranial haemorrhage in a full-term Malay baby boy following vacuum assisted delivery. The patient, a term baby boy was delivered by a vacuum extraction and later developed signs of increased intracranial pressure 72 hours after birth. Computed tomography (CT) of the brain showed a posterior fossa intracranial haemorrhage with acute obstructive hydrocephalus. He was initially treated with isolated ventricular shunting which later caused an upward cerebellar herniation. An immediate suboccipital craniectomy for evacuation of cerebellar haematoma was performed which resulted in a gradual recovery. PMID:16708744

Ghani, A R I; Prakash, R G; Abdullah, J

2006-03-01

127

Spontaneous fluctuation in the size of a midline posterior fossa arachnoid cyst.  

Science.gov (United States)

Arachnoid cysts of the posterior fossa are rather uncommon compared with their supratentorial counterparts. Spontaneous disappearance of middle cranial fossa arachnoid cysts has been reported but there are none in the English literature on the spontaneous fluctuation in size of a posterior fossa arachnoid cyst. We present a 41-year-old male, with a midline posterior fossa arachnoid cyst, which appeared to lessen in size spontaneously with complete disappearance of symptoms and then enlarged with a worsening in neurological status. PMID:10562848

Arunkumar, M J; Haran, R P; Chandy, M J

1999-06-01

128

Skin rash induced by ritonavir-boosted darunavir is common, but generally tolerable in an observational setting.  

Science.gov (United States)

Ritonavir-boosted darunavir (DRV/r) is a protease inhibitor widely used in the treatment of HIV-1 infection. However, skin rash is a well-known adverse event of DRV, and limited data are available from observational settings. This observational study examined the characteristics of DRV-induced skin rash in treatment-naïve patients who commenced once-daily DRV/r-containing antiretroviral therapy (ART). Of the 292 study patients, DRV rashes developed in 31 (11%) patients with a median latency of 10 days (developing from 7 to 14 days in 93%) from initiation of ART. DRV skin rash was generally mild, as only one patient (3%) had grade 3 rash whereas 24 (77%) patients had grade 2 and 6 (19%) patients had grade 1. Only two patients (7%) discontinued DRV/r due to skin rash, and the other continued DRV/r and their rashes disappeared completely without any complications. Interestingly, DRV rash occurred more frequently to patients with less advanced HIV-1 infection than those with advanced infection. The incidence of DRV rash was not significantly different between patients with and without history of sulfonamide allergy (p = 0.201). Furthermore, when we exclude patients without history of sulfonamide use and only examine patients with sulfonamide use (n = 145), the result was similar (p = 0.548). In conclusion, DRV rashes were frequently observed but the prognosis was benign. Most patients tolerated DRV rashes with use of oral steroid or antihistamine without discontinuation of DRV. To date, there is no clear clinical evidence to suggest that DRV should be avoided in patients with history of sulfonamide allergy. PMID:24507978

Nishijima, Takeshi; Gatanaga, Hiroyuki; Teruya, Katsuji; Mizushima, Daisuke; Aoki, Takahiro; Watanabe, Koji; Kinai, Ei; Honda, Haruhito; Yazaki, Hirohisa; Tanuma, Junko; Tsukada, Kunihisa; Kikuchi, Yoshimi; Oka, Shinichi

2014-04-01

129

Skin rash and anti-Ro/SS-A antibodies in an infant from a mother with silicone breast implants.  

Science.gov (United States)

An infant with erythematous rash born from a mother with silicone breast implants is described. The diagnosis of possible neonatal lupus was suggested based on the presence of the skin rash and positive Ro/SS-A antibodies in the infant and positive ANA and Ro/SS-A in the mother. PMID:7586790

Gedalia, A; Cuéllar, M L; Espinoza, L R

1995-01-01

130

Fretted Terrain Valley in Coloe Fossae Region  

Science.gov (United States)

[figure removed for brevity, see original site] Figure 1 Click on image for larger version The image in figure 1 shows lineated valley fill in one of a series of enclosed, intersecting troughs known as Coloe (Choloe) Fossae. Lineated valley fill consists of rows of material in valley centers that are parallel to the valley walls. It is probably made of ice-rich material and boulders that are left behind when the ice-rich material sublimates. Very distinct rows can be seen near the south (bottom) wall of the valley. Lineated valley fill is thought to result from mass wasting (downslope movement) of ice-rich material from valley walls towards their centers. It is commonly found in valleys near the crustal dichotomy that separates the two hemispheres of Mars. The valley shown here joins four other valleys with lineated fill near the top left corner of this image. Their juncture is a topographic low, suggesting that the lineated valley fill from the different valleys may be flowing or creeping towards the low area (movement towards the upper left of the image). The valley walls appear smooth at first glance but are seen to be speckled with small craters several meters in diameter at HiRISE resolution (see contrast-enhanced subimage). This indicates that at least some of the wall material has been stable to mass wasting for some period of time. Also seen on the valley wall are elongated features shaped like teardrops. These are most likely slightly older craters that have been degraded due to potentially recent downhill creep. It is unknown whether the valley walls are shedding material today. The subimage is approximately 140 x 400 m (450 x 1280 ft). Image PSP_001372_2160 was taken by the High Resolution Imaging Science Experiment (HiRISE) camera onboard the Mars Reconnaissance Orbiter spacecraft on November 11, 2006. The complete image is centered at 35.5 degrees latitude, 56.8 degrees East longitude. The range to the target site was 290.3 km (181.4 miles). At this distance the image scale ranges from 58.1 cm/pixel (with 2 x 2 binning) to 116.2 cm/pixel (with 4 x 4 binning). This image has been map-projected to 50 cm/pixel and north is up. The image was taken at a local Mars time of 3:23 PM and the scene is illuminated from the west with a solar incidence angle of 48 degrees, thus the sun was about 42 degrees above the horizon. At a solar longitude of 133.8 degrees, the season on Mars is Northern Summer. NASA's Jet Propulsion Laboratory, a division of the California Institute of Technology in Pasadena, manages the Mars Reconnaissance Orbiter for NASA's Science Mission Directorate, Washington. Lockheed Martin Space Systems, Denver, is the prime contractor for the project and built the spacecraft. The High Resolution Imaging Science Experiment is operated by the University of Arizona, Tucson, and the instrument was built by Ball Aerospace and Technology Corp., Boulder, Colo.

2006-01-01

131

Computer code to calculate the parameters used for radiation shielding against. gamma. rays. [RASH  

Energy Technology Data Exchange (ETDEWEB)

A computer code RASH for the parameters used in radiation shielding against ..gamma.. rays is described. The program is designed to calculate energy absorption coefficients in air, Rhm values, total attenuation coefficients of the shielding materials, and the parameters for the dose buildup factors. The calculations of these parameters are made with the interpolation method proposed by Akima.

Mukoyama, Takeshi (Kyoto Univ., Uji (Japan). Inst. for Chemical Research)

1981-02-01

132

Bilateral suborbital rash: A dermatologic manifestation of neuropsychiatric disease in a pediatric patient.  

Science.gov (United States)

A 10-year-old girl presented with a new onset bilateral suborbital rash. Dermatologic examination revealed violaceous, non-tender, well-demarcated patches with an atypical distribution and pigmentation. After further investigation, a diagnosis of Munchausen syndrome was made and the patient was referred to her primary care provider for further management. PMID:24852783

Tong, Lana X; Wang, Yen Tun; Beynet, David

2014-01-01

133

Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Objective? To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods? We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and develope [...] d a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results? Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1?year postoperatively. Conclusion? This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.

Alexandre Beraldo, Ordones; Marco Aurélio, Fornazieri; Fábio de Rezende, Pinna; Thiago Freire Pinto, Bezerra; Richard Louis, Voegels; Luiz Ubirajara, Sennes.

134

HLA-Cw*04 allele associated with nevirapine-induced rash in HIV-infected Thai patients  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background A high incidence of rash has been reported in HIV-1 patients who received the anti-retroviral drug nevirapine. In addition, several studies have suggested that polymorphisms of human leukocyte antigen (HLA genes may play important roles in nevirapine-induced rash. The aim of the present study was to evaluate the effects of different HLA-C alleles on rash associated with nevirapine in patients who started highly active anti-retroviral therapy (HAART containing nevirapine in Thailand. Results A case-control study was carried out involving HIV-1 patients under treatment at Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand between March 2007 and March 2008. The study included all HIV/AIDS patients being treated with nevirapine-containing regimens. The study population comprised 287 HIV/AIDS patients of whom 248 were nevirapine-tolerant and 39 developed rash after nevirapine treatment. From the nevirapine-tolerant patients, 60 were selected as the control group on the basis of age, sex, and therapy history matched for nevirapine-induced rash cases. We observed significantly more HLA-Cw*04 alleles in nevirapine-induced rash cases than in nevirapine-tolerant group, with frequencies of 20.51% and 7.50%, respectively (P = 0.009. There were no significant differences between the rash and tolerant groups for other HLA-C alleles except for HLA-Cw*03 (P = 0.015. Conclusion This study suggests that HLA-Cw*04 is associated with rash in nevirapine treated Thais. Future screening of patients' HLA may reduce the number of nevirapine-induced rash cases, and patients with alleles associated with nevirapine-induced rash should be started on anti-retroviral therapy without nevirapine.

Tunthanathip Preecha

2009-10-01

135

Children's vomiting following posterior fossa surgery: A retrospective study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

Dundon Belinda

2009-07-01

136

Endovascular treatment of anterior cranial fossa dural arteriovenous fistula  

International Nuclear Information System (INIS)

We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

2008-05-01

137

Solitary Renal Fossa Recurrence of Renal Cell Carcinoma After Nephrectomy  

Science.gov (United States)

Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences.

Chow, Ji-Jian; Ahmed, Kamran; Fazili, Zahoor; Sheikh, Mohammed; Sheriff, Matin

2014-01-01

138

Endovascular treatment of anterior cranial fossa dural arteriovenous fistula  

Energy Technology Data Exchange (ETDEWEB)

We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

Lv, Xianli; Li, Youxiang; Wu, Zhongxue [Beijing Neurosurgical Institute, Beijing (China); Capital Medical University, Beijing Tiantan Hospital, Beijing (China)

2008-05-15

139

A rare and potentially fatal cause of popliteal fossa swelling.  

Science.gov (United States)

Popliteal vein aneurysms (PVAs) represent a rare form of venous aneurysm and necessitate prompt diagnosis and management due to their well-established role as a source of pulmonary emboli. Surgical repair is usually curative; we present the case of a 47-year-old woman with a recurrent PVA presenting as a soft popliteal fossa mass with associated sensory deficit affecting the right foot, 4?years after initial operative repair. Venous duplex imaging demonstrated a saccular aneurysm originating from the posterior wall of the right popliteal vein. In light of the long-term risk of potentially life-threatening pulmonary embolism, surgical repair was undertaken by tangential aneurysmectomy and long saphenous vein patch venoplasty. This case emphasises the importance of including PVA in the differential diagnosis of popliteal fossa swellings as well as the need for long-term follow-up to detect late recurrence with subsequent avoidance of the otherwise significant potential morbidity and mortality. PMID:25006051

Kelay, Arun; Constantinou, Jason; Hamilton, Hamish

2014-01-01

140

Cushingoid Syndrome Following of Local Steroid Administration for Diaper Rash; A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: Prolonged exogenous administration of ACTH or hydrocortisone or its analogs results in a clinical pattern identical to the spontaneous disorder and is frequently referred to as Cushingoid syndrome. This syndrome is generally reported as a result of oral or parenteral steroids administration. Case Report: Our report presents a five-month old baby with typical Cushingoid changes following local steroid application due to diaper rash. Clobetasol was used for diaper rash, but had not used systemic corticosteroid. Serum Cortical and ACTH was very low and no detectable. After discontinuation of local steroid, Skin complication recovered gradually and after 5 months, completely. Conclusion: Local corticosteroids may be high absorption and cause systemic complication such as Adrenal insufficiency and cushingoid syndrome.

Z Haghshenas

2006-06-01

 
 
 
 
141

Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

Oh, Ha Yeun; Cho, Seong Whi [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of); Kim, Sung Hun [Dept. of Neurology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

2012-03-15

142

Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report  

International Nuclear Information System (INIS)

Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

2012-03-01

143

Temporal Craniotomy for Surgical Access to the Infratemporal Fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We propose a surgical approach for select patients that minimizes morbidity while allowing gross total resection of lesions in the anterior portion of the infratemporal fossa. The approach we describe is an extradural approach through a subtemporal craniectomy or craniotomy with the possible addition of a zygomatic osteotomy. Lesions that have a well-defined capsule and a texture that permits manipulation are ideal for this less invasive approach. We retrospectively reviewed six cases from th...

Hwang, Steven W.; Rahal, Jason P.; Wein, Richard O.; Heilman, Carl B.

2010-01-01

144

Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension  

Directory of Open Access Journals (Sweden)

Full Text Available Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery."nMaterials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied."nResults: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1 facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2 involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3 involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients."nConclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients."n"n"n"n"n 

Sadr-Hoseini S M

2003-11-01

145

Glenoid fossa fractures: Outcome of operative and nonoperative treatment  

Science.gov (United States)

Background: Glenoid fossa fractures are rare injuries having a prevalence of 0.1%. These fractures may be managed operatively if substantially displaced. However, several fractures of glenoid fossa are managed nonoperatively, even if displaced, due to high incidence of associated injuries which may render patient unfit to undergo major orthopaedic surgery. There is a relative paucity of articles reporting on outcome of treatment of glenoid fossa fractures. We present our experience of treating these injuries over past decade with operative and nonoperative methods. Materials and Methods: 21 patients of glenoid fossa fractures were included in this series with 14 males and 7 females. Patients with displacement of >5 mm who were fit to undergo surgery within 3 weeks of injury were operated using a posterior Judet's approach. Overall 8 patients with displaced fractures were operated (Group A) while 9 patients with displaced fractures (Group B) and 4 patients with undisplaced fractures (Group C) were managed nonoperatively. Results: The mean age and followup period in this series was 29 years and 7.3 years respectively. In group A, average constant score was 87.25. The least constant score was observed for group B (58.55) while group C had an average constant score of 86. Brachial plexus injury and fracture-dislocations had poorer outcome. Conclusion: Operative treatment for displaced glenoid fractures is a viable option at centers equipped to handle critically ill patients and subset of patients with fracture-dislocation as opposed to fracture alone should always be treated operatively due to persistent loss of function.

Sen, Ramesh K; Sud, Sachin; Saini, Gaurav; Rangdal, Sushil; Sament, Radheshyam; Bachhal, Vikas

2014-01-01

146

Posterior fossa arachnoid cysts and cerebellar tonsillar descent: short review.  

Science.gov (United States)

The objective of this study was to analyze the association of cerebellar tonsillar descent and syringomyelia in patients with posterior fossa arachnoid cysts. We reviewed the medical records of ten patients (mean, age 33; range, 24-49 years) diagnosed with posterior fossa arachnoid cyst and tonsillar descent. Symptoms evolved over a mean of 12 months (range, 6 months to 3 years). Syringomyelia was present in six cases. Six patients underwent a suboccipital craniectomy, three cases underwent an additional C1 laminectomy, and a further case had a limited craniectomy and tonsillar reduction. Three patients were also treated for hydrocephalus: one with a ventriculoperitoneal shunt and two with endoscopic third ventriculostomy. Two patients had conservative treatment. The posterior fossa arachnoid cysts were located at the vermis-cisterna magna (n = 4), the cerebellar hemispheres (n = 2), the cerebellopontine angle (n = 3), and the quadrigeminal cistern (n = 1). A patient with achondroplasia showed features of platybasia. Associated malformations included craniofacial dysmorphism in a patient diagnosed of trichorhinophalangeal syndrome and a case with a primary temporal arachnoid cyst. After a mean follow-up of 2 years (range, 3 months to 5 years), four patients showed resolution of their neurological symptoms, and two exhibited persisting ocular findings. Headaches and nuchalgia improved in four cases and persisted in four. Syringomyelia was resolved in four patients and improved in two. Patients harboring a posterior fossa arachnoid cyst may evolve with acquired Chiari malformation and syringomyelia. Initial management should be directed to decompressing the foramen magnum and should include the resection of the arachnoid cyst's walls. A wait-and-see attitude can be implemented in selected cases. In our experience, hydrocephalus should be properly addressed before treating the arachnoid cyst. PMID:20480382

Galarza, Marcelo; López-Guerrero, Antonio López; Martínez-Lage, Juan F

2010-07-01

147

Extensive Supratentorial Hemorrhages Following Posterior Fossa Meningioma Surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ataxia of 2 months’ duration, blurring and diminution of vision of 2 months’ duration and forgetfulness of 2 months’ duration. Fundus showed bilateral papille dema, and visual a...

Agrawal, Amit; Kakani, Anand; Ray, Kaushik

2010-01-01

148

Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. Methods A 54-year old male underwent left temporal resection because of brain tumor of h...

2011-01-01

149

Genetic linkage of familial granulomatous inflammatory arthritis, skin rash, and uveitis to chromosome 16.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Blau syndrome (MIM 186580), first described in a large, three-generation kindred, is an autosomal, dominantly inherited disease characterized by multiorgan, tissue-specific inflammation. Its clinical phenotype includes granulomatous arthritis, skin rash, and uveitis and probably represents a subtype of a group of clinical entities referred to as "familial granulomatosis." It is the sole human model with recognizably Mendelian inheritance for a variety of multisystem inflammatory diseases affe...

Tromp, G.; Kuivaniemi, H.; Raphael, S.; Ala-kokko, L.; Christiano, A.; Considine, E.; Dhulipala, R.; Hyland, J; Jokinen, A.; Kivirikko, S.; Korn, R.; Madhatheri, S.; Mccarron, S.; Pulkkinen, L.; Punnett, H.

1996-01-01

150

Skin rash associated with intravitreal bevacizumab in a patient with macular choroidal neovascularization  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Ioannis D Ladas, Marilita M Moschos, Thanos D Papakostas, Athanasios I Kotsolis, Ilias Georgalas, Michail ApostolopoulosDepartment of Ophthalmology, “G. Gennimatas” Hospital of Athens, University of Athens, Athens, GreecePurpose: The purpose of this observational case report is to describe a case of skin rash after intravitreal use of bevacizumab.Methods: A 50-year-old man with choroidal neovascularization in the right eye due to age-related macular degeneration was treated with t...

Ladas, Ioannis D.; Moschos, Marilita M.; Papakostas, Thanos D.; Kotsolis, Athanasios I.; Ilias Georgalas; Michail Apostolopoulos

2008-01-01

151

CT and MRI diagnosis of posterior fossa atypical ependymoma  

International Nuclear Information System (INIS)

Objective: To analyse the CT and MRI features of posterior fossa atypical ependymoma. Methods: Sixteen cases of posterior fossa atypical ependymoma proved by surgery and pathology had CT and (or) MRI scanning. There were 11 males and 5 females. The age ranged from 17 to 46 (mean, 31.2). Twelve cases ranged from 20 to 40 years old. the main symptoms of all cases were dizziness, unsteady walking and vomiting. Results: The locations of all cases were cerebellum (12 cases), vermis (3 cases) and cerebellopontile angle (1 cases). Fifteen cases were solid with multiple cystic changes and 1 case in the cerebellopontile angle was cystic. The tumor was usually close to the surface of cerebellum with rather extensive connection with dura mater or tentorium. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous density on CT scan and inhomogeneous intensity on MRI. Mild inhomogeneous enhancement was shown in most cases, while intense irregular enhancement in the others. Conclusions: The characteristic findings of the posterior fossa atypical ependymoma ependymoma were cerebellar intraparenchymatous multiple small cystic changes within solid tumor in most cases and inhomogeneous density and intensity on CT and MRI. The differential diagnosis is meningioma, metastasis and acoustic schwannoma

2000-01-01

152

Venous anomalies and abnormalities of the posterior fossa  

International Nuclear Information System (INIS)

The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called 'venous angioma' are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVA). Posterior fossa DVA, like the supra-tentorial ones are classified according to their drainage into deep and superficial type. They are exclusively located in the cerebellum or tectum. In 4 cases DVA was an incidental finding, in 3 an associated cerebral venous malformation (CVM) was found and felt to be the cause of the symptoms and only in one (Trigeminal pain) was a link between both suspected. Cavernous venous malformation (CVM) were found in frequent association with DVA (27%). 4 cases were single and 2 multiple. 5 CVM were located in the brain stem and 3 in the cerebellum. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all patients with CVM. In 2 cases venous dysplasia was found: 1 Sturge-Weber and 1 First branchial arch syndrome. Both posterior fossa venous abnormalities were incidental findings. (orig.)

1990-01-01

153

MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS  

Directory of Open Access Journals (Sweden)

Full Text Available Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications in different groups. A total of 108 patients with age ranging from 3 months to 18 years and a male to female ratio of 1.5 comprised the study population. Ninety-nine cases had hydrocephalus at the time of diagnosis and 81 patients underwent preoperative shunting. Of the remaining 18 patients, 13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroid therapy. The rest of the patients got no primary treatment for hydrocephalus. Three of these 5 patients had postoperative shunting after tumor removal, but the other 2 remained shunt free. The rate of postoperative complications including cerebrospinal fluid leakage and septic meningitis were significantly lower in patients with preoperative shunting. The results of this study are in favor of those that approve the effect of preoperative shunting in decreasing postoperative complications. This is well established when the tumor size is big or when the diagnosis of posterior fossa tumor is made in later stages or when hydrocephalus is severe. It could be concluded that preoperative shunting can decrease the rate of postoperative complications.

S. M. Abdollahzadeh-Hosseini

2006-06-01

154

Gamma Knife surgery for posterior fossa arteriovenous malformations  

International Nuclear Information System (INIS)

The long-term outcomes after Gamma Knife surgery (GKS) were retrospectively analyzed in patients with posterior fossa arteriovenous malformations (AVMs) to evaluate the efficacy, safety, and indications for this procedure. The medical records were reviewed of 75 patients who underwent GKS between 1992 and 2005 in our institution. The rate of complete AVM obliteration was 57.3% at 3 years and 80.2% at 5 years after GKS. Multivariate analysis showed that the significant factors for higher obliteration rates were younger patient age, smaller nidus volume, and smaller nidus maximum/minimum diameter. Two patients suffered hemorrhages during the latency interval. Clinical deterioration was observed in 10 patients with radiation-induced edema after the GKS. Larger nidus volume and AVM located adjacent to eloquent areas were significantly associated with the risk of neuropathy after GKS. One patient developed radiation-induced necrosis 4 years after confirmation of complete AVM obliteration. GKS is an effective and safe modality for the treatment of posterior fossa AVMs, resulting in high AVM obliteration rate with low complication rates based on neuroimaging and neurological symptoms. Posterior fossa AVMs tend to occur adjacent to eloquent areas, so we recommend preparing a conformed dose plan that considers both obliteration of the AVM nidus and preservation of neurological function. (author)

2011-07-01

155

Geology of the Bellona Fossae (V15) Region of Venus  

Science.gov (United States)

A preliminary geologic map of the the Bellona Fossae (V15) quadrangle on Venus was produced as part of the NASA-funded planetary mapping program. Geologic interpretations are based primarily on the basis of morphology, texture, radar reflectance, and relative stratigraphy derived from Magellan Synthetic Aperture Radar (SAR) images, based on FMAP mosaics showing SAR data at 75 m/pixel resolution, and compiled on a digital base map at 1:5M scale produced by the U.S. Geological Survey. This quadrangle covers approximately 5 million square kilometers of the northern lowlands of Venus, and it includes the Bellona Fossae and Fee Fossae fracture systems of western Kawelu Planitia and northern Ulfrun Regio, along with an arcuate chain of volcano-tectonic centers called coronae (e.g., Ki and Tituba Coronae). Exposed materials are dominated by relatively featureless regional plains and several centers of lobate plains (e.g., Uzume Fluctus) interpreted to be lava flow fields emplaced by effusion from separate vents. Based on stratigraphic relationships at unit contacts, the oldest exposed material units are isolated patches of complex-faulted tessera terrain, restricted to the eastern and southwestern margins of the quadrangle. Relatively small exposures of lineated plains, mountain belt, ridged plains, and dark plains materials are scattered throughout the quadrangle, with only a few impact craters and their associated ejecta and impact-induced flows (e.g., Mumtaz-Mahal crater) representing the latest materials. The tectonism associated with the coronae appears to predate the regional plains for the most part, but individual coronae are the source for lobate plains volcanism which implies that activity at these structural features encompasses much of the time span portrayed in the regional stratigraphy. Northeast-southwest-oriented lineaments exposed in Bellona Fossae not only are generally coincident with the coronae structures, but also cut patches of the stratigraphically late lobate plains units. Extensional tectonism evident in the north-south-oriented graben and lineaments of Fea Fossae cut both regional and lobate plains, and is associated with some of the greatest relief in the quadrangle. The general history portrayed in this quadrangle is consistent with published maps and reports of adjacent portions of the northern lowlands of Venus.

Zimbelman, J. R.

2002-05-01

156

Case series: acute mood symptoms associated with posterior fossa lesions in children.  

Science.gov (United States)

Nineteen children were acutely dysphoric, inattentive, irritable, and sometimes mute following midline posterior fossa neoplasm resection and arteriovenous malformation hemorrhage. These symptoms represent an acute manifestation of the cerebellar cognitive affective syndrome. The authors aimed to describe the acute psychiatric changes in mood and behavior in children with posterior fossa lesions and to evaluate the relationship of posterior fossa syndrome to cerebellar cognitive affective syndrome. PMID:15616170

Turkel, Susan Beckwitt; Shu Chen, Lan; Nelson, Marvin D; Hyder, Douglas; Gilles, Floyd H; Woodall, Linda; Braslow, Kenneth; Tavaré, C Jane

2004-01-01

157

Intensity-Modulated Arc Therapy for Pediatric Posterior Fossa Tumors  

Energy Technology Data Exchange (ETDEWEB)

Purpose: To compare intensity-modulated arc therapy (IMAT) to noncoplanar intensity-modulated radiation therapy (IMRT) in the treatment of pediatric posterior fossa tumors. Methods and Materials: Nine pediatric patients with posterior fossa tumors, mean age 9 years (range, 6-15 years), treated using IMRT were chosen for this comparative planning study because of their tumor location. Each patient's treatment was replanned to receive 54 Gy to the planning target volume (PTV) using five different methods: eight-field noncoplanar IMRT, single coplanar IMAT, double coplanar IMAT, single noncoplanar IMAT, and double noncoplanar IMAT. For each method, the dose to 95% of the PTV was held constant, and the doses to surrounding critical structures were minimized. The different plans were compared based on conformity, total linear accelerator dose monitor units, and dose to surrounding normal tissues, including the entire body, whole brain, temporal lobes, brainstem, and cochleae. Results: The doses to the target and critical structures for the various IMAT methods were not statistically different in comparison with the noncoplanar IMRT plan, with the following exceptions: the cochlear doses were higher and whole brain dose was lower for coplanar IMAT plans; the cochleae and temporal lobe doses were lower and conformity increased for noncoplanar IMAT plans. The advantage of the noncoplanar IMAT plan was enhanced by doubling the treatment arc. Conclusion: Noncoplanar IMAT results in superior treatment plans when compared to noncoplanar IMRT for the treatment of posterior fossa tumors. IMAT should be considered alongside IMRT when treatment of this site is indicated.

Beltran, Chris, E-mail: chris.beltran@stjude.org [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gray, Jonathan; Merchant, Thomas E. [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States)

2012-02-01

158

Nuclear magnetic resonance imaging of the posterior fossa disorders  

International Nuclear Information System (INIS)

Nuclear magnetic resonance scans (NMR-CT) were performed on patients with posterior fossa disorders such as acoustic neurinoma, cerebellar tumour (gangliocytoma), epidermoid tumour and spinocerebellar degeneration, and compared with X-ray computed tomography (CT) scans. The advantages of NMR-CT include lack of bone artifact, variety of image planes, transverse, sagital and coronal imaging, and high ability to differentiate tissues. The disadvantages include prolonged data accumulation time, lack of bone detail and calcification, limited spatial resolution and suitability of patients. (author)

1985-01-01

159

A 6-year-old boy with fever, rash and severe pneumonia  

Science.gov (United States)

The authors report a 6-year-old boy with fever, rash and cough. He was diagnosed with severe measles pneumonia and admitted to the paediatric intensive care unit with severe dyspnoea 8 days after symptom onset. He received intravenous antibiotics and high dose vitamin A. Three days later, he had recovered and was discharged home. He had not been vaccinated for measles, mumps and rubella according to the schedule. This case highlights the need for rapid diagnosis, appropriate treatment and determination of vaccination status of children with measles in order to prevent complications.

Kongthavonsakul, Kritsana; Washington, Charles Henry; Oberdorfer, Peninnah

2012-01-01

160

Malar rash in a painting by Jean-Baptiste Siméon Chardin (1699-1779)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the present report we describe a typical malar rash, as painted by Jean-Baptiste Siméon Chardin (1699-1779), French painter, one of the greatest of the 18th century, on the face of a child in “Le Bénédicité” (Hermitage, St. Petersburg). Three versions of this theme were more completed by Chardin, in various times of his life, but the malar eruption can be seen solely on the painting at the Hermitage. In the attempt to clarify, on a diagnostic ground, such a cutaneous abnormality, t...

2011-01-01

 
 
 
 
161

Malar rash in a painting by Jean-Baptiste Siméon Chardin (1699-1779  

Directory of Open Access Journals (Sweden)

Full Text Available In the present report we describe a typical malar rash, as painted by Jean-Baptiste Siméon Chardin (1699-1779, French painter, one of the greatest of the 18th century, on the face of a child in “Le Bénédicité” (Hermitage, St. Petersburg. Three versions of this theme were more completed by Chardin, in various times of his life, but the malar eruption can be seen solely on the painting at the Hermitage. In the attempt to clarify, on a diagnostic ground, such a cutaneous abnormality, the relationships between systemic lupus erythematosus and parvovirus B19 infection, i.e. the causative agent of fifth disease, are briefly discussed.

M. Vicarioto

2011-09-01

162

Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts - Implication for aetiology  

International Nuclear Information System (INIS)

Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. Redla, S., Husani, Y. and Colquhoun, I.R. (2001)

2001-10-01

163

Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure  

International Nuclear Information System (INIS)

Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater than 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stage of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential

1982-01-01

164

Ependymomas of the posterior cranial fossa: CT and MRI findings  

International Nuclear Information System (INIS)

We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2- and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap. All but one were separated from the vermis by a cleavage plane. In eight cases there was desmoplastic development through the foramina of the fourth ventricle, and five were heterogeneous due to necrosis and cystic change; one had a haemorrhagic area. In most cases the solid portion was isointense with grey matter on T1-weighted images, hyperintense on PD weighting, and isointense on T2-weighted images. On CT the tumour was isodense in six cases and calcification was detected in four. The presence of both desmoplastic development and a tumour/vermis cleavage plane in a posterior cranial fossa tumour isodense on CT is highly suggestive of ependymoma. (orig.)

1995-04-01

165

Patient age and treatment for middle cranial fossa arachnoid cysts  

Energy Technology Data Exchange (ETDEWEB)

An improved understanding of the natural history of primary middle cranial fossa arachnoid cysts is a prerequisite for the rational treatment of this condition. For this purpose we measured the initial and terminal volumes (IV and TV) of such cysts in 50 CT scans of 25 patients. We used an image analyzer, and calculated the rates of interval cyst volume changes. A slightly negative correlation was found between IV and patient age. The rates of interval volume changes did not correlate with IV or Galassi grade, but there was a strong negative correlation with patient age. In the non-surgical group of patients, the volume of the cysts increased in most patients under the age of 15 years, but was stable in all those over the age of 31. By comparison, in the surgical group, the cyst volume of all patients younger than 15 years decreased. These findings suggest that the natural history of middle cranial fossa arachnoid cyst is strongly influenced by the age of the patient. Consequently, the patient`s age should be taken into consideration when determining the treatment for this condition. (author)

Okumura, Yoshinari; Hirabayashi, Hidehiro; Hiramatsu, Ken-ichiro; Sakaki, Toshisuke [Nara Medical Univ., Kashihara (Japan)

1996-03-01

166

Patient age and treatment for middle cranial fossa arachnoid cysts  

International Nuclear Information System (INIS)

An improved understanding of the natural history of primary middle cranial fossa arachnoid cysts is a prerequisite for the rational treatment of this condition. For this purpose we measured the initial and terminal volumes (IV and TV) of such cysts in 50 CT scans of 25 patients. We used an image analyzer, and calculated the rates of interval cyst volume changes. A slightly negative correlation was found between IV and patient age. The rates of interval volume changes did not correlate with IV or Galassi grade, but there was a strong negative correlation with patient age. In the non-surgical group of patients, the volume of the cysts increased in most patients under the age of 15 years, but was stable in all those over the age of 31. By comparison, in the surgical group, the cyst volume of all patients younger than 15 years decreased. These findings suggest that the natural history of middle cranial fossa arachnoid cyst is strongly influenced by the age of the patient. Consequently, the patient's age should be taken into consideration when determining the treatment for this condition. (author)

1996-03-01

167

Neurostimulation at pterygopalatine fossa for cluster headaches and cerebrovascular disorders.  

Science.gov (United States)

There are numerous neural structures (parasympathetic, sympathetic, and trigeminal sensory) that are compacted in a small well defined area of the pterygopalatine fossa (PPF). These targets can be readily accessed via minimally invasive neuromodulation techniques making the methods more desirable than neurosurgical deep brain or hypothalamic intervention. Recent research has shed light over the important role of the sphenopalatine ganglion (SPG), which is located within the PPF, in cerebrovascular autonomic physiology as well as in the pathophysiology of different headache disorders (cluster headache, migraine, and trigeminal autonomic cephalalgias). Accordingly, neuromodulation of the autonomic fibers (parasympathetic and sympathetic) may play a key role in the management of headaches, stroke, or cerebral vasospasm. Another important structure within the PPF is the maxillary nerve (V2), which passes through the roof of the fossa. Here the trigeminal system is accessible for a reliable neuromodulation by targeting its second branch -the maxillary nerve- and this could be utilized in various painful conditions of the head and face. PMID:24859567

Narouze, Samer

2014-07-01

168

Neurobehavioral alterations in an adolescent following posterior fossa tumor resection.  

Science.gov (United States)

The posterior fossa syndrome (PFS) consists of a variety of symptoms, including cerebellar mutism, behavioral disturbances and personality changes. We report longitudinal clinical, neuroradiological and neurobehavioral findings in a 19-year-old left-handed patient, diagnosed with attentional deficit hyperactivity disorder (ADHD) at the age of 12, who underwent posterior fossa tumor resection. Although the patient did not develop cerebellar mutism after surgery, marked apathy and emotional indifference, urinary retention, eye-lid apraxia and visual hallucinosis became apparent after a brief interval of normal functioning. Based on these findings it is argued that the PFS might be considered a semiological heterogeneous condition with variable clinical expressions. Long-term follow-up investigations revealed subtle, but significant cognitive and affective deficits, resembling the cerebellar cognitive affective syndrome in adults. As demonstrated by functional neuroimaging studies with SPECT, symptoms were associated with perfusional deficits in the anatomoclinically suspected supratentorial regions, reflecting the distant impact of the cerebellum on cognitive and affective functions. PMID:17134992

Baillieux, Hanne; De Smet, Hyo Jung; Lesage, Geoffrey; Paquier, Philippe; De Deyn, Peter P; Mariën, Peter

2006-01-01

169

Diagnosis and treatment of arachnoid cysts of the posterior fossa.  

Science.gov (United States)

Arachnoid cysts of the posterior fossa are rare. When arachnoid cysts are encountered, the presenting symptoms are frequently otologic, with hearing loss and imbalance occurring commonly. Three cases are presented with a previously unreported otologic symptom, that of bilateral hearing loss, which in one case was fluctuant. None of the patients had the common symptoms of unilateral hearing loss and headache. With the advent of computed tomography and magnetic resonance imaging, these cysts may be readily identified, usually with diagnostic imaging alone. Unfortunately there is often a delay in diagnosis because of the vague and fleeting nature of the symptoms. Because no single diagnostic symptom pattern is able to characterize all cases, it is believed computed tomography or magnetic resonance imaging or both are indicated in patients with long-standing otologic complaints--even in the absence of unilateral symptoms. Treatment of posterior fossa arachnoid cysts primarily consists of surgical procedures designed to decompress the cyst. In this series, treatment with diuretics alone resulted in improvement of symptoms during several years of followup, with no evidence of enlargement of the cysts. PMID:2123320

Haberkamp, T J; Monsell, E M; House, W F; Levine, S C; Piazza, L

1990-10-01

170

Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. Methods A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa. Results The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation. Conclusions The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

Grahovac Gordan

2011-05-01

171

Petrology of the Tanigawadake pliocene plutonic body, North Fossa Magna, central Japan. Hokubu Fossa Magna Tanigawadake senshinsei shinseigantai no gansekigaku  

Energy Technology Data Exchange (ETDEWEB)

In the Tanigawadake belonging to the North Fossa Magna, the Tertiary Pliocene granitic rocks are distributed widely. Although this rock body has been called as the Tanigawa rock body or the Tanigawa quartz diorite so far, it was made clear that it was composed primarily of the granodiorite accompanying with the granite by the investigation this time. Accordingly this granitic body is called as the Tanigawadake Pliocene plutonic body below. The Tanigawadake Pliocene plutonic body belonged to the magnetite association advocated by Ishihara (1977), and in addition its Sr isotopic ratio was reported to be 0.7037, and then Ishihara et al. (1976) concluded that the plutonic rocks including this rock body in the Fossa Magna region originated basically from the mantle. In this paper, the chemical composition of the total rock and mineral of the Tanigawa Pliocene plutonic body to have been reported only few so far, including the specimens taken from the inside of the Kan{prime}etsu Tunnel in case of the expansion work of the Kan{prime}etsu Highway, was reported, and then the formation process of this rock body was discussed. 28 refs., 10 figs., 4 tabs.

Kawano, Y. (Geological Survey of Japan, Tsukuba (Japan)); Ohira, H. (Niigata Univ., Niigata (Japan). Graduate School); Shimazu, M. (Niigata Women' s College, Niigata (Japan))

1992-06-15

172

Epidermoid cyst of the posterior fossa: a case report Cisto epidermoide da fossa posterior: relato de caso  

Directory of Open Access Journals (Sweden)

Full Text Available Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of secondary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.Os cistos epidermoides do sistema nervoso central (SNC são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os cistos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão.

Eduardo Cambruzzi

2011-02-01

173

Epidermoid cyst of the posterior fossa: a case report / Cisto epidermoide da fossa posterior: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os cistos epidermoides do sistema nervoso central (SNC) são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os ci [...] stos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão. Abstract in english Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts [...] are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of secondary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.

Cambruzzi, Eduardo; Presa, Karinelli; Silveira, Luciano Carvalho; Perondi, Gerson Evandro.

174

Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear  

International Nuclear Information System (INIS)

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment

1986-01-01

175

Dynamic CT in posterior fossa diseases using a deconvolution technique  

International Nuclear Information System (INIS)

The controversial points arising from dynamic CT scans after a bolus injection of an intravenous contrast material were corrected according to the deconvolution technique in order to calculate the ideal mean transit time (MTT) non-invasively. Applying this technique to dynamic CT scans of posterior fossa diseases, a matrix algorithm was used in order to obtain the transfer function from the known input/output function. To be exact, the time-density curve (T/D curve) from the basilar artery, expressed by the triangular matrix, was used as an input function, while the T/D curve of the paired ROIs on the known midpons and cerebellum were both replaced with the column matrix. This technique has the advantage of being simple to implement, but the transformation also includes a factor which may give rise to unrealistic oscillation. How to correct it will be the subject of future discussion. (author)

1986-01-01

176

Endoscopic surgery for large posterior fossa arachnoid cysts.  

Science.gov (United States)

The authors report two cases of large arachnoid cysts of the posterior fossa treated by endoscopic surgery. One patient underwent a successful endoscopic cyst fenestration by burr hole approach after several procedures of shunt revision. In another an endoscope-assisted microsurgical intervention was necessary. Lateral (cerebellar or cerebellopontine angle) cysts, as two reported cases, may be treated through a lateral retromastoid approach by fenestration into the prepontine cistern and eventually into the cisterna magna. We advise to start the operation through a burr hole and to try to realize the fenestration by endoscopy only. If this attempt fails, an endoscope-assisted microsurgical technique may be performed by enlarging the craniectomy. In this last instance the endoscope is useful particularly deeply to fenestrate the anterior cyst wall in the prepontine or ambient cisterns, where it provides more illumination and helps to identify the nervous and vascular structures. PMID:11409307

Gangemi, M; Maiuri, F; Colella, G; Sardo, L

2001-03-01

177

Infratemporal Fossa Fasciae: Anatomical and Clinical-Surgical Study.  

Directory of Open Access Journals (Sweden)

Full Text Available The lack of thoroughness that characterizes the anatomical description of pterygo-temporo-mandibular and interpterygoid fasciae is indisputable; this shortcoming is not only found in classical but also in contemporary bibliography. Likewise, these are not contemplated in International Anatomical Terminology. This paper aims to provide a detailed description of the aforementioned fasciae and the ligaments that depend of them, thus as the bony bridges. Similarly, a correlation among these anatomical structures and trigeminal neuralgia will be developed, placing particular emphasis on its role as the possible etiological agents. In the process of performing this task, skulls (n=200, cadavers without previous fixing (n=10 and cadavers fixed in a 5% aqueous formaldehyde solution (n=20 were used. Following a standardized procedure, using appropriate instrumental and magnifying devices, the dissections were performed. It should be stressed that both, conventional and unconventional approaches, were executed. During each stage of this research pertinent photographic recording was taken. The distinctive anatomical characteristics of these fasciae have been precisely exhibited, detailing its shapes, limits, insertions and relations within infratemporal fossa. A meticulous description of pterygoalar and pterygospinosous ligament was attained and its relations with the colateral branches of mandibular nerve bear special highlighting. Indeed, the role played by these ligaments in the constitution of bony bridges surrounding the oval foramen was widely analyzed. After profound reflexion on the obtained results, a thorough description of pterygo-temporo-mandibular and interpterygoid fasciae and its ligaments was achieved allowing to drawing a parallel between its disposition in the infratemporal fossa and its possible ossification and the compression the nervous branches might undergo so that a trigeminal neuralgia befalls.

Menéndez, José María

2012-12-01

178

Neuralgies of the lower cranial nerves: Microsurgical posterior fossa exploration  

Directory of Open Access Journals (Sweden)

Full Text Available Neuralgias of the lower cranial nerves are trigeminal neuralgia (TN, glossopharingeal neuralgia (GphN, and geniculate neuralgia (GN. Microsurgical posterior fossa exploration with its variations microvascular decompression (MVD, partial sensory rhisotomy (PSR, and total sensory rhisotomy (TSR is one of the most efficient ways of treating these neuralgias. It was performed 130 operations in 125 patients with TN, 3 in GphN patients, 1 in GN patient, 1 in GN/TN patients, 1 in GphN/GN patient, and 2 in GN/hemifacial spasm patients. Of total of 125 patients with TN, MVD was performed in 63, PSR in 18, and MVD+PSR in 44 cases. In 5 patients with recidivate TN PSR was performed. Of total 3 patients with GphN MVD was performed in 2 cases, and extirpation of a small meningeoma in 1 case (it was not seen on CT. In the patients with GN TSR of intermediate nerve was performed, in GN/TN patients TSR of intermediate nerve and PSR of trigeminal nerve was performed, in the GN/GphN patients MVD of glossopharingeal and TSR of intermediate nerve were performed, and in the GN/hemifacial spasm patients TSR of intermediate and MVD of facial nerve were performed. The results of TN patients are: excellent in 82,4%, good in 12%, and poor in 5,6% of patients. There is no difference in complete pain relief, rate of recurrence, and complications between MVD, MVD+PSR and PSR operative groups (p>0,05. Among patients with other neuralgias the following results are noted: excellent in 4, good in 3, and poor in 1 patient. Microsurgical posterior fossa exploration is the method of choice in the treatment of the neuralgias of the lower cranial nerves.

Ivanovi? S.

2004-01-01

179

Use of bioassays in assessing health hazards from complex mixtures: A RASH analysis  

Energy Technology Data Exchange (ETDEWEB)

The Finney harmonic mean model for joint toxicity of ingredients in mixtures can be used to estimate the toxicity of the neat compound if one component can be substituted in potency-adjusted-doses for each of the other components. Chemical analysis data and relative potency values (computed according to the Rapid Screening of Hazard (RASH) method) were used to compare the toxicities as predicted from ingredients of cigarette smoke, PAHs in diesel exhaust, asphalt, coal tar, pitch, and creosote with the measured toxicities of the neat mixtures. Accuracy for cigarette smoke condensate, coal tar, pitch, and creosote were within a factor of three; asphalt within a factor of 18; but the PAC content of diesel particulate was inadequate to accurately describe the toxicity of diesel emissions.

Jones, T.D.

1993-10-14

180

Susceptibility to infectious rash illness in pregnant women from diverse geographical regions.  

Science.gov (United States)

Varicella-zoster (VZV), rubella (RV) and parvovirus B19 (B19V) infections are important causes of rash illness in pregnancy, due to their potential adverse impact on both mother and fetus. We determined susceptibility to these infections in pregnant women attending our hospital in 2002. Age and nationality were recorded. Sera were tested for VZV, RV, and B19V antibody by enzyme immunoassay. Of 7,980 women screened for VZV IgG, 11.3% were seronegative and therefore susceptible to infection. Across different worldwide regions, 6.9% of Irish and other Western European women were susceptible to VZV, compared to 19.7% of other women tested (p 79804

Knowles, S J; Grundy, K; Cahill, I; Cafferkey, M T

2004-12-01

 
 
 
 
181

Neuroimaging of pediatric posterior fossa tumors including review of the literature.  

Science.gov (United States)

Conventional, anatomical MRI is an essential tool for diagnosis and evaluation of location, quality, and extent of posterior fossa tumors, but offers limited information regarding tumor grade and type. Advanced MRI techniques such as diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) may improve the specific diagnosis of brain tumors in the posterior fossa in children. In this review the conventional neuroimaging findings, as well as the DWI, and DTI characteristics of common pediatric posterior fossa tumors are discussed and summarized. PMID:21989968

Poretti, Andrea; Meoded, Avner; Huisman, Thierry A G M

2012-01-01

182

'There are no significant side-effects from a bone scan injection' - a rash statement  

International Nuclear Information System (INIS)

Full text: Adverse reactions to radiopharmaceuticals are very uncommon, mild and generally occur a few hours post-injection. For these reasons they are poorly documented and rarely seen in nuclear medicine departments. Diphosphonates produce the most reports and the annual incidence is reputed to be between 0.3 and 33 events per 100,000 administrations. Very few of these require medical intervention and appear to resolve quickly. We report a case of a 78-year-old retired medical practitioner who underwent a staging whole body bone scan for renal cell carcinoma. 880 MBq of Tc-HDP was injected intravenously without extravasation and routine whole body images obtained 2 hours later. He awoke next morning with a macular rash and intense pruritis involving his chest, which over one week spread to involve his whole trunk, arms and then legs. The rash remained symptomatic for three months requiring continuous topical therapy. The patient was already on regular anti-histamine tablets. Dermatological review confirmed a drug reaction. There is a history of chronic renal failure requiring peritoneal dialysis. While multiple medications were being ingested, including phenergan for pruritus, there were no changes to his usual regime around this time and no other obvious causal agents. A previous bone scan 5 years ago passed uneventfully. Review of the literature provides scanty information as therapy is seldom required and when indicated is purely symptomatic. There are no reports of a prolonged adverse event. This case almost certainly represents a hypersensitivity reaction to a common bone radio-pharmaceutical and reminds us that very rarely these may be quite severe and prolonged. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

2002-05-04

183

Skin rash and arthritis a simplified appraisal of less common associations.  

Science.gov (United States)

Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information. PMID:23980929

Cozzi, A; Doria, A; Gisondi, P; Girolomoni, G

2014-06-01

184

Rash and hepatitis within days of starting a new antiretroviral regimen: nevirapine hypersensitivity, secondary syphilis or both?  

Science.gov (United States)

We report a case in which an HIV-positive man developed general malaise, skin rash and biochemical hepatitis within days of starting a nevirapine-based antiretroviral treatment regimen. At the same time, his syphilis serology proved positive. We discuss the diagnostic dilemma: was this a nevirapine hypersensitivity reaction, secondary syphilis or both? PMID:23970648

Saxon, Cara J; Helbert, Matthew R; Komolafe, Adeniyi J; Higgins, Stephen P

2014-03-01

185

Size of posterior fossa in Chiari type 1 malformation in adults.  

Science.gov (United States)

The clinical and neuroradiological findings in five patients with Chiari Type 1 malformation presenting symptoms in adult life are presented. New posterior fossa ratio methods have been applied to this material. The posterior cranial fossae are demonstrated to be small, and the most significant deviation from normal gave the ratio h/Tw: posterior fossa height in proportion to Twining's line. The implications of these findings are discussed in relation to the static and dynamic factors that are operating in the development of neurological symptoms in Chiari type 1 malformation. A final discussion is given comparing the Chiari type 1 malformations to meningo-myelocele. The findings using posterior fossa ratio methods may strengthen the indications for suboccipital craniectomy in these patients. PMID:676804

Nyland, H; Krogness, K G

1978-01-01

186

Diagnosis and outcomes of middle cranial fossa repair for patients with superior semicircular canal dehiscence syndrome.  

Science.gov (United States)

The aim of this study was to retrospectively review the clinical presentation, diagnostic features, in particular cervical vestibular evoked myogenic potentials (cVEMPs), and the outcomes of surgical repair for superior semicircular canal dehiscence syndrome (SSCDS). SSCDS is a well-described syndrome of auditory and vestibular symptoms due to a bony dehiscence of the superior semicircular canal in the middle cranial fossa. A series of six procedures on five patients with SSCDS who underwent surgical repair via a middle fossa craniotomy were retrospectively reviewed. Preoperative and postoperative audiometric and vestibular symptoms as well as investigation findings were reviewed. Auditory and vestibular symptoms improved and hearing was preserved in all patients. The low frequency pseudo-conductive loss was corrected in four out of five patients, and the lowered preoperative cVEMP thresholds normalised following successful middle cranial fossa repair. In this series, middle fossa repair of SSCD was safe and effective with excellent sensorineural hearing preservation. PMID:20074960

Phillips, D J; Souter, M A; Vitkovic, J; Vitkovitch, J; Briggs, R J

2010-03-01

187

Topographic Post-Formation Modifications of Inverted Fluvial Features in the Western Medusa Fossae Formation, Mars  

Science.gov (United States)

Topographic analyses of sinuous ridges in the western Medusa Fossae Formation (MFF) show gradients locally reversing direction of slope along the presumed flow direction, interpreted as indication of differential settling of the western MFF.

Lefort, A.; Burr, D. M.; Beyer, R. A.; Howard, A. D.

2011-03-01

188

Recovery of sensorineural hearing loss following operative management of a posterior fossa arachnoid cyst. Case report.  

Science.gov (United States)

Arachnoid cysts are benign, intraarachnoid cysts filled with cerebrospinal fluid that are usually encountered in the middle cranial fossa. If present in the posterior fossa, they usually produce nonspecific signs and symptoms such as headaches, dizziness and vertigo. We report the rare presentation of a young girl with right-sided sensorineural hearing loss and tinnitus secondary to a right cerebellopontomedullary arachnoid cyst. The patient underwent a suboccipital retrosigmoid (retromastoid) craniectomy with fenestration of the arachnoid cyst. Subsequently, the patient experienced improvement in hearing with near-complete resolution of sensorineural hearing loss. To the authors' knowledge, postoperative near-complete resolution of hearing loss secondary to posterior fossa arachnoid cysts in a pediatric patient has not been previously reported. The authors also review the literature with respect to posterior fossa arachnoid cysts and discuss their clinical features, diagnosis, and management. PMID:19645544

Jayarao, Mayur; Devaiah, Anand K; Chin, Lawrence S

2009-08-01

189

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infrate...

Abdel-Aziz Mosaad

2012-01-01

190

Locating the Internal Auditory Canal during the Middle Fossa Approach: An Alternative Technique  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Options for the surgical exposure of the internal auditory canal (IAC) include the translabyrinthine, retrosigmoid, and middle fossa approaches. Of the three, the anatomical reference points to the IAC are most subtle when it is exposed from above. The classically described methods for localizing the canal during the middle fossa approach direct the surgeon's attention initially towards the lateral extremity of the canal, a location where the margin for error is at its minimum. The cochlea, s...

Jackler, Robert K.; Gladstone, Hayes B.

1995-01-01

191

A reappraisal of the relationship between arachnoid cysts of the middle fossa and chronic subdural haematoma.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

It has been increasingly recognised that patients with arachnoid cysts of the middle fossa appear more susceptible to the development of subdural haematomas. Seven patients with arachnoid cysts of the middle fossa and associated subdural haematomas are presented. Intra-cystic haemorrhage, masking the presence of an arachnoid cyst on computed tomography (CT) is highlighted. Repeat of CT scanning in young patients with subdural haematomas in the absence of severe trauma is recommended. Two theo...

Page, A.; Paxton, R. M.; Mohan, D.

1987-01-01

192

CT and MRI diagnosis of tumor originating in the pterygopalatine fossa  

International Nuclear Information System (INIS)

Objective: To investigate the CT and MRI findings of tumors originating in the pterygopalatine fossa so as to promote the diagnostic accuracy. Methods: All 11 patients with tumors arising from the pterygopalatine fossa were confirmed by pathology and surgery. CT and MRI appearances were analyzed retrospectively. Results: The tumors included 3 neurilemmomas, 2 neurofibromas, 3 angiofibromas, 2 adenoid cystic carcinomas, and 1 melanoma, and they all extended through communicating pathways of the pterygopalatine fossa. On HRCT, neurogenic tumors caused enlargement of the pterygopalatine fossa with thinning of their bony walls, while MRI demonstrated isointense signal to brain on T1WI and hyperintense signal on T2WI. Two neurofibromas showed homogeneous enhancement after administration of contrast medium while 3 neurilemmomas showed heterogeneous enhancement. On HRCT scans, angiofibroma caused enlargement of the pterygopalatine fossa, eroding their bony walls. On MR imaging, the lesions were isointense compared to muscle on T1WI, hyperintense on T2WI with marked postcontrast enhancement. One case of angiofibroma showed scattered stippling or stria-shaped signal voids and inhomogeneous postcontrast enhancement. On CT scans, adenoid cystic carcinoma revealed moth-eaten bony wall of the pterygopalatine fossa with poorly defined margins and irregular shapes. Adenoid cystic carcinoma showed hypointense signal compared to muscle on T1WI, inhomogeneous hyperintense signal on T2WI and heterogeneous postcontrast enhancement. One case of melanoma showed enlargement of pterygopalatine fossa and destruction of the bony walls except for the anterior wall by invading adjacent structures with well-defined border and irregular shape. On MR imaging, the lesion showed isointense signal compared to muscle on T1WI and hyperintense signal on T2WI with discrete mottled or linear signal voids and inhomogeneous postcontrast enhancement. Conclusion: HRCT can depict bony changes clearly and MRI can demonstrate optimally the extent of the lesion in pterygopalatine fossa. Both imaging modalities can contribute to the diagnosis of neurogenic tumor and angiofibroma and can provide information for therapeutic procedure and surgical planning

2003-10-01

193

The significance of the pterygopalatine fossa angiography before endoscopic sinus surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective?To investigate the value of pterygopalatine fossa angiography in fresh cadaveric heads, so as to provide a useful guidance and an individualized operative procedure for endoscopic sinus surgery. Methods?Three fresh cadaveric heads were used in the present study. After injection with 10%, 5% iodine fluorine into carotid artery, 3D vascular structure of the pterygopalatine fossa was constructed. The posterior wall of the maxillary sinus was dissected by gently removing the fat tis...

2013-01-01

194

Results of radiotherapy with cobalt-60 of malignant tumors of the tonsillar fossa  

International Nuclear Information System (INIS)

From 1963 to 1978 119 patients with a carcinoma of the tonsillar fossa received cobalt-60-therapy from 60 to 70 Gy to the primary lesion and the lymph nodes. The 5-year-survival-rate was 34%, with a combined therapy of surgery and irradiation it was 43.6%. For 44 patients with a sarcoma of the tonsillar fossa the 5-year-survival was 32%. For the patients with a carcinoma chemotherapy was only given for palliation. (orig.)

1985-03-01

195

Microanatomy and Surgical Approaches to the Infratemporal Fossa: An Anaglyphic Three-Dimensional Stereoscopic Printing Study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: The infratemporal fossa (ITF) is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone that is sitting deep to the ramus of the mandible. The principal structure to understanding its relationships is the lateral pterygoid muscle. Other important structures are the medial pterygoid muscle, the maxillary artery, the pterygoid venous plexus, the otic ganglion, the chorda tympa...

Isolan, Gustavo Rassier; Rowe, Richard; Al-mefty, Ossama

2007-01-01

196

Phyllosilicate and Olivine around a Fracture in Nili Fossae  

Science.gov (United States)

The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this observation of part of the Nili Fossae region at the western margin of the Isidis impact basin at 3:07 (UTC) on December 12, 2006, near 21.9 degrees north latitude, 78.2 degrees east longitude. The image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 18 meters (60 feet) across. The image is about 11 kilometers (7 miles) wide at its narrowest point. The Isidis basin resulted from a gigantic impact on the surface of Mars early in the planet's history. The image of the Isidis basin at the top left is the colored elevation data from the Mars Orbiter Laser Altimeter (MOLA) overlain on a digital image mosaic from the Viking mission. Reds represent higher elevations, and blue lower elevations. The western rim of the Isidis basin has numerous, concentric troughs (or 'fossae') which may have formed during faulting associated with the impact event. Since then, the Nili Fossae region has since been heavily eroded, and is one of the most mineralogically diverse spots on Mars. This CRISM image targets one of region's smaller fractures. The image is shown overlain on the Viking digital image mosaic at lower left. The lower right CRISM image was constructed from three visible wavelengths (0.71, 0.60 and 0.53 microns in the red, green and blue image planes, respectively) and is close to what the human eye would see. The blue on the right of the image is an artifact from light scattering in the atmosphere. The upper right image was constructed from three infrared channels (2.38, 1.80 and 1.15 microns in the red, green and blue image planes, respectively) to highlight the mineralogy of the area. The bright green areas are rich in 'phyllosilicates,' a category of minerals including clays. The purple material along the walls of the fracture likely contains small amounts of the iron- and magnesium-rich mineral pyroxene. The yellow-brown material contains the iron- and magnesium-rich mineral olivine. Olivine and pyroxene are minerals associated with igneous activity. Overlaying CRISM data with images from the High-Resolution Imaging Science Experiment (HiRISE) camera shows that the phyllosilicates are in small, eroded outcrops of rock. The olivine is most abundant in sand dunes on the surface. The use of these two instruments together reveals more about the history of the region: Olivine sands covered the area shown in the image after the interaction of water and rock formed the phyllosilicates and after the fracture formed. The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Led by The Johns Hopkins University Applied Physics Laboratory, the CRISM team includes expertise from universities, government agencies and small businesses in the United States and abroad.

2007-01-01

197

Nili Fossae in Natural Color and Across the Spectrum  

Science.gov (United States)

The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) took this image of the Nili Fossae region at 0643 UTC (2:43 a.m. EDT) on June 21, 2007, near 21.15 degrees north latitude, 74.24 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 20 meters (66 feet) across. The region covered is just over 10 kilometers (6.2 miles) wide at its narrowest point, and is one of several dozen that CRISM has taken to map the minerals at candidate landing sites for the Mars Science Laboratory (MSL) mission, which will launch in 2010. The Nili Fossae region is critical to understanding the history of water on Mars and whether water ever formed environments suitable for life, because the region is underlain by a layer of phyllosilicate (clay) minerals. This type of mineralogy formed where water was in contact with Mars' crustal rocks for very long periods, altering the silicates in volcanic rocks. In addition, phyllosilicates can encapsulate and preserve organic chemicals associated with life (if life was present). Its rocky record of an ancient wet environment makes Nili Fossae a top contender among the 30-plus landing sites being considered for MSL, whose objectives include measuring the chemistry preserved in an ancient wet environment. This series of four different versions of the same 544-color image illustrates the mineral-mapping capability that comes from moving beyond the wavelength range of the human eye, and into infrared wavelengths where minerals leave distinct 'fingerprints' in reflected sunlight. At upper left, more than three dozen of the distinct wavelengths measured by CRISM were combined to mimic how the human eye would see the image. The subtle shading comes from the Sun's position high in Mars' sky when the image was taken, creating few shadows. The bland, butterscotch color comes from the dust coating nearly all of the Martian surface to some degree. At upper right, three infrared wavelengths (2.53, 1.50 and 1.08 micrometers) replace the red, green and blue image planes. These wavelengths are less sensitive to dust, and begin to show the spectral variations in the underlying rocks. The two bottom versions combine different wavelengths to show strength of absorption due to the different minerals that are present, providing indications of the minerals' presence and distribution. The lower left version combines measurements of the strength of iron mineral absorptions at 0.53, 0.86 and 1.0 microns in the red, green and blue image planes. Bluer areas have more pyroxene, a mineral found in volcanic basaltic rock, whereas reddish and especially orange areas have more oxidized iron minerals. The lower right version combines measurements of mineral absorptions at 1.0, 1.9 and 2.3 microns in the red, green and blue image planes. Redder areas are richer in pyroxene, and green and blue areas contain more phyllosilicate minerals. The combination of basaltic rocks and highly altered phyllosilicates in close proximity would allow MSL to make detailed measurements of rocks formed in two distinct environments. The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Led by The Johns Hopkins University Applied Physics Laboratory, the CRISM team includes expertise from universities, government agencies and small businesses in the United States and abroad.

2007-01-01

198

MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation  

Energy Technology Data Exchange (ETDEWEB)

Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Shakudo, Miyuki [Osaka City General Hospital, Department of Radiology, Osaka (Japan); Tanaka, Hiroyuki [Hyogo College of Medicine, Department of Gynecology, Nishinomiya (Japan); Minagawa, Kyoko [Hyogo College of Medicine, Department of Pediatrics, Nishinomiya (Japan)

2007-12-15

199

Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors  

International Nuclear Information System (INIS)

Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB patients may correspond to the additional damage of combined irradiation and chemotherapy on neuroaxonal cell viability and number.

2012-03-01

200

Polygonal Dike Networks in the Medusae Fossae Formation  

Science.gov (United States)

1. Introduction 1.1 The Medusae Fossae Formation The Medusae Fossae Formation (MFF) is a widespread and voluminous formation which covers 2.1 x 106 km2 between 130-230ºE and 12ºS-12ºN [1-3]. As a fine-grained, friable deposit, its surface is dominated by aeolian features such as yardangs [3-5] and a large number of both fresh and indurated transverse aeolian ridges [TARs] [5]. The deposition of the MFF began at the latest in the Hesperian [6], and over time it has been recognized that, by virtue of its fine-grained nature, the MFF may preserve an important record of Martian history, most directly as a result of the burial and exhumation of channels found in the Zephyria region of the formation [7]. In order to better document the occurrence of smallscale features of interest within the MFF, we examined 427 High Resolution Imaging Science Experiment (HiRISE) images spread across the formation, during which the occurrence of features of interest were mapped [8]. HiRISE images were supplemented by Mars Reconnaissance Orbiter Context Imager (CTX), Mars Express High Resolution Stereo Camera (HRSC) and Mars Global Surveyor Mars Orbiter Camera (MOC) images where needed. Here we describe the occurrence and characteristics of several polygonal networks of rectilinear ridges. 1.2 Rectilinear Ridges on Mars Rectilinear ridges have been recognized in several different areas on Mars. Long, linear to slightly curving or en echelon ridges hypothesized to be exhumed magmatic dikes have been found in a variety of environments on Mars [9-13], particularly in formerly glaciated terrains where magma may have been emplaced into an icy substrate. A network of rectilinear ridges was described in detail in an unnamed crater on the dichotomy boundary [14]. These chaotic, intersecting ridges, forming irregular polygons ~1 km across, are hypothesized to be brecciated dikes emplaced during the process of crater formation [14]. A group of intersecting rectilinear ridges, informally known as "Inca City" and seen to be eroding out of the south polar layered deposits, was observed in early MOC images and hypothesized to be lithified duneforms, clastic dikes, or magmatic dikes [15]. More recently, smaller networks of linear ridges (polygons ~25 m across) have been identified in Gale Crater, where they have been attributed to preferential cementation of material due to the circulation of fluids through fracture networks [16].

Kerber, L.; Dickson, J. L.; Forget, F.; Head, J. W.; Grosfils, E. B.

2013-09-01

 
 
 
 
201

Does Sunscreen Prevent Epidermal Growth Factor Receptor (EGFR) Inhibitor–Induced Rash? Results of a Placebo-Controlled Trial from the North Central Cancer Treatment Group (N05C4)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This study assessed whether sunscreen prevents or mitigates rashes in patients prescribed epidermal growth factor receptor inhibitors, and found that sunscreen as prescribed in the study did not prevent or attenuate these rashes.

Jatoi, Aminah; Thrower, Abby; Sloan, Jeff A.; Flynn, Patrick J.; Wentworth-hartung, Nicole Lea; Dakhil, Shaker R.; Mattar, Bassam I.; Nikcevich, Daniel A.; Novotny, Paul; Sekulic, Aleksandar; Loprinzi, Charles L.

2010-01-01

202

The results of radiosurgical management of 72 middle fossa meningiomas  

International Nuclear Information System (INIS)

Of 812 patients with intracranial tumours treated by radiosurgery during the period 1984-1990, 129 had meningiomas. Of these latter, 72 had middle fossa meningiomas. Patients with meningiomas treated by us since March 1990 are not included in this report since we established the investigative principle of a minimum of 30 months follow-up. Seventeen of the 72 patients were treated after incomplete surgical resection, and 21 for tumour regrowth. In 34 patients, radiosurgery was the primary treatment. The tumour was calculated by the ellipsoid method. It ranged from 0.588-76.346ml. Radiosurgery was performed using the non-invasive stereotactic fixation head device (Greitz-Bergstroem) adapted to the Fixster frame, and dynamic irradiation performed with the linear accelerator, using especially designed collimators. The total tumour dose for each patient ranged from 15-45Gy. The minimum follow-up was 2.5 years and the maximum 8 years. In 50 patients there was tumour shrinkage ranging from 24-91% of the initial tumour volume. Shrinkage was associated with central tumour necrosis in 11 of these 50 patients. In 18 patients the tumour volume remained stable. In 2 patients there was tumour progression and in 2 there was regrowth after initial reduction of tumour volume. There were no significant treatment complications. Radiosurgery is preferable to re-operation in recurrent meningiomas and indicated after incomplete surgical removal. In high risk patients, as well as in 'unresectable' meningiomas, it is an obvious alternative to microsurgery. (authors)

1993-01-01

203

The management of right iliac fossa pain - is timing everything?  

LENUS (Irish Health Repository)

BACKGROUND: Right iliac fossa (RIF) pain remains the commonest clinical dilemma encountered by general surgeons. We prospectively audited the management of acute RIF pain, examining the relationship between symptom duration, use of pre-operative radiological imaging and patient outcome. METHODS: Over a six-month period, 302 patients, median age 18 years, 59% female, were admitted with RIF pain. Symptoms, clinical findings and laboratory results were documented. Patient management, timing of radiological investigations and operations, and outcome were recorded prospectively. RESULTS: Non-specific abdominal pain (26%), gynaecological (22%) and miscellaneous causes (14%) accounted for most admissions. Ultimately, 119 patients (39%) had appendicitis. Anorexia, tachycardia or rebound tenderness in the RIF significantly predicted a final diagnosis of appendicitis. Patients with perforated appendicitis (n = 29) had a longer duration of pre-hospital symptoms (median 50h) compared to those with simple appendicitis (median 17 h) (p<0.001). The use of pre-operative imaging resulted in an increased time to surgery but was not associated with increased post-operative morbidity or perforated appendicitis. CONCLUSION: The majority of patients presenting to hospital with RIF pain did not have appendicitis. Increased duration of pre-hospital symptoms was the main factor associated with perforated appendicitis. However, increased in-hospital time to theatre was not associated with perforated appendicitis or post-operative morbidity.

McCartan, D P

2012-01-31

204

Hemangioblastoma of the posterior fossa: the role of multimodality treatment / Hemangioblastoma da fossa posterior: papel do tratamento multimodal  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Os autores fazem revisão de uma série de pacientes com hemangioblastomas da fossa posterior tratados entre 1973 e 1993: 32 pacientes foram analisados com 24 deles recebendo ressecção, 8 recebendo radiocirurgia e 2 recebendo radioterapia convencional. A mortalidade dos pacientes submetidos a ressecçã [...] o foi considerada aceitável com 2 mortes (8%) c com morbidade de outros 3 pacientes (12,5%). A revisão de literatura sugere que a radioterapia convencional com altas doses (45-60 Gy) pode ter um papel no controle pós-operatório dos hemangioblastomas e em alguns casos pode ser empregada mesmo antes da ressecção com o objetivo de facilitar a cirurgia. O tratamento radiocirúrgico é considerado coadjuvante. Resultados ruins foram obtidos com a radiocirurgia em tumores grandes em que doses baixas (menos que 20 Gy) foram utilizadas. Devido a raridade e complexidade destes tumores, principalmente quando associados com a doença de von Hippel-Lindau, um estudo multicêntrico pode ser útil na avaliação da combinação e otimização dessas modalidades de tratamento. Abstract in english The authors made a review of a series of patients with hemangioblastomas of the posterior fossa treated between 1973 and 1993. A total of 32 patients were analyzed with 24 patients receiving resection, 8 patients receiving radiosurgery and 2 patients receiving conventional radiotherapy. The mortalit [...] y in the patients with a resection was considered acceptable with 2 deaths (8%) and with a morbidity of 3 patients (12.5%). A review of the literature suggests that conventional radiotherapy with high doses (45-60 Gy) may have a role in the post-operative control of hemangioblastomas and in some cases could be employed even before the resection in order to facilitate the surgery. The radiosurgical treatment is regarded like adjuvant. Poor results were obtained with radiosurgery in large tumors where low doses (less than 20 Gy) were used. Because of the rarity and complexity of these tumors, mainly when associated with von Hippel-Lindau disease, a multicenter study could be useful with the assessment of the optimal utilization and combination of these treatment modalities.

Georg, Alvaro E.; Lunsford, L. Dade; Kondziolka, Douglas; Flickinger, John C.; Maitz, Ann.

205

Hemangioblastoma of the posterior fossa: the role of multimodality treatment Hemangioblastoma da fossa posterior: papel do tratamento multimodal  

Directory of Open Access Journals (Sweden)

Full Text Available The authors made a review of a series of patients with hemangioblastomas of the posterior fossa treated between 1973 and 1993. A total of 32 patients were analyzed with 24 patients receiving resection, 8 patients receiving radiosurgery and 2 patients receiving conventional radiotherapy. The mortality in the patients with a resection was considered acceptable with 2 deaths (8% and with a morbidity of 3 patients (12.5%. A review of the literature suggests that conventional radiotherapy with high doses (45-60 Gy may have a role in the post-operative control of hemangioblastomas and in some cases could be employed even before the resection in order to facilitate the surgery. The radiosurgical treatment is regarded like adjuvant. Poor results were obtained with radiosurgery in large tumors where low doses (less than 20 Gy were used. Because of the rarity and complexity of these tumors, mainly when associated with von Hippel-Lindau disease, a multicenter study could be useful with the assessment of the optimal utilization and combination of these treatment modalities.Os autores fazem revisão de uma série de pacientes com hemangioblastomas da fossa posterior tratados entre 1973 e 1993: 32 pacientes foram analisados com 24 deles recebendo ressecção, 8 recebendo radiocirurgia e 2 recebendo radioterapia convencional. A mortalidade dos pacientes submetidos a ressecção foi considerada aceitável com 2 mortes (8% c com morbidade de outros 3 pacientes (12,5%. A revisão de literatura sugere que a radioterapia convencional com altas doses (45-60 Gy pode ter um papel no controle pós-operatório dos hemangioblastomas e em alguns casos pode ser empregada mesmo antes da ressecção com o objetivo de facilitar a cirurgia. O tratamento radiocirúrgico é considerado coadjuvante. Resultados ruins foram obtidos com a radiocirurgia em tumores grandes em que doses baixas (menos que 20 Gy foram utilizadas. Devido a raridade e complexidade destes tumores, principalmente quando associados com a doença de von Hippel-Lindau, um estudo multicêntrico pode ser útil na avaliação da combinação e otimização dessas modalidades de tratamento.

Alvaro E. Georg

1997-06-01

206

A study of the pterygopalatine fossa and it's ganglion in a South African skeletal and cadaver population  

Digital Repository Infrastructure Vision for European Research (DRIVER)

It is well known that pain experienced by patients diagnosed with trigeminal neuralgia or facial pain syndrome can be effectively treated by blocking the contents of the pterygopalatine fossa. Such a procedure is not widely used due to the difficulty in locating the pterygopalatine fossa which is obscured by bony and soft tissue structures. Radiography still seems to be the most effective method in locating the pterygopalatine fossa. The aim of this study was to re-look the pterygopalatine fo...

2008-01-01

207

Anticonvulsant hypersensitivity syndrome mimicking a viral illness with skin rash: a case report.  

Science.gov (United States)

Anticonvulsant hypersensitivity syndrome (ACHSS) is rare and defined by a group of systemic symptoms: a typical clinical triad with skin rash, high fever and lymphadenopathy, with or without multiple organ dysfunctions. Its variable presentation renders diagnosis particularly difficult yet important, as delayed diagnosis can lead to serious complications. We describe a 31-year-old woman sent to the emergency department with symptoms of high fever, peripheral lymphadenopathy, arthralgia, nausea, vomiting and a vesiculobullous eruption resembling measles. First diagnostic hypothesis was that of a viral illness. However, thorough second anamnesis pointed towards a possible drug aetiology, as the patient had been prescribed lamotrigine 8 days prior to admission. Blood analysis showed an inflammatory syndrome, thrombocytopenia and moderate lymphopenia. A few days later, results indicated old immunisation for measles. Skin biopsy revealed dermal inflammation with presence of hypereosinophilia, thereby confirming ACHSS. It is important to recognise and treat this rare reaction to anticonvulsants as early as possible in order to prevent its potentially life-threatening complications. PMID:24156229

Gérard, V; Delgrange, E; de Halleux, C; Vanpee, D

2013-01-01

208

Genetic linkage of familial granulomatous inflammatory arthritis, skin rash, and uveitis to chromosome 16  

Energy Technology Data Exchange (ETDEWEB)

Blau syndrome (MIM 186580), first described in a large, three-generation kindred, is an autosomal, dominantly inherited disease characterized by multiorgan, tissue-specific inflammation. Its clinical phenotype includes granulomatous arthritis, skin rash, and uveitis and probably represents a subtype of a group of clinical entities referred to as {open_quotes}familial granulomatosis.{close_quotes} It is the sole human model with recognizably Mendelian inheritance for a variety of multisystem inflammatory diseases affecting a significant percentage of the population. A genomewide search for the Blau susceptibility locus was undertaken after karyotypic analysis revealed no abnormalities. Sixty-two of the 74-member pedigree were genotyped with dinucleotide-repeat markers. Linkage analysis was performed under dominant model of inheritance with reduced penetrance. The marker D16S298 gave a maximum LOD score of 3.75 at {theta} = .04, with two-point analysis. LOD scores for flanking markers were consistent and placed the Blau susceptibility locus within the 16p12-q21 interval. 46 refs., 3 figs., 3 tabs.

Tromp, G.; Kuivaniemi, H.; Ala-Kokko, L. [Thomas Jefferson Univ., Philadelphia, PA (United States)] [and others

1996-11-01

209

The enlargement of geniculate fossa of facial nerve canal: a new CT finding of facial nerve canal fracture  

International Nuclear Information System (INIS)

Objective: To discuss the value of enlargement of geniculate fossa of facial nerve canal in the diagnosis of facial nerve canal fracture. Methods: Thirty patients with facial nerve canal fracture underwent axial and coronal CT scan. The correlation between the fracture and the enlargement of geniculate fossa of facial nerve canal was analyzed. The ability of showing the fracture and enlargement of geniculate fossa of facial nerve canal in axial and coronal imaging were compared. Results: Fracture of geniculate fossa of facial nerve canal was found in the operation in 30 patients, while the fracture was detected in CT in 18 patients. Enlargement of geniculate ganglion of facial nerve was detected in 30 patients in the operation, while the enlargement of fossa was found in CT in 28 cases. Enlargement and fracture of geniculate fossa of facial nerve canal were both detected in CT images in 18 patients. Only the enlargement of geniculate fossa of facial nerve canal was shown in 12 patients in CT. Conclusion: Enlargement of geniculate fossa of facial nerve canal was a useful finding in the diagnosis of fracture of geniculate fossa in patients with facial paralysis, even no fracture line was shown on CT images. (authors)

2006-12-01

210

Surgery for malignant maxillary tumors involving the middle cranial fossa.  

Science.gov (United States)

The purpose of this study was to evaluate the disease-free survival (DFS) of patients with maxillary malignant tumors invading the middle cranial fossa (MCF) who underwent a lateral or anterolateral skull base resection. This study was a retrospective analysis in a tertiary referral center and included 62 patients with maxillary malignant tumors invading the MCF (stage T4b) treated with surgery with or without postoperative radiotherapy. All patients had sharp pain and involvement of at least one branch of the trigeminal nerve. Twenty-eight patients had not been treated previously, and 34 had previously been treated elsewhere. The MCF dura was infiltrated and resected in 36 cases, and in nine of these, there was an intradural extension of the tumor, with temporal lobe and/or cavernous sinus invasion. Thirty-six patients underwent reconstruction with a temporalis muscle pedicled flap, and 26 patients with a free flap. There was a 22% overall rate of postoperative complications, but no intraoperative deaths. The median follow-up time was 49 months (range 2 to 186). Overall DFS was 33.9% and was higher for untreated patients (46.4% versus 23.5%) and for patients in whom clean margins were achieved (51.4% versus 12.5%). The survival time for patients who died of disease was 9 months for squamous cell carcinoma and 38 months for adenoid-cystic carcinoma. All patients experienced anesthesia in the territory of the resected trigeminal branches, but their pain vanished, and their quality of life improved. Lateral skull base surgery may achieve satisfactory oncologic results for patients with low-grade tumors, with improved quality of life for almost all patients. PMID:20808528

Cantu, Giulio; Solero, Carlo L; Riccio, Stefano; Colombo, Sarah; Pompilio, Madia; Aboh, Ikenna V; Formillo, Paolo; Arana, Gabriel Hübner

2010-03-01

211

Malignant melanoma of nasal fossae, a propos of a case  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: The melanoma of the nasal fossae represents a 4% of all sinonasal malignant tumors. The symptoms are unspecific, thus delaying diagnosis. We present a case of a woman of 80 years of age. She has hypertension and a degenerative heart disease, and presents nasal respiratory insufficiency, left otalgia and epistaxis of 8 months of evolution. Examination revealed a dark, polypoidal, fleshy mass. The CT revealed a mass that occupied that space, without bone erosion. A biopsy of the mass revealed that it was an amelanotic melanoma. Due to the age of the patient and her general pathology, endoscopic sinonasal surgery was applied. The pathological anatomic analysis confirmed that it was a malignant round cell melanoma with the following phenotype: positive for Vimentin, positive for nuclear S-100, focal positive for HMB-45, negative, melan A+ negative for HMB-45 with heterogeneous intensity, and negative for ENE and ALC. The patient did not present symptoms until a year later, when she discovered a small laterocervical adenopathy. A FNAP confirmed that the melanoma had metastatized. The patient underwent a radical neck dissection and remained 15 months without symptoms. She is currently going through monthly revisions. Discussion: The treatment of choice is surgery. Selective neck dissection is not justified. This tumor is radioresistant. Active immunotherapy (a combination of Interferon and Cimetidine and targeted chemotherapy have also been used, mainly in inoperable cases. Five-year survival ranges between 6.5% and 34%.Conclusion: We propose endoscopic surgery for non-infiltrating tumors or for patients who cannot undergo very aggressive surgery due to their general condition.

Gómez-González JL

2012-07-01

212

Arachnoid cyst of the middle cranial fossa. Report of an atypical extension  

Energy Technology Data Exchange (ETDEWEB)

The middle cranial fossa is the most common site for intracranial arachnoid cysts. Galassi and his associates have provided a useful classification of middle fossa arachnoid cysts based on their computed tomographic appearances. The Type I cyst is a small lenticular lesion. The Type II cyst is quadrangular in shape, reflecting a completely open insula. The Type III cyst appears as a large area of smoothly rounded lucency, with a significant compression of the brain. We report a 2-year-old boy with a middle fossa arachnoid cyst. This cyst differed from the type of Galassi's classification in its extension. Computerized tomograms showed low-density lesions of the bilateral middle cranial fossa and suprasellar area, which was not enhanced with contrast medium. Magnetic Resonance Imaging (MRI) showed a CSF-like pattern (Kjos) and revealed delicate anatomical structures in the surrounding brain. Arachnoid cysts are usually single lesions. However, not infrequently these cystic cavities may be divided by membranous septa into two or more compartments. Bilateral, more or less symmetrical arachnoid cysts in the middle cranial fossa as seen in this patient, however, seem to be very rare. Only a few such cases have been reported previously. MRI was superior to X-ray CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into Kjos's three groups on the basis of the intensity pattern of the cyst contents, thereby improving diagnostic specificity and patient management.

Tsukiyama, T.; Nishimoto, H.; Kasahara, E.; Iwasaki, M.; Tsubokawa, T.; Tanaka, O.

1987-02-01

213

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

Abdel-Aziz Mosaad

2012-06-01

214

Prevalence of clinically important posterior fossa emissary veins on CT angiography  

Science.gov (United States)

Purpose: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT) angiography. Materials and Methods: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. Results: Of 166 patients, the mastoid emissary vein (MEV) was not identified in 37 (22.3%) patients. It was found bilaterally in 82 (49.4%) and unilaterally in 47 (28.3%) patients. Only six patients had more than one MEV that were very small (5 mm) veins. The posterior condylar vein (PCV) was not identified in 39 (23.5%) patients. It was found bilaterally in 97 (58.4%) and unilaterally in 30 (18.1%) patients. Only 15 patients had a very large (>5 mm) PCV. The petrosquamosal sinus (PSS) was identified only in one patient (0.6%) on the left side. The occipital sinus was found in two patients (1.2%). Conclusions: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region.

Pekcevik, Yeliz; Sahin, Hilal; Pekcevik, Ridvan

2014-01-01

215

Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects. Case presentation A 46-year-old man consulted his doctor due to symptoms of depression. He did not suffer from any allergy but drinking red wine caused vasomotor rhinitis. Antidepressive treatment with fluoxetine 20 mg daily was initiated which was successful. After three weeks of treatment an itching rash appeared. An adverse drug reaction (ADR induced by fluoxetine was suspected and fluoxetine treatment was discontinued. The symptoms disappeared with clemastine and betametasone treatment. Since the depressive symptoms returned sertraline medication was initiated. After approximately two weeks of sertraline treatment he noted an intense itching sensation in his scalp after eating a piece of chocolate cake. The itch spread to the arms, abdomen and legs and the patient treated himself with clemastine and the itch disappeared. He now realised that he had eaten a chocolate cake before this episode and remembered that before the first episode he had had a chocolate mousse dessert. He had never had any reaction from eating chocolate before and therefore reported this observation to his doctor. Conclusions This case report suggests that there may be individuals that are very sensitive to increases in serotonin concentrations. Dermal side reactions to SSRI-drugs in these patients may be due to high activity in the serotonergic system at the dermal and epidermo-dermal junctional area rather than a hypersensitivity to the drug molecule itself.

Svenson Svante

2004-11-01

216

Primitive neuroectodermal tumors in the posterior fossa: excluding medulloblastoma based on pathology  

Energy Technology Data Exchange (ETDEWEB)

Four children, with histopathologically confirmed posterior fossa primitive neuroectodermal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are not specific for primitive neuroectodermal tumors, as similar findings are seen in medulloblastoma, ependymoma and other tumors. Therefore, we think that the primitive neuroectodermal tumors should be included in the differential diagnosis when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.

Suh, Kyung Jin; Kim, Tae Hun; Kim, Yong Joo; Kang, Duk Sik; Shon, Youn Kyung [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of); Kim, Sun Young [College of Medicine, Youngnam University, Daegu (Korea, Republic of)

1992-01-15

217

The value of the examination of visuooculomotor reflexes in diagnosis of posterior cranial fossa lesions.  

Science.gov (United States)

The aim of this study was to compare the frequency of pathological types of smooth-pursuit and saccadic movements in different localizations of vestibular lesions. We tested 112 patients using videonystagmography. The smooth pursuit was appreciated qualitatively on the basis of Malecki's patterns. We analyzed the saccadic movements taking three parameters into consideration: latency, velocity, and accuracy. The patients suffered from posterior cranial fossa lesions, supratentorial damage, and peripheral vestibular disorders. We discovered that testing of smooth pursuit and saccades was very helpful in pointing to the localization of the damage in the posterior fossa. The frequency of the pathological saccadic and eye-tracking movements was similar for the different sites of deficit inside the posterior fossa, so recognizing the precise localization of lesion in this anatomical region was difficult. PMID:17147042

Ka?mierczak, Henryk; Pawlak-Osi?ska, Katarzyna

2006-01-01

218

DEMOGRAPHIC DATA COMPARISON OF PREVALENCE OF MASS IN RIGHT ILIAC FOSSA: A PROSPECTIVE HOSPITAL BASED STUDY  

Directory of Open Access Journals (Sweden)

Full Text Available Mass in the right iliac fossa is one of the commonest problems faced in surgical practice. The present study was conducted to find the incidence of mass in patients attending surgery department. A total of 50 cases were included in the study. Their demographic data was collected and analysed to find the incidence of mass in right iliac fossa. The results showed a high incidence of appendicular mass (44% with male preponderance; followed by ileocaecal tuberculosis and carcinoma of caecum. The incidence of appendicular mass was highest in the age of 21-30 years. Appendicular abscess and ileocaecal tuberculosis showed highest incidence in the age group of 31-40 years. In the age group of 51-60 years carcinoma of caecum was observed the most. Several factors like age, gender, food habits and occupation caused the development of mass in the abdomen. Coolies and agriculturists were more prone to development of mass in the right iliac fossa.

Sunil Kumar M*, Mohan, Sarath Babu K, Deepak Hongaiah, Pradeep Kumar T and Balakrishna MA

2014-03-01

219

Posterior fossa tumors and their impact on sleep and ventilatory control: a clinical perspective.  

Science.gov (United States)

The cerebellum, classically viewed as a motor structure of the brain, may play a role in respiration. Brainstem dysfunction has been implicated in sleep disordered breathing (SDB), but apnea after surgery of brain tumors in the posterior fossa, not involving the brainstem has been reported. We report four cases with posterior fossa tumors without brainstem invasion who suffered SDB after surgery diagnosed by polysomnography (PSG). Advanced MRI techniques with DTI were used to find correlations with SDB. Abnormal signals in the superior, middle and inferior cerebellar peduncles were seen in these patients with the most severe changes in the inferior peduncle. SDB may be under diagnosed in the setting of posterior fossa tumors without brainstem involvement. Damage to the cerebellar peduncles, especially the inferior cerebellar peduncle, without brainstem involvement, can cause significant disruption of respiration. PMID:23727229

Lee, Amy; Chen, Maida Lynn; Abeshaus, Sergey; Poliakov, Andrew; Ojemann, Jeffrey G

2013-11-01

220

A Case Report of Infratemporal Fossa Hydatid Cyst, an Unusual Location  

Directory of Open Access Journals (Sweden)

Full Text Available "nIntroduction: Hydatid disease has a high incidence in the countries of the temperate zone such as Iran. Only few cases in the head and neck region have been reported in literature. We described a rare case of infratemporal fossa echinococcus granulosus in a thirteen-year-old girl from an endemic area (Dashte Moghan in Iran. "nClinical findings: A thirteen-year-old girl with a right sided frozen eye and facial swelling was admitted in our hospital. In the obtained CT scan there was a cyst in the right infratemporal area. She had a past history of brain hydatid cyst. The cyst was resected and the histological diagnosis was hydatid cyst. The liver was not affected in this patient. "nConclusion: Infratemporal fossa is a rare location for hydatid disease and we should consider the diagnosis for any cystic lesion of the infratemporal fossa in an endemic area.  

Shervin Sharifkashany

2009-01-01

 
 
 
 
221

Synovial chondromatosis of the temporomandibular joint with extension to the middle cranial fossa  

Directory of Open Access Journals (Sweden)

Full Text Available A rare case of synovial chondromatosis with extension to the middle cranial fossa is reported. Synovial chondromatosis, a benign disorder characterized by multiple cartilaginous, free-floating nodules that originate from the synovial membrane is not exclusive to the temporomandibular joint (TMJ. This condition is commonly seen in the axial skeleton and can involve multiple joints. In this case, synovial chondromatosis of the TMJ led to complete bony erosion of the glenoid fossa extending into the middle cranial fossa. Although plain radiographs showed the involvement of the joint, Computed Tomography (CT and Magnetic Resonance Imaging (MRI provided more detailed information about the lesion in all three dimensions. This case demonstrates the value of CT and MRI in both the diagnosis and treatment planning. A review of previously reported cases of synovial chondromatosis with cranial extensions is included.

Mupparapu M

2005-01-01

222

Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child  

Energy Technology Data Exchange (ETDEWEB)

The fossa navicularis is a notch-like bone defect in the basiocciput that has been hitherto considered as an anatomical variant of the clivus and not previously described as a potential source of clival or skull base pathology. We report the imaging findings in a 5-year-old child who presented acutely with a retropharyngeal abscess and osteomyelitis of the clivus. Imaging after treatment revealed a ''notch-like'' defect in the anterior clivus consistent with a fossa navicularis. Based on these appearances, we postulate that the lymphoid tissue of the pharyngeal tonsil residing in the fossa navicularis served as a route through which infection spread and subsequently developed into clival osteomyelitis, which is a rare diagnosis. This case is unique, and we believe that the presence of this variant in young children may be important and is not merely an anatomical curiosity. (orig.)

Prabhu, Sanjay P.; Zinkus, Timothy [Children' s Hospital Boston and Harvard Medical School, Division of Neuroradiology, Department of Pediatric Radiology, Boston, MA (United States); Cheng, Alan G. [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States); Stanford University School of Medicine, Department of Otolaryngology, Head and Neck Surgery, Stanford, CA (United States); Rahbar, Reza [Children' s Hospital Boston and Harvard Medical School, Department of Otolaryngology and Communication Enhancement, Boston, MA (United States)

2009-09-15

223

Dynamic CSF flow study in the pathophysiology of syringomyelia associated with arachnoid cysts of the posterior fossa.  

Science.gov (United States)

Two patients with posterior fossa arachnoid cysts associated with syringomyelia are discussed adding to the five cases already reported in the literature. The formation and progression of syringomyelia secondary to a posterior fossa cyst and its possible pathophysiology by dynamic CSF flow studies using magnetic resonance (MR) imaging are discussed and reviewed. PMID:11013645

Arunkumar, M J; Korah, I; Chandy, M J

1998-02-01

224

Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa  

International Nuclear Information System (INIS)

Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late morbidity. Patients with N2 and N3 neck disease were effectively treated with radiation and the selective use of neck dissections. The concomitant boost schedule is our preferred fractionation approach for treating patients with intermediate stage tonsil cancer who are not participating in our current research protocols

1997-08-01

225

Incisive Fossa Case Report Fosa Incisiva - Reporte de un Caso  

Directory of Open Access Journals (Sweden)

Full Text Available The importance of the radiographic anatomy knowledge in the interpretation of the pathologies is undeniable. The base of this knowledge is a great familiarity with the anatomy of the region that is going to be evaluated. Thus, it is important to recognize what is considered normal, as well as the anatomical variations, so that one can identify what is pathologic. In this case report we describe a radiographic finding in leucoderm patient, 13 years old and one month, submitted to a panoramic radiography in a private clinic in São Paulo - Brazil, for evaluation of the third molars. During the radiographic reading, a bilateral radiolucid area with an inverted tear shape could be observed in the region between the roots of the lateral incisive teeth and upper canines. Although it was an image that suggested bone rarefaction, the integrity of the hard lamina was evident in both sides. During the patient's clinical examination, a bilateral asymmetry was not observed, as well as any kind of sintomatology. In our case report, according to the clinical and radiographic findings, we conclude that the diagnosis was bilateral incisive fossa.La importancia de los conocimientos de anatomía radiográfica en la interpretación de las patologías es innegable. La base de este conocimiento es familiarizarse con la anatomía de la región que va a ser evaluada. Por tanto, es importante reconocer lo que se considera normal, así como las variaciones anatómicas y, de esta manera, identificar lo que es patológico. En este caso clínico, se describe un hallazgo radiológico en un paciente leucodérmico, de 13 años y un mes de edad, quiense realizó, para la evaluación de los terceros molares, una radiografía panorámica en una clínica privada en São Paulo - Brasil. Durante la lectura radiológica, se pudo observar en la región entre las raíces de los dientes incisivos laterales y caninos superiores una zona radiolúcida bilateral con una forma de lágrima invertida. Aunque era una imagen que sugería rarefacción ósea, la integridad de la lámina dura se hizo evidente en ambos lados. Durante la exploración clínica del paciente, no se observó una asimetría bilateral, así como cualquier tipo de sintomatología. En este caso, de acuerdo con los hallazgos clínicos y radiográficos, se concluye que el diagnóstico es la presencia de una fosa incisiva bilateral.

Nilton Alves

2010-09-01

226

Incisive Fossa Case Report / Fosa Incisiva - Reporte de un Caso  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish La importancia de los conocimientos de anatomía radiográfica en la interpretación de las patologías es innegable. La base de este conocimiento es familiarizarse con la anatomía de la región que va a ser evaluada. Por tanto, es importante reconocer lo que se considera normal, así como las variaciones [...] anatómicas y, de esta manera, identificar lo que es patológico. En este caso clínico, se describe un hallazgo radiológico en un paciente leucodérmico, de 13 años y un mes de edad, quiense realizó, para la evaluación de los terceros molares, una radiografía panorámica en una clínica privada en São Paulo - Brasil. Durante la lectura radiológica, se pudo observar en la región entre las raíces de los dientes incisivos laterales y caninos superiores una zona radiolúcida bilateral con una forma de lágrima invertida. Aunque era una imagen que sugería rarefacción ósea, la integridad de la lámina dura se hizo evidente en ambos lados. Durante la exploración clínica del paciente, no se observó una asimetría bilateral, así como cualquier tipo de sintomatología. En este caso, de acuerdo con los hallazgos clínicos y radiográficos, se concluye que el diagnóstico es la presencia de una fosa incisiva bilateral. Abstract in english The importance of the radiographic anatomy knowledge in the interpretation of the pathologies is undeniable. The base of this knowledge is a great familiarity with the anatomy of the region that is going to be evaluated. Thus, it is important to recognize what is considered normal, as well as the an [...] atomical variations, so that one can identify what is pathologic. In this case report we describe a radiographic finding in leucoderm patient, 13 years old and one month, submitted to a panoramic radiography in a private clinic in São Paulo - Brazil, for evaluation of the third molars. During the radiographic reading, a bilateral radiolucid area with an inverted tear shape could be observed in the region between the roots of the lateral incisive teeth and upper canines. Although it was an image that suggested bone rarefaction, the integrity of the hard lamina was evident in both sides. During the patient's clinical examination, a bilateral asymmetry was not observed, as well as any kind of sintomatology. In our case report, according to the clinical and radiographic findings, we conclude that the diagnosis was bilateral incisive fossa.

Nilton, Alves.

227

Arachnoid cyst of the middle fossa and subdural hygroma: an uncommon association  

International Nuclear Information System (INIS)

The middle fossa is the most common site for arachnoid cysts and the presence of subdural hematomas has been well-established. Occasionally, as a consequence of mild cranial trauma, or even spontaneously, the capsule of the cyst can be damaged, allowing part of the contents to empty into the extra cerebral compartment. We present two cases of congenital arachnoid cysts of middle fossa media complicated by subdural hygroma and intracranial hypertension, and we discuss the possible mechanisms involved in this uncommon association. 9 refs

1995-01-01

228

Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach.  

Science.gov (United States)

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar accidentally displaced into the pterygopalatine fossa is presented, and the removal of the tooth via intraoral approach is described. PMID:23476814

Ozer, Nedim; Uçem, Fulya; Saruhano?lu, Alp; Yilmaz, Serdar; Tanyeri, Hakk?

2013-01-01

229

Visualization of extra-axial mass in posterior fossa with metrizamide (Amipaque) CT cisternography  

International Nuclear Information System (INIS)

Metrizamide (Amipaque) CT cisternography were performed to 20 adult cases. Discussed is CT image visualization of 15 cases of posterior fossa lesions. 170 mgl/ml of Metrizamide concentration is sufficient for visualization. Posterior fossa cisterns were well visualized and helpful to analyse relationships between brain parenchym, extra-axial lesion, and bony structure. In C-P angle mass cases, cases larger than 3 cm in diameter gave poor visualization of surrounding subarachnoidal space. High density mass case showed disappearance of mass in high density cisternal image. No severe side effect of contrast media was observed. (author)

1979-01-01

230

Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery  

Energy Technology Data Exchange (ETDEWEB)

We report the MRI findings in a girl aged 3 years and 10 months who developed a spinal subdural haematoma after posterior fossa open surgery for cerebellar malignant rhabdoid tumour. Emergency surgery was performed immediately because of increased intracranial pressure. Control MRI 48 h after surgery showed a spinal subdural haematoma without clinical signs of paresis or bladder dysfunction. Spinal subdural haematoma is rare, and only few cases have been reported, especially in children. This report suggests that ''silent'' (without clinical symptoms) postoperative spinal acute subdural haemorrhage can occur after posterior fossa surgery. (orig.)

Porto, L.; Turowski, B.; Lanfermann, H.; Zanella, F.E. [Institut fuer Neuroradiologie, Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany); Kieslich, M. [Neuropediatric Department, Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany)

2002-05-01

231

Evaluation of linear tomography accuracy in localization of nasal fossa and maxillary sinus  

Directory of Open Access Journals (Sweden)

Full Text Available Background and Aim: Accurate measurement of bone height and width is essential prior to dental implant placement. The method of surgery as well as, the type and size of implants are determined according to dimensions of the residual bone. The purpose of this study was to evaluate the accuracy of linear tomography in localization of the floor of nasal fossa and maxillary sinus, and to determine the width of maxillary bone at the designated site for implant placement.Materials and Methods: In this test evaluation study, the vertical distances between the alveolar crest and the floor of nasal fossa and the floor of maxillary sinus was measured by the tomographic slices in 12 sites of three dry human skulls. In addition, the width of maxillary bone was measured at the same slices. The skulls were then sectioned through the marked places. Then the radiographic values were compared with the real values of bone sections.Results: After correction of tomographic values by the magnification factor of the unit, the mean absolute measurement error for vertical values at nasal fossa and maxillary sinus area in tomographic slices were 0.28 mm (SD= 0.24 and 1.1 mm (SD= 0.68 respectively. The mean absolute measurement error for maxillary width at the nasal fossa and maxillary sinus area were 0.65 mm (SD= 0.50 and 0.55 mm (SD= 0.45 respectively. 100 % of vertical values at nasal fossa area and 50 % of vertical values at maxillary sinus area were within ± 1 mm error limit. In addition, 50 % of width measurements at nasal fossa area and 83.3 % at maxillary sinus area were within ± 1 mm error limit.Conclusion: The linear tomography is more accurate in height estimation at nasal fossa area and in width estimation at maxillary sinus area. The accuracy of linear tomography in height and width estimation is within acceptable limits at both nasal fossa and maxillary sinus area.

Talaeipour AR.

2007-07-01

232

Spontaneous decompression of a posterior fossa arachnoid cyst: a case report.  

Science.gov (United States)

The authors present a case of spontaneous regression of a posterior fossa, supracerebellar arachnoid cyst causing hydrocephalus in a 7-month-old male child. The patient presented with macrocrania, bulging fontanelle and upgaze paresis of the eyes. There was complete improvement of these symptoms on the morning of the day of surgery without any obvious precipitating factors, including trauma. CT scan showed complete resolution of the cyst and hydrocephalus. The child was doing well at 1 year of follow-up. To the best of our knowledge, this is the first case report of spontaneous resolution of a posterior fossa arachnoid cyst. PMID:11641628

Pandey, P; Tripathi, M; Chandra, P S; Singh, V P; Mehta, V S

2001-09-01

233

Meningoencefalitis aséptica como manifestación de un síndrome de rash con eosinofilia y síntomas sistémicos asociados a drogas por lamotrigina / Aseptic meningoencephalitis as infectation of a sindrome of rash with eosinophilia and systemic symptoms associated with drugs caused by lamotrigine  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La meningitis aséptica (MA) se define por la presencia de hallazgos en el líquido cefalorraquídeo compatibles con una meningitis, sin que se logre aislar una bacteria que la produzca. Las causas de MA son diversas, entre las que se encuentran las drogas. Entre los fármacos que más frecuentemente se [...] han asociado a MA, se encuentran los antiinflamatorios no esteroidales, antibióticos, inmunoglobulinas y anticonvulsivantes aromáticos. Cuando la MA forma parte de una respuesta sistémica que acompaña a una manifestación cutánea, puede tratarse de un rash con eosinofilia y síntomas sistémicos asociado a drogas (DRESS, acrónimo derivado del inglés DrugRash with Eosinophilia and Systemic Symptoms), considerada una reacción adversa grave a medicamentos. La lamotrigina es un anticonvulsivante no aromático ampliamente utilizado para el tratamiento de la epilepsia y el trastorno bipolar que ha sido asociada con MA. Comunicamos un caso de meningoencefalitis aséptica como manifestación de DRESS asociado al uso de lamotrigina. Abstract in english Aseptic meningitis (AM) is defined by the presence of cerebrospinal fluid findings consistent with meningitis, without achieving the isolation of a bacterium that produces it. Drugs are one of the diverse causes of AM. Drugs frequently associated with AM include immunoglobulin's, nonsteroidal anti-i [...] nflammatory, antibiotics, and aromatic anticonvulsants. When AM is part of a systemic response accompanying a cutaneous manifestation it may be a DRESS (Drug Rash with Eosinophilia and Systemic Symptoms), considered a serious adverse reaction to drugs. Lamotrigine is a non-aromatic anticonvulsant widely used for the treatment of epilepsy and bipolar disorder, which has been associated with AM. We report a case of aseptic meningoencephalitis as a manifestation of DRESS associated to lamotrigine.

Pablo, Reyes S; Paulina, Silva P.

234

Revised classification of posterior fossa cysts and cystlike malformations based on the results of multiplanar MR imaging.  

Science.gov (United States)

MR and clinical data on 31 patients with posterior fossa CSF collections were analyzed. A clear separation of these patients into classical categories was not possible because of new information obtained from the MR images. We present a new classification of these disorders. The Dandy-Walker malformation, Dandy-Walker variant, and mega-cisterna magna seem to represent a continuum of developmental anomalies of the posterior fossa. A possible embryologic basis for this continuum is suggested. Discrete posterior fossa CSF collections that are clearly separate from the fourth ventricle and vallecula are classified as posterior fossa cysts. Posterior fossa CSF collections that communicate with the fourth ventricle and are associated with cerebellar atrophy are classified as prominent cisterna magna. Both the Dandy-Walker complex and posterior fossa cysts can cause enlargement of the posterior fossa and scalloping of the inner table of the occipital bone. The Dandy-Walker complex presents with seizures, developmental delay, and enlarging head size; it requires CSF diversion when associated with hydrocephalus. Posterior fossa cysts present with symptoms of a posterior fossa mass; they generally require surgical resection. Prominent cisterna magna is a result of degenerative disorders and requires no surgical therapy. This new classification facilitates both diagnosis and therapy of these disorders. MR revealed that disorders previously referred to as the Dandy-Walker malformation, the Dandy-Walker variant, and the mega-cisterna magna actually are not separate entities, but appear to represent steps on a continuum of developmental anomalies of the posterior fossa. Because of this, we suggest a new term, the Dandy-Walker complex, be used to describe this continuum. PMID:2816648

Barkovich, A J; Kjos, B O; Norman, D; Edwards, M S

1989-12-01

235

Does Sunscreen Prevent Epidermal Growth Factor Receptor (EGFR) Inhibitor-Induced Rash? Results of a Placebo-Controlled Trial from the North Central Cancer Treatment Group (N05C4)  

Science.gov (United States)

Purpose. Rash occurs in >50% of patients prescribed epidermal growth factor receptor (EGFR) inhibitors. This study was undertaken to determine whether sunscreen prevents or mitigates these rashes. Methods. This placebo-controlled, double-blinded trial enrolled rash-free patients starting an EGFR inhibitor. Patients were randomly assigned to sunscreen with a sun protection factor of 60 applied twice a day for 28 days versus placebo. They were then monitored for rash and quality of life (Skindex-16) during the 4-week intervention and for an additional 4 weeks. Results. Fifty-four patients received sunscreen, and 56 received placebo; the arms were balanced at baseline. During the 4-week intervention, physician-reported rash occurred in 38 (78%) and 39 (80%) sunscreen-treated and placebo-exposed patients, respectively (p = 1.00); no significant differences in rash rates emerged over the additional 4 weeks. There were no significant differences in rash severity, and patient-reported outcomes of rash yielded similar conclusions. Adjustment for sun intensity by geographical zone, season, and use of photosensitivity medications did not yield a significant difference in rash across study arms (p = .20). Quality of life scores declined but remained comparable between arms. Conclusions. Sunscreen, as prescribed in this trial, did not prevent or attenuate EGFR inhibitor–induced rash.

Thrower, Abby; Sloan, Jeff A.; Flynn, Patrick J.; Wentworth-Hartung, Nicole Lea; Dakhil, Shaker R.; Mattar, Bassam I.; Nikcevich, Daniel A.; Novotny, Paul; Sekulic, Aleksandar; Loprinzi, Charles L.

2010-01-01

236

"The Clock Is Ticking": The Timely Management of a Painful Skin Rash in a Seventy-Year-Old Woman  

Science.gov (United States)

Necrotizing fasciitis is an uncommon but a potentially fatal condition and can affect any part of the body. Most patients have pre-existing conditions that render them susceptible to infection, although etiology is unclear. Diagnosis is primarily clinical and is often delayed because of the unfamiliarity of the condition among clinicians. Management consists of immediate resuscitation, early surgical debridement, and administration of broad spectrum intravenous antibiotics. We report a case of a 70 year old woman who presented with a painful erythematous rash, was admitted as a case of cellulitis, later developed worsening of symptoms and septic shock, and was diagnosed as necrotizing fasciitis.

Patel, Vijaykumar G.; Nichols, Michelle L.

2014-01-01

237

Confirmation of rubella within 4 days of rash onset: comparison of rubella virus RNA detection in oral fluid with immunoglobulin M detection in serum or oral fluid.  

Science.gov (United States)

Rubella virus infection is typically diagnosed by the identification of rubella virus-specific immunoglobulin M (IgM) antibodies in serum, but approximately 50% of serum samples from rubella cases collected on the day of rash onset are negative for rubella virus-specific IgM. The ability to detect IgM in sera and oral fluids was compared with the ability to detect rubella virus RNA in oral fluids by reverse transcription-PCR (RT-PCR) by using paired samples taken within the first 4 days after rash onset from suspected rubella cases during an outbreak in Perú. Sera were tested for IgM by both indirect and capture enzyme immunoassays (EIAs), and oral fluids were tested for IgM by a capture EIA. Tests for IgM in serum were more sensitive for the confirmation of rubella than the test for IgM in oral fluid during the 4 days after rash onset. RT-PCR confirmed more suspected cases than serum IgM tests on days 1 and 2 after rash onset. The methods confirmed approximately the same number of cases on days 3 and 4 after rash onset. However, a few cases were detected by serum IgM tests but not by RT-PCR even on the day of rash onset. Nine RT-PCR-positive oral fluid specimens were shown to contain rubella virus sequences of genotype 1C. In summary, RT-PCR testing of oral fluid confirmed more rubella cases than IgM testing of either serum or oral fluid samples collected in the first 2 days after rash onset; the maximum number of confirmations of rubella cases was obtained by combining RT-PCR and serology testing. PMID:19005151

Abernathy, Emily; Cabezas, Cesar; Sun, Hong; Zheng, Qi; Chen, Min-hsin; Castillo-Solorzano, Carlos; Ortiz, Ana Cecilia; Osores, Fernando; Oliveira, Lucia; Whittembury, Alvaro; Andrus, Jon K; Helfand, Rita F; Icenogle, Joseph

2009-01-01

238

Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid ?  

Science.gov (United States)

Rubella virus infection is typically diagnosed by the identification of rubella virus-specific immunoglobulin M (IgM) antibodies in serum, but approximately 50% of serum samples from rubella cases collected on the day of rash onset are negative for rubella virus-specific IgM. The ability to detect IgM in sera and oral fluids was compared with the ability to detect rubella virus RNA in oral fluids by reverse transcription-PCR (RT-PCR) by using paired samples taken within the first 4 days after rash onset from suspected rubella cases during an outbreak in Perú. Sera were tested for IgM by both indirect and capture enzyme immunoassays (EIAs), and oral fluids were tested for IgM by a capture EIA. Tests for IgM in serum were more sensitive for the confirmation of rubella than the test for IgM in oral fluid during the 4 days after rash onset. RT-PCR confirmed more suspected cases than serum IgM tests on days 1 and 2 after rash onset. The methods confirmed approximately the same number of cases on days 3 and 4 after rash onset. However, a few cases were detected by serum IgM tests but not by RT-PCR even on the day of rash onset. Nine RT-PCR-positive oral fluid specimens were shown to contain rubella virus sequences of genotype 1C. In summary, RT-PCR testing of oral fluid confirmed more rubella cases than IgM testing of either serum or oral fluid samples collected in the first 2 days after rash onset; the maximum number of confirmations of rubella cases was obtained by combining RT-PCR and serology testing.

Abernathy, Emily; Cabezas, Cesar; Sun, Hong; Zheng, Qi; Chen, Min-hsin; Castillo-Solorzano, Carlos; Ortiz, Ana Cecilia; Osores, Fernando; Oliveira, Lucia; Whittembury, Alvaro; Andrus, Jon K.; Helfand, Rita F.; Icenogle, Joseph

2009-01-01

239

Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.  

Science.gov (United States)

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury. PMID:21862340

Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

2012-07-01

240

Analysis of Patterns of Aeolian Processes in the Medusa Fossae Region  

Science.gov (United States)

The team proposes an indirect method to quantify the wind effects on Mars’ surface. We look to measure the dimensions of yardangs, to determine whether characteristics of aeolian processes are related to the characteristics of yardangs in the Medusa Fossae region.

Figueroa, M.; Amara, S.; Das, S.; Nagarajan, S.; Prasad, T.

2011-03-01

 
 
 
 
241

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature. Case presentation We report two cases of people (a 23-year-old man and a 41-year-old man with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma. Conclusion It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

Pillai Promod

2009-02-01

242

High-resolution CT of the pterygopalatine fossa and its communications  

International Nuclear Information System (INIS)

The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via eight foramina and canals. We studied the pterygopalatine fossa, foramen rotundum, inferior orbital fissure, sphenopalatine foramen, pterygoid canal, greater and lesser palatine foramen, palatinovaginal canal, and the pterygomaxillary fissure with high-resolution CT to characterise the anatomy and variants of these structures. These structures were evaluated using axial and coronal planes. In the morphometric study, the distance between the foramina rotunda did not show statistically significant differences between the anterior and posterior segments. The pterygoid canal was slightly narrower in the anterior segment (23.9 mm) than in the posterior segment (25.2 mm). The pterygoid canal narrowed in the anterior (1.8 mm) to posterior (1.2 mm) direction (P < 0.01). The distance between the pterygoid canal and the lower wall of the sphenoid sinus was 2.2 mm anteriorly and 2.8 mm posteriorly (P < 0.01). The pterygoid canal showed various relationships with the sphenoid and ethmoid sinuses. In addition, a previously unreported situation, where the foramen rotundum was surrounded by the spheroid sinus, was observed. (orig.). With 4 figs., 2 tabs

1996-05-01

243

High-resolution CT of the pterygopalatine fossa and its communications  

Energy Technology Data Exchange (ETDEWEB)

The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via eight foramina and canals. We studied the pterygopalatine fossa, foramen rotundum, inferior orbital fissure, sphenopalatine foramen, pterygoid canal, greater and lesser palatine foramen, palatinovaginal canal, and the pterygomaxillary fissure with high-resolution CT to characterise the anatomy and variants of these structures. These structures were evaluated using axial and coronal planes. In the morphometric study, the distance between the foramina rotunda did not show statistically significant differences between the anterior and posterior segments. The pterygoid canal was slightly narrower in the anterior segment (23.9 mm) than in the posterior segment (25.2 mm). The pterygoid canal narrowed in the anterior (1.8 mm) to posterior (1.2 mm) direction (P < 0.01). The distance between the pterygoid canal and the lower wall of the sphenoid sinus was 2.2 mm anteriorly and 2.8 mm posteriorly (P < 0.01). The pterygoid canal showed various relationships with the sphenoid and ethmoid sinuses. In addition, a previously unreported situation, where the foramen rotundum was surrounded by the spheroid sinus, was observed. (orig.). With 4 figs., 2 tabs.

Kim, H.S. [Department of Diagnostic Radiology, Severance Hospital, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of); Kim, D.I. [Department of Diagnostic Radiology, Severance Hospital, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of); Chung, I.H. [Department of Anatomy, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of)

1996-05-01

244

Ameloblastoma de fossa nasal: revisão bibliográfica e relato de dois casos  

Directory of Open Access Journals (Sweden)

Full Text Available O ameloblastoma é um tumor bastante incomum na cavidade nasal. Surge a partir do epitélio odontogênico, podendo estender-se ao seio maxilar, órbitas e base de crânio. Apresentamos dois casos de ameloblastoma em fossa nasal direita, associados a sintomas nasossinusais e seus principais achados, clínicos e cirúrgicos.

Almeida Washington L. C.

2001-01-01

245

Teratoma of the posterior fossa CT and MR aspects A case  

International Nuclear Information System (INIS)

The CT and MR findings are reported for a patient diagnosed as having teratoma of the posterior fossa with onset in the form of intracranial hypertension. The objective of this article is to report the detection of the lesion, as well as its origin in the closure defect of the cranial cavity with the formation of a cutaneous fistula, and review the recent literature

1994-01-01

246

A Rare Case of Metastatic Renal Cell Carcinoma in Posterior Fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Renal cell carcinoma (RCC is a tumor with high degree of potentiality for distant metastasis. Intracranial metastasis is a very rare location for this tumor. Here is presented a 47-year-old female with history of RCC and cerebellar metastasis. Key Words: Renal Cell Carcinoma, Metastasis, Posterior Fossa

H Moin

2005-09-01

247

A new morphometric method for the sella turcica and the hypophyseal fossa and its clinical relevance.  

Science.gov (United States)

The sella turcica and the hypophyseal fossa should be considered different entities, the latter being part of the former. Their morphology and dimensions correlate to some extent with those of the contained pituitary gland and have, for this reason, attracted the interest of anatomists and radiologists. With the application of MRI, however, these data are of limited use in the diagnosis of pituitary disorders, although they remain valuable with regard to a microsurgical approach to the hypophysis. The proposed morphometric method was applied to 20 dry skulls. We first made casts of the corresponding sellae. Their volumes were then measured by immersion. The frontal section of each hypophyseal fossa was obtained through its deepest point and magnified. The Cartesian co-ordinates of the contour of the section were used to evaluate the corresponding area and centroid. The volume of each fossa was finally obtained by the use of Pappus' theorem applied to solids of rotation. The volumes of the sellae obtained as above ranged from 460 mm3 to 1570 mm3 with a mean value of 835 mm3. These figures are comparable to those reported from previous authors. To our knowledge the method described has enabled a close approximation of the volumes of the hypophyseal fossae to be made for the first time. These volumes ranged from 24 mm3 to 300 mm3, with a mean value of 157 mm3. Similar numerical methods might be applicable in vivo by the use of MR imaging. PMID:16425149

Venieratos, D; Anagnostopoulou, S; Garidou, A

2005-11-01

248

Developmental arachnoid cysts of the posterior fossa-an analysis of 13 cases.  

Science.gov (United States)

Thirteen cases of posterior fossa arachnoid cyst are described. Presenting features were usually headache, vomiting, lethargy, and delayed development in infants. Association with congenital defects is sometimes noted. The cysts are considered to result from abnormalities occurring in foetal life. PMID:602849

Averback, P

1977-01-01

249

Cisternography and CT scanning with 111In-DTPA in evaluation of posterior fossa arachnoid cysts.  

Science.gov (United States)

A patient with a large, long-standing posterior fossa arachnoid cyst was evaluated. Computed tomography was used to demonstrate the cyst. 1111In-DTPA cisternography demonstrated the communication of the cyst with the subarachnoid space, stasis of the 111In in the cystic space, and incomplete ascent of cerebrospinal fluid over the cerebral hemispheres. PMID:477145

Lusins, J; Nakagawa, H; Sorek, M; Goldsmith, S

1979-04-01

250

Osteoma of anterior cranial fossa complicated by intracranial mucocele with emphasis on its radiological diagnosis  

Directory of Open Access Journals (Sweden)

Full Text Available We present a 43-year-old female patient who had recurrent headache for one year. An intracranial bony lesion surrounded by a cyst in the anterior cranial fossa was found on imaging. Postoperative histological examination confirmed the diagnosis of osteoma and mucocele.

Ye Jinhu

2008-01-01

251

Osteoma of anterior cranial fossa complicated by intracranial mucocele with emphasis on its radiological diagnosis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We present a 43-year-old female patient who had recurrent headache for one year. An intracranial bony lesion surrounded by a cyst in the anterior cranial fossa was found on imaging. Postoperative histological examination confirmed the diagnosis of osteoma and mucocele.

2008-01-01

252

[Post-traumatic arteriovenious fistula of the posterior fossa (author's transl)].  

Science.gov (United States)

The authors report a case of post-traumatic arterioveinous fistula of the dura-mater associated with an extradural hematoma of the posterior fossa. The traumatic nature of the lesion is confirmed by the presence of an occipital fracture facing the fistule responsable for the extradural hematoma. The authors have found on similar case citied in the literature (11). PMID:752817

Petrov, V; Stevenaert, A; Collignon, J

1978-01-01

253

The significance of the pterygopalatine fossa angiography before endoscopic sinus surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Objective?To investigate the value of pterygopalatine fossa angiography in fresh cadaveric heads, so as to provide a useful guidance and an individualized operative procedure for endoscopic sinus surgery. Methods?Three fresh cadaveric heads were used in the present study. After injection with 10%, 5% iodine fluorine into carotid artery, 3D vascular structure of the pterygopalatine fossa was constructed. The posterior wall of the maxillary sinus was dissected by gently removing the fat tissue with sinus forceps. All anatomical structures, such as vascular, nerve and muscle structures were then exposed. The anatomical characteristics of vasculature in the pterygopalatine fossa and the imaging data were compared. Results?The pterygopalatine segment at the third portion of the MA was well shown in the imaging system. According to Morton and Khan morphologic classification of the third portion of the internal maxillary artery, the proportion of Y type, M type, and intermediate type was 33.3%, 16.7% and 50.0%, respectively. Using an endoscopic endonasal approach, the PPF was exposed through its anteromedial surface. The first visible structures would be the branches of the MA. It appeared that the anatomical land-markers of the pterygopalatine fossa area was well shown by both intranasal endoscopic view and imaging data. Conclusion?CTA is a useful technique for pterygopalatine fossa imaging before surgical dissection. The terminal segment of MA provides direct anatomical topography features of the PPF. This technique provides useful information for the individual surgery in this area. DOI: 10.11855/j.issn.0577-7402.2013.11.013

Hong-yu XING

2013-11-01

254

What are the advantages of the endoscopic canine fossa approach in treating maxillary sinus aspergillomas?  

Science.gov (United States)

Aspergilloma of the maxillary sinus is a non-invasive mycotic infection of the immunocompetent host. Nowadays its treatment remains surgical removal, and endoscopic endonasal middle meatus antrostomy is retained as the most popular approach. In our experience, a complementary endoscopic canine fossa approach is often needed to achieve a complete resection of the fungus ball. This fact led us to ask ourselves if an isolated endoscopic canine fossa approach had any advantages over the endonasal middle meatus antrostomy. In this paper we retrospectively analyse the results of the surgical treatment of 31 patients presenting maxillary sinus aspergillomas. These patients were all operated between January 1997 and January 2003 in our Otolaryngology Department. They were divided in three groups. Group A included 10 patients operated through an endonasal middle meatotomy only, group B included 9 patients who were operated through a combined approach (endonasal middle meatus antrostomy and endoscopic canine fossa approach), and group C included 12 patients who were operated through an endoscopic canine fossa approach alone. No recurrences were noted in any group, but in group B three patients presented mild complications like persistent purulent discharge through the meatotomy and nasal crusting. The endoscopic canine fossa approach offers several advantages over other techniques. These include an optimal visualization of all maxillary sinus walls and recesses, the possibility of performing the procedure under local anaesthesia and on an outpatient basis, the preservation of the anatomy and physiology of the natural maxillary ostium and an easy removal of the eventual foreign bodies of dental origin in the sinusal cavity that could favourite the development of an aspergilloma. PMID:15626257

Chobillon, Marcos Alejandro Jiménez; Jankowski, Roger

2004-12-01

255

Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation  

Energy Technology Data Exchange (ETDEWEB)

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

Wadin, K.; Thomander, L.; Wilbrand, H.

256

Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas / Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações n [...] o tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos) operados entre 2002 e 2006 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%). Todos os tumores eram histologicamente benignos. Dois pacientes (8%) apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%). Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (média 31,5±20,1 meses), não houve recidiva. A minicraniotomia supra-orbitária superciliar é uma via de abordagem eficaz para o tratamento de meningiomas da fossa craniana anterior e para-selares selecionados. Abstract in english The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approa [...] ch to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years) operated on between 2002 and 2006 through a supra-orbital eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%). All tumors were histologically benign. Two patients (8%) experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%). One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months), with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.

Manoel Antonio de, Paiva-Neto; Oswaldo Inácio de, Tella-Jr.

257

Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada at...

2013-01-01

258

Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 m...

Costa Jr, Leodante B.; Agustinho de Andrade; Gustavo Fonseca Valadão

2004-01-01

259

Tumor promotion by 12-O-tetradecanoylphorbol-13-acetate in an ultra-short-term skin carcinogenesis bioassay using rasH2 mice.  

Science.gov (United States)

Assessment of the skin tumor-promoting potential of 12-O-tetradecanoylphorbol-13-acetate (TPA) after initiation with 7,12-dimethylbenz[a]anthracene (DMBA) was conducted using rasH2 transgenic (Tg) mice and their nontransgenic (non-Tg) littermates. Mice were treated with DMBA (50 ?g/100 ?L acetone) on clipped back skin at the commencement of the study, and 1 week thereafter, TPA was applied at 8 ?g/200 ?L or 4 ?g/200 ?L acetone, once or twice weekly, for 7 weeks. Skin nodules were observed in the rasH2 Tg mice from week 4, and the incidence reached 100% at weeks 5 and 6. The number of skin nodules (multiplicity) in the 8-?g twice-weekly, 8-?g once-weekly, 4-?g twice-weekly, and 4-?g once-weekly groups was 62.4, 46.2, 62.6, and 36.9, respectively. The non-Tg mice also developed skin nodules, but the sensitivity to induction in the rasH2 Tg mice was higher. No nodules were observed in the acetone groups, but single nodules were apparent in the no-treatment rasH2 Tg and non-Tg groups. In conclusion, skin promotion effects could be detected within only 8 weeks in the rasH2 mice, and the concentration of 4 ?g TPA once weekly was sufficient as a positive control. This short-term skin carcinogenesis bioassay using rasH2 mice could represent a useful tool for the assessment of drug and chemical safety with cutaneous treatment. PMID:23610217

Kawabe, M; Urano, K; Suguro, M; Numano, T; Taguchi, F; Tsutsumi, H; Furukawa, F

2013-09-01

260

Posterior fossa arachnoid cyst presenting with an isolated twelfth nerve paresis. Case report and review of the literature.  

Science.gov (United States)

An unusual case of a posterior fossa arachnoid cyst containing atypical fluid is described in a patient presenting with an isolated ipsilateral twelfth nerve paresis. Despite the chronicity of symptoms, surgical decompression resulted in a satisfactory functional recovery. PMID:1651196

Cartwright, M J; Eisenberg, M B; Page, L K

1991-01-01

 
 
 
 
261

History and morphology of faulting in the Noctis Labyrinthus-Claritas Fossae Region of Mars  

International Nuclear Information System (INIS)

The topographically high areas cut by Noctis Labyrinthus, Noctis Fossae, and Claritas Fossae were subjected to only minor resurfacing during and following local tectonic activity. Principal resurfacing materials consist of lava flows from Syria Planum and Tharsis Montes. Thus, these areas preserve much of the fault record produced by tectonism in this region. Although recent geologic maps of the area have been produced from Viking images, the only detailed fault histories available until now were described from Mariner 9 images. Much of the faulting in the Tharsis tectonic province was centered in Syria Planum; therefore, understanding the fault history in this region is critical to understanding the stress history and tectonism of Tharsis as a whole

1987-05-01

262

Dose Attenuation in the Mid-Cranial Fossa with 6 MV photon Beam Irradiations  

International Nuclear Information System (INIS)

In X-ray irradiation, dose distribution depends on multiple parameters, one of them being tissue inhomogeneity to change the dose significantly. Considerable dose attenuation through the mid-cranial fossa is expected because of various bony structures in it. Dose distribution around the mid-cranial fossa, following irradiation with 6 MV photon beam, was measured with LiF TLD micro-rod, and compared with the expected dose in the same sites. In our calculation with Cf(correction factor), the expected dose attenuation revealed about 3.74% per 1 cm thickness of bone tissue. And the differences between the expected dose with correction for bone tissue and the measured dose by TLD was small, agreeing within an average variation of ±0.21%

1990-06-01

263

Repair of spontaneous cerebrospinal fluid otorrhea from defect of middle cranial fossa.  

Science.gov (United States)

Spontaneous cerebrospinal fluid (CSF) otorrhea is defined as CSF otorrhea where there are no identifiable causes including previous trauma, surgery, infection, neoplasm or congenital anomaly. The condition is rare. The origin of CSF leak is commonly a defect in the tegmen of the middle cranial fossa. The pathophysiology of spontaneous CSF otorrhea is unclear. Two theories of the etiology of bony defects of the temporal bone are the congenital bony defect theory and arachnoid granulation theory. The authors experienced a case of a 49-year-old female patient admitted with the complaint of persistent right ear fullness. Computed tomography revealed a large defect of the middle fossa and suspicious CSF otorrhea through the defect of tegmen tympani. Repair was successful with multiple bone chips using the transmastoid approach. The postoperative course was good and there has been no recurrence of the CSF leakage. PMID:24653924

Boo, Sung Hyun; Goh, Young Bum; Han, Chi-Sung

2013-12-01

264

Magnetic resonance imaging findings of true bifid mandibular condyle with duplicated mandibular fossa.  

Science.gov (United States)

Bifid mandibular condyle (BMC) is a rare asymptomatic morphological alteration with no predilection for age group or gender. Its morphology varies from a shallow groove to two condylar heads with separate necks, oriented mediolaterally or anteroposteriorly. This report describes an unusual case of anteroposterior bifid condyle in a 39-year-old female patient with the main complaint of mouth-opening limitation and a deviation of the mandible to the left side. Magnetic resonance imaging (MRI) findings revealed a bifid condyle on the left side and duplicated mandibular fossa, with the articular disc over the anterior head. The MRI images in the open-mouth position revealed minimal movement of the condyle. Despite the increased number of mediolateral bifid mandibular condyle cases described in the literature, none of previously reported cases of BMC included an anteroposterior bifid condyle case with two distinct mandibular fossa. PMID:22674644

Melo, S L S; Melo, D P; Oenning, A C C; Haiter-Neto, F; Almeida, S M; Campos, P S F

2012-07-01

265

[Pseudodiverticulitis coeci--the atypical etiology of right iliac fossa pain--a case report].  

Science.gov (United States)

The aim of our paper is to show on the diagnosis of coecal diverticul as infrequent reason of right iliac fossa pain. We present the case report of 43-years old woman, which underwent appendectomy some years sooner, and was accepted into the hospital because of 48-hours taking right iliac fossa pain. Local peritoneal irritation was present. During laparotomy resection of right colon with the toilette of abdominal cavity was performed. Histology diagnosed the right colon pseudodiverticulitis. In case of diagnosis of right colon pseudodiverticulitis before surgery and without peritoneal irritation, the most of authors recommend the conservative management with antibiotics. If the surgery is required, the local resection of diverticul with appendectomy is recommended. If the local resection is not possible, the ileocoecal resection has lower mortality as the right hemicolectomy. PMID:20731317

Toporcer, T; Harbul'ak, P; Baumöhlová, H; Lakyová, L; Radonak, J

2010-07-01

266

Hypertrophic olivary degeneration with gadolinium enhancement after posterior fossa surgery in a child with medulloblastoma.  

Science.gov (United States)

Hypertrophic olivary degeneration (HOD) is a rare transsynaptic form of degeneration occurring secondary to the disruption of the dentato-rubro-olivary pathway ("Guillain-Mollaret triangle"). HOD can be caused by ischemic, hemorrhagic, traumatic, or neoplastic lesions, and it can also occur following posterior fossa surgery. MRI characteristics of HOD include T2 signal increase and hypertrophy. To date, blood–brain barrier disruption has not been reported in HOD. Here, we present the first case of HOD with temporary gadolinium enhancement in a 10-year-old child 7 months after resection of a posterior fossa medulloblastoma. The recognition of gadolinium enhancement as a radiological feature of HOD may help to distinguish between this benign secondary condition and tumor recurrence. PMID:24122017

Nowak, Johannes; Alkonyi, Balint; Rutkowski, Stefan; Homola, György A; Warmuth-Metz, Monika

2014-05-01

267

Surgical approach to the pterygopalatine fossa-comparison between anterior approach and lateral approach.  

Science.gov (United States)

The anterior and the lateral approach for resecting an invading tumor in the pterygopalatine fossa region were compared. An anterior approach was applied for resecting a malignancy that originated from the maxillary tuberosity, upper hard plate, and maxillary sinus, and a lateral approach was applied for resecting a malignancy that originated from the upper gingiva and buccal mucosa. The anterior approach was capable of exposing the whole maxilla, although it was difficult to achieve such exposure by the lateral approach. However, the submandibular incision technique used in the Dingman approach was useful for upper neck dissection as well as for exposure of the artery and vein to anastomose them for reconstruction. The anterior approach should be useful for resection of the pterygopalatine fossa concomitant with total maxillectomy. On the other hand, the lateral approach might have an advantage in terms of its cosmetic effects. PMID:23524736

Uehara, Masataka; Tominaga, Kazuhiro; Asahina, Izumi

2013-03-01

268

Endoscopic fenestration of posterior fossa arachnoid cyst for the treatment of presyrinx myelopathy--case report.  

Science.gov (United States)

A 32-year-old man presented with an arachnoid cyst of the posterior fossa manifesting as cervical syringomyelic myelopathy. Magnetic resonance (MR) imaging demonstrated edematous enlargement and T2 prolongation of the cervical spinal cord, indicating a "presyrinx" state. MR imaging showed the inferior wall of the cyst, which disturbed cerebrospinal fluid (CSF) pulsatile movement between the intraspinal and intracranial subarachnoid spaces. The cyst wall was fenestrated with a neuroendoscope. The presyrinx state and the CSF movement improved. Posterior fossa arachnoid cyst, as well as Chiari malformation, can cause CSF flow disturbance at the craniocervical junction and syringomyelia. Endoscopic fenestration is less invasive than foramen magnum decompression and should be the procedure of choice. PMID:12416571

Nomura, Sadahiro; Akimura, Tatsuo; Imoto, Hirochika; Nishizaki, Takafumi; Suzuki, Michiyasu

2002-10-01

269

Endoscopic management of posterior fossa arachnoid cyst in an adult: case report and technical note.  

Science.gov (United States)

The authors report a case of large arachnoid cysts of the posterior fossa treated by endoscopic surgery. A 40-year-old man was admitted with a 3-month history of headache and progressive gait imbalance, with no significant medical history. At the time of admission, neurological examination revealed no abnormalities except for tandem imbalance. Brain computerized tomography (CT) scan and magnetic resonance imaging (MRI) revealed a posterior fossa arachnoid cyst (PFAC) causing brain stem compression accompanied by hydrocephalus. The patient was treated by endoscopic fenestration of the cyst with a paramedian suboccipital transcortical approach. Postoperatively the patient's complaints showed improvement and he was discharged with no complications. Follow up MRI showed a decrease in the cyst's size and the hydrocephalus with decompression of the brain stem. PMID:20963702

Gazioglu, Nurperi; Kafadar, Ali Metin; Tanriover, Necmettin; Abuzayed, Bashar; B?ceroglu, Huseyin; Ciplak, Nejat

2010-10-01

270

Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination  

Science.gov (United States)

In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

2003-06-01

271

Midfacial Degloving: The Best Alternative for Treatment of Trans-sphenoidal Meningocele of the Pterygopalatine Fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Trans-sphenoid anterobasal temporal lobe meningoceles are rare and can be associated with temporal lobe epilepsy or recurrent meningitis. Surgical treatment is described via complicated infratemporal or intracranial approaches with high morbidity. A 32-year-old man presented with an 18-year history of two types of seizures and confirmed epileptic activity in electroencephalogram. A trans-sphenoid meningocele in the left pterygopalatine fossa was found on computed tomography and magnetic reson...

Kantas, Ilias; Tzindros, Georgios; Papadopoulou, Anna; Marangos, Nikolaos

2006-01-01

272

Arachnoid cysts of the left temporal fossa: impaired preoperative cognition and postoperative improvement.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Thirteen adult patients were operated on for symptomatic arachnoid cysts in the left temporal fossa; seven with an internal shunt procedure during local anaesthesia, and five with a craniotomy with fenestration of the cyst to the basal cisterns. In one patient, an initial internal shunt was transformed to a cystoperitoneal shunt. After surgery, all patients experienced relief of symptoms. Reduction of cyst volume occurred in 11 patients. The patients were tested for brain asymmetries related ...

Wester, K.; Hugdahl, K.

1995-01-01

273

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed patients and rarely associated with systemic lupus erythematosus. I [...] n the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa.

Fabrício Guimarães, Gonçalves; Leslie, Lamb; Raquel, Del Carpio-O' Donovan.

274

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

Directory of Open Access Journals (Sweden)

Full Text Available Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV, an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa.

Fabrício Guimarães Gonçalves

2011-12-01

275

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

International Nuclear Information System (INIS)

Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

2011-01-01

276

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

Energy Technology Data Exchange (ETDEWEB)

Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

2011-11-15

277

ISG viewing wand-guided endoscopic catheter placement for treatment of posterior fossa CSF collections.  

Science.gov (United States)

Six patients presented with either entrapped fourth ventricles or noncommunicating cerebrospinal fluid collections of the posterior fossa requiring drainage. These collections were treated with shunt systems whose proximal catheter was placed into the fourth ventricle via a coronal burr hole using an endoscope guided by Eleckta's ISG Viewing Wand. The technique and its advantages are described as are the complications and early outcomes. PMID:9655147

Arginteanu, M; Abbott, R; Frempong, A

1997-12-01

278

Gonadal activity in male and female captive fossas (Cryptoprocta ferox) during the mating season.  

Science.gov (United States)

The fossa is an endangered, mongoose-like carnivore species endemic to Madagascar with a breeding season (BS) in the southern hemisphere spring. For the present study, faecal samples of captive fossas were collected for over 1 year for five males and four non-pregnant females, and for two pregnant animals during the reproductive period. The goal was to assess gonadal activity using non-invasive hormone measurements of faecal testosterone (T) and gestagen metabolites using assays previously established in our laboratory and further validated in this study. All study animals were housed in northern hemisphere zoos. In males, the seasonal T metabolite profile revealed a peak in spring (March). High performance liquid chromatography (HPLC) analysis was used to characterize the faecal hormone metabolite composition. The highest immunoreactivity was detected in the position of dihydrotestosterone, whereas native T was not detected. In the two pregnant females, gestagen metabolite concentrations increased 4-9 days after the initial matings and remained elevated throughout gestation with concentrations dramatically higher than those of the non-pregnant females during the BS. In these females, gestagen metabolite analyses did not reveal a seasonal pattern similar to the males. The HPLC-analysis revealed that the major proportion of immunoreactivity was associated with an unknown metabolite, whereas native progesterone was undetectable. The seasonal hormone pattern of male fossas gives proof of the reproductive seasonality of this species. The elevated 5alpha-pregnan-3beta-ol-20-one levels in pregnant animals allows for the characterization of pregnancy in the fossa based on analysis of faecal steroid metabolite concentrations. PMID:19754545

Vogler, B R; Blevins, B; Goeritz, F; Hildebrandt, T B; Dehnhard, M

2009-07-01

279

Endoscopic Endonasal Transturbinate Approach to the Pterygopalatine Fossa in the Management of Juvenile Nasopharyngeal Angiofibromas  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pterygopalatine fossa (PPF) is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA) often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the ...

2012-01-01

280

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF) following a tooth extraction. Based on magnetic resonance imaging (MRI) characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the P...

2012-01-01

 
 
 
 
281

Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar...

2013-01-01

282

Imaging techniques in evaluation of juvenile angiofibroma with lateral extension in the pterygopalatine and infratemporal fossa  

International Nuclear Information System (INIS)

Juvenile angiofibroma is a benign tumour arising in the nasopharynx and penetrating laterally into the pterygopalatine fossa, infratemporal fossa and orbit. Precise preoperative evaluation of the presence and extension of its lateral spread is crucial for choosing the best surgical approach and performing radical operation. The aim of the study was to assess usefulness of imaging methods in diagnosis and evaluation of lateral extension of juvenile angiofibroma. In a group of 39 patients operated on from 1973 to 2002 due to juvenile angiofibroma in 21 (54%) cases a lateral extension of the tumor was diagnosed. All patients underwent carotid angiography (CA) and lateral plain skull X-ray. Computed tomography (CT) was performed in 18,and magnetic resonance imaging (MRI) in 4 patients. In all cases the extension of the tumor and its lateral spread was verified during surgery. A widening of the pterygopalatine fossa on lateral plain X-ray was present in 13 (62%) patients. CT and MRI demonstrated the presence of lateral extension in all patients diagnosed with these methods. In 9 cases, lateral CA revealed dislodgement of the internal maxillary artery by the tumor in the pterygopalatine fossa. The presence of big lateral extension of the juvenile angiofibroma is demonstrated on lateral plain X-ray as anterior bowing of the posterior wall of the maxillary sinus (Holman-Miller sign). MRI shows better than CT the extent and margins of the tumor in soft tissues. Lateral CA shows dislodgement of the internal maxillary artery and its course in relation to the lateral extension of the tumor, which is important for surgical planning. (author)

2004-01-01

283

Agenesis of the vermis cerebelli and malformations of the posterior fossa in childhood and adolescence.  

Science.gov (United States)

Three cases of cerebellar vermis agenesis are reported and the relevant literature (19 other cases) is reviewed. Other posterior fossa malformations, such as a mega-cisterna magna, arachnoid cyst and Dandy-Walker syndrome, are discussed both from the pathological and clinical view point. We put forward a hypothesis that agenesis of the cerebellar vermis and Dandy-Walker syndrome could be regarded as two different stages of the same malformation. PMID:503277

Mercuri, S; Curatolo, P; Giuffrè, R; Di Lorenzo, N

1979-09-01

284

Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours  

Energy Technology Data Exchange (ETDEWEB)

In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

2004-03-01

285

Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI  

Energy Technology Data Exchange (ETDEWEB)

A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

Pollo, C.; Porchet, F. [Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland); Meuli, R. [Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland)

2003-08-01

286

Alvarado score as an admission criterion in children with pain in right iliac fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Acute appendicitis is an important differential diagnosis in children with pain in the right iliac fossa. Some patients have equivocal signs that make the diagnosis difficult. Many patients with suspected acute appendicitis are admitted for observation and finally discharged because they did not have appendicitis. We decided to design this study to investigate whether the Alvarado score could be used by emergency room doctors as a criterion for admission to hospital. Pat...

Shreef Khalid; Waly Amira; Abd-Elrahman Sarhan; Abd Elhafez M

2010-01-01

287

Isolated iliac artery aneurysm rupture presenting as left iliac fossa pain and diarrhoea: A case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Isolated iliac aneurysm rupture is rare and difficult to diagnose, but needs to be actively considered and excluded. We document the case of a 71 year old female who presented with left iliac fossa pain and diarrhoea and was subsequently found to have a ruptured isolated iliac artery aneurysm. This case demonstrates the importance of urgent diagnostic CT in surgical patients, who present with features of abdominal pain and shock. The key to survival is early diagnosis, appropriate resuscitati...

Hartley, Emma; Richards, James

2011-01-01

288

Acute lymphoblastic leukemia and posterior fossa arachnoid cyst in a five-year-old girl.  

Science.gov (United States)

The authors experienced a case of acute lymphoblastic leukemia whose leukemic karyotypes were associated with changes in chromosome 21 ploidy, and she was also found to have an arachnoid cyst in the posterior fossa. The association between arachnoid cyst and leukemia as described in the literature appear to be quite rare. The clinical and radiologic features of arachnoid cyst as well as cytogenetic abnormalities of the leukemic clones are described in the present article. PMID:16231564

Lu, Chia-Shun; Chiu, Cheng-Hsun; Chen, Shih-Hsiang; Jaing, Tang-Her

2005-01-01

289

Sudden cochlear hearing loss as presenting symptom of arachnoid cyst of the posterior fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Arachnoid cysts account for almost 1% of neoformations located in the cerebellopontine angle. The aetiopathogenesis is unknown. Arachnoid cysts of the cranial posterior fossa may produce symptoms typical of a tumour such as headache, dizziness, tinnitus and progressive sensorineural hearing loss. Management of these lesions is still controversial; if the arachnoid cyst is symptomatic, surgical treatment is usually recommended. The case is described of an adult female with sudden unilateral co...

Cadoni, G.; Agostino, S.; Volante, M.; Scipione, Ms

2006-01-01

290

Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases)  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male), the average age and curve angle was 15...

MR Etemadifar; Mobini, B.; Behtash, H.; Ameri, E.

2005-01-01

291

O papel do acesso via fossa média no tratamento da paralisia facial traumática / The role of the middle fossa approach in the management of traumatic facial paralysis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Há vários aspectos controversos no tratamento da paralisia facial traumática. Um destes é a natureza precisa da intervenção cirúrgica a ser usada, uma vez que a decisão de ser realizada tenha sido feita. FORMA DE ESTUDO: Clínico retrospectivo. OBJETIVOS E MÉTODOS: Entre o período de junho de 1984 e [...] junho de 1993, 220 casos de paralisia facial traumática com boa função coclear foram tratados na Universidade de São Paulo pela seguinte técnica cirúrgica: descompressão dos segmentos mastóideo e timpânico através do acesso transmastoídeo e descompressão do gânglio geniculado e dos 50% distais do segmento labiríntico, usando-se o acesso pela fossa média. Apresentamos uma revisão de literatura e a discussão e resultados de nosso trabalho. Abstract in english Management of traumatic facial paralysis has several controversial aspects. One of these is the precise nature of surgical intervention to be used once the decision to operate has been made. STUDY DESIGN: chart review. AIMS AND METHODS: Between June 1984 and June 1993, 220 cases of traumatic facial [...] paralysis with good cochlear reserve were treated at the University of São Paulo by the following surgical approach: decompression of the tympanic and mastoid segments by the transmastoid approach and decompression of the geniculate ganglion and the distal 50% of the labyrinthine segment by the middle fossa approach. We present a review of the literature and a discussion and results of our management.

Bento, Ricardo Ferreira; Pirana, Sulene; Brito Neto, Rubens Vuonno de; Sanchez, Tanit Ganz; Castilho, Arthur Menino; Sweet, Robert Carl.

292

O papel do acesso via fossa média no tratamento da paralisia facial traumática The role of the middle fossa approach in the management of traumatic facial paralysis  

Directory of Open Access Journals (Sweden)

Full Text Available Há vários aspectos controversos no tratamento da paralisia facial traumática. Um destes é a natureza precisa da intervenção cirúrgica a ser usada, uma vez que a decisão de ser realizada tenha sido feita. FORMA DE ESTUDO: Clínico retrospectivo. OBJETIVOS E MÉTODOS: Entre o período de junho de 1984 e junho de 1993, 220 casos de paralisia facial traumática com boa função coclear foram tratados na Universidade de São Paulo pela seguinte técnica cirúrgica: descompressão dos segmentos mastóideo e timpânico através do acesso transmastoídeo e descompressão do gânglio geniculado e dos 50% distais do segmento labiríntico, usando-se o acesso pela fossa média. Apresentamos uma revisão de literatura e a discussão e resultados de nosso trabalho.Management of traumatic facial paralysis has several controversial aspects. One of these is the precise nature of surgical intervention to be used once the decision to operate has been made. STUDY DESIGN: chart review. AIMS AND METHODS: Between June 1984 and June 1993, 220 cases of traumatic facial paralysis with good cochlear reserve were treated at the University of São Paulo by the following surgical approach: decompression of the tympanic and mastoid segments by the transmastoid approach and decompression of the geniculate ganglion and the distal 50% of the labyrinthine segment by the middle fossa approach. We present a review of the literature and a discussion and results of our management.

Ricardo Ferreira Bento

2004-08-01

293

A superciliary approach for anterior cranial fossa lesions in children. Technical note.  

Science.gov (United States)

Many subfrontal and orbitofrontal craniotomy techniques have been proposed and developed for anterior cranial fossa lesions. The purpose of this study was to evaluate the surgical experience with the frontolateral keyhole craniotomy through a superciliary skin incision in children. The keyhole craniotomy is a modification of the traditional pterional approach. This modified approach, a craniotomy with a 2.5 x 3-cm bone opening just above the eyebrow through a superciliary incision, has been previously described in adults for many lesions situated in the anterior cranial fossa, including tumors and aneurysms. The authors review their experience in using this approach in 27 children for a variety of intracranial lesions. This approach was used for 28 procedures in children ranging in age from 1 to 16 years (mean age 10 years). The lesions included arachnoid cysts, cerebrospinal fluid fistulas, and tumors; no vascular lesions were treated. The authors have found this craniotomy to be a safe and simple approach for treating anterior cranial fossa and suprasellar lesions in children. PMID:16122012

Jallo, George I; Suk, Ian; Bognár, László

2005-07-01

294

Evaluation of peritumoral area associated with brain tumor in posterior cranial fossa using three dimensional SPECT  

International Nuclear Information System (INIS)

We measured peritumoral hypoperfusion volume associated with brain tumor in posterior cranial fossa using SPECT and compared the result with volumes of tumor and peritumoral edema on MRI. Seventeen patients with brain tumor in posterior cranial fossa, who underwent 123 I-IMP SPECT and MRI before operation, were studied. The SPECT images were performed in three dimension using a panning visualization software (application visualization system medical viewer: AVS-MV). The peritumoral hypoperfusion area on three dimensional SPECT was larger than the volume of edema on MRI with a statistical different (p<0.001). Acoustic tumor cases showed a good correlation between the volume of peritumoral hypoperfusion area on three dimensional SPECT and the volume of edema on MRI. These results suggest tumor volume in posterior cranial fossa affects cerebral circulation. It is assumed that pressure exerted by the tumor may contribute to the reduction in cerebral blood flow. The large amount of data provided by three dimensional SPECT images, gives reliable results and furthermore, makes objective evaluation possible because it eliminates the need to set region of interest (ROI) in the analysis. The application of SPECT to assess the extent of hypoperfusion volume, is considered a new and clinically useful tool. (author)

2002-01-01

295

Pattern of recurrence in children with midline posterior fossa malignant neoplasms  

Energy Technology Data Exchange (ETDEWEB)

Background. Surveillance imaging of the brain and spinal neuraxis in patients with posterior fossa malignant tumors is commonly performed, with the assumption that early detection of tumor recurrence will improve outcome. However, the benefit of this imaging has not been proven. To evaluate the usefulness of spinal surveillance imaging in children with nonmetastatic (at diagnosis, M0) posterior fossa ependymoma and medulloblastoma. Materials and methods. This retrospective study included 65 children (3 months to 16 years, mean 5.7 years) treated between 1985 and 1997 for ependymoma (22) and medulloblastoma (43). Medical records were reviewed for pathology and treatment data. Serial imaging of the head and spine was reviewed for evidence of tumor recurrence. Results. Twenty-four patients (37 %) had tumor recurrence, including 13 with ependymoma and 11 with medulloblastoma. Of the 17/24 recurrent patients initially diagnosed as M0 (6 medulloblastoma and 11 ependymoma), 13 (76 %) had a cranial recurrence only, and 4 (24 %) presented with concomitant cranial and spinal recurrence. No M0 patient presented solely with spinal metastases at recurrence. Conclusion. This study suggests that spinal surveillance imaging in patients with posterior fossa ependymoma or medulloblastoma initially staged as M0 may not be useful, as these patients initially recur intracranially. Thus, until an intracranial recurrence is detected, these patients may be spared the time, expense and sedation risk necessary for spinal imaging. (orig.)

Wootton-Gorges, S.L.; Foreman, N.K.; Albano, E.A.; Dertina, D.M.; Nein, P.K.; Shukert, B.; Cesario, K.B.; Gage, S.; Rumack, C.M.; Strain, J.D. [Children' s Hospital, Department of Radiology, Denver, CO (United States)

2000-02-01

296

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

Kamal Kataria

2012-05-01

297

Analysis of mandibular condylar and glenoid fossa fractures with computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using ?{sup 2} test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. (orig.)

Ogura, Ichiro; Sasaki, Yusuke; Kaneda, Takashi [Nihon University School of Dentistry at Matsudo, Department of Radiology, Matsudo, Chiba (Japan)

2014-04-15

298

Neurinomas of the facial nerve extending to the middle cranial fossa  

International Nuclear Information System (INIS)

Three cases with neurinomas of the facial nerve are reported, especially with regard to the computerized tomographic (CT) findings. All of them had a long history of facial-nerve dysfunction, associated with hearing loss over periods from several to twenty-five years. Intraoperative findings demonstrated that these tumors arose from the intrapetrous portion, the horizontal portion, or the geniculate portion of the facial nerve and that they were located in the middle cranial fossa. The histological diagnoses were neurinomas. CT scans of three cases demonstrated round and low-density masses with marginal high-density areas in the middle cranial fossa, in one associated with diffuse low-density areas in the left temporal and parietal lobes. The low-density areas on CT were thought to be cysts; this was confirmed by surgery. Enhanced CT scans showed irregular enhancement in one case and ring-like enhancement in two cases. High-resolution CT scans of the temporal bone in two cases revealed a soft tissue mass in the middle ear, a well-circumscribed irregular destruction of the anterior aspect of the petrous bone, and calcifications. These findings seemed to be significant features of the neurinomas of the facial nerve extending to the middle cranial fossa. We emphasize that bone-window CT of the temporal bone is most useful in detecting a neurinoma of the facial nerve in its early stage in order to preserve the facial- and acoustic-nerve functions. (author)

1986-01-01

299

Case records of the Massachusetts General Hospital: Case 5-2014: 2014: A 59-year-old man with fever, confusion, thrombocytopenia, rash, and renal failure.  

Science.gov (United States)

A 59-year-old man was admitted to this hospital because of fever, confusion, rash, thrombocytopenia, and renal failure, 10 days after a hunting trip in the Nevada valley. Diagnostic procedures were performed, and diagnostic test results were received from another hospital. PMID:24521112

Baggett, Meridale V; Turbett, Sarah E; Schwartzenberg, Shmuel S; Stone, James R

2014-02-13

300

Relationship Between Pterygopalatine Fossa Volume and Cephalic and Upper Facial Indexes Relación Entre el Volumen de la Fosa Pterigopalatina y los índices Cefálico y Facial Superior  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The maxilary nerve can be block in the pterygopalatine fossa, entering from oral cavity via greater palatine canal. The aim of this study was to analyse the volume of the pterygopalatine fossa and its relationship with upper facial height and cephalic indexes. In 71 human adults skulls, without sex distinction, was determined the volume of the pterygopalatine fossa and cephalic and upper facial height indexes. Through a t test (p < 0.05) were compared the average volume between cephalic and f...

César Andrés Coronado Gallardo; Iván Claudio Suazo Galdames; Mario Gonzalo Cantín López; Daniela Alejandra Zavando Matamala

2008-01-01

 
 
 
 
301

Morphological study of defects of the atrial septum within the oval fossa: implications for transcatheter closure of left-to-right shunt.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE--To determine the anatomical variability of the oval fossa in cases of atrial septal defect and to find out which factors might make such defects suitable or unsuitable for closure by umbrella or clamshell devices. DESIGN--100 specimens with defects of the atrial septum within the oval fossa were studied, especially the position of the defects within the fossa; the area of the defect in relation to the total area of the oval fossa; the shape of the rims and flap valve of the oval fo...

1992-01-01

302

Cisticercose do quarto ventrículo simulando neoplasia da fossa posterior a cintilografia cerebral: relato de um caso Cysticercosis of the fourth ventricle simulating posterior fossa tumor on brain scan: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available É relatado o caso de uma criança de 12 anos de idade apresentando quadro de hipertensão endocraniana e síndrome cerebelar, cujos exames neurológico e neuroradiológicos foram sugestivos de neoplasia de fossa posterior. A cintilografia cerebral mostrou um quadro compatível com a existência de tumor da fossa posterior, da linha mediana, mais provavelmente meduloblastoma ou astrocitoma. Pela intervenção cirúrgica foi verificado tratar-se de cisticercose, sendo removido um cisto do 4ºventrícuio. Os autores sugerem que em áreas geográficas com alta prevalência de neurocisticercose na população infantil a hipótese da forma pseudotumoral seja lembrada, quando da tentativa de caracterização do tipo de lesão da fossa posterior, detectada pela cintilografia cerebral.The case of a twelve year old child with intracerebral hypertension and cerebellar syndrome in whom the neuroradiological and neurological examinations were sugestive of posterior cranial fossa tumor is reported. The brain scan depicted the scintigraphic pattern of midline neoplasms, most likely medullo-blastoma or astrocytoma. At surgery a Cysticercus cellulosae was removed from the fourth the fourth ventricle. The authors suggest that in geographical areas with high prevalence of neurocysticercosis in the infantile population the hypothesis of the pseudotumoral form of the disease be remembered when one attempts to characterize the type of neoplasms of the posterior fossa as detected by brain scan.

Sydney F. de Morais-Rego

1978-12-01

303

Cisticercose do quarto ventrículo simulando neoplasia da fossa posterior a cintilografia cerebral: relato de um caso / Cysticercosis of the fourth ventricle simulating posterior fossa tumor on brain scan: a case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese É relatado o caso de uma criança de 12 anos de idade apresentando quadro de hipertensão endocraniana e síndrome cerebelar, cujos exames neurológico e neuroradiológicos foram sugestivos de neoplasia de fossa posterior. A cintilografia cerebral mostrou um quadro compatível com a existência de tumor da [...] fossa posterior, da linha mediana, mais provavelmente meduloblastoma ou astrocitoma. Pela intervenção cirúrgica foi verificado tratar-se de cisticercose, sendo removido um cisto do 4ºventrícuio. Os autores sugerem que em áreas geográficas com alta prevalência de neurocisticercose na população infantil a hipótese da forma pseudotumoral seja lembrada, quando da tentativa de caracterização do tipo de lesão da fossa posterior, detectada pela cintilografia cerebral. Abstract in english The case of a twelve year old child with intracerebral hypertension and cerebellar syndrome in whom the neuroradiological and neurological examinations were sugestive of posterior cranial fossa tumor is reported. The brain scan depicted the scintigraphic pattern of midline neoplasms, most likely med [...] ullo-blastoma or astrocytoma. At surgery a Cysticercus cellulosae was removed from the fourth the fourth ventricle. The authors suggest that in geographical areas with high prevalence of neurocysticercosis in the infantile population the hypothesis of the pseudotumoral form of the disease be remembered when one attempts to characterize the type of neoplasms of the posterior fossa as detected by brain scan.

Sydney F. de, Morais-Rego; Nilton L., Latue.

304

Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil = Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil  

Directory of Open Access Journals (Sweden)

Full Text Available The present work had the objective to study parasitic copepods in thenasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae, Schizodon borellii (Anostomidae, Prochilodus lineatus (Prochilodontidae, Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae. Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984; and Rhinergasilus piranhus Boeger & Thatcher, 1988. There were differences in parasite corporal measurements and in the quantity of parasites per host in relation to copepod parasites from the Amazon region. The present study constitutes one of the few studies of identification of copepod parasites in the nasal fossae of fish from the Southern region of Brazil.O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatrofamílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais,variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.

Ana Carolina Figueiredo Lacerda

2007-10-01

305

The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE To analyze and discuss about the clinical characteristics, pathological types, surgical modalities and techniques, and postoperative complications in children with tumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa, admi? ed and treated in our hospital during the period of January 1996 to January 2007. All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases were female. The age ranged from 9 months to 14 years old, with an average of 6.1 ± 0.5 of age. Cranial CT or MRI examination was conducted before and after the surgery on all patients.RESULTS The primary manifestations for this group of patients were increased intracranial pressure and/or ataxia. Postoperative pathological diagnoses showed: 46 cases of medulloblastoma, 43 cases of astrocytoma, 11 cases of ependymoma (including 1 case of degenerative ependymoma, 1 case of dermoid cyst, and 1 case of teratoma. In this group of the patients, radical surgery was used in 68 cases and subtotal surgical removal used in 31 cases, while surgical removal of large section was performed on 3 cases. There were no deaths from surgery reported. Ninety-one cases showed significant symptomatic improvement when compared with preoperative conditions, while 11 cases showed either no improvement or more severely affected afterward. For 6 cases, postoperative ventriculoperitoneal shunt was performed within 7 days to 2 months after the surgery. Sixty-three patients gained follow-up for 3 to 60 months in duration. Thirty-nine patients regained normal life and were able to learn well, while there were 7 patients who could not live normally on their own. During the follow-up period, there were 17 cases of recurrence and 7 cases of death. In 23 cases of medulloblastoma in children with age of 3 years old or above, 2 cases who underwent surgical removal of intracranial ependymoma received small dosage of postoperative X-ray radiotherapy on the the brain and spinal cord. Nine cases of medulloblastoma in children under age of 3 and 17 cases of astrocytoma diagnosed after the surgery received chemotherapy of Carmustine.CONCLUSION Medulloblastomas and astrocytomas were the most common types of pediatric tumor of posterior cranial fossa, right followed by ependymoma, and dermoid cysts and teratomas were rare. Early correct diagnosis, proper selection of appropriate surgical modality and the surgical margin, proper treatment of postoperative complications, and the selecting right radiotherapy or chemotherapy were the key factors in infl uencing the prognostic outcome of children with tumor of posterior cranial fossa.

Duo CHEN

2009-04-01

306

The reverse lateral arm flap, based on the interosseous recurrent artery, for cubital fossa burns.  

Science.gov (United States)

The reverse lateral arm flap based on the interosseous recurrent artery was used successfully to reconstruct cubital fossa defects caused by high voltage electric burn in two cases. The flap is nourished by the septocutaneous perforators of the posterior radial collateral artery which anastomoses around the lateral epicondyle with the interosseous recurrent artery. The primary benefits of this flap are that it is an easy and rapid one-stage procedure, with no necessity of sacrificing a main artery or local muscle, and it requires no immobilisation of the involved joint. PMID:8087373

Lai, C S; Lin, S D; Chou, C K; Tsai, C C

1994-07-01

307

Computer-assisted-endoscopic Surgery of a Large Trigeminal Schwannoma in the Pterygopalatine Fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Case Report: A 33 year-old woman presented with a history of many years of a tumor in the pterygopalatine fossa. The tumor (5x 4.5 cm) extended to the sphenoid and maxillary sinuses, the nasal cavity, the skull base with an erosion of the cavernous sinus and the orbit with a close contact with the ophthalmic nerve. The patient had first refused to undergo the surgery because only an external approach through a paranasal and Caldwell-Luc incision had been proposed to her. We proposed a strictl...

2009-01-01

308

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient  

Directory of Open Access Journals (Sweden)

Full Text Available Aspergillosis of the central nervous system (CNS is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF following a tooth extraction. Based on magnetic resonance imaging (MRI characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.

Anqi Xiao

2012-04-01

309

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF [...] ) following a tooth extraction. Based on magnetic resonance imaging (MRI) characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.

Anqi, Xiao; Shu, Jiang; Yi, Liu; Kaihong, Deng; Chao, You.

310

The experience of neurofibromatosis type I originating from pterygopalatine fossa and salivary gland.  

Science.gov (United States)

One patient of neurofibromatosis type I originating from the pterygopalatine fossa and salivary gland underwent surgery in our department. At the outset, the case was misdiagnosed as arising from salivary gland tumors, and surgery was immediately performed. The tumor was entered directly, which induced ferocious bleeding. The subsequent hemostasis with tamponade and compression caused intracranial venous sinus thrombosis, which induced irreversible intracranial complications and finally resulted in death. The experience regarding the diagnosis and treatment of the case was retrospectively reviewed and shared in this article. PMID:24448534

Jin, Bin; Shen, Bin; Dong, Pin; Xu, Hongming; Wang, Fei

2014-07-01

311

Surgical resection of ulcer of the popliteal fossa and myoplasty by using a gastrocnemius muscle flap  

International Nuclear Information System (INIS)

In a 71-year-old female patient, radiation-induced ulcer of the popliteal fossa was resected, and a flap of the gastrocnemius muscle was planted. Anatomy of the region and the method of the operation were shown. This kind of flap can cover the space of 14 x 14 cm, and sequelae of auto-transplantation of the muscle are very rare. Since the operative technique is rather simple and the muscular flap survives well, this operation may succeed in many cases, if they are selected. (Ueda, J.)

1982-01-01

312

Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant  

International Nuclear Information System (INIS)

A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

2003-05-01

313

A Case Report of Infratemporal Fossa Hydatid Cyst, an Unusual Location  

Digital Repository Infrastructure Vision for European Research (DRIVER)

"nIntroduction: Hydatid disease has a high incidence in the countries of the temperate zone such as Iran. Only few cases in the head and neck region have been reported in literature. We described a rare case of infratemporal fossa echinococcus granulosus in a thirteen-year-old girl from an endemic area (Dashte Moghan) in Iran. "nClinical findings: A thirteen-year-old girl with a right sided frozen eye and facial swelling was admitted in our hospital. In the obtained CT scan there wa...

Shervin Sharifkashany; Fatemeh Khanali

2009-01-01

314

Slit-like jugular foramen due to abnormal bone growth at jugular fossa  

Directory of Open Access Journals (Sweden)

Full Text Available An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narrowing of jugular foramen know as Vernet’s syndrome is discussed along with case.

Budhiraja V

2010-05-01

315

Rod Migration into the Posterior Fossa after Harms Operation : Case Report and Review of Literatures  

Digital Repository Infrastructure Vision for European Research (DRIVER)

C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2...

Chun, Hyoung-joon; Bak, Koang Hum; Kang, Tae Hoon; Yi, Hyeong-joong

2010-01-01

316

Giant posterior fossa arachnoid cyst causing tonsillar herniation and cervical syringomyelia.  

Science.gov (United States)

Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia. PMID:24381458

Joshi, Vijay P; Valsangkar, Ashwin; Nivargi, Satish; Vora, Nitant; Dekhne, Anish; Agrawal, Amit

2013-01-01

317

A differential diagnosis in postural headache: herniation of a giant posterior fossa arachnoid cyst.  

Science.gov (United States)

The causes of postural headache are usually associated with low intracranial pressure. However, there are still rare causes of posture-related headaches that are not associated with low intracraninal pressure and caused by pathologic processes. Herein, we report a patient with giant posterior fossaarachnoid cyst herniating below the level of foramen magnum presenting with postural headache, which has not been described previously in the literature. Emergency physicians should be aware that posterior fossa arachnoid cysts should be considered one of the differential diagnoses in patients with postural headache. PMID:18272121

Lu, Kuan-Che; Chao, Chun-Chieh; Wang, Tzong-Luen; Chong, Chee-Fah; Chen, Chien-Chih

2008-02-01

318

Neglected foreign body infratemporal fossa, a typical presentation: a case report.  

Science.gov (United States)

A 25 year old male presented to our ENT OPD with the history of hyperemic swelling left zygomatic area with a pointed pustule in the centre resembling a furuncle,which progressed into a discharging sinus, complicated by trismus. The patient had a past history of trauma in the vicinity of the left zygomatic area 4-months back with a pointed stick the tip of the stick which had got lodged in the wound at that time was removed. The diagnostic dilemma was solved as neglected foreign body infratemporal fossa. PMID:22754853

Sajad, Mir; Kirmani, Masood A; Patigaroo, A R

2011-07-01

319

The ischiorectal fossa: an alternative route for the administration of prostaglandin in cattle  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Three experiments were conducted to investigate the ischiorectal fossa (IRF) as a route for the administration of prostaglandin F2? (dinoprost) in cattle. In Experiment 1, 21 nonlactating Holstein cows were given 100 ?g of gonadotropin releasing hormone (GnRH), intramuscularly (IM), and, 7 d later, 25 mg of dinoprost into the IRF. Sixteen cows had serum progesterone concentrations ? 1.0 ng/mL at the time of dinoprost treatment, and all of these had rapid and complete luteolysis; the other...

Colazo, Marcos G.; Marti?nez, Marcelo F.; Kastelic, John P.; Mapletoft, Reuben J.; Carruthers, Terry D.

2002-01-01

320

Transverse Myelitis Associated With an Itchy Rash and HyperCKemia: Neuromyelitis Optica Associated With Dermatitis Herpetiformis.  

Science.gov (United States)

IMPORTANCE Neuromyelitis optica is associated with severe neurodisability if not recognized and treated promptly. Several autoimmune disorders are associated with this condition and may vary in their presentation. It is essential that clinicians are aware of the uncommon presenting features of neuromyelitis optica and associated autoimmune conditions. OBSERVATIONS A 53-year-old woman presented with nausea and vomiting and was noted to have an asymptomatic elevated creatinine kinase level, which improved with conservative management. She had a history of iron-deficiency anemia due to long-standing celiac disease that was managed with a gluten-free diet. She then presented with recurrent transverse myelitis and a vesicobullous rash over her arms and feet that was pruritic and excoriating. Skin biopsy results confirmed a clinical diagnosis of dermatitis herpetiformis and antibody test findings against aquaporin-4 were positive, leading to a diagnosis of neuromyelitis optica spectrum disorder. She was treated with methylprednisolone sodium succinate, plasma exchange, and azathioprine and has remained in remission. CONCLUSIONS AND RELEVANCE This report highlights the association of neuromyelitis optica with dermatitis herpetiformis, which can present even without clinical features of celiac disease. Nausea, vomiting, and asymptomatic hyperCKemia should be recognized as rare presenting features of neuromyelitis optica. PMID:24637913

Iyer, Anand; Rathnasabapathi, Devipriya; Elsone, Liene; Mutch, Kerry; Terlizzo, Monica; Footitt, David; Jacob, Anu

2014-05-01

 
 
 
 
321

Prophylactic Tetracycline Does Not Diminish the Severity of Epidermal Growth Factor Receptor (EGFR) Inhibitor Induced Rash: Results from the North Central Cancer Treatment Group (Supplementary N03CB)1  

Science.gov (United States)

PURPOSE Previous studies suggest tetracycline and other antibiotics lessen the severity of epidermal growth factor receptor (EGFR) inhibitor-induced rash. This study sought to confirm such findings. METHODS Patients starting an EGFR inhibitor were eligible for this randomized, double-blinded, placebo-controlled study and had to be rash-free. They were then randomly assigned to tetracycline 500 milligrams orally twice a day for 28 days versus a placebo. Rash development and severity (monthly physician assessment and weekly patient-reported questionnaires), quality of life (SKINDEX-16), and adverse events were monitored during the 4-week intervention and then for an additional 4 weeks. The primary objective was to compare the incidence of grade 2 or worse rash between study arms; 32 patients per group provided a 90% probability of detecting a 40% difference in incidence with a type I error rate of 0.05 (2-sided). RESULTS 65 patients were enrolled, and groups were balanced on baseline characteristics. During the first 4 weeks, healthcare provider-reported data found that 27 tetracycline-treated patients (82%) and 24 placebo-exposed patients (75%) developed a rash. This rash was a grade 2+ in 17 (52%) and 14 (44%), respectively (p=0.62). Comparable grade 2+ rash rates were observed during weeks 5 through 8 as well as with patient-reported rash data throughout the study period. Quality of life was comparable across study arms, and tetracycline was well tolerated. CONCLUSION Although previous studies suggest otherwise, this randomized, double-blinded, placebo-controlled did not find that tetracycline lessened rash incidence or severity in patients who were taking EGFR inhibitors.

Jatoi, Aminah; Dakhil, Shaker R.; Sloan, Jeff A.; Kugler, John W.; Rowland, Kendrith M.; Schaefer, Paul L.; Novotny, Paul J.; Wender, Donald B.; Gross, Howard M.; Loprinzi, Charles L.

2014-01-01

322

The relationship between rash, tumour KRAS mutation status and clinical and quality of life outcomes in patients with advanced colorectal cancer treated with cetuximab in the NCIC CTG/AGITG CO.17.  

Science.gov (United States)

Abstract Background. The NCIC CTG/AGITG CO.17 trial demonstrated that cetuximab monotherapy improved overall and progression-free survival (OS and PFS) in patients previously treated for advanced colorectal cancer. A strong relationship was observed between benefit from cetuximab and development of rash. In this analysis, the association of rash and benefit from cetuximab is explored and presented by KRAS mutation status. Material and methods. Rash was graded by NCI CTC 2.0 criteria. Landmark analysis was performed by excluding patients who died or dropped out within 28 days and then grouping by worst grade of rash experienced by day 28. Multivariate Cox models were conducted separately for patients with KRAS wild-type (WT) tumours and KRAS mutated (MUT) tumours. CO.17 primary outcome was OS. Results. Development of grade 2 + rash on cetuximab was associated with a trend towards increased OS (HR 0.61 with 95% CI 0.36-1.02 and p = 0.06) and PFS (HR 0.68 with 95% CI 0.45-1.03 and p = 0.07) as compared to grade 0/1 rash in patients with WT tumours. In patients with WT tumours on cetuximab both grade 0/1 and grade 2 + rash were associated with increased PFS (HR 0.57 95% CI 0.38-0.86; p = 0.008; and HR 0.32 95% CI 0.21-0.49; p < 0.0001) respectively, in comparison with best supportive care (BSC). Only development of grade 2 + rash on cetuximab was associated with increased OS (HR 0.52 with 95% CI 0.34-0.80 and p = 0.003) in comparison with BSC. No significant difference was found in OS or PFS among patients on cetuximab with MUT tumours with either rash grade as compared to BSC. No consistent trend was observed for the association of severity of rash and quality of life (QoL). Conclusion. As all patients with WT tumours benefitted to some extent from cetuximab regardless of the grade of rash, grade of rash was not a useful predictive marker. PMID:24495042

Sommeijer, Dirkje W; Karapetis, Christos S; Zalcberg, John R; Tu, Dongsheng; Jonker, Derek J; Simes, John; Tebbutt, Niall; Yip, Desmond; Price, Timothy J; O'Callaghan, Chris J

2014-07-01

323

Removal of orbital-maxillary sinus-pterygopalatine fossa foreign body with external and endoscopic combined approach.  

Science.gov (United States)

Craniofacial trauma involving the pterygopalatine fossa region is reported to be rare. We present a case of a foreign body involving the orbit, maxillary sinus, and pterygopalatine fossa in a 4-year-old boy. The object was a reed shaft. Three-dimensional computed tomographic scans and magnetic resonance imaging were done to make a correct diagnosis and to apply the best surgical treatment. The Caldwell-Luc approach combined with endoscopic approach was applied to remove all the fragments of the foreign body, which had been decayed in the human body. One month later, the patient showed satisfactory aesthetic and functional results. PMID:24914753

Wu, Xiaoshan; Li, Aifang; Tan, Jia; Ou, Xinrong

2014-07-01

324

Reduced CYP2D6 function is associated with gefitinib-induced rash in patients with non-small cell lung cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Rash, liver dysfunction, and diarrhea are known major adverse events associated with erlotinib and gefitinib. However, clinical trials with gefitinib have reported different proportions of adverse events compared to trials with erlotinib. In an in vitro study, cytochrome P450 (CYP) 2D6 was shown to be involved in the metabolism of gefitinib but not erlotinib. It has been hypothesized that CYP2D6 phenotypes may be implicated in different adverse ev...

2012-01-01

325

Incidence of rubella IgM antibodies in individuals with febrile rash illness attending clinics in Akwa Ibom State, Nigeria, 2006-2009  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific...

Bassey Enya; Moses Anietie Effiong; Udo Sunde Moffat; Bassey Emem

2011-01-01

326

Fractura de cavidad glenoidea: reporte de un caso / Glenoid fossa fracture: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish Las fracturas del componente craneofacial aumentan su frecuencia y severidad día con día en las salas de urgencias. Las disrupciones de la mandíbula pueden clasificarse de acuerdo a su localización anatómica, siendo más frecuentes las del ángulo (36.3%) y el cuerpo (21.2%) y poco comunes las de apóf [...] isis coronoides (0.25%).¹ Las fracturas de coronoides, condilares y de arco cigomático, pueden enmascarar un fractura de cavidad glenoidea, ya que clínicamente existe restricción de la motricidad mandibular. Presentamos el caso de un paciente de 38 años, con fracturas de complejo cigomaticomaxilar, apófisis coronoides y cavidad glenoidea derecho. Abstract in english Emergency rooms have seen a gradual increase of patients afflicted by craniofacial fractures. Mandible fractures can be classified according to their anatomical location. The most frequent fractures are angle fractures (36.3%) and body of the mandible fractures (21.2%). Coronoid process fractures ar [...] e uncommon (0.25%)¹ Zygomatic arch, condylar or coronoid process fractures can mask a fracture of the glenoid fossa, since, clinically, there is restriction of mandibular movements. The case here presented is that of a 38 year patient afflicted with fractures of the maxillary-zygomatic complex, coronoid process as well as right glenoid fossa.

Rodríguez Piña, Carlos Alain; Miranda Villasana, José Ernesto.

327

Surface microbiota analysis of Taleggio, Gorgonzola, Casera, Scimudin and Formaggio di Fossa Italian cheeses.  

Science.gov (United States)

The composition of the bacterial consortia of the smear Italian cheeses and their role on quality and safety is still poorly understood. The objective of this study was to identify and characterize the bacterial communities present on the surface of five traditional Italian cheeses, Casera Valtellina, Scimudin, Formaggio di Fossa, Gorgonzola and Taleggio. DGGE analysis performed using total DNA obtained from cheese surfaces enabled us to identify the dominant bacterial populations. Bands showing different intensity and identified as Staphylococcus, Micrococcus, Psychrobacter, Enterococcus and Brevibacterium species were detected on the surface of cheeses. The cluster analysis showed that Gorgonzola, Taleggio and Formaggio di Fossa cheeses present high similarity in their surface bacterial composition while major differences in the DGGE profiles were observed in Scimudin and Casera. The molecular taxonomical identification among the Gram positive isolates, reveals the presence of the following bacterial genera: Staphylococcus, Micrococcus, Macrococcus, Enterococcus, Lactobacillus, Carnobacterium, Leuconostoc, Brevibacterium, Corynebacterium, Brochothrix, Bacillus. The combination of culture dependent and independent techniques allowed us to obtain information about the bacterial species covering the surface of five different traditional Italian cheeses. PMID:20167385

Fontana, Cecilia; Cappa, Fabrizio; Rebecchi, Annalisa; Cocconcelli, Pier Sandro

2010-04-15

328

A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia  

International Nuclear Information System (INIS)

We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls. (orig.)

1984-11-01

329

High precision locations of long-period events at La Fossa Crater (Vulcano Island, Italy  

Directory of Open Access Journals (Sweden)

Full Text Available Since the last eruption in 1888-90, the volcanic activity on Vulcano Island (Aeolian Archipelago, Italy has been limited to fumarolic degassing. Fumaroles are mainly concentred at the active cone of La Fossa in the northern sector of the island and are periodically characterized by increases in temperature as well as in the amount of both CO2 and He. Seismic background activity at Vulcano is dominated by micro-seismicity originating at shallow depth (<1-1.5 km under La Fossa cone. This seismicity is related to geothermal system processes and comprises long period (LP events. LPs are generally considered as the resonance of a fluid-filled volume in response to a trigger. We analyzed LP events recorded during an anomalous degassing period (August-October 2006 applying a high precision technique to define the shape of the trigger source. Absolute and high precision locations suggest that LP events recorded at Vulcano during 2006 were produced by a shallow focal zone ca. 200 m long, 40 m wide and N30-40E oriented. Their occurrence is linked to magmatic fluid inputs that by modifying the hydrothermal system cause excitation of a fluid-filled cavity.

Salvatore Rapisarda

2009-06-01

330

Transorbital neuroendoscopic management of sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa.  

Science.gov (United States)

Transnasal endoscopic surgery has remained at the forefront of surgical management of sinogenic complications involving the frontal sinus, orbit, and anterior skull base. However, the difficulty in accessing certain areas of these anatomical regions can potentially limit its use. Transorbital neuroendoscopic surgery (TONES) was recently introduced to transgress the limits of transnasal endoscopic surgery; the access that it provides could add additional surgical pathways for treating sinogenic complications involving the frontal sinus, orbit, and anterior cranial fossa. We describe a prospective series of 13 patients who underwent TONES for the management of various sinogenic complications, including epidural abscess, orbital abscess, and fronto-orbital mucocele or mucopyocele, as well as subperiosteal abscess presenting with orbital apex syndrome. The primary outcome measurement was the efficacy of TONES in treating these pathologies. TONES provided effective access to the frontal sinus, orbit, and the anterior cranial fossa. All patients demonstrated postoperative resolution of initial clinical symptoms with well-hidden surgical scars. There were no ophthalmologic complications or recurrence of pathology. Based on our experience, TONES appears to provide a valuable addition to the current surgical armamentarium for treating selected complications of sinusitis. PMID:24294556

Lim, Jae H; Sardesai, Maya G; Ferreira, Manuel; Moe, Kris S

2012-12-01

331

Severe toxicity of skin rash, fever and diarrhea associated with imatinib: case report and review of skin toxicities associated with tyrosine kinase inhibitors  

Directory of Open Access Journals (Sweden)

Full Text Available Xuan Huang1, Samir Patel2, Nasir Ahmed2, Karen Seiter2, Delong Liu21Department of Medicine, Richmond University Medical Center, New York, NY, USA; 2Division of Oncology and Hematology, New York Medical College and Westchester Medical Center, New York, NY, USAAbstract: Chronic myeloid leukemia (CML is characterized by a Philadelphia chromosome which contains an oncogene, bcr-abl. This oncogene encodes a tyrosine kinase which is constitutively activated. Imatinib, a tyrosine kinase inhibitor (TKI, has been widely used in the treatment of CML. Dasatinib and nilotinib were recently approved for the treatment of CML. Other TKIs, such as bosutinib, erlotinib, and sunitinib, are under study for the treatment of CML as well as other hematologic and solid malignancies. Skin rash has been reported as one of the most common side effects of the TKIs. Here we present a case of severe skin rash together with unusual symptoms of high fever and diarrhea induced by imatinib in a CML patient. The dermatologic toxicities from a variety of tyrosine kinase inhibitors are reviewed and general principles of management are also discussed.Keywords: chronic myeloid leukemia, skin rash, tyrosine kinase inhibitor, imatinib

Delong Liu

2008-10-01

332

Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa  

Directory of Open Access Journals (Sweden)

Full Text Available A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibilidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica.Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experimental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. RESULTS: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. CONCLUSION: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Luiz Artur Costa Ricardo

2010-02-01

333

La Verbena azul en el tratamiento del niño con salpullido / The blue Verbena to treat the child with rash  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la miliaria es una enfermedad inflamatoria de la piel, usualmente conocida como salpullido, es muy frecuente en niños pequeños sobre todo en los meses de verano. Objetivo: valorar la eficacia de la infusión de Verbena azul en el control de la miliaria común. Métodos: se realizó un ensa [...] yo clínico fase II, a partir de la preparación de una infusión de hojas frescas o secas molidas, que se vertieron en 12 litros de agua hirviente, se tapó y se separó del fuego después de añadirle la planta, se dejó reposar y se coló. Fue aplicada tibia en todo el cuerpo durante 21 días, en dos secciones, al levantarse, y en la tarde luego del baño diario. El estudio se realizó en 30 lactantes de raza blanca, que acudieron con esta patología a la consulta de Medicina Natural y Tradicional, en el consultorio 6 del poblado de Altagracia, en el periodo entre junio del 2004 y junio del 2005, los cuales pertenecían al Policlínico Comunitario Docente "Carlos J. Finlay" de la Ciudad de Camagüey. Los datos se recogieron mediante una encuesta, confeccionada de acuerdo con los objetivos planteados en la investigación. Resultados: el grupo más afectado fue el de 3 a 6 meses, todos los pacientes fueron blancos, no se encontraron diferencias significativas en cuanto al sexo. La variedad clínica más frecuente fue la cristalina, y los meses en que más se presentó fueron entre junio y agosto. Conclusiones: este tratamiento presentó una alta eficacia en el control de la sintomatología de la miliaria común; se curaron 9 de cada 10 pacientes. Abstract in english Introduction: miliaria is an skin inflammatory disease known as rash and is very frequent in small children mainly during summer months. Objective: assessing the efficacy of the infusion of blue Verbena in controlling common heat rash. Methods: a phase II clinical trial was conducted from the prepar [...] ation of an infusion of fresh leaves or dry grinded poured out in 12 liters of boiling water, was covered and removed from fire after adding the plant, it was doughed and strained. It was applied warm in whole body for 21 days in t wo sessions, to stand up and at evening after daily bath. A study was conducted in 30 white infants presenting with this pathology who came to the Natural and Traditional Medicine Service in the No.6 consulting room of the Altagracia settlement from June, 2004 to June, 2005 of "Carlos J. Finlay" Teaching Community polyclinic of the Camagüey city. Data were collected by survey, designed according to the objectives proposed in research. Results: the more involved group was that aged 3-6 months, all patients were white; there were not significant differences as regards sex. The more frequent clinical variety was the crystalline one and more prevalent months were June and August. Conclusions: present treatment was highly effective in the control of symptomatology of the common miliaria; nine of ten patients were cured.

Roberto, Galiano Piquet; Bárbaro, Usatorres Rodríguez.

334

Surgical strategy for tumors located in or extending from the intracranial space to the infratemporal fossa-Advantages of the transcranial approach (zygomatic infratemporal fossa approach) and the indications for a combined transcranial and transcervical approach-.  

Science.gov (United States)

The surgical strategy for tumors located in or extending from the intracranial space to the infratemporal fossa was analyzed in 12 cases with various pathologies. A case of mandibular nerve schwannoma, which extended 1 cm below the external orifice of the foramen ovale, was completely removed via the epidural subtemporal approach without zygomatic osteotomy with partial removal of the middle cranial base. The inferior margin of infratemporal tumor could be accessed via the transcranial route with zygomatic or orbitozygomatic osteotomy without complications including facial nerve injury in nine cases, and the lowest level of the infratemporal tumors was approximately 4.5 cm below the outer surface of the middle cranial base. In five of these 9 cases (2 schwannomas, 1 myxoma, 1 chondrosarcoma, and 1 malignant peripheral nerve sheath tumor), the tumors were localized in the infratemporal fossa, and in the other 4 cases (2 meningiomas, 1 glioblastoma, and 1 ameloblastoma), the tumors extended to both the intracranial space and the infratemporal fossa. In two cases (recurrent jugular schwannoma and mandibular osteosarcoma), a combined transcranial and transcervical approach (mandibular swing approach) was essential, because the resection line of the lower margin was too far from the middle cranial base. These results indicate that the transcranial approach, with or without zygomatic or orbitozygomatic osteotomy (zygomatic infratemporal fossa approach), is safe and effective for removal of some infratemporal tumors, and that a combined transcranial and transcervical approach is useful for removing infratemporal tumors with extensive downward extension. PMID:20035132

Yoshida, Kazunari; Kawase, Takeshi; Tomita, Toshiki; Ogawa, Kaoru; Kawana, Hiromasa; Yago, Kaori; Asanami, Soichiro

2009-12-01

335

Simple Technique for in Field Samples Collection in the Cases of Skin Rash Illness and Subsequent PCR Detection of Orthopoxviruses and Varicella Zoster Virus  

Science.gov (United States)

Background In case of outbreak of rash illness in remote areas, clinically discriminating monkeypox (MPX) from severe form of chickenpox and from smallpox remains a concern for first responders. Objective The goal of the study was therefore to use MPX and chickenpox outbreaks in Democratic Republic of Congo (DRC) as a test case for establishing a rapid and specific diagnosis in affected remote areas. Methods In 2008 and 2009, successive outbreaks of presumed MPX skin rash were reported in Bena Tshiadi, Yangala and Ndesha healthcare districts of the West Kasai province (DRC). Specimens consisting of liquid vesicle dried on filter papers or crusted scabs from healing patients were sampled by first responders. A field analytical facility was deployed nearby in order to carry out a real-time PCR (qPCR) assay using genus consensus primers, consensus orthopoxvirus (OPV) and smallpox-specific probes spanning over the 14 kD fusion protein encoding gene. A PCR-restriction fragment length polymorphism was used on-site as backup method to confirm the presence of monkeypox virus (MPXV) in samples. To complete the differential diagnosis of skin rash, chickenpox was tested in parallel using a commercial qPCR assay. In a post-deployment step, a MPXV-specific pyrosequencing was carried out on all biotinylated amplicons generated on-site in order to confirm the on-site results. Results Whereas MPXV proved to be the agent causing the rash illness outbreak in the Bena Tshiadi, VZV was the causative agent of the disease in Yangala and Ndesha districts. In addition, each on-site result was later confirmed by MPXV-specific pyrosequencing analysis without any discrepancy. Conclusion This experience of rapid on-site dual use DNA-based differential diagnosis of rash illnesses demonstrates the potential of combining tests specifically identifying bioterrorism agents and agents causing natural outbreaks. This opens the way to rapid on-site DNA-based identification of a broad spectrum of causative agents in remote areas.

Magazani, Edmond K.; Garin, Daniel; Muyembe, Jean-Jacques T.; Bentahir, Mostafa; Gala, Jean-Luc

2014-01-01

336

Reduced CYP2D6 function is associated with gefitinib-induced rash in patients with non-small cell lung cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Rash, liver dysfunction, and diarrhea are known major adverse events associated with erlotinib and gefitinib. However, clinical trials with gefitinib have reported different proportions of adverse events compared to trials with erlotinib. In an in vitro study, cytochrome P450 (CYP 2D6 was shown to be involved in the metabolism of gefitinib but not erlotinib. It has been hypothesized that CYP2D6 phenotypes may be implicated in different adverse events associated with gefitinib and erlotinib therapies. Methods The frequency of each adverse event was evaluated during the period in which the patients received gefitinib or erlotinib therapy. CYP2D6 phenotypes were determined by analysis of CYP2D6 genotypes using real-time polymerase chain reaction techniques, which can detect single-nucleotide polymorphisms. The CYP2D6 phenotypes were categorized into 2 groups according to functional or reduced metabolic levels. In addition, we evaluated the odds ratio (OR of the adverse events associated with each factor, including CYP2D6 activities and treatment types. Results A total of 232 patients received gefitinib therapy, and 86 received erlotinib therapy. Reduced function of CYP2D6 was associated with an increased risk of rash of grade 2 or more (OR, 0.44; 95% confidence interval [CI], 0.21–0.94; *p = 0.03, but not diarrhea ? grade 2 (OR, 0.49; 95% CI, 0.17–1.51; *p = 0.20 or liver dysfunction ? grade 2 (OR, 1.08; 95% CI, 0.52–2.34; *p = 0.84 in the gefitinib cohort. No associations were observed between any adverse events in the erlotinib cohort and CYP2D6 phenotypes (rash: OR, 1.77; 95% CI, 0.54–6.41; *p = 0.35/diarrhea: OR, 1.08; 95% CI, 0.21–7.43; *p = 0.93/liver dysfunction: OR, 0.93; 95% CI, 0.20–5.07; *p = 0.93. Conclusions The frequency of rash was significantly higher in patients with reduced CYP2D6 activity who treated with gefitinib compared to patients with functional CYP2D6. CYP2D6 phenotypes are a risk factor for the development of rash in response to gefitinib therapy.

Suzumura Tomohiro

2012-12-01

337

Cisternography and CT scanning with /sup 111/In-DTPA in evaluation of posterior fossa arachnoid cysts  

Energy Technology Data Exchange (ETDEWEB)

A patient with a large, long-standing posterior fossa arachnoid cyst was evaluated. Computed tomography was used to demonstrate the cyst. /sup 111/In-DTPA cisternography demonstrated the communication of the cyst with the subarachnoid space, stasis of the /sup 111/In in the cystic space, and incomplete ascent of cerebrospinal fluid over the cerebral hemispheres.

Lusins, J.; Nakagawa, H.; Sorek, M.; Goldsmith, S.

1979-04-01

338

[Tumors of the skull base, extending into the orbit, paranasal sinuses, nasal cavity, pterygopalatine and infratemporal fossa].  

Science.gov (United States)

The first of two papers focusing on surgery of skull base tumors invading orbit, sinonasal cavities, pterygopalatine and infratemporal fossae the authors described foundation and development of craniofacial oncology as a new discipline in skull base surgery, modern approaches to diagnostic evaluation of craniofacial mass lesions and basic principles of surgical management. PMID:24564081

Cherekaev, V A; Kadasheva, A B; Gol'bin, D A; Belov, A I; Kozlov, A V; Reshetov, I V; Lasunin, N V; Spirin, D S

2013-01-01

339

Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour  

Science.gov (United States)

Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

2011-01-01

340

Contribution of sup(99m)Tc pertechnetate brain scintigraphy in the diagnosis of tumours of posterior fossa  

International Nuclear Information System (INIS)

The present work concerns 38 posterior cranial fossa tumour cases subjected to sup(99m)Tc pertechnetate brain scintigraphy between May 1974 and June 1976. 33 of these patients have undergone an anatomical check while for the remaining 5, the existence of a posterior fossa tumour is established from the conjunction of clinical signs and other paraclinical examinations. The procedure was the same for all these 38 patients: after a 300 ?C/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations

1976-01-01

 
 
 
 
341

Cisternography and CT scanning with "1"1"1In-DTPA in evaluation of posterior fossa arachnoid cysts  

International Nuclear Information System (INIS)

A patient with a large, long-standing posterior fossa arachnoid cyst was evaluated. Computed tomography was used to demonstrate the cyst. "1"1"1In-DTPA cisternography demonstrated the communication of the cyst with the subarachnoid space, stasis of the "1"1"1In in the cystic space, and incomplete ascent of cerebrospinal fluid over the cerebral hemispheres

1979-01-01

342

Persistent cognitive dysfunction secondary to cerebellar injury in patients treated for posterior fossa tumors in childhood.  

Science.gov (United States)

Traditionally, the cerebral hemispheres have been regarded as the region of the brain responsible for cognitive functions, while the cerebellum has been considered to be primarily involved in motor functions. Recent studies focus also on the possible involvement of the cerebellum in neurocognitive functions. The aim of this study was to determine the neuropsychological profile of young adults treated for a posterior fossa tumor in childhood and look for possible support for the presence of the so-called 'cerebellar cognitive affective syndrome' in these patients. Two groups of young adults were studied. The astrocytoma group (n = 12) had been treated for a low-grade cerebellar astrocytoma with surgery alone (mean age at surgery was 8.6 years and mean age at neuropsychological testing was 23.5 years). The medulloblastoma group (n = 11) had been treated with surgery followed by radiotherapy and chemotherapy (mean age at surgery was 6.1 years and mean age at neuropsychological testing was 23.1 years). The neuropsychological test battery comprised measures of intelligence, motor function, attention, psychomotor speed, verbal memory and visual memory. The medulloblastoma group performed poorer than the astocytoma group on all neuropsychological measures except one. Nonetheless, the astrocytoma group also had impaired scores compared with standard norms on measures of motor speed, attention and executive function. No significant correlation between age at time of treatment and grade of neuropsychological impairment was found in the astrocytoma group, though there was a tendency that young age at time of treatment correlated with better outcome on IQ measures. In the medulloblastoma group, age was significantly correlated with outcome, for both IQ and degree of neuropsychological impairment. For this group, young age at time of treatment indicated a worse outcome. Conclusions: Persistent cognitive dysfunction was detected in patients treated for posterior fossa medulloblastoma and cerebellar astrocytoma. The astrocytoma group was treated with surgery alone, indicating that a cerebellar lesion can result in cognitive dysfunction. Thus, this study gives support to the existence of the cerebellar cognitive affective syndrome. Follow-up of all patients treated for posterior fossa tumor in childhood should include an extensive neuropsychological testing at regular intervals. This may be of benefit for school planning and later work planning. PMID:15886508

Rønning, Camilla; Sundet, Kjetil; Due-Tønnessen, Bernt; Lundar, Tryggve; Helseth, Eirik

2005-01-01

343

Topographic Constraints on the Mode of Formation of an Enigmatic Flow in Cerberus Fossae, Mars  

Science.gov (United States)

We use a digital elevation model (DEM), derived from stereo Context Camera (CTX) images referenced to Mars Orbiter Laser Altimeter (MOLA) data, and shadow length measurements made from High Resolution Imaging Science Experiment (HiRISE) images, to investigate the geometry of a young enigmatic flow in S.W. Cerberus Fossae, Mars. The flow originates from an almost circular (1.2 x 1.5 km) pit within a remnant of a yardang at 0o 35'N, 155o 17'E, within the lower unit of the Medusae Fossae Formation. The flow is ~42 km long and 0.5 to 2.0 km wide, and MOLA data indicate that the flow falls ~50 m along its length. The flow has a broad distal fan of material ~8 x 14 km in size that has a platey surface texture. The source area of the flow displays several sets of semi-concentric ridges with different centers of curvature, and the CTX DEM shows this depression is ~20 m deep, implying a volume of ~0.03 km3 for the removed material. Measurements made from the DEM of the height of the bounding walls of several 160 - 200 m wide constrictions, where 'over-spill' from the flow forms a clear disrupted margin to the flow on the adjacent hills, indicate that the flow was never more than ~8 - 10 m thicker than it currently appears. The total surface area of the flow is ~153 km2 and 25 shadow length measurements made from HiRISE images of the flow margins at 16 different places along the flow give a typical thickness of ~4 m. These measurements imply a volume for the flow of ~0.6 km3, which is 20 times larger than the volume of the flow's source area, thereby demonstrating that a significant amount of new material was erupted to form the flow. The available morphologic and topographic data raise the intriguing probability that the flow is most likely not a lava flow, but is instead a mud flow produced by water reaching the surface within the yardang materials and the subsequent mobilization of the unconsolidated material that comprised the yardang. This proposed mud flow origin consequently raises the possibility that other similar young platey-textured flows in Cerberus Fossae are also non-volcanic.

Mouginis-Mark, P. J.; Wilson, L.

2013-12-01

344

Acoustic neurinoma and posterior fossa meningioma - clinical and CT radiologic findings  

International Nuclear Information System (INIS)

Clinical and computed tomography (CT) findings of twenty-three patients with acoustig neurinoma (AN) and eleven patients with posterior fossa meningioma (PFM) are described. AN frequently (94%) presents with the complaint of hearing loss, while PFM often (60%) presents with non-specific pains in the head or neck. The CT characteristics of AN and PFM in this series were similar to those found in most previous publications. The maximal measured mean diamter of PFM (40.2 mm) was significantly larger than that of AN (26.4 mm). Hydrocephalus was apparently influenced by tumor location rather than by its size. It is concluded that diagnostic ability has been improved in cases of CPA tumors, but not in those of non-CPA PFM, probably because of the earlier clinical presentation of the former. Clinical efforts are still necessary to detect the smaller tumors. (orig.)

1986-01-01

345

Venous sinus volume in the caudal cranial fossa in Cavalier King Charles spaniels with syringomyelia.  

Science.gov (United States)

Syringomyelia (SM) in Cavalier King Charles spaniels (CKCS) has a complex pathophysiology. Recent studies support a relationship between altered venous drainage and cerebrospinal fluid flow dynamics. The aim of this study was to evaluate the relationship between venous sinus and parenchymal volume within the caudal cranial fossa (CCF) in CKCS with SM (n=22) and without SM (n=12) using magnetic resonance venography (MRV). MRI and MRV images were used to obtain volumetric calculations of CCF volume, as well as the percentage of this volume occupied by parenchyma (CCFP%) and venous sinuses (CCFV%). In CKCS with SM, CCFP% was significantly higher (P<0.001), whilst CCFV% was significantly lower (P=0.001) than in CKCS without SM. These results support a role for reduced venous drainage and parenchymal 'overcrowding' of the CCF in the pathophysiology of SM. PMID:23755937

Fenn, Joe; Schmidt, Martin J; Simpson, Harriet; Driver, Colin J; Volk, Holger A

2013-09-01

346

Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns  

International Nuclear Information System (INIS)

Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author)

1996-06-01

347

Hydrogel-induced cervicomedullary compression after posterior fossa decompression for Chiari malformation. Case report.  

Science.gov (United States)

The use of an absorbable hydrogel dural sealant has been approved for neurosurgical applications with no published reports of complications to date. The authors present the case of a 13-year-old girl with syringomyelia and quadriparesis who underwent posterior fossa decompression and dural augmentation for Chiari malformation Type I. Dural closure was performed with a dural substitute patch, hydrogel dural sealant, and gelatin sponge. Magnetic resonance imaging, performed after initial postoperative improvement in the patient's quadriparesis deteriorated, demonstrated an expanding epidural mass collection causing cervicomedullary compression. Exploration on postoperative Day 15 revealed an expanded layer of hydrogel underlying a layer of gelatin sponge. The authors conclude that hydrogel dural sealants should be used cautiously in spaces that cannot tolerate significant mass effect. PMID:17465365

Blackburn, Spiros L; Smyth, Matthew D

2007-04-01

348

Computer-assisted-endoscopic Surgery of a Large Trigeminal Schwannoma in the Pterygopalatine Fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Case Report: A 33 year-old woman presented with a history of many years of a tumor in the pterygopalatine fossa. The tumor (5x 4.5 cm extended to the sphenoid and maxillary sinuses, the nasal cavity, the skull base with an erosion of the cavernous sinus and the orbit with a close contact with the ophthalmic nerve. The patient had first refused to undergo the surgery because only an external approach through a paranasal and Caldwell-Luc incision had been proposed to her. We proposed a strictly endoscopic surgery after embolisation that allowed the diagnosis and the complete removal of this extended trigeminal schwannoma. The computer-assisted endoscopic surgery allowed the preservation of the intracranial structures, the internal carotid artery and the ophthalmic nerve; the morbidity was minimal and the patient was totally free of pain after surgery. There was no recurrence of the tumor after a follow-up of 2 years.

Ghanooni, Rose

2009-12-01

349

Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation  

Energy Technology Data Exchange (ETDEWEB)

A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

Tewari, Sanjit O., E-mail: tewaris@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Osborne, Joseph, E-mail: osbornej@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

2013-12-15

350

Radiological evaluation of mine water discharges from hard coal mining in the Fossa Eugeniana Area, Germany  

International Nuclear Information System (INIS)

Discharges of radium-carrying mine waters from hard coal mining in the area of the Fossa Eugeniana and the Rheinberger Altrhein in Germany have caused elevated radioactivity in sediments and soils. Extensive measurements of the ambient dose rate revealed some small area contaminations as well as a larger one in a nature protection area at the Rheinberger Altrhein. For the evaluation of the potential radiation exposure investigations of the activity concentrations of river sediments, soils, and biological materials were performed. The potential exposure of members of the public was modelled on the basis of the German Guidelines for the Calculation of Radiation Exposure due to Radioactivity from Mining Activities. In the assessment the present situation as well as its possible future development was considered. (orig.)

2008-05-01

351

Posterior fossa arachnoid cyst, tonsillar herniation, and syringomyelia in trichorhinophalangeal syndrome Type I.  

Science.gov (United States)

The authors report the case of a patient with Chiari malformation Type I (CM-I) and syringomyelia probably caused by a retrocerebellar arachnoid cyst. The patient's phenotype corresponded to trichorhinophalangeal syndrome Type I. The authors attributed the origin of both the retrocerebellar cyst and the abnormal posterior fossa to endochondral ossification anomalies that occur in this syndrome. The patient's spinal pain was most likely a result of the combination of CM-I and syringomyelia. To the best of the authors' knowledge, this is the first report on the association of CM-I and syringomyelia with a retrocerebellar arachnoid cyst occurring in a patient with trichorhinophalangeal syndrome Type I. The authors discuss the pathogenetic mechanisms involved in the production of tonsillar descent and syringomyelia in this patient, and review the current literature on related conditions that can result in this association. PMID:18826365

Martínez-Lage, Juan F; Ruiz-Espejo, Antonio; Guillén-Navarro, Encarna; Almagro, María-José

2008-10-01

352

Outcome in children with space-occupying posterior fossa arachnoid cysts.  

Science.gov (United States)

While prognostic information for Dandy-Walker syndrome and non-progressive cerebellar ataxia/cerebellar hypoplasia is available, surprisingly scant literature reports are found for space-occupying posterior fossa arachnoid cysts (PFAC). We describe the outcome of patients with symptomatic PFAC shunted as infants. Only 11 children were seen over a 20-year period (1980-1999). Cyst location was retrocerebellar (n = 8), supravermian (n = 2) and in the cerebellopontine angle (n = 1). Motor and cognitive impairments in one child were interpreted as the result of neurosurgical complications (intraventricular and intracerebral haemorrhage). One 6-year-old boy had mild truncal ataxia and mild cognitive delay. The 9 other patients had no evidence of ataxia or clumsiness and had average, some even above average, cognitive ability and scholastic achievements. Epilepsy was not a feature. We conclude that the prognosis of PFAC for cognitive development and neurological signs is favourable. PMID:12200740

Boltshauser, E; Martin, F; Altermatt, S

2002-06-01

353

Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI  

Energy Technology Data Exchange (ETDEWEB)

The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients` ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

Kamikawa, Shuji; Kuwamura, Keiichi [Hyogo Prefectural Awaji Hospital, Sumoto (Japan); Tamaki, Norihiko

1998-07-01

354

Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI  

International Nuclear Information System (INIS)

The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

1998-07-01

355

Anatomic study of the lacrimal fossa and lacrimal pathway for bypass surgery with autogenous tissue grafting  

Science.gov (United States)

Purpose: To study the microsurgical anatomy of the lacrimal drainage system and to provide anatomical evidence for transnasal endoscopic lacrimal drainage system bypass surgery by autogenous tissue grafting. Materials and Methods: A total of 20 Chinese adult cadaveric heads in 10% formaldehyde, comprising 40 lacrimal ducts were used. The middle third section of the specimens were examined for the following features: the thickness of the lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section of the upper opening, middle part, and lower opening of the nasolacrimal canal; the horizontal, 30° oblique, and 45° oblique distances from the lacrimal caruncle to the nasal cavity; the distance from the lacrimal caruncle to the upper opening of the nasolacrimal duct; and the included angle between the lacrimal caruncle–nasolacrimal duct upper opening junction and Aeby's plane. Results: The middle third of the anterior lacrimal crest was significantly thicker than the vertical middle line and the posterior lacrimal crest (P > 0.05). The horizontal distance, 30° oblique distance, and 45° oblique distance from the lacrimal caruncle to the nasal cavity exhibited no significant differences (P > 0.05). The included angle between the lacrimal caruncle and the lateral wall middle point of the superior opening line of the nasolacrimal duct and Aeby's plane was average (49.9° ± 1.8°). Conclusion: The creation of the bony tunnel should start from the middle or posterior middle part of the lacrimal fossa, extending toward the anterior inferior region with an optimal downward oblique angle of 45°.

Tao, Hai; Ma, Zhi-zhong; Wu, Hai-Yang; Wang, Peng; Han, Cui

2014-01-01

356

Incidence, Risks, and Sequelae of Posterior Fossa Syndrome in Pediatric Medulloblastoma  

International Nuclear Information System (INIS)

Purpose: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma. Methods and Materials: Between 1990 and 2007, 63 children with medulloblastoma at Emory University and Children's Healthcare of Atlanta were treated with craniectomy followed by radiation. Fifty-one patients were assigned to a standard-risk group, and 12 patients were assigned to a high-risk group. Five patients had 2 residual tumor, 4 had ?1.5-cm2 residual tumor, and the remainder had no residual tumor. Eleven patients had disseminated disease. Patients received craniospinal irradiation at a typical dose of 23.4 Gy or 36 Gy for standard- or high-risk disease, respectively. The posterior fossa was given a total dose of 54 or 55.8 Gy. Nearly all patients received chemotherapy following cooperative group protocols. Results: Median follow-up was 7 years. PFS developed in 18 patients (29%). On univariate analysis, brainstem invasion, midline tumor location, younger age, and the absence of radiographic residual tumor were found to be predictors of PFS; the last two variables remained significant on multivariate analysis. From 1990 to 2000 and from 2001 to 2007, the proportions of patients with no radiographic residual tumor were 77% and 94%, respectively. During the same eras, the proportions of patients with PFS were 17% and 39%. Only 4 patients had complete recovery at last follow-up. Conclusions: The incidence of PFS increased in the latter study period and is proportional to more aggressive surgery. Children with midline tumors exhibiting brainstem invasion are at increased risk. With the increased incidence of PFS and the permanent morbidity in many patients, the risks and benefits of complete tumor removal in all patients need to be reexamined.

2010-05-01

357

[Treatment and diagnosis of middle fossa arachnoid cyst: ventriculofiberscopy and cine-MRI].  

Science.gov (United States)

The treatment of intracranial arachnoid cysts in controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shrivelling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. PMID:9666495

Kamikawa, S; Kuwamura, K; Tamaki, N

1998-07-01

358

Transcatheter closure of fossa ovalis atrial septal defect: a single institutional experience.  

Science.gov (United States)

Transcatheter closure of the fossa ovalis atrial septal defect with adequate rims has become the procedure of choice in recent times. We report our experience with 439 patients who were selected for percutaneous device closure and 430 of whom underwent transcatheter closure of fossa ovalis atrial septal defects from May 1997 to May 2006. Device closure was not attempted in the remaining nine patients after initial evaluation due to high right atrial pressure following balloon occlusion (n=1 not parallel, high pulmonary vascular resistance (n=1), significant coronary artery disease (n=1), or the fact that the atrial septal defect was unsuitable for device closure (n=6). The anatomical size of the atrial septal defects ranged from 7-40 mm. Six patients underwent a combined procedure at the time of the atrial septal defect device closure (balloon pulmonary valvotomy in 4 cases, balloon pulmonary valvotomy and patent ductus arteriosus device closure in 1, and pulmonary ductus arteriosus coil closure in 1). The patients were in the age group of 2-77 years, the mean age being 20 years. Major complications occurred in seven cases. In 4 patients, there was device embolization immediately after deployment; there was left atrial appendage perforation, in one patient leading to cardiac tamponade during deployment of the device, and development of pulmonary edema in two patients. The cases in which device embolization took place underwent conventional surgery for atrial septal defect patch closure, while the patient with left atrial appendage perforation underwent emergency surgery (suturing of the left atrial appendage). Both patients with pulmonary edema were managed conservatively. The immediate success rate of device closure was 96.9%. All but one patient with multiple defects had no residual shunt at follow-up. On three months' to nine years' follow-up, the device remained stable, with no significant residual shunt and no history of thrombus formation on transthoracic echocardiography. PMID:19039149

Tomar, Munesh; Radhakrishnan, Sitaraman; Shrivastava, Savitri

2006-01-01

359

Alvarado score as an admission criterion in children with pain in right iliac fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Acute appendicitis is an important differential diagnosis in children with pain in the right iliac fossa. Some patients have equivocal signs that make the diagnosis difficult. Many patients with suspected acute appendicitis are admitted for observation and finally discharged because they did not have appendicitis. We decided to design this study to investigate whether the Alvarado score could be used by emergency room doctors as a criterion for admission to hospital. Patients and Methods: This is a prospective study comprising 350 patients who attended the emergency department with suspected acute appendicitis in the period from May 2007 to April 2009. All patients were scored by Alvarado score in the emergency department before admission. The Alvarado score is based on three symptoms, three signs and two laboratory findings. The decision for admission and surgery was made independent of the score. The diagnosis of patients who underwent appendicectomy was confirmed by both operative findings and postoperative histopathology. Results: We studied the Alvarado scores of 350 patients who presented to the emergency department with pain in the right iliac fossa; their age ranged from 8 to 14 years; 182 patients (52% operated with the aim to treat acute appendicitis, 168 patients (48% were discharged without surgical intervention and advised to attend the out-patient clinic after 24 hours for re-evaluation. we have found that patients with a low Alvarado score (less than 6 did not have acute appendicitis. Conclusion: Patients with equivocal signs can present a diagnostic challenge and are very often admitted to the surgical department for observation. The Alvarado score can be used as a scoring system that help in taking the decision for admission of cases with suspected acute appendicitis especially by primary healthcare providers.

Shreef Khalid

2010-01-01

360

Estimates of seismic activity in the Cerberus Fossae region of Mars  

Science.gov (United States)

The 2016 NASA InSight lander is the first planetary mission designed to study the deep interior of Mars. InSight's Seismic Experiment for Interior Structure (SEIS) package will quantify global and regional seismic activity and determine parameters like core properties, mantle composition, and Martian lithospheric thickness. An improved understanding of the location, magnitude, and frequency of potential seismic sources is essential for optimization of instrument design, sampling strategy, and interpretation of mission data. We focus on forecasting seismic activity for the Cerberus Fossae of the Elysium Planitia, chosen for their proximity to the proposed landing site and their recent formation and assuming these are active tectonic grabens. The minimum age we determine for the units around the Fossae, using Context Camera and High Resolution Imaging Science Experiment imagery for crater density surveying, is 10 Ma, placing them in the Late Amazonian. We are able to determine the rate of motion from measurements of observed throw, assuming that the faults remain active. Digital terrain models, made from stereo-image pairs from the High Resolution Stereo Camera (HRSC), are used to determine the maximum throw on four graben systems. Using these measured throws to estimate a length-averaged slip and assuming an inferred slip rate from surface age, we estimate an annual moment release of 1.58-1.03+2.35×1017Nm. From this we calculate an annual size-frequency distribution of events using the Gütenberg-Richter relationship. We estimate that between 1.5×100and 1.9×105events per year will have an amplitude greater than the peak band noise and so will be detectable at the InSight landing site.

Taylor, J.; Teanby, N. A.; Wookey, J.

2013-12-01

 
 
 
 
361

Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report  

Directory of Open Access Journals (Sweden)

Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17, estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17, pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

Yvens B. Fernandes

1995-09-01

362

Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea / Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nov [...] a abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea. Abstract in english The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal [...] turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy. RESULTS: Only the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani. CONCLUSION: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.

Aline Gomes, Bittencourt; Robinson Koji, Tsuji; João Paulo Ratto, Tempestini; Alfredo Luiz, Jacomo; Ricardo Ferreira, Bento; Rubens de, Brito.

363

Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea  

Directory of Open Access Journals (Sweden)

Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea.The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy. RESULTS: Only the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani. CONCLUSION: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.

Aline Gomes Bittencourt

2013-04-01

364

[A new cause of intra and extrahepatic cholangitis: the drug hypersensitivity syndrome or DRESS (Drug Rash with Eosinophilia and Systemic Symptoms)].  

Science.gov (United States)

The DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) corresponds to a drug reaction generally including cutaneous eruption, fever, hematologic abnormalities such as eosinophilia and atypical lymphocytosis and one or more specific visceral lesions specially in the liver. We report a case of drug hypersensitivity syndrome or DRESS associated with intra and extra-hepatic biliary lesions. This syndrome was associated with sulfasalazine and naproxene therapy. A reactivation of HHV6 was documented in the continuations of the DRESS and could play a role in the symptomms. PMID:16514397

Condat, Bertrand; Zanditenas, David; Collot, Véronique; Legoupil, Nathalie; Cazals-Hatem, Dominique; Hauuy, Marie-Pierre; Bonnet, Joëlle; Ngo, Yann; Roucoules, Jacques; Blazquez, Martine

2006-01-01

365

Confirmation of Rubella within 4 Days of Rash Onset: Comparison of Rubella Virus RNA Detection in Oral Fluid with Immunoglobulin M Detection in Serum or Oral Fluid ?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Rubella virus infection is typically diagnosed by the identification of rubella virus-specific immunoglobulin M (IgM) antibodies in serum, but approximately 50% of serum samples from rubella cases collected on the day of rash onset are negative for rubella virus-specific IgM. The ability to detect IgM in sera and oral fluids was compared with the ability to detect rubella virus RNA in oral fluids by reverse transcription-PCR (RT-PCR) by using paired samples taken within the first 4 days after...

Abernathy, Emily; Cabezas, Cesar; Sun, Hong; Zheng, Qi; Chen, Min-hsin; Castillo-solorzano, Carlos; Ortiz, Ana Cecilia; Osores, Fernando; Oliveira, Lucia; Whittembury, Alvaro; Andrus, Jon K.; Helfand, Rita F.; Icenogle, Joseph

2009-01-01

366

Hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis presenting with a vasculitic syndrome, acute nephritis and a puzzling skin rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Anti-neutrophil cytoplasmic antibody-associated vasculitis has been associated with many drugs and it is a relatively rare side effect of the antihypertensive drug hydralazine. The diagnosis and management of patients who have anti-neutrophil cytoplasmic antibody-associated vasculitis may be challenging because of its relative infrequency, variability of clinical expression and changing nomenclature. The spectrum of anti-neutrophil cytoplasmic antibody-associated vasculitis is wide and can be fatal. This case documents a 62-year-old woman who presented with hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis with a puzzling cutaneous rash. Case presentation We report a rare case of hydralazine-induced anti-neutrophil cytoplasmic antibody-associated vasculitis in a 62-year-old Caucasian woman who presented with a vasculitic syndrome with a sore throat, mouth ulcers and otalgia after several months of constitutional symptoms. She then proceeded to develop a rash over her right lower limb. Clinically, the rash had features to suggest Sweet’s syndrome, but also had some appearances consistent with embolic phenomena and did not have the appearance of palpable purpure usually associated with cutaneous vasculitis. Differential diagnoses were hydralazine-associated Sweet’s syndrome, streptococcal-induced cutaneous eruption or an unrelated contact dermatitis. A midstream urine sample detected glomerular blood cells in the setting of anti-neutrophil cytoplasmic antibody-positive renal vasculitis and Streptococcus pyogenes bacteremia. A renal biopsy revealed a pauci-immune, focally necrotizing glomerulonephritis with small crescents. Her skin biopsy revealed a heavy neutrophil infiltrate involving the full thickness of the dermis with no evidence of a leucocytoclastic vasculitis, but was non-specific. She was initially commenced on intravenous lincomycin for her bloodstream infection and subsequently commenced on immunosuppression after cessation of hydralazine. The patient was subsequently discharged from hospital after a rapid clinical improvement. Conclusion Hydralazine-induced anti-neutrophil cytoplasmic antibody-positive renal vasculitis is a rare adverse effect and can present with a severe vasculitic syndrome with multiple organ involvement. Features of this association include the presence of high titres of anti-myeloperoxidase-anti-neutrophil cytoplasmic antibody with multi-antigenicity, positive anti-histone antibodies and the lack of immunoglobulin and complement deposition histopathogically. A rash that is characteristic of Sweet’s syndrome has also been described as an association. Prompt cessation of hydralazine may be sufficient to reverse disease activity but immunosuppression may be needed for definite treatment.

Keasberry Justin

2013-01-01

367

Sinuous Ridges as Tools to Investigate Post-Flow Modification in the Aeolis-Zephyria Plana, Western Medusae Fossae Formation, Mars  

Science.gov (United States)

The longitudinal profiles of inverted fluvial features located in the Medusa Fossae Formation exhibit undulations that we interpret as evidence of post-fluvial deformation of the region. We propose and evaluate possible deformation processes.

Lefort, A.; Burr, D. M.; Beyer, R. A.; Howard, A. D.

2012-03-01

368

Multiple systemic metastases of posterior fossa - primitive neuroectodermal tumor (PF-PNET) in adult: case report Metastases sistêmicas múltiplas de tumor neuroectodérmico primitivo (PNET) na fossa posterior em adulto: relato de caso  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF- PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.A presença de metástases múltiplas sistêmicas decorrentes de um tumor neur...

2003-01-01

369

Impairment of intellectual functions after surgery and posterior fossa irradiation in children with ependymoma is related to age and neurologic complications  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background To investigate the neuropsychological outcome of children treated with surgery and posterior fossa irradiation for localized infratentorial ependymoma. Methods 23 patients (age 0.3 – 14 years at diagnosis) who were treated with local posterior fossa irradiation (54 Gy) underwent one (4 patients) or sequential (19 patients) neuropsychologic evaluation. The last evaluation was performed at a median of 4.5 (1 to 15.5) years after RT. Re...

von Hoff Katja; Kieffer Virginie; Habrand Jean-Louis; Kalifa Chantal; Dellatolas Georges; Grill Jacques

2008-01-01

370

Sphenoid sinus mucocele penetrating to the orbit, anterior and middle cranial fossae and parapharyngeal space: a case report.  

Science.gov (United States)

Mucocele, though is a common lesion, rarely penetrates to the surrounding intra- and extracranial spaces. We describe the case of 45-year-old male with 2 years history of a chronic left nasal obstruction and a concentric visual field deficit in the left eye as the only manifestations. Diagnostic CT and MRI imaging revealed a mucocele originating from the posterior ethmoid and sphenoid sinuses and penetrating intracranially to the anterior and middle cranial fossae and extracranially to the pterygopalatine fossa and the parapharyngeal space. This extensive localization appears to be an extremely rare entity, which, to our knowledge, has not been described in the English literature yet. The clinical features and a literature review are also presented. PMID:20476593

Chmielewski, Rafa?; Paprocki, Arkadiusz; Morawski, Krzysztof; Niemczyk, Kazimierz

2010-01-01

371

Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols  

International Nuclear Information System (INIS)

Posterior fossa artifacts constitute a characteristic limitation of cranial CT. To identify practical benefits and drawbacks of newer CT systems with reduced collimation in routine cranial imaging, we aimed to investigate image quality, posterior fossa artifacts and parenchymal delineation in non-enhanced CT (NECT) with 1-, 4-, 16- and 64-slice scanners using standard scan protocols. We prospectively enrolled 25 consecutive patients undergoing NECT on a 64-slice CT. Three groups with 25 patients having undergone NECT on 1-, 4- and 16-slice CT machines were matched regarding age and sex. Standard routine CT parameters were used on each CT system with helical acquisition in the posterior fossa; the parameters varied regarding collimation and radiation dose. Three blinded readers independently assessed the cases regarding image quality, infra- and supratentorial artifacts and delineation of brain parenchymal structures on a five-point ordinal scale. Reading orders were randomized. A proportional odds model that accounted for the correlated nature of the data was fit using generalized estimating equations. Posterior fossa artifacts were significantly reduced, and the delineation of infratentorial brain structures was significantly improved with the thinner collimation used for the newer CT systems (p0.5). The thinner collimation available on modern CT systems leads to reduced posterior fossa artifacts and to a better delineation of brain parenchyma in the posterior fossa. (orig.)

2008-08-01

372

Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unu...

Marcelo Pandolfi Basso; Adriana Borgonovi Christiano; André Luís Cozetto de Oliveira; Geni Satomi Cunrath; João Gomes Netinho

2012-01-01

373

Familial Posterior Fossa Brain Tumors of Infancy Secondary to Germline Mutation of the hSNF5 Gene  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We have identified a family afflicted over multiple generations with posterior fossa tumors of infancy, including central nervous system (CNS) malignant rhabdoid tumor (a subset of primitive neuroectodermal tumors, or PNET) and choroid plexus carcinoma. Various hereditary tumor syndromes, including Li-Fraumeni syndrome, Gorlin syndrome, and Turcot syndrome, have been linked to increased risk of developing CNS PNETs and choroid plexus tumors. Malignant rhabdoid tumors of the CNS and kidney sho...

Taylor, Michael D.; Gokgoz, Nalan; Andrulis, Irene L.; Mainprize, Todd G.; Drake, James M.; Rutka, James T.

2000-01-01

374

Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a high-resolution mRNA microarr...

Aarhus, Mads; Helland, Christian A.; Lund-johansen, Morten; Wester, Knut; Knappskog, Per

2010-01-01

375

Arachnoid cysts in the middle cranial fossa: cause and treatment of progressive and non-progressive symptoms.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Ten consecutive patients with arachnoid cysts in the middle cranial fossa, diagnosed by CT, were studied. They were divided into three clinical groups: (1) four patients with progressive symptoms caused by secondary bleeding, (2) five patients with non-progressive symptoms of headache or epilepsy, and (3) one asymptomatic patient. The nine symptomatic patients were operated upon and eight showed clinical improvement. Measurements of the CT scans revealed equal brain volumes on the affected an...

Meche?, F. G.; Braakman, R.

1983-01-01

376

Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a high-resolution mRNA microarray analys...

Aarhus, Mads; Helland, Christian A.; Lund-johansen, Morten; Wester, Knut; Knappskog, Per

2010-01-01

377

Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a ...

Aarhus Mads; Helland Christian A; Lund-Johansen Morten; Wester Knut; Knappskog Per M

2010-01-01

378

A comparative study of the pterygopalatine fossa and its ganglion in a South African skeletal and cadaver population  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Blocking the contents of the pterygopalatine fossa (PPF) is a highly effective method in alleviating pain in trigeminal neuralgia (TN) and other facial pain syndromes. This, however, is not a widely used technique, due to the difficulty in locating the PPF which is obscured by bony and soft tissue structures. Despite the various unspecific techniques that have been attempted, in many cases radiography still seems to be used as it is the most effective method in locating the PPF. The aim of th...

2008-01-01

379

Interdisciplinary Clinical Management of High Grade Arteriovenous Malformations and Ruptured Flow-Related Aneurysms in the Posterior Fossa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Posterior fossa arteriovenous malformations are rare entities and treatment modalities technically challenging. In recent years new therapeutic options have emerged through microsurgical and endovascular means. Based on a series of six cases we describe combined interdisciplinary treatment strategies and report the outcome in a midterm follow-up interval of 12 months. Clinical case data were collected during acute phase and follow-up including standardized angiographic control intervals durin...

Mpotsaris, A.; Loehr, C.; Harati, A.; Lohmann, F.; Puchner, M.; Weber, W.

2010-01-01

380

Dimensions of the posterior fossa in patients symptomatic for Chiari I malformation but without cerebellar tonsillar descent  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Chiari I malformation (CMI) is diagnosed by rigid radiographic criteria along with appropriate clinical symptomatology. The aim of this study was to investigate the dimensions of the posterior cranial fossa in patients without significant tonsillar descent but with symptoms comparable to CMI. Methods Twenty-two patients with signs and symptoms comparable to CMI but without accepted radiographic criteria of tonsillar descent > 3–5 mm were re...

2005-01-01

 
 
 
 
381

Vascular Decompression of Trigeminal and Facial Nerves in the Posterior Fossa under Endoscope-Assisted Keyhole Conditions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: The aim of this study was to determine the use and safety of the endoscope as an adjunct during trigeminal and facial nerve decompression procedures performed under keyhole conditions in the posterior fossa. Method: We performed 67 surgeries in 65 patients with symptomatic trigeminal and facial nerve compression syndromes. The diagnosis was made mainly on the basis of clinical history, examination, and magnetic resonance imaging scans. Surgery was performed in all cases under endos...

Charalampaki, P.; Kafadar, A. M.; Grunert, P.; Ayyad, A.; Perneczky, A.

2008-01-01

382

Impacted cisterna magna without syringomyelia associated with lancinating headache, throbbed nuchal pain and paraparesis treated byposterior fossa decompression Cisterna magna impactada sem siringomielia associada a cefaléia lancinante, dor na nuca terebrante e paraparesia tratadas com descompressão da fossa posterior  

Directory of Open Access Journals (Sweden)

Full Text Available A 29-year-old woman with acute lancinating headache, throbbed nuchal pain and subacute paraparesis underwent brain MRI in supine position that depicted: the absence of the cisterna magna, filled by non herniated cerebellar tonsils and compression of the brain stem and cisternae of the posterior fossa, which are aspects of the impacted cisterna magna without syringomyelia and without hydrocephalus. During eight days, pain was constant and resistant to drug treatment. Osteodural-neural decompression of the posterior fossa, performed with the patient in sitting position, revealed: compression of the brainstem, fourth ventricle and foramen of Magendie by herniated cerebellar tonsils, which were aspirated. Immediately after surgery, the headache and nuchal pain remmited. MRI depicted the large created cisterna magna and also that the cerebellar tonsils did not compress the fourth ventricle, the foramen of Magendie and the brainstem, besides the enlargement of posterior fossa cisternae. Four months after surgery, headache, nuchal pain and paraparesis had disappeared but hyperactive patellar and Achilles reflexes remained.Uma paciente de 29 anos de idade com quadro agudo de cefaléia lancinante, dor terebrante na nuca e paraparesia subaguda foi submetida a RM do encéfalo, em posição supina, que revelou: ausência da cisterna magna, preenchida por tonsilas cerebelares não herniadas e compressão do tronco encefálico e das cisternas da fossa posterior, compatíveis com o diagnóstico de cisterna magna impactada sem siringomielia e sem hidrocefalia. Por oito dias a dor foi constante e resistente aos analgésicos. Com a paciente em posição sentada, foi realizada descompressão osteodural-neural da fossa posterior associada a aspiração das tonsilas cerebelares. Os achados perioperatórios foram caracterizados por herniação das tonsilas cerebelares que comprimiam o tronco cerebral, o quarto ventrículo e o forame de Magendie. No pós-operatório imediato houve remissão da cefaléia e da dor na nuca. A RM evidenciou a cisterna magna recém-criada, alargamento do quarto ventrículo e das cisternas do tronco encefálico. Quatro meses depois, a paciente continuava sem cefaléia, sem dor na nuca e sem paraparesia. Entretanto, permaneceu a hiperatividade dos reflexos patelares e aquileus.

José Alberto Gonçalves da Silva

2007-12-01

383

Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases  

Energy Technology Data Exchange (ETDEWEB)

Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab.

Kueker, W. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Mull, M. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Thron, A. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany)

1997-08-01

384

Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases  

International Nuclear Information System (INIS)

Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab

1997-08-01

385

Lumbar meningeal enhancement after surgery in the posterior cranial fossa: a normal finding in children?  

International Nuclear Information System (INIS)

Purpose: Spinal meningeal Gd-DTPA enhancement after cranial surgery is a known observation of a not well understood underlying mechanism. This paper demonstrates that this MRI finding is a normal meningeal reaction to subarachnoid hemorrhage, which should not be mistaken for metastatic spread. Material and methods: Three pediatric patients were examined by MRI for metastatic spread of malignant infratentorial tumors along the spinal canal two to nine days after the removal of the primary cerebral lesion. The findings were compared with a control group that underwent cranial surgery (cyst resection or fenestration of the posterior cranial fossa) without major bleeding into the subarachnoid space. Unenhanced and enhanced sequences were obtained to prove that the high singal within the CSF is caused by an abnormal Gd-DTPA uptake and not by methemoglobin. Results: Meningeal enhancement was observed in all patients with intraoperative bleeding resembling subarachnoid masses on enhanced T1-weighted images. This was not present in any patient of the control group. This finding lasts for approximately two weeks. Conclusion: The meningeal enhancement renders immediate postoperative studies inconclusive for the detection of metastatic spread. Consequently, the obligatory tumor staging along the spinal canal should ideally be done prior to the resection of a cerebral tumor. (orig.)

2002-12-01

386

[Ethmoid sinus mucocele penetrating to the orbit and anterior cranial fossa - case report].  

Science.gov (United States)

Paranasal sinus mucocele is the cystic formation lined by inflammatory changed mucoperiosteum. This is slow-growing pathology with a tendency to bone erosion. The symptoms are dependent on the direction of the penetration, and are as follows: increasing headaches, deformations of frontal or orbital region, ophthalmic manifestations such as lacrimation, decreased visual acuity, exophthalmos, ocular movement limitation, diplopia. The most common location of the mucocele is fronto-ethmoid region. The most useful diagnostic tests are a magnetic resonance imaging (MRI) and a computed tomography (CT) which show the progress of the disease and bone destructions. Surgery is the only method of treatment (external approach or FESS). This paper reports the case of a 74-year-old woman with ethmoid mucocele penetrating into the orbit, frontal sinus and anterior cranial fossa with compression of frontal lobe of the brain. The patient underwent CT and MRI and was treated with endoscopic intranasal marsupialization of the cyst. There are no clinical signs of disease recurrence 7 months after surgery. The endoscopic surgical management in treatment of sinus mucocele is a good alternative to the operation from external approach because of its low invasiveness, low complication risk, rapid healing and good therapeutic effects. PMID:24021830

Paradowska-Opa?ka, Beata; Kawczy?ski, Maciej; Jaworowska, Ewa

2013-01-01

387

Quality of life after microsurgery for vestibular schwannoma via the middle cranial fossa approach.  

Science.gov (United States)

The aim of this study was to analyse the quality of life (QOL) of patients who had undergone microsurgery for vestibular schwannomas (VS). A questionnaire was sent to 117 consecutive patients who had been operated on using the middle cranial fossa (MCF) approach between October 2005 and June 2011. The response rate was 91/117 (78 %) of which 86 were suitable for analysis. The questionnaire consisted of the Short Form-36 (SF-36) Health Survey including a self-designed, disease-specific section. Demographic data, tumour size, hearing status and facial nerve function were extracted from our VS database. Patients scored significantly lower in seven of the eight subscales of the SF-36 compared to German normative QOL data. But when compared to a normative group of patients with hearing loss, only two subscales were affected. The alteration of the subscales was correlated with objective and subjective parameters. Vertigo and postoperative hearing status could be identified as the parameters with the strongest influence on QOL. PMID:24061568

Scheich, Matthias; Ginzkey, Christian; Reuter, Edith; Harnisch, Wilma; Ehrmann, Desiree; Hagen, Rudolf

2014-07-01

388

The value of metrizamide CT cisternography in the diagnosis of suprasellar and posterior fossa tumors  

International Nuclear Information System (INIS)

We have studied the diagnostic value of metrizamide CT cisternography (MCTC) in 22 patients. Six patients received metrizamide for the delineation of suprasellar tumors, 8 for posterior fossa tumors, and 8 for miscellaneous lesions, such as congenital cystic lesions and subdural fluid collections. Metrizamide with a concentration of 170 mgI/ml was used; 10 ml of it was introduced through the lumbar intrathecal route in every case. The patients were kept in a 15-degree Trendelenburg position, and Computed Tomography with an ACTA scanner (ACTA 200FS) was performed in principle one hour after the intrathecal injection and, if necessary, serially thereafter. The morphology of the subarachnoid space was well visualized in detail by CSF enhancement with metrizamide in all cases. The contours of the tumors in and around the basal cisterns were clearly shown; their relationship to the adjacent structures became more evident upon direct coronal section or upon coronal and sagittal reconstruction. It is suggested that the differential diagnosis in the suprasellar tumors and the C-P angle tumors can be made by means of the exact representation of the contours and extension of these tumors. MCTC can delineate the brain-stem glioma more accurately than the conventional CT scan: thus, it offers a definite advantage for the diagnosis and evaluation of those tumors which show isodensity on precontrast and no enhancement on postcontrast conventional CT scan. An arachnoid cyst or a porencephalic cyst can be diagnosed by the evaluation of the CSF-flow pattern. (author)

1982-01-01

389

Value of metrizamide CT cisternography in the diagnosis of suprasellar and posterior fossa tumors  

Energy Technology Data Exchange (ETDEWEB)

We have studied the diagnostic value of metrizamide CT cisternography (MCTC) in 22 patients. Six patients received metrizamide for the delineation of suprasellar tumors, 8 for posterior fossa tumors, and 8 for miscellaneous lesions, such as congenital cystic lesions and subdural fluid collections. Metrizamide with a concentration of 170 mgI/ml was used; 10 ml of it was introduced through the lumbar intrathecal route in every case. The patients were kept in a 15-degree Trendelenburg position, and Computed Tomography with an ACTA scanner (ACTA 200FS) was performed in principle one hour after the intrathecal injection and, if necessary, serially thereafter. The morphology of the subarachnoid space was well visualized in detail by CSF enhancement with metrizamide in all cases. The contours of the tumors in and around the basal cisterns were clearly shown; their relationship to the adjacent structures became more evident upon direct coronal section or upon coronal and sagittal reconstruction. It is suggested that the differential diagnosis in the suprasellar tumors and the C-P angle tumors can be made by means of the exact representation of the contours and extension of these tumors. MCTC can delineate the brain-stem glioma more accurately than the conventional CT scan: thus, it offers a definite advantage for the diagnosis and evaluation of those tumors which show isodensity on precontrast and no enhancement on postcontrast conventional CT scan. An arachnoid cyst or a porencephalic cyst can be diagnosed by the evaluation of the CSF-flow pattern.

Takahara, N.; Mizuno, M.; Suwa, J.; Yamanouchi, Y.; Matsumura, H. (Kansai Medical School, Moriguchi, Osaka (Japan))

1982-02-01

390

Improved Treatment of the Breast and Supraclavicular Fossa Based on a Simple Geometrical Principle  

International Nuclear Information System (INIS)

In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the “match” is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.

2011-01-01

391

A study of pterygopalatine fossa involvement in nasopharyngeal carcinoma on CT  

International Nuclear Information System (INIS)

Objective: To get deeper understanding of the CT manifestation of PPF invaded by NPC so as to enhance the diagnostic accuracy. Methods: Sixty-six patients with pathologically proven NPC, scanned by conventional CT, were analyzed retrospectively. Another 30 patients, scanned by both conventional CT and HRCT, were studied prospectively. Results: Of all these 96 cases, 41 cases were found with PPF invasion, 21 cases being invaded through sphenopalatine foramen, 5 cases through infratemporal fossa, 15 cases through unidentifiable routes. After PPF involvement, the subsequent sphenoid sinus invasion via sphenoehtmoid recess or pterygoid canal could be found in 7 cases, 11 cases with pterygoid canal involvement and 10 cases with sphenoid sinus erosion were shown with coronal HRCT, while 5 cases and 3 cases accordingly were presented with axial HRCT (P < 0.05). Conclusion: The structures adjacent to PPF can be involved following PPF invasion, and the way through which sphenoid sinus is invaded deserves further attention. Axial HRCT is advantageous over conventional CT in showing the bone destruction of pterygoid canal and sphenoid sinus, while coronal HRCT is significantly superior to axial HRCT in presenting the involvement of the above-mentioned structures

2001-09-01

392

Covert orienting in three etiologies of congenital hydrocephalus: the effect of midbrain and posterior fossa dysmorphology.  

Science.gov (United States)

Covert orienting is related to the integrity of the midbrain, but the specificity of the relation is unclear. We compared covert orienting in three etiologies of congenital hydrocephalus (aqueductal stenosis [AS], Dandy-Walker malformation [DWM], and spina bifida myelomeningocele [SBM]--with and without tectal beaking) to explore the effects of midbrain and posterior fossa malformations. We hypothesized a stepwise order of group performance reflecting the degree of midbrain tectum dysmorphology. Performance on an exogenously cued covert orienting task was compared using repeated measures analysis of covariance, controlling for age. Individuals with SBM and tectal beaking demonstrated the greatest disengagement cost in the vertical plane, whereas individuals with AS performed as well as a typically developing (TD) group. Individuals with SBM but no tectal beaking and individuals with DWM showed greater disengagement costs in the vertical plane relative to the TD group, but better performance relative to the group with SBM and tectal beaking. Individuals with AS, DWM, and SBM and tectal beaking demonstrated poorer inhibition of return than TD individuals. Impairments in attentional disengagement in SBM are not attributable to the general effects of hydrocephalus, but are instead associated with specific midbrain anomalies that are part of the Chiari II malformation. PMID:24528548

Treble-Barna, Amery; Kulesz, Paulina A; Dennis, Maureen; Fletcher, Jack M

2014-03-01

393

Long-term outcome after operation for trigeminal neuralgia in patients with posterior fossa tumors.  

Science.gov (United States)

During a 20-year period, 26 patients with typical symptoms of trigeminal neuralgia were found to have posterior fossa tumors at operation. These cases included 14 meningiomas, eight acoustic neurinomas, two epidermoid tumors, one angiolipoma, and one ependymoma. The median patient age was 60 years and 69% of the patients were women. Sixty-five percent of the symptoms were left sided. The median preoperative duration of symptoms was 5 years. The distribution of pain among the three divisions of the trigeminal nerve was similar to that found in patients with trigeminal neuralgia who did not have tumors; however, more divisions tended to be involved in the tumor patients. The mean postoperative follow-up period was 9 years. At operation, the root entry zone of the trigeminal nerve was examined for vascular cross-compression in 21 patients. Vessels compressing the nerve at the root entry zone were observed in all patients examined. Postoperative pain relief was frequent and long lasting. Using Kaplan-Meier methods the authors estimated excellent relief in 81% of the patients 10 years postoperatively, with partial relief in an additional 4%. PMID:8622156

Barker, F G; Jannetta, P J; Babu, R P; Pomonis, S; Bissonette, D J; Jho, H D

1996-05-01

394

Evaluation of axillary fossa lymph nodes metastasis with mammography in patients with breast cancer  

International Nuclear Information System (INIS)

Objective: To investigate X-ray characteristics of axillary fossa lymph nodes (ALNs)metastases in patients with breast cancer. Methods: 11 cases of breast cancer confirmed by operation were performed with mammography. The breast, the samples of the breast and the ALNs were all detected. The X-ray characteristics of ALNs were compared with pathologic findings. Results: There were 46 metastatic lymph nodes and 52 non-metastatic nodes. There were 10 metastaic and 8 non-metastic lymph nodes among 18 lymph nodes with maximum diameter larger than 10mm. There were 42 metastatic and 5 non-metastatic lymph nodes among 42 high density solid ymph nodes. Only 4 out of 46 metastatic lymph nodes showed normal density. Conclusion: The metastases of ALNs had poor correlation with the size. The high density, irregular cortex and adjacent fat tissue change of the ALNs in patients with breast cancer are probably indicative of metastases. Molybdenum target mammography is amodality of choice for the assessment of ALNs in patients with breast cancer. (authors)

2007-08-01

395

Geology of Hebrus Valles and Hephaestus Fossae, Mars: evidence for basement control of fluvial patterns  

Energy Technology Data Exchange (ETDEWEB)

Hebrus Valles (HV) and Hephaestus Fossae (HF) are valley systems located SW of Elysium Mons in the low northern plains of Mars. HV share many of their characteristics with other martian outflow channels--widely interpreted as having formed by catastrophic flooding. The NW-trending HV system is 250 km long and begins in an elongate depression. Individual channels are less than 1 km wide; a braided reach is about 10 km wide. Streamlined islands are abundant in the middle reach. HV terminate as a series of narrow distributaries. No sedimentary deposits are obviously related to the development of the channel. HV cut across a broad expanse of older plains dotted by irregular mesas and smaller knobs. HF are a connected series of linear valley segments which branch and cross downslope but have high junction angles. Locally, the channel pattern is polygonal. HF are parallel to HV but are considerably deeper and longer (600 km). HF also originate in a depression, but to the NW they terminate near the gradational boundary between the knobby plains and polygonally fractured terrain of Utopia Planitia. The valley pattern has led some to suggest that HF are tectonic features. It is suggested that like HV, HF are also of fluvial origin. Downcutting to, or subsurface flow at this pre-existing surface red to a channel pattern that was strongly controlled by the polygonal troughs buried beneath the younger knobby plains materials.

Christiansen, E.H.

1985-01-01

396

Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases  

Directory of Open Access Journals (Sweden)

Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

MR Etemadifar

2005-05-01

397

Conventional-radiographic and computer-assisted cisternography of the posterior fossa with Metrizamide  

International Nuclear Information System (INIS)

Conventional radiographic and computer-assisted (CT) cisternography of the posterior fossa using Metrizamide was carried out in 25 and 33 patients respectively. The contrast medium was injected by the lumbar or cervical route. During conventional cisternography, contrast medium distribution is most easily controlled by a lateral injection at the level of the first to second cervical vertebra. Because of its physical properties, Metrizamide results in good demonstration of detail. CT cisternography is usually able to demonstrate an extra-cerebral space-occupying lesion with a diameter greater than 1 cm. This procedure has fewer complications due to the contrast medium or the technique, since small amounts of Metrizamide achieve an adequate increase in the design of the CSF; it is therefore possible to inject this by a lumbar route and to carry out the entire examination with the patient supine. Both conventional and CT cisternography permit very accurate diagnosis in the region of the foramen magnum. Both procedures can be used on their own or as an addition to conventional Metrizamide myelography. (orig.)

1979-01-01

398

Declarative and procedural learning in children and adolescents with posterior fossa tumours  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma, given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects and one control (twelve subjects. The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version 1 of the California Verbal Learning Test-Children's Version- CVLT- 2 to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available Results The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. Conclusion The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

Casares Encarnación

2006-03-01

399

Improved Treatment of the Breast and Supraclavicular Fossa Based on a Simple Geometrical Principle  

Energy Technology Data Exchange (ETDEWEB)

In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the 'match' is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.

Yavetz, Dalia, E-mail: dalia.yavetz@gmail.com [Institute of Radiotherapy, Tel Aviv (Israel); Corn, Benjamin W.; Matceyevsky, Diana; Ben-Josef, Rahamim; Soyfer, Viacheslav [Institute of Radiotherapy, Tel Aviv (Israel); Bershtein, Igal [Diagnostic Imaging, Tel Aviv Medical Center, Tel Aviv (Israel); Inbar, Moshe; Ron, Ilan [Department of Medical Oncology, Tel Aviv (Israel); Jiveliouk, Irena [Institute of Radiotherapy, Tel Aviv (Israel); Department of Medical Oncology, Tel Aviv (Israel); Diagnostic Imaging, Tel Aviv Medical Center, Tel Aviv (Israel); Schifter, Dan [Institute of Radiotherapy, Tel Aviv (Israel)

2011-01-01

400

Developmental changes in the posterior cranial fossa of children studied by CT  

International Nuclear Information System (INIS)

Although CT is widely used, it has not been employed in the study of the development of the normal PF during childhood. We reviewed 181 brain CT examinations, with no abnormal findings, to determine normative data for the posterior cranial fossa (PF) in children. The volume of the PF and the supratentorial cranial cavity (SC) was assessed by summing consecutive CT cross-sectional areas. Linear mesurements of the PF structures - cerebellum, vermis, brain stem and fourth ventricle - were also performed. The PF grows rapidly during the first 3 years of life and thereafter a smaller increase in size is observed. All the PF structures showed a positive correlation with the PF volume. The PF volume increased in parallel with that of the SC and the PF/SC volume ratio remained relatively constant during childhood. The establishment of normative data for the volume of the PF and its contents may be of value in the CT study of diseases associated with morphological alterations in the PF. (orig.)

1996-01-01

 
 
 
 
401

Posterior fossa arachnoid cyst masking a delayed diagnosis of hyperparathyroidism in a child.  

Science.gov (United States)

Background. Primary hyperparathyroidism in childhood is a very rare entity, often being diagnosed late after the onset of its presenting symptoms. It most commonly affects patients in their fourth decade of life and beyond. The inclusion of primary hyperparathyroidism in the differential diagnosis is necessary when evaluating patients presenting with nonspecific symptoms such as polyuria, fatigue, weight loss, abdominal pain, nausea, and vomiting. Methods. We report the case of an eleven-year-old girl presenting with three years history of headaches, visual disturbance, along with episodes of emotional lability. Neuroimaging confirmed a large posterior fossa arachnoid cyst. It was decided to manage this lesion conservatively with surveillance. Only after further hospital admissions with recurrent loss of consciousness, dizziness, and nausea to add to her already existing symptoms, a full biochemical and endocrine assessment was performed to look for more specific causes for her presentation. These pointed to a diagnosis of primary hyperparathyroidism. Conclusions. The inclusion of primary hyperparathyroidism in the differential diagnosis should be considered when evaluating paediatric patients presenting with nonspecific (neurological, gastrointestinal, and renal) symptoms in order to establish a prompt diagnosis of the disorder and to avoid severe complications of prolonged hypercalcaemia and end-organ damage. PMID:23227372

Dhamija, B; Kombogiorgas, D; Hussain, I; Solanki, G A

2012-01-01

402

Endoscopic endonasal transturbinate approach to the pterygopalatine fossa in the management of juvenile nasopharyngeal angiofibromas.  

Science.gov (United States)

Pterygopalatine fossa (PPF) is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA) often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the management of JNA. Submucous inferior turbinoplasty was performed, and sphenopalatine artery, the feeder to the tumor, was identified at the sphenopalatine foramen. The posterior wall of maxillary sinus was removed. Internal maxillary artery was identified in the PPF and was ligated with a hemoclip. The tumor in the PPF was pushed into the nasal cavity. These procedures were all performed via submucous turbinate tunnel. Then, the tumor was successfully removed in en bloc from the nasal cavity by transnasal approach without ethmoidectomy. This approach improves accessibility and visualization in the PPF and potential to reduce intraoperative bleeding due to ligation of the feeder safely without touching the tumor. Endoscopic transturbinate approach is effective in the management of early stage of JNA. PMID:22953122

Kodama, Satoru; Mabuchi, Hideaki; Suzuki, Masashi

2012-01-01

403

Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior / Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a [...] fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%), seio maxilar (76,5%), seio esfenoidal (63,8%), paredes da cavidade nasal (59,5%) e palato (42,5%). A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%), fístulas liquóricas (15,2%), meningite (6,5%) e hematoma (6,5%). CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva. Abstract in english BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 [...] patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were: the orbit (76.5%), maxilar sinus (76.5%), sphenoidal sinus (63.8%), nasal cavity walls (59.5%) and palate (42.5%). The dura-mater was involved in 32,6% of the patients. Free-flap reconstructions employing the rectus abdominis muscle flaps were the leading procedure in 93.5% of patients. The successful rate of the free-tissue transfer was 97.8%. Complications occurred in 58,6% of patients, the most frequent were: local infection (21.7%), cerebrospinal fluid leakage (15.3%), meningitis(6.5%) and hematoma (6.5%). CONCLUSIONS: The microvascular free-tissue transfer reconstruction allows more extensive resections of those tumors with safety borders, presenting acceptable complication rates, offering the patients a better quality of life, longer life expectance with low incidence of recurrent disease.

Galvão, Mario Sergio Lomba; Sá, Geraldo Mattos de; Farias, Terence; Anlicoara, Rafael; Dias, Fernando Luiz; Sbalchiero, Juliano Carlos.

404

Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%, seio maxilar (76,5%, seio esfenoidal (63,8%, paredes da cavidade nasal (59,5% e palato (42,5%. A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%, fístulas liquóricas (15,2%, meningite (6,5% e hematoma (6,5%. CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva.BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were: the orbit (76.5%, maxilar sinus (76.5%, sphenoidal sinus (63.8%, nasal cavity walls (59.5% and palate (42.5%. The dura-mater was involved in 32,6% of the patients. Free-flap reconstructions employing the rectus abdominis muscle flaps were the leading procedure in 93.5% of patients. The successful rate of the free-tissue transfer was 97.8%. Complications occurred in 58,6% of patients, the most frequent were: local infection (21.7%, cerebrospinal fluid leakage (15.3%, meningitis(6.5% and hematoma (6.5%. CONCLUSIONS: The microvascular free-tissue transfer reconstruction allows more extensive resections of those tumors with safety borders, presenting acceptable complication ra