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Sample records for cerebral cavernous malformations

  1. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao;

    2015-01-01

    -controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability...... vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.......Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case...

  2. Vascular permeability in cerebral cavernous malformations.

    Science.gov (United States)

    Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao; Girard, Romuald; Shenkar, Robert; Guo, Xiaodong; Shah, Akash; Larsson, Henrik B W; Tan, Huan; Li, Luying; Wishnoff, Matthew S; Shi, Changbin; Christoforidis, Gregory A; Awad, Issam A

    2015-10-01

    Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observational study investigated whether the brains of human subjects with familial CCM show vascular hyperpermeability by dynamic contrast-enhanced quantitative perfusion magnetic resonance imaging, in comparison with CCM cases without familial disease, and whether lesional or brain vascular permeability correlates with CCM disease activity. Permeability in white matter far (WMF) from lesions was significantly greater in familial than in sporadic cases, but was similar in CCM lesions. Permeability in WMF increased with age in sporadic patients, but not in familial cases. Patients with more aggressive familial CCM disease had greater WMF permeability compared to those with milder disease phenotype, but similar lesion permeability. Subjects receiving statin medications for routine cardiovascular indications had a trend of lower WMF, but not lesion, permeability. This is the first demonstration of brain vascular hyperpermeability in humans with an autosomal dominant disease, as predicted mechanistically. Brain permeability, more than lesion permeability, may serve as a biomarker of CCM disease activity, and help calibrate potential drug therapy.

  3. Genetics Home Reference: cerebral cavernous malformation

    Science.gov (United States)

    ... Awad IA. Pathobiology of human cerebrovascular malformations: basic mechanisms and clinical relevance. Neurosurgery. 2004 Jul;55(1): ... with a qualified healthcare professional . About Genetics Home Reference Site Map Contact Us Selection Criteria for Links ...

  4. Is cerebral cavernous malformation a pre-glioma lesion?

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji-yang; MING Zong-yi; WU An-hua

    2012-01-01

    Glioma is the most malignant tumor in the brain,the origin of glioma is still unknown.Recently some papers indicated that glioma may be developed from cerebral cavernous malformation (CCM).We describe a man with a right temporal lobe CCM,after gamma-knife radiotherapy,the patient developed a low-grade astrocytoma in the area of the preexistent CCM.This case,together with other reports,may indicated an oncogenetic properties of CCM,and we proposed that CCM may be a pre-glioma lesion.

  5. Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

    Directory of Open Access Journals (Sweden)

    Nikolaos Mouchtouris

    2015-01-01

    Full Text Available Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

  6. Image-guided resection of cerebral cavernous malformations

    Institute of Scientific and Technical Information of China (English)

    毛颖; 周良辅; 杜固宏; 陈亮

    2003-01-01

    Objective To evaluate retrospectively the effectiveness of image-guided navigation techniques in the management of cerebral CMs.Methods Between July 1997 and January 2001, 44 patients underwent image-guided resection of cerebral CMs. To counteract brain shift, a small silicon catheter was implanted as a guide in the case of deep-seated lesions (except in the case of brain stem CMs) and before excision of multiple lesions. Results A total of 27 men and 17 women with a mean age of 35 years underwent surgical procedures (5 patients had multiple lesions). The lesions were located in the frontal (n=14), lobe temporal lobe (n=12), parietal lobe (n=6), cerebellum (n=6), thalamus (n=5), pons (n=5), and orbital region (n=1). Under the guidance of a StealthStation navigator, total removal of the lesions was achieved in all patients. Follow-up revealed marked improvement of preoperative symptoms in 26 patients and no additional deficits in 13 patients. Five patients suffered from additional neurological deficits, but two of them gradually improved during the follow-up period. Conclusions With the assistance of an image-guided surgical system, functional areas can be effectively avoided and surgical injury can be decreased. This system is well suited for accurate localization and safe resection of small, deep-seated CMs.

  7. Surveying genetic variants and molecular phylogeny of cerebral cavernous malformation gene, CCM3/PDCD10.

    Science.gov (United States)

    Kumar, Abhishek; Bhandari, Anita; Goswami, Chandan

    2014-12-01

    The three cerebral cavernous malformations (CCMs) genes namely CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10 have been identified for which mutations cause cerebral cavernous malformations. However, the protein products of these genes involved in forming CCM signaling, are still poorly understood imposing an urgent need to understand these genes and their signaling processes in details. So far involvement of CCM3/PDCD10 in the cavernous angioma has been characterized from biochemical and biophysical analyses. However, there is no comprehensive study illustrating the phylogenetic history and comprehensive genetic variants of CCM3/PDCD10. Herein, we explored the phylogenetic history and genetic variants of CCM3/PDCD10 gene. Synteny analyses revealed that CCM3/PDCD10 gene shared same genomic loci from Drosophila to human and the gene structure of CCM3/PDCD10 is conserved from human to Branchiostoma floridae for about 500 MYs with some changes in sea urchin and in insects. The conserved CCM3/PDCD10 is characterized by presence of indels in the N-terminal dimerization domain. We identified 951 CCM3/PDCD10 variants by analysis of 1092 human genomes with top three variation classes belongs to 84% SNPs, 6.9% insertions and 6.2% deletions. We identified 22 missense mutations in the human CCM3/PDCD10 protein and out of which three mutations are deleterious. We also identified four stop-codon gaining mutations at the positions E34*, E68*, E97* and E140*, respectively. This study is the first comprehensive analysis of the CCM3/PDCD10 gene based on phylogenetic origin and genetic variants. This study corroborates that the evolution of CCM proteins with tubular organization evolvements by endothelial cells.

  8. Unilateral facial palsy in an infant: an unusual presentation of familial multiple cerebral cavernous malformation.

    LENUS (Irish Health Repository)

    Zakaria, Zaitun

    2012-01-01

    Cerebral cavernous malformation (CCM) in infants tends to have genetic predisposition. These cavernomas have a progressive course of events and associated neurological symptoms with increase in age. They most commonly present with seizure and syndrome of increased intracranial pressure comprising of headache, vomiting and focal neurological signs. We describe a case of a 7-month-old infant who presented with an acute onset of right facial paralysis with a background of familial CCM. The CT and MRI scan revealed fresh haemorrhage in the right cerebellar and pontine cavernomas with surrounding oedema and no evidence of obstructive hydrocephalus. These two cavernomas re-bled in a week duration causing episodes of incessant crying and irritability. After discussing the pros and cons of treatment, owing to stable clinical status, the patient is currently been managed conservatively.

  9. Unilateral facial palsy in an infant: an unusual presentation of familial multiple cerebral cavernous malformation.

    Science.gov (United States)

    Zakaria, Zaitun; Kaliaperumal, Chandrasekaran; Caird, John; Sattar, Mohammad

    2012-01-01

    Cerebral cavernous malformation (CCM) in infants tends to have genetic predisposition. These cavernomas have a progressive course of events and associated neurological symptoms with increase in age. They most commonly present with seizure and syndrome of increased intracranial pressure comprising of headache, vomiting and focal neurological signs. We describe a case of a 7-month-old infant who presented with an acute onset of right facial paralysis with a background of familial CCM. The CT and MRI scan revealed fresh haemorrhage in the right cerebellar and pontine cavernomas with surrounding oedema and no evidence of obstructive hydrocephalus. These two cavernomas re-bled in a week duration causing episodes of incessant crying and irritability. After discussing the pros and cons of treatment, owing to stable clinical status, the patient is currently been managed conservatively. PMID:23203183

  10. FAM222B Is Not a Likely Novel Candidate Gene for Cerebral Cavernous Malformations.

    Science.gov (United States)

    Spiegler, Stefanie; Kirchmaier, Bettina; Rath, Matthias; Korenke, G Christoph; Tetzlaff, Fabian; van de Vorst, Maartje; Neveling, Kornelia; Acker-Palmer, Amparo; Kuss, Andreas W; Gilissen, Christian; Fischer, Andreas; Schulte-Merker, Stefan; Felbor, Ute

    2016-07-01

    Cerebral cavernous malformations (CCMs) are prevalent slow-flow vascular lesions which harbour the risk to develop intracranial haemorrhages, focal neurological deficits, and epileptic seizures. Autosomal dominantly inherited CCMs were found to be associated with heterozygous inactivating mutations in 3 genes, CCM1 (KRIT1), CCM2 (MGC4607), and CCM3 (PDCD10) in 1999, 2003 and 2005, respectively. Despite the availability of high-throughput sequencing techniques, no further CCM gene has been published since. Here, we report on the identification of an autosomal dominantly inherited frameshift mutation in a gene of thus far unknown function, FAM222B (C17orf63), through exome sequencing of CCM patients mutation-negative for CCM1-3. A yeast 2-hybrid screen revealed interactions of FAM222B with the tubulin cytoskeleton and STAMBP which is known to be associated with microcephaly-capillary malformation syndrome. However, a phenotype similar to existing models was not found, neither in fam222bb/fam222ba double mutant zebrafish generated by transcription activator-like effector nucleases nor in an in vitro sprouting assay using human umbilical vein endothelial cells transfected with siRNA against FAM222B. These observations led to the assumption that aberrant FAM222B is not involved in the formation of CCMs. PMID:27587990

  11. Stabiliztin of VEGFR2 Signaling by Cerebral Cavernous Malformation 3 is Critical for Vascular Development

    Energy Technology Data Exchange (ETDEWEB)

    Y He; H Zhang; L Yu; M Gunel; T Boggon; H Chen; W Min

    2011-12-31

    Cerebral cavernous malformations (CCMs) are human vascular malformations caused by mutations in three genes of unknown function: CCM1, CCM2, and CCM3. CCM3, also known as PDCD10 (programmed cell death 10), was initially identified as a messenger RNA whose abundance was induced by apoptotic stimuli in vitro. However, the in vivo function of CCM3 has not been determined. Here, we describe mice with a deletion of the CCM3 gene either ubiquitously or specifically in the vascular endothelium, smooth muscle cells, or neurons. Mice with global or endothelial cell-specific deletion of CCM3 exhibited defects in embryonic angiogenesis and died at an early embryonic stage. CCM3 deletion reduced vascular endothelial growth factor receptor 2 (VEGFR2) signaling in embryos and endothelial cells. In response to VEGF stimulation, CCM3 was recruited to and stabilized VEGFR2, and the carboxyl-terminal domain of CCM3 was required for the stabilization of VEGFR2. Indeed, the CCM3 mutants found in human patients lacking the carboxyl-terminal domain were labile and were unable to stabilize and activate VEGFR2. These results demonstrate that CCM3 promotes VEGFR2 signaling during vascular development.

  12. Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, Oriana S. [Yale Univ., New Haven, CT (United States); Deng, Hanqiang [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Liu, Dou [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Ya [Yale Univ. School of Medicine, New Haven, CT (United States); Wei, Rong [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Deng, Yong [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Fan [Yale Univ. School of Medicine, New Haven, CT (United States); Louvi, Angeliki [Yale Univ. School of Medicine, New Haven, CT (United States); Turk, Benjamin E. [Yale Univ., New Haven, CT (United States); Boggon, Titus J. [Yale Univ., New Haven, CT (United States); Su, Bing [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China)

    2015-08-03

    Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystal structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.

  13. Crystal Structure of CCM3, a Cerebral Cavernous Malformation Protein Critical for Vascular Integrity

    Energy Technology Data Exchange (ETDEWEB)

    Li, X.; Zhang, R; Zhang, H; He, Y; Ji, W; Min, W; Boggon, T

    2010-01-01

    CCM3 mutations are associated with cerebral cavernous malformation (CCM), a disease affecting 0.1-0.5% of the human population. CCM3 (PDCD10, TFAR15) is thought to form a CCM complex with CCM1 and CCM2; however, the molecular basis for these interactions is not known. We have determined the 2.5 {angstrom} crystal structure of CCM3. This structure shows an all {alpha}-helical protein containing two domains, an N-terminal dimerization domain with a fold not previously observed, and a C-terminal focal adhesion targeting (FAT)-homology domain. We show that CCM3 binds CCM2 via this FAT-homology domain and that mutation of a highly conserved FAK-like hydrophobic pocket (HP1) abrogates CCM3-CCM2 interaction. This CCM3 FAT-homology domain also interacts with paxillin LD motifs using the same surface, and partial CCM3 co-localization with paxillin in cells is lost on HP1 mutation. Disease-related CCM3 truncations affect the FAT-homology domain suggesting a role for the FAT-homology domain in the etiology of CCM.

  14. Cerebral Cavernous Malformation: A Portuguese Family with a Novel CCM1 Mutation

    Science.gov (United States)

    Marto, João Pedro; Gil, Inês; Calado, Sofia; Viana-Baptista, Miguel

    2016-01-01

    Introduction Cerebral cavernous malformation (CCM) is a vascular disorder characterized by the presence of central nervous system cavernomas. In familial forms, mutations in three genes (CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10) were identified. We describe a Portuguese family harboring a novel CCM1 mutation. Case Presentation The proband is a woman who at the age of 55 years started to have complex partial seizures and episodic headache. Although nothing was found during her neurological examination, brain MRI showed bilateral, supra- and infratentorial cavernomas. She had a sister who, at the age 61 years, suffered a tonic-clonic seizure. Neurological examination was normal and imaging investigation demonstrated a right frontal intracerebral hemorrhage and multiple cavernomas. In the following years, she suffered several complex partial seizures and had a new intracerebral hemorrhage located in the right temporal lobe. Genetic analysis was performed and a novel nucleotide substitution, i.e. c.1927C>T (p.Gln643*) within the exon 17 of the CCM1 gene, was detected in both sisters. The substitution encodes a stop codon, with a consequent truncated KRIT1 protein, therefore supporting its pathogenic role. Further affected family members were detected, suggesting an autosomal dominant pattern of inheritance. Conclusion We report a Portuguese family with a novel CCM1 (KRIT1) mutation – c.1927C>T (p.Gln643*). A better knowledge of the phenotype-genotype correlation is needed to improve the management of CCM patients.

  15. Conditional deletion of Ccm2 causes hemorrhage in the adult brain: a mouse model of human cerebral cavernous malformations

    OpenAIRE

    Cunningham, Kirk; Uchida, Yutaka; O'Donnell, Erin; Claudio, Estefania; Li, Wenling; Soneji, Kosha; Wang, Hongshan; Mukouyama, Yoh-suke; Siebenlist, Ulrich

    2011-01-01

    Cerebral cavernous malformations (CCM) are irregularly shaped and enlarged capillaries in the brain that are prone to hemorrhage, resulting in headaches, seizures, strokes and even death in patients. The disease affects up to 0.5% of the population and the inherited form has been linked to mutations in one of three genetic loci, CCM1, CCM2 and CCM3. To understand the pathophysiology underlying the vascular lesions in CCM, it is critical to develop a reproducible mouse genetic model of this di...

  16. A locus for cerebral cavernous malformations maps to chromosome 7q in two families

    Energy Technology Data Exchange (ETDEWEB)

    Marchuk, D.A.; Gallione, C.J. [Duke Univ. Medical Center, Durham, NC (United States); Morrison, L.A.; Davis, L.E.; Clericuzio, C.L. [Univ. of New Mexico School of Medicine, Albuquerque, NM (United States)] [and others

    1995-07-20

    Cavernous malformations (angiomas) affecting the central nervous system and retina can be inherited in autosomal dominant pattern (OMIM 116860). These vascular lesions may remain clinically silent or lead to a number of neurological symptoms including seizure, intracranial hemorrhage, focal neurological deficit, and migraine. We have mapped a gene for this disorder in two families, one of Italian-American origin and one of Mexican-American origin, to markers on proximal 7q, with a combined maximum lod score of 3.92 ({theta} of zero) with marker D7S479. Haplotype analysis of these families places the locus between markers D7S502 proximally and D7S515 distally, an interval of approximately 41 cM. The location distinguishes this disorder from an autosomal dominant vascular malformation syndrome where lesions are primarily cutaneous and that maps to 9p21. 16 refs., 3 figs., 1 tab.

  17. Multiple cerebral cavernous malformations: typical pattern on MR imaging and appearance of a new lesion in the follow-up MRI

    International Nuclear Information System (INIS)

    Cerebral cavernous malformations (CCM) are common, mostly benign vascular anomalies of the CNS. Clinical features are seizures, headache and focal neurological signs. Often they are asymptomatic. Apart from sporadically cases CCM occur as an autosomal dominant condition. Familial cases are associated with a high frequency of multiple lesions. MRI is most sensitive in the detection of cavernous malformations. The MRI findings of CCM are variable, depending on hemorrhage and calcifications. The typical appearance of CCM are heterogenous ''popcorn-like'' lesions of different size with a mixed signal core and a hypointense hemosiderin rim. Our report concerns a 22 year old man with multiple cerebral cavernous malformations whose follow-up MRI of brain showed the appearance of a new lesion. (orig.)

  18. Functional Analyses of Human and Zebrafish 18-Amino Acid In-Frame Deletion Pave the Way for Domain Mapping of the Cerebral Cavernous Malformation 3 Protein

    NARCIS (Netherlands)

    Voss, Katrin; Stahl, Sonja; Hogan, Benjamin M.; Reinders, Joerg; Schleider, Elisa; Schulte-Merker, Stefan; Felbor, Ute

    2009-01-01

    Cerebral cavernous malformations (CCMs) may cause recurrent headaches, seizures, and hemorrhagic stroke and have been associated with loss-of-function mutations in CCM1/KRIT1, CCM2, and CCM3/programmed cell death 10 (PDCD10). The CCM3/PDCD10 amino acid sequence does not reveal significant homologies

  19. Functional analyses of human and zebrafish 18-amino acid in-frame deletion pave the way for domain mapping of the cerebral cavernous malformation 3 protein

    NARCIS (Netherlands)

    Voss, K.; Stahl, S.; Hogan, B.M.; Reinders, J.; Schleider, E.; Schulte-Merker, S.; Felbor, U.

    2009-01-01

    Cerebral cavernous malformations (CCMs) may cause recurrent headaches, seizures, and hemorrhagic stroke and have been associated with loss-of-function mutations in CCM1/KRIT1, CCM2, and CCM3/programmed cell death 10 (PDCD10). The CCM3/PDCD10 amino acid sequence does not reveal significant homologies

  20. Familial cerebral cavernous malformations: Rio de Janeiro study and review of the recommendations for management Malformação cavernosa cerebral familiar: um estudo no Rio de Janeiro e revisão das recomendações para tratamento

    OpenAIRE

    Flávio Domingues; Gasparetto, Emerson L.; Ricardo Andrade; Fabio Noro; Antônio Eiras; Judith Gault; Carlos Eduardo Silva Correia; Jorge Marcondes de Souza

    2008-01-01

    OBJECTIVE: Multiple cerebral cavernous malformation (CCM) is the hallmark of familial presentation of cavernous malformation in the brain. We describe an ongoing Familial Cerebral Cavernous Malformation Project in the Rio de Janeiro state showing genetic profile and the pattern of emergent neuroimaging findings of this particular population besides a review of the updated recommendations for management of familial CCM versus patients harboring sporadic lesions. METHOD: Four families of our co...

  1. Features of a Chinese family with cerebral cavernous malformation induced by a novel CCM1 gene mutation

    Institute of Scientific and Technical Information of China (English)

    WANG Xue; LIU Xue-wu; Nora Lee; LIU Qi-ji; LI Wen-na; HAN Tao; WEI Kun-kun

    2013-01-01

    Background Familial cerebral cavernous malformations (CCMs),characterized by hemorrhagic stroke,recurrent headache and epilepsy,are congenital vascular anomalies of the central nervous system.Familial CCMs is an autosomal dominant inherited disorder and three CCM genes have been identified.We report a Chinese family with CCMs and intend to explore clinical,pathological,magnetic resonance imaging (MRI) features and pathogenic gene mutation of this family.Methods Totally 25 family members underwent brain MRI examination and clinical check.Two patients with surgical indications had surgical treatment and the specimens were subjected to histopathological and microstructural examination.In addition,polymerase chain reaction (PCR) and direct sequencing were performed with genomic DNA extracted from 25 family members' blood samples for mutation detection.Results Brain MRI identified abnormal results in seven family members.All of them had multiple intracranial lesions and four cases had skin cavernous hemangioma.T2-weighted sequence showed that the lesions were typically characterized by an area of mixed signal intensity.Gradient-echo (GRE) sequence was more sensitive to find microcavernous hemangiomas.There was a wide range in the clinical manifestations as well as the age of onset in the family.The youngest patient was an 8-year-old boy with least intracranial lesions.Histopathological and microstructural examination showed that CCMs were typically discrete multi-sublobes of berry-like lesions,with hemorrhage in various stages of illness evolution.They were formed by abnormally enlarged sinusoids and the thin basement membranes.A novel T deletion mutation in exon 14 of CCM1 gene was identified by mutation detection in the seven patients.But unaffected members and healthy controls did not carry this mutation.Conclusions The clinical manifestations were heterogenic within this family.We identified a novel mutation (c.1396delT) was the disease-causing mutation for this

  2. The Role of Hemosiderin Excision in Seizure Outcome in Cerebral Cavernous Malformation Surgery: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Di Ruan

    Full Text Available Whether the excision of hemosiderin surrounding cerebral cavernous malformations (CCMs is necessary to achieve a seizure-free result has been the subject of debate. Here, we report a systematic review of related literature up to Jan 1, 2015 including 594 patients to assess the effect of hemosiderin excision on seizure outcome in patients with CCMs by meta-analysis.Ten studies comparing extended hemosiderin excision with only lesion resection were identified by searching the English-language literature. Meta-analyses, subgroup analyses and sensitivity analysis were conducted to determine the association between hemosiderin excision and seizure outcome after surgery.Seizure outcome was significantly improved in the patients who underwent an extended excision of the surrounding hemosiderin (OR, 0.62; 95% CI: 0.42-0.91; P = 0.01. In subgroup analysis, studies from Asia (OR, 0.42; 95% CI: 0.25-0.71; P = 0.001, male-majority (female ratio 1 year before surgery (OR, 0.43; 95% CI: 0.22-0.84; P = 0.01, lesion diameter > 2 cm (OR, 0.41; 95% CI: 0.19-0.87; P = 0.02 and short-term (< 3 years follow-up (OR, 0.48; 95% CI: 0.29-0.80; P = 0.005 tended to correlate with a significantly favorable outcome.Patients who underwent extended surrounding hemosiderin excision could exhibit significantly improved seizure outcomes compared to patients without hemosiderin excision. However, further well-designed prospective multiple-center RCT studies are still needed.

  3. Cytochrome P450 and matrix metalloproteinase genetic modifiers of disease severity in Cerebral Cavernous Malformation type 1

    Science.gov (United States)

    Choquet, Hélène; Trapani, Eliana; Goitre, Luca; Trabalzini, Lorenza; Akers, Amy; Fontanella, Marco; Hart, Blaine L.; Morrison, Leslie A.; Pawlikowska, Ludmila; Kim, Helen; Retta, Saverio Francesco

    2016-01-01

    Background Familial Cerebral Cavernous Malformation type 1 (CCM1) is an autosomal dominant disease caused by mutations in the Krev Interaction Trapped 1 (KRIT1/CCM1) gene, and characterized by multiple brain lesions. CCM lesions manifest across a range of different phenotypes, including wide differences in lesion number, size and susceptibility to intracerebral hemorrhage (ICH). Oxidative stress plays an important role in cerebrovascular disease pathogenesis, raising the possibility that inter-individual variability in genes related to oxidative stress may contribute to the phenotypic differences observed in CCM1 disease. Here, we investigated whether candidate oxidative stress-related cytochrome P450 (CYP) and matrix metalloproteinase (MMP) genetic markers grouped by superfamilies, families or genes, or analyzed individually influence the severity of CCM1 disease. Methods Clinical assessment and cerebral susceptibility-weighted magnetic resonance imaging (SWI) were performed to determine total and large (≥5 mm in diameter) lesion counts as well as ICH in 188 Hispanic CCM1 patients harboring the founder KRIT1/CCM1 ‘common Hispanic mutation’ (CCM1–CHM). Samples were genotyped on the Affymetrix Axiom Genome-Wide LAT1 Human Array. We analyzed 1,122 genetic markers (both single nucleotide polymorphisms (SNPs) and insertion/deletions) grouped by CYP and MMP superfamily, family or gene for association with total or large lesion count and ICH adjusted for age at enrollment and gender. Genetic markers bearing the associations were then analyzed individually. Results The CYP superfamily showed a trend toward association with total lesion count (P=0.057) and large lesion count (P=0.088) in contrast to the MMP superfamily. The CYP4 and CYP8 families were associated with either large lesion count or total lesion count (P=0.014), and two other families (CYP46 and the MMP Stromelysins) were associated with ICH (P=0.011 and 0.007, respectively). CYP4F12 rs11085971, CYP8A

  4. Variable expression of cerebral cavernous malformations in carriers of a premature termination codon in exon 17 of the Krit1 gene

    Directory of Open Access Journals (Sweden)

    Gamero Miguel A

    2003-07-01

    Full Text Available Abstract Background Cerebral cavernous malformations (CCM present as either sporadic or autosomal dominant conditions with incomplete penetrance of symptoms. Differences in genetic and environmental factors might be minimized among first-degree relatives. We therefore studied clinical expression in a family with several affected members. Methods We studied a three-generation family with the onset of CCM as a cerebral haemorrhage in the younger (four-year-old sibling. Identification and enumeration of CCMs were performed in T2-weighted or gradient-echo MRIs of the whole brains. Genetic analysis comprised SCCP, sequencing and restriction polymorphism of the Krit1 gene in the proband and at risk relatives. Results The phenotypes of cerebral cavernous malformations (CCMs in carriers of Krit1 mutations were very variable. We identified a novel frameshift mutation caused by a 1902A insertion in exon 17 of the Krit1 gene, which leads to a premature TAA triplet and predicts the truncating phenotype Y634X. A very striking finding was the absence of both clinical symptoms and CCMs in the eldest sibling harbouring the 1902insA. Conclusions Patients in this family, harbouring the same mutation, illustrate the very variable clinical and radiological expression of a Krit1 mutation. The early and critical onset in the proband contrasts with minor clinical findings in affected relatives. This consideration is important in genetic counselling.

  5. Cerebral Cavernous Malformations (CCM)

    Science.gov (United States)

    ... such as weight loss, daily exercise, improvement in sleep hygiene, avoidance of triggers or to advise on medical ... lifestyle changes (weight loss, daily exercise, improvement in sleep hygiene, avoidance of triggers), medications for symptomatic relief, or ...

  6. Brainstem cavernous malformations: a review with two case reports Malformações cavernosas do tronco cerebral: uma revisão com relato de dois casos

    Directory of Open Access Journals (Sweden)

    Adolfo Ramírez-Zamora

    2009-09-01

    Full Text Available Central nervous system (CNS cavernous malformations (CMs are developmental malformations of the vascular bed with a highly variable clinical course due to their dynamic nature. We present one case of "de novo" brainstem cavernous malformation after radiation therapy adding to the increasing number of reported cases in the medical literature, and the case of a pregnant patient with symptomatic intracranial hemorrhage related to brainstem CMs to illustrate the complex nature in management of these patients, followed by a review of clinical and radiographic characteristics. CMs account for 8-15% of all intracranial and intraspinal vascular malformations. Although traditionally thought to be congenital in origin, CMs may present as acquired lesions particularly after intracranial radiation therapy. Clinical manifestations are protean and surgical treatment should be considered for patients with progressive neurologic deficits.Malformações cavernosas (MFC do sistema nervoso central são malformações do desenvolvimento do leito vascular com múltiplas apresentações clínicas devido a sua natureza dinâmica. Apresentamos dois casos de malformações cavernosas do tronco cerebral: o primeiro após radioterapia e o segundo em paciente grávida com hemorragia intracraniana sintomática. MFC são responsáveis por cerca de 8-15% de todas as malformações vasculares. Embora tradicionalmente sejam genéticas, as MFC podem também ser adquiridas, particularmente após radioterapia. As manifestações clínicas são variáveis e o tratamento cirúrgico deve ser considerado para pacientes com quadros neurológicos progressivos.

  7. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge;

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  8. Radiological features of childhood giant cavernous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Ozgen, Burce; Senocak, Efsun; Oguz, Kader K. [Hacettepe University, Department of Radiology, Faculty of Medicine, Ankara (Turkey); Soylemezoglu, Figen [Hacettepe University, Department of Pathology, School of Medicine, Ankara (Turkey); Akalan, Nejat [Hacettepe University, Department of Neurosurgery, School of Medicine, Ankara (Turkey)

    2011-04-15

    Giant cavernous malformations (GCM) are very large, low-flow vascular malformations, which usually have atypical imaging features and are commonly misdiagnosed preoperatively as neoplasms or vascular malformations. These lesions have mostly been reported in children. As cavernomas show different features in children compared to adults, we evaluated the imaging features of pediatric GCMs in order to help in the preoperative diagnosis of these malformations. Brain MR studies of nine children (mean age of 4 years; 8 months-9 years) with biopsy-proven GCM were retrospectively evaluated. We defined GCMs as cavernomas of {>=}4 cm. Lesions were evaluated regarding their size, location, signal characteristics, general appearance (uni/multilocular) as well as regarding the presence of mass effect, edema, and fluid-fluid levels and were classified according to the Mottolese classification of pediatric cavernomas. Lesion locations were parietal (n = 5), frontal (n = 2), temporal, and intraventricular. Seven lesions were in the periventricular region (with five in the periatrial region). Six patients had T1 hyperintense multilobulated lesions with ''bubbles of blood'' appearance and three patients had heterogeneous lesions with reticular core. All lesions had mass effect, edema (marked in four cases), and peripheral hemosiderin rim. Fluid-fluid levels were also common (n = 7). Most of our lesions (six of nine) were classified as type IIIA, two as type IIIC, and one as type IA. In children, a GCM should be considered in case of very large hemorrhagic intra-axial mass with ''bubbles of blood'' multicystic appearance, surrounding hemosiderin ring, fluid-fluid levels, and accompanying edema-mass effect, especially in the periatrial location. (orig.)

  9. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  10. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... patients and this could contribute to predisposition to hemorrhagic stroke. Extreme stimulants such as cocaine and other illicit drugs have been shown to cause brain hemorrhages among patients without prior ... even after a hemorrhagic event. Should symptoms suddenly appear, don't delay ...

  11. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

    Directory of Open Access Journals (Sweden)

    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  12. Surgical management of cavernous malformations coursing with drug resistant epilepsy

    Directory of Open Access Journals (Sweden)

    Mario Arturo Alonso-Vanegas

    2012-01-01

    Full Text Available Cerebral cavernous malformations (CM are dynamic lesions characterized by continuous size changes and repeated bleeding. When involving cortical tissue, CM pose a significant risk for the development of drug-resistant epilepsy, which is thought to be result of an altered neuronal network caused by the lesion itself and its blood degradation products. Preoperative evaluation should comprise a complete seizure history, neurological examination, epilepsy-oriented MRI, EEG, video-EEG, completed with SPECT, PET, functional MRI and/or invasive monitoring as needed. Radiosurgery shows variable rates of seizure freedom and a high incidence of complications, thus microsurgical resection remains the optimal treatment for CM coursing with drug-resistant epilepsy.Two thirds of patients reach Engel I class at three-year follow-up, regardless of lobar location. Those with secondarily generalized seizures, a higher seizure frequency, and generalized abnormalities on preoperative or postoperative EEG, show poorer outcomes, while factors such as gender, duration of epilepsy, lesion size, age, bleeding at the time of surgery, do not correlate consistently with seizure outcome. Electrocorticography and a meticulous removal of all cortical hemosiderin –beyond pure lesionectomy– reduce the risk of symptomatic recurrences.

  13. Familial cerebral cavernous malformations: Rio de Janeiro study and review of the recommendations for management Malformação cavernosa cerebral familiar: um estudo no Rio de Janeiro e revisão das recomendações para tratamento

    Directory of Open Access Journals (Sweden)

    Flávio Domingues

    2008-12-01

    Full Text Available OBJECTIVE: Multiple cerebral cavernous malformation (CCM is the hallmark of familial presentation of cavernous malformation in the brain. We describe an ongoing Familial Cerebral Cavernous Malformation Project in the Rio de Janeiro state showing genetic profile and the pattern of emergent neuroimaging findings of this particular population besides a review of the updated recommendations for management of familial CCM versus patients harboring sporadic lesions. METHOD: Four families of our cohort of 9 families were genetically mapped showing mutational profile linked to CCM1. The neuroimaging paradigm was shifted from T2*gradient-echo (GRE sequence to susceptibility weighting MR phase imaging (SWI. RESULTS: Only two index cases were subjected to surgery. There was no surgical intervention in any of the kindreds of our entire cohort of 9 families of our Neurovascular Program within seven years of follow-up. The genetic sequencing for mutacional profile in four of these families has demonstrated only CCM1 gene affected. Our management of the familial CCM is according to the review of the literature recommendations. CONCLUSIONS: The Project of Familial Cerebral Cavernous Malformations of Rio de Janeiro detected mutations of the gene CCM1 in the first four families studied. Familial cavernous malformation are to be settled apart from the more common sporadic lesion. A set of recommendations was searched for in the literature in order to deal with these specific patients and kindreds.OBJETIVOS: A apresentação de malformação cavernosa cerebral (CCM através de múltiplas lesões cerebrais é a marca da forma familiar da doença. Os autores descrevem o Projeto Malformação Cavernosa Cerebral Familiar, em andamento no Rio de Janeiro, demonstrando o perfil genético e o padrão atual de achados neurorradiológicos dessa população específica e uma revisão das recomendações atuais para o manuseio e tratamento dos portadores dessa forma da doen

  14. 以癫痫发作为主的脑内海绵状血管畸形的手术治疗%Surgical Treatment of Cerebral Cavernous Malformation Presenting Epileptic Seizures

    Institute of Scientific and Technical Information of China (English)

    周峰; 吴俊; 彭磊; 王硕; 桑林; 郑重; 解飞; 葛留锁; 马延山

    2014-01-01

      结论对于合并癫痫的海绵状血管畸形患者应早期进行手术。术中应完整切除海绵状血管畸形病灶(包括病灶周边的胶质瘢痕层和含铁血黄素层),同时行皮层热灼术。%Objective To provide effective surgical methods for patients with cavernous malformation complicated with epilepsy. Methods Twenty-seven patients with cavernous malformation complicated with epilepsy in our department were retrospectively analyzed. Simultaneously, we compared different epilepsy prognosis and other relevant factors between patients accepted total resection (including the gliotic and hemosiderin-stained brain tissue adjacent to the lesions) and patients accepted total resection combined with cortex thermocoagulation. Results ① Prognosis of patients treated with total resection combined with cortex thermocoagulation was much better than those who only accepted total resection (P=0.036). ②Prognosis of patients whose course of epilepsy is less than 1 year was much better than those whose course is more than 1 year (P=0.022).③There were no statistical signiifcances for epilepsy prognosis in sex, age, the lobe where the cavernous malformation located, different epilepsy seizures, whether preoperative application of antiepileptic drugs (AEDs) and postoperative Karnofsky Performance Status Scale (KPS). Conclusion The analysis of outcome showed that patients with cavernous malformation complicated with epilepsy beneifted signiifcantly from early surgery. And at the same time, in order to achieve better effect from the surgery, total resection of cavernous malformation (including the gliotic hemosiderin-stained brain tissue adjacent to the lesions) must be adopted, and cortex thermocoagulation treatment should be applied.

  15. KRIT1 mutations in three Japanese pedigrees with hereditary cavernous malformation

    Science.gov (United States)

    Hirota, Kengo; Akagawa, Hiroyuki; Kikuchi, Asami; Oka, Hideki; Hino, Akihiko; Mitsuyama, Tetsuryu; Sasaki, Toshiyuki; Onda, Hideaki; Kawamata, Takakazu; Kasuya, Hidetoshi

    2016-01-01

    Cerebral cavernous malformation is a neurovascular abnormality that can cause seizures, focal neurological deficits and intracerebral hemorrhage. Familial forms of this condition are characterized by de novo formation of multiple lesions and are autosomal-dominantly inherited via CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10 mutations. We identified three truncating mutations in KRIT1 from three Japanese families with CCMs: a novel frameshift mutation, a known frameshift mutation and a known splice-site mutation that had not been previously analyzed for aberrant splicing. PMID:27766163

  16. A giant frontal cavernous malformation with review of literature

    Science.gov (United States)

    Sharma, Arvind; Mittal, Radhey Shyam

    2016-01-01

    Cavernous malformations (CMs) are vascular anomalies with dilated spaces called caverns. These spaces are lined by endothelial cells and collage and devoid of smooth muscle or intervening neural tissue, and filled with blood at various stages of stasis, thrombosis, organization, and calcification. Most CMs are relatively small in size but when they are large enough they can produce sing of mass effect and may simulate neoplastic, vascular, inflammatory pathology. Giant CM (size >6 cm) are very rare lesions and very few cases are reported in world literature. We are reporting such a rare case of a 16 year male. Our case is also unique in the sense that it is the largest reported CM in Indian population. PMID:27114662

  17. Electrocorticography-Guided Surgical Treatment of Solitary Supratentorial Cavernous Malformations with Secondary Epilepsy

    Institute of Scientific and Technical Information of China (English)

    Chao Wang; Chao You; Guo-qiang Han; Jun Wang; Yun-biao Xiong; Chuang-xi Liu

    2014-01-01

    Objective To evaluate the efficacy of electrocorticographic (ECoG) monitoring and the application of different surgical approaches in the surgical treatment of solitary supretentorial cavernous malformations with secondary epilepsy. Methods This study enrolled a consecutive series of 36 patients with solitary supratentorial cavernous malformations and secondary epilepsy who underwent surgery with intraoperative ECoG monitoring in the Department of Neurosurgery between January 2004 and January 2008. The patients were composed of 15 males and 21 females, aged between 8 and 52 years (mean age 27.3±2.8 years) at the time of surgery. Epilepsy history, the type of epilepsy at the presentation, lesion location, the incidence of residual epileptiform discharges, and postoperative outcomes were evaluated. Results Histopathological examination indicated cavernous malformations and hippocampal sclerosis in 36 and 5 cases, respectively. Neuronal degeneration, glial cell proliferation, and neurofibrillary tangles were found in all the resected cerebral tissues of extended lesionectomy of residual epileptic foci. Lesionectomy, anterior temporal lobectomy, anterior temporal lobectomy plus cortical thermocoagulation, extended lesionectomy, extended lesionectomy plus cortical thermocoagulation were performed in 4, 4, 1, 14, and 13 cases, respectively. Residual epileptiform discharges were captured in 9 out of the 14 patients who had additional cortical thermocoagulation. According to Engle class for postoperative outcomes, 27 cases were class I (75.00%), 5 were class II (13.89%), 2 were class III (5.56%), and 2 were class IV (5.56%), thus the total effective rate (class I+class II) was 88.89%. Neither of epilepsy history, the type of epilepsy, and the location of cavernous malformation was significantly related to outcomes (P>0.05). A significant relationship was found between the incidence of residual epileptiform discharges and outcomes (P=0.041). Conclusions Intraoperative ECo

  18. Gamma knife radiosurgery for cerebral arteriovenous malformations.

    Science.gov (United States)

    Kemeny, A A; Radatz, M W R; Rowe, J G; Walton, L; Hampshire, A

    2004-01-01

    Since its introduction, gamma knife radiosurgery has become an important treatment modality for cerebral arteriovenous malformations. This paper is a brief overview of the technique used, of the clinical results achieved and of the experience gained in Sheffield.

  19. Effects of vascular endothelial growth factor on angiogenesis of the endothelial cells isolated from cavernous malformations

    Institute of Scientific and Technical Information of China (English)

    TAN YuZhen; ZHAO Yao; WANG HaiJie; ZHOU LiangFu; MAO Ying; LIU Rui; SHU Jia; WANG YongFei

    2008-01-01

    Human cerebral cavernous malformation (CM) is a common vascular malformation of the central nervous system. We have investigated the biological characteristics of CM endothelial cells and the cellular and molecular mechanisms of CM angiogenesis to offer new insights into exploring effective measures for treatment of this disease. The endothelial cells were isolated from CM tissue masses dissected during operation and expanded in vitro. Expression of VEGFR-1 and VEGFR-2 was examined with immunocytochemical staining. Proliferation, migration and tube formation of CM endothelial cells were determined using MTT, wounding and transmigration assays, and three-dimensional collagen type Ⅰ gel respectively. The endothelial cells were successfully isolated from the tissue specimens of 25 CMs dissected without dipolar electrocoagulation. The cells show the general characteristics of the vascular endothelial cells. Expression of VEGFR-1 and VEGFR-2 on the cells is higher than that on the normal cerebral microvascular endothelial cells. After treatment with VEGF, numbers of the proliferated and migrated cells, the maximal distance of cell migration and the length and area of capillary-like struc-tures formed in the three-dimensional collagen gel increase significantly. These results demonstrate that expression of VEGFR-1 and VEGFR-2 on CM endothelial cells is up-regulated. By binding to re-ceptors, VEGF may activate the downstream signaling pathways and promote proliferation, migration and tube formation of CM endothelial cells. VEGF/VEGFR signaling pathways play important regulating roles in CM angiogenesis.

  20. Spontaneous Partial Regression of Cerebral Arteriovenous Malformation

    OpenAIRE

    Choi, Jae Ho; Shin, Ji Hoon; Cho, Seong Shik; Choi, Deuk Lin; Byun, Bark Jang; Kim, Dong Won

    2002-01-01

    Arteriovenous malformation (AVM) of the brain is one of the important pathologic conditions which cause intracerebral or subarachnoid hemorrhage, epilepsy, or chronic cerebral ischemia. The spontaneous regression of cerebral AVM is reported to be very rare and more likely to occur when the AVM is small, is accompanied by hemorrhage, and has fewer arterial feeders. We report a case of right occipital AVM which at follow-up angiography performed four years later showed near-complete spontaneous...

  1. Spontaneous partial regression of cerebral arteriovenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Ho; Shin, Ji Hoon; Cho, Seong Shik; Choi, Deuk Lin; Byun, Bark Jang; Kim, Dong Won [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2002-01-01

    Arteriovenous malformation (AVM) of the brain is one of the important pathologic conditions which cause intracerebral or subarachnoid hemorrhage, epilepsy, or chronic cerebral ischemia. The spontaneous regression of cerebral AVM is reported to be very rare and more likely to occur when the AVM is small, is accompanied by hemorrhage, and has fewer arterial feeders. We report a case of right occipital AVM which at follow-up angiography performed four years later showed near-complete spontaneous regression.

  2. Radiotherapy for Small Cerebral Arteriovenous Malformation

    OpenAIRE

    Yamashita, Tetsuo; Kurokawa, Yasushi; Kashiwagi, Shiro; Abiko, Seisho; Shiroyama, Yujiro; Kamiryo, Toshifumi; Nakano, Shigeki; Eguchi, Yuuki; Tsurutani, Toru; Ito, Haruhide

    1991-01-01

    The result of two types of radiation therapy for small cerebral arteriovenous malformations (AVM) were analyzed, and the indications and limitations of radiation therapy for small AVMs discussed. Four patients with small AVMs received radiation therapy. There were three males and one female, ranging in age from 7 to 44 years with an average of 29 years. One cerebral AVM was located in the right thalamus, two were in the left central sulcus and one was in the left parietal lobe. Three AVMs wer...

  3. CEREBRAL ARTERIOVENOUS MALFORMATIONS IN CHILDREN. ENDOVASCULAR TREATMENT

    OpenAIRE

    Scheglov, D.; Zagorodniy, V.

    2013-01-01

    The objective — to learn the features of the cerebral arteriovenous malformations (АVМ) endovascular treatment in children. Materials and methods. Totally 39 children with cerebral AVMs were treated at the center from 2005 to 2012. The average age of the patients (12.6 ± 1.2) years. It was found that the most of AVMs were occurred in temporoparietal subcortical area — 46.2 % cases. Results. Small size of AVMs were detected in 15.4 % of patients, the middle — in 33.3 %, the large — in 38.5 %, ...

  4. Gamma Knife treatment for cerebral arteriovenous malformations.

    Science.gov (United States)

    Kemeny, Andras A; Radatz, Matthias W R; Rowe, Jeremy G; Walton, Lee; Vaughan, Paul

    2007-01-01

    One of the earliest indications for Gamma Knife treatment, radiosurgery for cerebral arteriovenous malformations, has stood the test of time. While initially only the ideal cases (small, compact nidus in a non-eloquent site) were chosen, increasingly larger, more complex AVMs were treated. Combination treatment with embolisation and surgery enables most lesions to be treated with success and remarkably low complication rate. This paper is a brief overview of the experience gained in Sheffield.

  5. Is the Gamma Knife Treatment of Cerebral Cavernous Angioma Effective?

    OpenAIRE

    Wenchuan, Zhang; Wenxiang, Zhong; Xuhui, Wang

    2013-01-01

    The treatment of cerebral cavernous angioma (CCA) has caused great controversy. In the case of recurrent haemorrhage, frequent epileptic attacks, clear dysneuria, etc., and by taking into consideration focal positions, number of foci, and conditions conducive to operations, it is our opinion that excision of CCA foci is the first choice to cure the disease. Controversy regarding the gamma knife treatment of CCA has existed for a long time. The main reason behind this i...

  6. Loop Modeling Forward and Feedback Analysis in Cerebral Arteriovenous Malformation

    OpenAIRE

    Y. Kiran Kumar; Shashi.B.Mehta; Manjunath Ramachandra

    2013-01-01

    Cerebral Arteriovenous Malformation (CAVM) hemodynamic in disease condition results changes in the flow and pressure level in blood vessels. Cerebral Arteriovenous Malformation (CAVM) is an abnormal shunting of vessels between arteries and veins. It is one of the common Brain disorder. In general, the blood flows of cerebral region are from arteries to veins through capillary bed. This paper is focus on the creation of a new electrical model for spiral loop structures that will simulate the p...

  7. Tailored keyhole surgery for basal ganglia cavernous malformation with preoperative three-dimensional pyramidal tracts assessment and intraoperative electrophysiological monitoring

    Institute of Scientific and Technical Information of China (English)

    Kai Quan; Geng Xu; Fan Zhao; Wei Zhu

    2016-01-01

    Background:Accurately mapping the pyramidal tracts preoperatively and intraoperatively is the primary concern when operating on cavernous malformations (CMS) in the basal ganglia.We have conducted new methods for preoperative planning and have tailored lesion resection to prevent the damage of pyramidal tracts.Patients and methods:Eleven patients harboring cavernous malformations in basal ganglia were treated surgically from April 2008 to January 2015.Surgical planning was based on three-dimensional diffusion tensor pyramidal tractography and Virtual Reality system.Intraoperative detecting of pyramidal tracts with subcortical stimulation mapping and motor evoked potential monitoring were performed.The extent of resection and postoperative neurological function were assessed in each case.Results:Total removal of the cavernous malformations were achieved in each case.Four of the total eleven cases presented temporary neurological deficits,including one occurrence of hemiparesis and three occurrences of hemianesthesia.No permanent neurological deficit was developed in this series of cases.Conclusion:Three-dimensional diffusion tensor pyramidal tractography is quite helpful for preoperative planning of basal ganglia cavernous malformations,especially in choosing a suitable surgical approach.Intraoperative detection of pyramidal tracts with subcortical stimulation mapping and motor evoked potential monitoring play important roles in preventing damage to pyramidal tracts during lesion resection.

  8. Animal Models in Studying Cerebral Arteriovenous Malformation

    OpenAIRE

    Ming Xu; Hongzhi Xu; Zhiyong Qin

    2015-01-01

    Brain arteriovenous malformation (AVM) is an important cause of hemorrhagic stroke. The etiology is largely unknown and the therapeutics are controversial. A review of AVM-associated animal models may be helpful in order to understand the up-to-date knowledge and promote further research about the disease. We searched PubMed till December 31, 2014, with the term “arteriovenous malformation,” limiting results to animals and English language. Publications that described creations of AVM animal ...

  9. Pathogenesis of cerebral malformations in human fetuses with meningomyelocele

    NARCIS (Netherlands)

    de Wit, Olga A; den Dunnen, Wilfred Fa; Sollie, Krystyne M; Muñoz, Rosa Iris; Meiners, Linda C; Brouwer, Oebele F; Rodríguez, Esteban M; Sival, Deborah A

    2008-01-01

    BACKGROUND: Fetal spina bifida aperta (SBA) is characterized by a spinal meningomyelocele (MMC) and associated with cerebral pathology, such as hydrocephalus and Chiari II malformation. In various animal models, it has been suggested that a loss of ventricular lining (neuroepithelial/ependymal denud

  10. Pathogenesis of cerebral malformations in human fetuses with meningomyelocele

    Directory of Open Access Journals (Sweden)

    Brouwer Oebele F

    2008-03-01

    Full Text Available Abstract Background Fetal spina bifida aperta (SBA is characterized by a spinal meningomyelocele (MMC and associated with cerebral pathology, such as hydrocephalus and Chiari II malformation. In various animal models, it has been suggested that a loss of ventricular lining (neuroepithelial/ependymal denudation may trigger cerebral pathology. In fetuses with MMC, little is known about neuroepithelial/ependymal denudation and the initiating pathological events. The objective of this study was to investigate whether neuroepithelial/ependymal denudation occurs in human fetuses and neonates with MMC, and if so, whether it is associated with the onset of hydrocephalus. Methods Seven fetuses and 1 neonate (16–40 week gestational age, GA with MMC and 6 fetuses with normal cerebral development (22–41 week GA were included in the study. Identification of fetal MMC and clinical surveillance of fetal head circumference and ventricular width was performed by ultrasound (US. After birth, MMC was confirmed by histology. We characterized hydrocephalus by increased head circumference in association with ventriculomegaly. The median time interval between fetal cerebral ultrasound and fixing tissue for histology was four days. Results At 16 weeks GA, we observed neuroepithelial/ependymal denudation in the aqueduct and telencephalon together with sub-cortical heterotopias in absence of hydrocephalus and/or Chiari II malformation. At 21–34 weeks GA, we observed concurrence of aqueductal neuroepithelial/ependymal denudation and progenitor cell loss with the Chiari II malformation, whereas hydrocephalus was absent. At 37–40 weeks GA, neuroepithelial/ependymal denudation coincided with Chiari II malformation and hydrocephalus. Sub-arachnoidal fibrosis at the convexity was absent in all fetuses but present in the neonate. Conclusion In fetal SBA, neuroepithelial/ependymal denudation in the telencephalon and the aqueduct can occur before Chiari II malformation

  11. Animal Models in Studying Cerebral Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Ming Xu

    2015-01-01

    Full Text Available Brain arteriovenous malformation (AVM is an important cause of hemorrhagic stroke. The etiology is largely unknown and the therapeutics are controversial. A review of AVM-associated animal models may be helpful in order to understand the up-to-date knowledge and promote further research about the disease. We searched PubMed till December 31, 2014, with the term “arteriovenous malformation,” limiting results to animals and English language. Publications that described creations of AVM animal models or investigated AVM-related mechanisms and treatments using these models were reviewed. More than 100 articles fulfilling our inclusion criteria were identified, and from them eight different types of the original models were summarized. The backgrounds and procedures of these models, their applications, and research findings were demonstrated. Animal models are useful in studying the pathogenesis of AVM formation, growth, and rupture, as well as in developing and testing new treatments. Creations of preferable models are expected.

  12. Cerebral Arteriovenous Malformation Associated with Moyamoya Disease

    OpenAIRE

    Noh, Jung-Hoon; Yeon, Je Young; Park, Jae-Han; Shin, Hyung Jin

    2014-01-01

    The coexistence of moyamoya disease (MMD) with an arteriovenous malformation (AVM) is exceedingly rare. We report two cases of AVM associated with MMD. The first case was an incidental AVM diagnosed simultaneously with MMD. This AVM was managed expectantly after encephalo-duro-arterio-synangiosis (EDAS) as the main feeders stemmed from the internal carotid artery, which we believed would be obliterated with the progression of MMD. However, the AVM persisted with replacement of the internal ca...

  13. [Macro- and microscopic systematization of cerebral cortex malformations in children].

    Science.gov (United States)

    Milovanov, A P; Milovanova, O A

    2011-01-01

    For the first time in pediatric pathologicoanatomic practice the complete systematization of cerebral cortex malformations is represented. Organ, macroscopic forms: microencephaly, macroencephaly, micropolygyria, pachygyria, schizencephaly, porencephaly, lissencephaly. Histic microdysgenesis of cortex: type I includes isolated abnormalities such as radial (IA) and tangential (I B) subtypes of cortical dislamination; type II includes sublocal cortical dislamination with immature dysmorphic neurons (II A) and balloon cells (II B); type III are the combination focal cortical dysplasia with tuberous sclerosis of the hippocampus (III A), tumors (III B) and malformations of vessels, traumatic and hypoxic disorders (III C). Band heterotopias. Subependimal nodular heterotopias. Tuberous sclerosis. Cellular typification of cortical dysplasia: immature neurons and balloon cells.

  14. Endovascular Therapy Followed by Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations

    OpenAIRE

    Arai, Y.; Handa, Y.; Ishii, H; Ueda, Y.; Uno, H; Nakajima, T.; Hirose, S; Kubota, T.

    2006-01-01

    Pre-radiosurgical embolization was carried out using cyanoacrylate in seven of 13 patients with cerebral arteriovenous malformations (AVMs) treated by stereotactic radiosurgery (SRS) with a linear accelerator (LINAC). The aim of embolization before SRS was the reduction of AVM volume and/or the elimination of vascular structures bearing an increased risk of haemorrhage. Staged-volume SRS was also performed in two patients because of residual irregular shaped nidus of AVMs even after the embol...

  15. Loop Modeling Forward and Feedback Analysis in Cerebral Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Y. Kiran Kumar

    2013-01-01

    Full Text Available Cerebral Arteriovenous Malformation (CAVM hemodynamic in disease condition results changes in the flow and pressure level in blood vessels. Cerebral Arteriovenous Malformation (CAVM is an abnormal shunting of vessels between arteries and veins. It is one of the common Brain disorder. In general, the blood flows of cerebral region are from arteries to veins through capillary bed. This paper is focus on the creation of a new electrical model for spiral loop structures that will simulate the pressure at various locations of the CAVM Complex blood vessels. The proposed model helps Doctors to take diagnostic and treatment planning for treatment by non-invasive measurement.. This can cause rupture or decreased blood supply to the tissue through capillary causing infarct. Measuring flow and pressure without intervention along the vessel is big challenge due to loop structures of feedback and forward flows in Arteriovenous Malformation patients. In this paper, we proposed a lumped model for the spiral loop in CAVM Structures that will help doctors to find the pressure and velocity measurements non-invasively.

  16. Telencephalic Flexure and Malformations of the Lateral Cerebral (Sylvian) Fissure.

    Science.gov (United States)

    Sarnat, Harvey B; Flores-Sarnat, Laura

    2016-10-01

    After sagittal division of the prosencephalon at 4.5 weeks of gestation, the early fetal cerebral hemisphere bends or rotates posteroventrally from seven weeks of gestation. The posterior pole of the telencephalon thus becomes not the occipital but the temporal lobe as the telencephalic flexure forms the operculum and finally the lateral cerebral or Sylvian fissure. The ventral part is infolded to become the insula. The frontal and temporal lips of the Sylvian fissure, as well as the insula, all derive from the ventral margin of the primitive telencephalon, hence may be influenced by genetic mutations with a ventrodorsal gradient of expression. The telencephalic flexure also contributes to a shift of the hippocampus from a dorsal to a ventral position, the early rostral pole of the hippocampus becoming caudal and dorsal becoming ventral. The occipital horn is the most recent recess of the lateral ventricle, hence most vulnerable to anatomic variations that affect the calcarine fissure. Many major malformations include lack of telencephalic flexure (holoprosencephaly, extreme micrencephaly) or dysplastic Sylvian fissure (lissencephalies, hemimegalencephaly, schizencephaly). Although fissures and sulci are genetically programmed, mechanical forces of growth and volume expansion are proposed to be mainly extrinsic (including ventricles) for fissures and intrinsic for sulci. In fetal hydrocephalus, the telencephalic flexure is less affected because ventricular dilatation occurs later in gestation. Flexures can be detected prenatally by ultrasound and fetal magnetic resonance imaging and should be described neuropathologically in cerebral malformations. PMID:27590993

  17. Radiosurgery with a linear accelerator in cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Esteves, Sergio Carlos Barros; Nadalin, Wladimir; Piske, Ronie Leo; Benabou, Salomon; Souza, Evandro de; Oliveira, Antonio Carlos Zuliani de [Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP (Brazil)]. E-mail: estevesrt@uol.com.br

    2008-07-01

    Objective. To evaluate results achieved with radiosurgery and complications of the procedure when treating arteriovenous malformations with linear accelerator. Methods. This retrospective study was conducted between October 1993 and December 1996. Sixty-one patients with arteriovenous malformations were treated with radiosurgery utilizing a 6 MW energy linear accelerator. Ages of the 32 female and 29 male patients ranged from 6 to 54 years (mean: 28.3 years). The most frequent initial symptom was cephalea (45.9%), followed by neurological deficit (36.1%). Cerebral hemorrhage diagnosed by image was observed in 35 patients (57.3%). Most arteriovenous malformations (67.2%) were graded Spetzler III and IV. Venous stenosis (21.3%) and aneurysm (13.1%) were the most frequent angio-architecture changes. The dose administered varied from 12 to 27.5 Gy in the periphery of the lesion. Results. Out of twenty-eight patients that underwent conclusive angiography control, complete obliteration was achieved in 18 (72%) and treatment failed in 7 (absence of occlusion with more than 3 years of follow-up). Four were submitted to a second radiosurgery, and one of these has shown obliteration after 18 months of follow-up. Discussion. Several factors were analyzed regarding the occlusion rate (gender, age, volume, localization, Spetzler, flow , embolization, total of isocenters, prescribed dose and chosen isodose) and complications (total of isocenters, localization, volume, maximum dose, prescribed dose and chosen isodose). Analyzed variables showed no statistical significance for obliteration of the vessel, as well as for treatment complications. The largest diameter of the arteriovenous malformation, its volume and the dose administered did not influence time of obliteration. Conclusion. Radiosurgery is effective in the treatment of arteriovenous malformations and can be an alternative for patients with clinical contraindication or with lesions in eloquent areas. In the studied

  18. Expression of angiogenic factors in cerebral arteriovenous malformations

    Institute of Scientific and Technical Information of China (English)

    Mingguang Zhao; Youli Chen; Zhenquan Song; Yongzhong Gao; Peiyu Pu; Xuezhong Wei

    2007-01-01

    BACKGROUND: In the process of vascularization, vascular endothelial growth factor (VEGF),angiopoietin-2 and Tie2 are involved in the migration, differentiation and proliferation of vascular endothelial cells, and stimulate the rapid angiogenesis; Tie1 and angiopoietin-1 play important roles in facilitating the formation of vascular lumen and maintaining the integrity of vascular wall. Thus the distributions and expressions may be associated with the occurrence of cerebral arteriovenous malformation.OBJECTIVE: To observe the biological effects of angiogenic factors in the occurrence and development of cerebral arteriovenous malformation.DESIGN: An observational comparative experiment.SETTINGS: Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA; Department of Neurosurgery, General Hospital of Tianjin Medical University.PARTICIPANTS: Fresh samples of complete cerebral arteriovenous malformations resected in 47 patients were collected from the Department of Neurosurgery, General Hospital of Tianjin Medical University from August 1999 to May 2001, including 22 males and 25 females, the mean age was 34.5 years. Informed consents were obtained from all the patients or their relatives. The initial symptom was hemorrhage in 28 cases. All the patients were classified according to the clinical imaging data and Spetzler-Martin grading standard, including 11 cases of grade Ⅰ , 17 cases of grade Ⅱ, 11 cases of grade Ⅲ, and 8 cases of grade Ⅳ - Ⅴ. Normal brain tissues resected by decompression due to trauma were taken from 8 patients as controls, including 5 males and 3 females, aging 12 - 65 years.METHODS: ① The expressions of VEGF, Tie receptors, angiopoietin-1, angiopoietin-2, proto-oncogene c-myc and proliferating cell nuclear antigen(PCNA) in the samples of cerebral arteriovenous malformation were detected with immunohistochemical method. Under light microscope, the positively stained rat-anti-human factor

  19. Magnetic resonance imaging of a cerebral cavernous haemangioma in a dog : clinical communication

    Directory of Open Access Journals (Sweden)

    J.P. Schoeman

    2002-07-01

    Full Text Available A 13-month-old, neutered, male Golden retriever presented with seizures and progressive depression. Clinical and neurological assessment was consistent with severe intracranial disease. The neurological condition progressively deteriorated and magnetic resonance imaging (MRI revealed the presence of a large, contrast-enhancing, space-occupying mass in the right cerebral hemisphere. Therapy with corticosteroids, mannitol and furosemide ameliorated the signs of depression and ataxia, but the owner elected euthanasia after 1 week. Post mortem examination of the brain confirmed the presence of a large haemorrhagic lesion in the right olfactory lobe, the histopathological appearance of which was consistent with cerebral cavernous haemangioma. This is the 1st case describing the MRI appearance of a cavernous haemangioma of the cerebrum in the veterinary literature.

  20. Radiosurgery with linac based photon knife in cerebral arteriovenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Choi, Tae Jin [College of Medicine, Keimyung Univ., Taegu (Korea, Republic of)

    2003-03-01

    The purpose of this study was to analyze the effect of a linear accelerator based Photon Knife Radiosurgery System developed by the staff of Keimyung University Dongsan Medical Center for the treatment of cerebral arteriovenous malformation. Between December 1993 and October 2000, 30 patients with cerebral arteriovenous malformation (AVM) were treated with the Linac based Photon Knife Radiosurgery System in the Department of Therapeutic Radiology at Keimyung University Dongsan Medical Center. The median age was 34, ranging from 7 to 63 years, with a 2: 1 male to female ratio. The locations of the AVM nidi were the frontal lobe (motor cortex), parietal lobe, and the thalamus, in that order. The diameters of the AVM nidi ranged 1.2 to 5.5 cm with a mean of 2.9 cm, and target volumes of between 0.5 and 20.6 cc, with a mean of 6.8 cc. The majority of patients received radiation doses of between 1,500 and 2,500 cGy, with a mean of 2,000 cGy, at 8O% the isodose line. Twenty-five patients were treated with one isocenter, 4 with two, and 1 with four. The follow-up radiological evaluations were performed with cranial computed tomogram (CT) or MRI between 6 month and one year interval, and if the AVM nidus had completely disappeared in the CT or MRI, we confirmed this was a complete obliteration, with a cerebral or magnetic resonance angiogram (MRA). The median follow-up period was 39 months with a range of 10 to 103 months. Twenty patients were radiologically followed up for over 20 months, with complete obliteration observed in 14 (70%). According to the maximal diameter. all four of the small AVM (<2 cm) completely obliterated, 8 of the 10 patients with a medium A VM (2 - 3 cm) showed a complete obliteration, and two showed partial obliteration, Among the patients with a large AVM (>3 cm), only one showed complete obliteration, and 5 showed partial obliteration, but 3 of these underwent further radiosurgery 3 years later. One who followed up for 20 months following

  1. Curative effect and surgical techniques of microsurgery for cerebral arteriovenous malformation: a report of 65 cases

    OpenAIRE

    Sheng-bao WANG; Sun, Zheng-Hui; Wu, Chen; Xu-jun SHU; Wen-xin WANG; Xue, Zhe

    2015-01-01

    Objective To assess the safety and efficacy of microsurgical resection of cerebral arteriovenous malformation (AVM).  Methods A total of 65 patients with cerebral AVMs were treated with microsurgical resections from April to August 2010 in our hospital. Of the 65 patients, 26 were male and 39 were female with age ranging from 4 to 72 years (average 42 years). Initial symptoms included cerebral hemorrhage in 32 cases, seizures in 10 cases, headache in 6 cases, neurological dysfunction ...

  2. Surgical strategy for cerebral arteriovenous malformation with acute hemorrhage

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, there have been craniocerebral operation, interventional embolization,stereotactic radiotherapy and other methods in treating cerebral arteriovenous malformation (AVM).However, the standard of different therapeutic regimens of cerebral AVM at the acute stage of hemorrhage has not been completely identified.OBJECTIVE: To observe the clinical characteristics and therapeutic effects of AVM at the acute stage of hemorrhage in patients, and to analyze corresponding therapeutic strategies.DESIGN: Non-randomized clinical observation.SETTING: Department of Neurosurgery, Foshan First People's Hospital, Sun Yat-sen University.PARTICIPANTS: Forty-six patients with cerebral AVM complicated by hemorrhage admitted to Department of Neurosurgery, Foshan First People's Hospital between January 1999 and December 2006,were involved in this study. All the patients were confirmed as cerebral AVM complicated by hemorrhage by brain angiography or/and postoperational pathology. The involved patients, 32 males and 14 females,averaged 25 years old, ranging from 6 to 62 years. Informed consents of therapeutic items were obtained from the relatives of all the patients.METHODS: ①On admission, skull CT and brain angiography were conducted in the involved subjects. ②The therapeutic method was confirmed according to the consciousness, hematoma region, hematoma volume,imageological results following comprehensive analysis: DSA examination was permitted to identify the size and position of abnormal vessel mass, and the distribution of feeding artery and draining vein. Craniocerebral operation was carried out as early as possible in patients with severe or progressive conscious disturbance, in which most of hematoma with obvious occupied effect or cerebral hernia was located in lobe of brain. The primary thing was to clean intracerebral hematoma for in time decompression. According to different situations, corresponding therapeutic measures were used for resecting abnormal

  3. Radiosurgery for cerebral arteriovenous malformation during pregnancy: A case report focusing on fetal exposure to radiation

    OpenAIRE

    Nagayama, Kazuki; Kurita, Hiroki; Tonari, Ayako; Takayama, Makoto(Department of Health and Physical Education, Tokyo Gakugei University); Shiokawa, Yoshiaki

    2010-01-01

    Introduction: We present the case of a pregnant woman who underwent linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) and we discuss the fetal exposure to radiation. Clinical Presentation: A 20-year-old woman at 18 weeks of gestation presented with right cerebral hemorrhage and underwent urgent evacuation of the hematoma. She recovered well after surgery, but cerebral angiography after the surgery revealed a small deeply seated arteriovenous malformation (AVM) in the right fron...

  4. Cavernous Angioma and Children

    Science.gov (United States)

    ... Canoeing – Wear a life vest and helmet Caving Golf Ice-skating or hockey – Wear a helmet Boxing ... emergency. Cavernous malformations may play a role in learning or behavior problems a child might experience. Knowing ...

  5. Outcome of cerebral arteriovenous malformations after linear accelerator reirradiation

    OpenAIRE

    Moraes, Paulo L.; Rodrigo S Dias; Eduardo Weltman; Adelmo J Giordani; Salomon Benabou; Segreto, Helena R. C.; Segreto, Roberto A.

    2015-01-01

    Background: The aim of this study was to evaluate the clinical outcome of patients undergoing single-dose reirradiation using the Linear Accelerator (LINAC) for brain arteriovenous malformations (AVM). Methods: A retrospective study of 37 patients with brain AVM undergoing LINAC reirradiation between April 2003 and November 2011 was carried out. Patient characteristics, for example, gender, age, use of medications, and comorbidities; disease characteristics, for example, Spetzler-Martin ...

  6. Risk of cerebral arteriovenous malformation rupture during pregnancy and puerperium

    OpenAIRE

    Liu, Xing-ju; Wang, Shuo; Zhao, Yuan-li; Teo, Mario; Guo, Peng; Zhang, Dong; Wang, Rong; Cao, Yong; Ye, Xun; Kang, Shuai; Ji-zong ZHAO

    2014-01-01

    Objective: To determine whether the risk of arteriovenous malformation (AVM) rupture is increased during pregnancy and puerperium. Methods: Participants included 979 female patients with intracranial AVM admitted to Beijing Tiantan Hospital between 1960 and 2010. Two neurosurgery residents reviewed medical records for each case. Of them, 393 patients with ruptured AVM between 18 and 40 years of age were used for case-crossover analysis. Number of children born and clinical information during ...

  7. The role of SDF-1/CXCR4 in the vasculogenesis and remodeling of cerebral arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Wang L

    2015-09-01

    Full Text Available Lingyan Wang,1 Shaolei Guo,2 Nu Zhang,2 Yuqian Tao,3 Heng Zhang,1 Tiewei Qi,2 Feng Liang,2 Zhengsong Huang2 1Department of Neurosurgery ICU, 2Department of Neurosurgery, 3Department of Neurology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China Background: Cerebral arteriovenous malformation (AVM involves the vasculogenesis of cerebral blood vessels and can cause severe intracranial hemorrhage. Stromal cell-derived factor-1 (SDF-1 and its receptor, CXCR4, are believed to exert multiple physiological functions including angiogenesis. Thus, we investigated the role of SDF-1/CXCR4 in the vasculogenesis of cerebral AVM.Methods: Brain AVM lesions from surgical resections were analyzed for the expression of SDF-1, CXCR4, VEGF-A, and HIF-1 by using immunohistochemical staining. Flow cytometry was used to quantify the level of circulating endothelial progenitor cells (EPCs. Further, in an animal study, chronic cerebral hypoperfusion model rats were analyzed for the expression of SDF-1 and HIF-1. CXCR4 antagonist, AMD3100, was also used to detect its effects on cerebral vasculogenesis and SDF-1 expression.Results: Large amounts of CXCR4-positive CD45+ cells were found in brain AVM lesion blood vessel walls, which also have higher SDF-1 expression. Cerebral AVM patients also had higher level of EPCs and SDF-1. In chronic cerebral hypoperfusion rats, SDF-1, HIF-1, and CD45 expressions were elevated. The application of AMD3100 effectively suppressed angiogenesis and infiltration of CXCR4-positive CD45+ cells in hypoperfusion rats compared to controls.Conclusion: The SDF-1/CXCR4 axis plays an important role in the vasculogenesis and migration of inflammatory cells in cerebral AVM lesions, possibly via the recruitment of bone marrow EPCs. Keywords: cerebral arteriovenous malformation, SDF-1/CXCR4, chronic cerebral hypoperfusion, endothelial progenitor cells

  8. Automatic localization of cerebral cortical malformations using fractal analysis

    Science.gov (United States)

    De Luca, A.; Arrigoni, F.; Romaniello, R.; Triulzi, F. M.; Peruzzo, D.; Bertoldo, A.

    2016-08-01

    Malformations of cortical development (MCDs) encompass a variety of brain disorders affecting the normal development and organization of the brain cortex. The relatively low incidence and the extreme heterogeneity of these disorders hamper the application of classical group level approaches for the detection of lesions. Here, we present a geometrical descriptor for a voxel level analysis based on fractal geometry, then define two similarity measures to detect the lesions at single subject level. The pipeline was applied to 15 normal children and nine pediatric patients affected by MCDs following two criteria, maximum accuracy (WACC) and minimization of false positives (FPR), and proved that our lesion detection algorithm is able to detect and locate abnormalities of the brain cortex with high specificity (WACC  =  85%, FPR  =  96%), sensitivity (WACC  =  83%, FPR  =  63%) and accuracy (WACC  =  85%, FPR  =  90%). The combination of global and local features proves to be effective, making the algorithm suitable for the detection of both focal and diffused malformations. Compared to other existing algorithms, this method shows higher accuracy and sensitivity.

  9. [Elective cerebral arteriovenous malformation treatment with onyx after coil embolization of ruptured, flow-realeted aneurysm of the posterior circulation].

    Science.gov (United States)

    Poncyljusz, Wojciech; Falkowski, Aleksander; Rać, Monika; Sagan, Leszek; Kojder, Ireneusz

    2012-01-01

    Intracranial arteriovenous posterior circulation malformation was planned to embolize by onyx injection after acute coil embolization of ruptured flow-realeted aneurysm of posterior cerebral artery. Control angiography revealed completely embolized malformation with normal vessel patency at the end of procedure. There were no adverse events related to this procedure and no neurologic deficit at the discharge. PMID:23276020

  10. Moyamoya syndrome associated with γ knife surgery for cerebral arteriovenous malformation: case report.

    Science.gov (United States)

    Uozumi, Yoichi; Sumitomo, Masaki; Maruwaka, Mikio; Araki, Yoshio; Izumi, Takashi; Miyachi, Shigeru; Kato, Takenori; Hasegawa, Toshinori; Kida, Yoshihisa; Okamoto, Sho; Wakabayashi, Toshihiko

    2012-01-01

    A 30-year-old female developed moyamoya syndrome after gamma knife surgery (GKS) for cerebral arteriovenous malformation (AVM), and was treated with bypass surgery. She suffered from flittering scotoma, right transient hemianopsia, and headache for 1 year. Cerebral angiography revealed a Spetzler-Martin grade III AVM located in the left occipital lobe. After staged embolization, GKS was performed with a minimum dose of 20 Gy to the periphery of the nidus at the 50% isodose level of the maximum target dose. Gradual nidus regression was achieved, and the clinical symptoms disappeared completely. However, at 30 months after GKS, the patient suffered transient ischemic attack. Cerebral angiography showed left middle cerebral artery occlusion with moyamoya vessels. The patient underwent direct and indirect bypass surgery. After surgery, the patient was free from ischemic symptoms. Chronic inflammation and long-term changes in expression of cytokines and growth factors after GKS may have triggered this case.

  11. Impact on cognitive functions following gamma knife radiosurgery for cerebral arteriovenous malformations

    OpenAIRE

    A Raghunath; Niranjana Bennett; Arivazhagan Arimappamagan; Bhat, Dhananjaya I; Dwarakanath Srinivas; Thennarasu, K.; Jamuna, R.; Sampath Somanna

    2016-01-01

    Background: Radiosurgery is an alternative to surgical resection of arteriovenous malformation (AVM). Very few studies have addressed the concern of radiation injury to the brain and its attendant adverse effects on cognitive function. Materials and Methods: This prospective study included all patients who underwent gamma knife radiosurgery (GKRS) at our institute for cerebral AVM between 2006 and December 2008 (n = 34). All patients underwent neuropsychological evaluation before the procedur...

  12. Utility of Intraoperative Fetal Heart Rate Monitoring for Cerebral Arteriovenous Malformation Surgery during Pregnancy

    OpenAIRE

    FUKUDA, Kenji; MASUOKA, Jun; TAKADA, Shigeki; Katsuragi, Shinji; Ikeda, Tomoaki; IIHARA, Koji

    2014-01-01

    We report two methods of intraoperative fetal heart rate (FHR) monitoring in cases of cerebral arteriovenous malformation surgery during pregnancy. In one case in her third trimester, cardiotocography was used. In another case in her second trimester, ultrasound sonography was used, with a transesophageal echo probe attached to her lower abdomen. Especially, the transesophageal echo probe was useful because of the advantages of being flexible and easy to attach to the mother's lower abdomen c...

  13. 3D Road-Mapping in the Endovascular Treatment of Cerebral Aneurysms and Arteriovenous Malformations

    OpenAIRE

    Rossitti, S.; Pfister, M

    2009-01-01

    3D road-mapping with syngo iPilot was used as an additional tool for assessing cerebral aneurysms and arteriovenous malformations (AVMs) for endovascular therapy. This method provides accurate superimposition of a live fluoroscopic image (native or vascular road-map) and its matching 2D projection of the 3D data set, delivering more anatomic information on one additional display. In the endovascular management of cases with complex anatomy, 3D road-mapping provides excellent image quality at ...

  14. Outcome of cerebral arteriovenous malformations after linear accelerator reirradiation

    Directory of Open Access Journals (Sweden)

    Paulo L Moraes

    2015-01-01

    Full Text Available Background: The aim of this study was to evaluate the clinical outcome of patients undergoing single-dose reirradiation using the Linear Accelerator (LINAC for brain arteriovenous malformations (AVM. Methods: A retrospective study of 37 patients with brain AVM undergoing LINAC reirradiation between April 2003 and November 2011 was carried out. Patient characteristics, for example, gender, age, use of medications, and comorbidities; disease characteristics, for example, Spetzler-Martin grading system, location, volume, modified Pollock-Flickinger score; and treatment characteristics, for example, embolization, prescription dose, radiation dose-volume curves, and conformity index were analyzed. During the follow-up period, imaging studies were performed to evaluate changes after treatment and AVM cure. Complications, such as edema, rupture of the blood-brain barrier, and radionecrosis were classified as symptomatic and asymptomatic. Results: Twenty-seven patients underwent angiogram after reirradiation and the percentage of angiographic occlusion was 55.5%. In three patients without obliteration, AVM shrinkage made it possible to perform surgical resection with a 2/3 cure rate. A reduction in AVM nidus volume greater than 50% after the first procedure was shown to be the most important predictor of obliteration. Another factor associated with AVM cure was a prescription dose higher than 15.5 Gy in the first radiosurgery. Two patients had permanent neurologic deficits. Factors correlated with complications were the prescription dose and maximum dose in the first procedure. Conclusion: This study suggests that single-dose reirradiation is safe and feasible in partially occluded AVM. Reirradiation may not benefit candidates whose prescribed dose was lower than 15.5 Gy in the first procedure and initial AVM nidus volume did not decrease by more than 50% before reirradiation.

  15. Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy

    International Nuclear Information System (INIS)

    Purpose: Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital based study. Material and Methods: The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP. Results: Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm. Conclusions: Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP. (authors)

  16. Cerebral malformation induced by prenatal X-irradiation: an autoradiographic and Golgi study

    Energy Technology Data Exchange (ETDEWEB)

    Ferrer, I.; Xumetra, A.; Santamaria, J. (Neuropatologia, Depto. Anatomia Patologica, C.S. ' Principes de Espana' , Hospitalet de Llobregat, Barcelona (Spain))

    1984-01-01

    Brain malformations are produced after X-irradiation at different post-conceptional ages in the rat. Malformed cortical patterns result from abnormal organisation and capricious orientation of the neurons, while a radical migratory pattern of neuroblasts outwards to the cerebral cortex is preserved in animals irradiated on the fourteenth, sixteenth or eighteenth days of gestation. Migratory disturbances are restricted to the large subcortical ectopic masses found in rats irradiated on the fourteenth gestational day and to pyramidal ectopic nodules in the hippocampus in rats irradiated on the sixteenth gestational day. Subcortical ectopic masses develop from ectopic germinal rosettes and are formed by several types of cortical neuron distributed in a stereotyped pattern. The presence of large numbers of intrinsic, afferent and efferent connections are indicative of integrative functions of the subcortical masses.

  17. [Medullary venous malformation with azygos anterior cerebral artery aneurysm: a case report].

    Science.gov (United States)

    Harada, K; Kobayashi, S; Sigemori, M; Watanabe, M; Kuramoto, S

    1987-03-01

    A case of medullary venous malformation with azygos anterior cerebral artery aneurysm is reported, which was associated with the leptomenigeal angiomatosis on the cortex of the right frontal lobe. A 62-year-old female was admitted to the Kurume University Hospital on June 21, 1985, because of a convulsive seizure. On admission, neurological and general examinations, except for slightly liver function disorder, was no abnormality. Plain CT scan showed the cortical atrophy and two small high-density areas in the right frontal lobe. Enhanced CT scan showed a high-density area in the genu of the corpus callosum. MRI (magnetic resonance imaging), on T2 weighted image, showed a high signal intensity area in the right paraventricular deep white matter and the right frontal region. A right internal carotid angiogram in the venous phase showed numerous enlarged medullary veins in the deep frontal region, converging into a single large draining vein that empties into the basal vein of Rosenthal. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. Twenty eight days after admission, a right frontal cranioplastic craniotomy was performed. During operation, the surface of the right frontal lobe was covered by fine, vascular networks, which was reddish brown. A right frontal lobectomy, including venous malformation and vascular networks, was performed. The aneurysm was clipped via an interhemispheric approach. Histologically, the malformation vessels had spread into the subarachnoid space.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3600991

  18. MRI evidence for preserved regulation of intracranial pressure in patients with cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Meinel, Felix G.; Fischer, Judith; Pomschar, Andreas; Wöhrle, Natalie; Koerte, Inga K.; Steffinger, Denise [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich (Germany); Laubender, Rüdiger P. [Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Marchioninistr. 15, 81377 Munich (Germany); Muacevic, Alexander [European Cyberknife Center Munich, 81377 Munich (Germany); Reiser, Maximilian F. [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich (Germany); Alperin, Noam [Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33136 (United States); Ertl-Wagner, Birgit, E-mail: birgit.ertl-wagner@med.uni-muenchen.de [Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Marchioninistr. 15, 81377 Munich (Germany)

    2014-08-15

    Purpose: The purpose of this study was to investigate intracranial pressure and associated hemo- and hydrodynamic parameters in patients with cerebral arteriovenous malformations AVMs. Methods: Thirty consecutive patients with arteriovenous malformations (median age 38.7 years, 27/30 previously treated with radiosurgery) and 30 age- and gender-matched healthy controls were investigated on a 3.0 T MR scanner. Nidus volume was quantified on dynamic MR angiography. Total arterial cerebral blood flow (tCBF), venous outflow as well as aqueductal and craniospinal stroke volumes were obtained using velocity-encoded cine-phase contrast MRI. Intracranial volume change during the cardiac cycle was calculated and intracranial pressure (ICP) was derived from systolic intracranial volume change (ICVC) and pulse pressure gradient. Results: TCBF was significantly higher in AVM patients as compared to healthy controls (median 799 vs. 692 mL/min, p = 0.007). There was a trend for venous flow to be increased in both the ipsilateral internal jugular vein (IJV, 282 vs. 225 mL/min, p = 0.16), and in the contralateral IJV (322 vs. 285 mL/min, p = 0.09), but not in secondary veins. There was no significant difference in median ICP between AVM patients and control subjects (6.9 vs. 8.6 mmHg, p = 0.30) and ICP did not correlate with nidus volume in AVM patients (ρ = −0.06, p = 0.74). There was a significant positive correlation between tCBF and craniospinal CSF stroke volume (ρ = 0.69, p = 0.02). Conclusions: The elevated cerebral blood flow in patients with AVMs is drained through an increased flow in IJVs but not secondary veins. ICP is maintained within ranges of normal and does not correlate with nidus volume.

  19. Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation

    International Nuclear Information System (INIS)

    Acute respiratory distress syndrome (ARDS) is characterized by sudden onset of respiratory distress, infiltrates on radiographs consistent with pulmonary oedema, hypoxaemia and increased work in breathing. Infiltrates on radiographs are bilateral, but may be patchy or diffuse and fluffy or dense. It is associated with absence of left heart failure and a PaO2/FiO2 ratio of ≤200. Ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide (DMSO), which was approved by the US FDA in July 2005, is used as an embolic agent for cerebral arteriovenous malformation (AVM). It is a biocompatible liquid polymer that precipitates and solidifies on contact with blood, thus forming a soft and spongy embolus. We report a case of ARDS following therapeutic embolization with ethylene vinyl alcohol copolymer for cerebral AVM under general anaesthesia. Experienced perioperative physicians adopted standard anaesthetic technique and monitoring for this procedure. Acute respiratory distress and hypoxaemia developed in the patient following extubation of the trachea. Infiltrates seen on postprocedural chest radiographs were consistent with pulmonary oedema. DMSO, the solvent for the ethylene vinyl alcohol copolymer, is excreted via the lungs after administration and we postulate that DMSO was the possible cause of ARDS in this patient. Monitoring of haemodynamic parameters (invasive blood pressure, electrocardiography) and ventilatory parameters (ETCO2, SpO2, airway pressure monitoring) are important in the recognition of this possible event. One should be vigilant and anticipate this complication following therapeutic embolization with ethylene vinyl alcohol polymer for the treatment of cerebral AVM. (orig.)

  20. Multimodality treatment for cerebral arteriovenous malformations. Complementary role of proton beam radiotherapy

    International Nuclear Information System (INIS)

    A total of 29 cerebral arteriovenous malformations (AVMs) treated at the University of Tsukuba with multimodality treatment including proton beam (PB) radiotherapy for cerebral AVMs between 2005 and 2011 were retrospectively evaluated. Eleven AVMs were classified as Spetzler-Martin grades I and II, 10 as grade III, and 8 as grades IV and V. For AVMs smaller than 2.5 cm and located on superficial and non-eloquent areas, surgical removal with/without embolization was offered as a first-line treatment. For some small AVMs located in deep or eloquent lesions, gamma knife (GK) radiosurgery was offered. Some AVMs were treated with only embolization. AVMs larger than 2.5 cm were embolized to achieve reduction in size, to enhance the safety of the surgery, and to render the AVM amenable to GK radiosurgery. For larger AVMs located in deep or eloquent areas, PB radiotherapy was offered with/without embolization. Immediately after the treatment, 24 patients exhibited no neurological worsening. Four patients had moderate disability, and 1 patient had severe disability. Three patients suffered brain damage after surgical resection, and 2 patients suffered embolization complications. However, no neurological worsening was observed after either GK radiosurgery or PB radiotherapy, but 3 patients treated by PB radiotherapy suffered delayed hemorrhage. Fractionated PB radiotherapy for cerebral AVMs seems to be useful for the treatment of large AVMs, but careful long-term follow up is required to establish the efficacy and safety. (author)

  1. Onyx in treatment of large and giant cerebral aneurysms and arteriovenous malformations

    Institute of Scientific and Technical Information of China (English)

    宋冬雷; 冷冰; 周良辅; 顾宇翔; 陈衔城

    2004-01-01

    @@ Onyx, a novel embolization material, is a mixture of ethylene-vinyl alcohol copolymer (EVOH), dimethyl sulfoxide (DMSO), and micronized tantalum. The polymer is dissolved in DMSO and is prepared in different concentration. Onyx HD-500 for aneurysm embolization contains 20% copolymer and 80% DMSO. Onyx-18 for arteriovenous malformations (AVMs) embolization contains 6.0% copolymer and 94.0% DMSO. When Onyx comes in contact with water or blood, the copolymer precipitates because of rapid diffusion of the DMSO solvent. It possesses stronger cohesiveness, but less likely to entrap the microcatheter. From September 2003, we have used Onyx to treat large and giant cerebral aneurysms and AVMs successfully in 10 patients. Here we report our preliminary experience with the Onyx technique.

  2. The causes and the nursing interventions of the complications due to repeated embolization therapy for huge cerebral arteriovenous malformations

    International Nuclear Information System (INIS)

    Objective: To investigate the causes of the complications occurred after repeated embolization therapy for huge cerebral arteriovenous malformations and to discuss their nursing interventions. Methods: A total of 54 embolization procedures were performed in 17 patients with huge cerebral arteriovenous malformations. The clinical data were retrospectively analyzed. The causes of complications were carefully examined and the preventive measures were discussed. The prompt and necessary nursing interventions were formulated in order to prevent the complications or serious consequences. Results: Among the total 17 patients, one patient gave up the treatment because of the cerebral hemorrhage which occurred two months after receiving 3 times of embolization therapy. One patient experienced cerebral vascular spasm during the procedure, which was relieved after antispasmodic medication and no neurological deficit was left behind. Two patients developed transient dizziness and headache, which were alleviated spontaneously. One patient presented with nervousness, fear and irritability, which made him hard to cooperate with the operation and the basis intravenous anesthesia was employed. No complications occurred in the remaining cases. Conclusion: The predictive nursing interventions for the prevention of complications are very important for obtaining a successful repeated embolization therapy for huge cerebral arteriovenous malformations, which will ensure that the patients can get the best treatment and the complications can be avoided. (authors)

  3. MUTATIONS IN KATNB1 CAUSE COMPLEX CEREBRAL MALFORMATIONS BY DISRUPTING ASYMMETRICALLY DIVIDING NEURAL PROGENITORS

    Science.gov (United States)

    Mishra-Gorur, Ketu; Çağlayan, Ahmet Okay; Schaffer, Ashleigh E.; Chabu, Chiswili; Henegariu, Octavian; Vonhoff, Fernando; Akgümüş, Gözde Tuğce; Nishimura, Sayoko; Han, Wenqi; Tu, Shu; Baran, Burcin; Gumus, Hakan; Dilber, Cengiz; Zaki, Maha S.; Hossni, Heba AA; Rivière, Jean-Baptiste; Kayserili, Hülya; Spencer, Emily G.; Rosti, Rasim O.; Schroth, Jana; Per, Hüseyin; Cağlar, Caner; Cağlar, Cagri; Dölen, Duygu; Baranoski, Jacob F.; Kumandaş, Sefer; Minja, Frank J.; Erson-Omay, E. Zeynep; Mane, Shrikant M.; Lifton, Richard P.; Xu, Tian; Keshishian, Haig; Dobyns, William B; Chi, Neil C.; Šestan, Nenad; Louvi, Angeliki; Bilgüvar, Kaya; Yasuno, Katsuhito; Gleeson, Joseph G.; Günel, Murat

    2016-01-01

    SUMMARY Exome sequencing analysis of over 2,000 children with complex malformations of cortical development identified 5 independent homozygous deleterious mutations in KATNB1, encoding the regulatory subunit of the microtubule severing enzyme katanin. Mitotic spindle formation is defective in patient-derived fibroblasts, a consequence of disrupted interactions of mutant KATNB1 with KATNA1, the catalytic subunit of katanin, and other microtubule associated proteins. Loss of KATNB1 orthologs in zebrafish (katnb1) and flies (kat80) results in microcephaly, recapitulating the human phenotype. In the developing Drosophila optic lobe, kat80 loss specifically affects the asymmetrically dividing neuroblasts, which display supernumerary centrosomes and spindle abnormalities during mitosis, leading to cell cycle progression delays and reduced cell numbers. Furthermore, kat80 depletion results in dendritic arborization defects in sensory and motor neurons, affecting neural architecture. Taken together, we provide insight into the mechanisms by which KATNB1 mutations cause human cerebral cortical malformations, demonstrating its fundamental role during brain development. PMID:25521378

  4. Onyx® in endovascular treatment of cerebral arteriovenous malformations – a review

    International Nuclear Information System (INIS)

    Arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, bypassing the capillary system. In most cases, the disorder may be asymptomatic. The objective of endovascular AVM treatment is set individually for each case upon consultations with a neurosurgeon and a neurologist. The endpoint of the treatment should consist in prevention of AVM bleeding in a management procedure characterized by a significantly lower risk of complications as compared to the natural history of AVM. Endovascular interventions within AVM may include curative exclusion of AVM from circulation, embolization adjuvant to resection or radiation therapy, targeted closure of a previously identified bleeding site as well as palliative embolization. Onyx was first described in the 1990s. It is a non-adhesive and radiolucent compound. Onyx-based closure of the lumen of the targeted vessel is obtained by means of precipitation. The process is enhanced peripherally to the main flux of the injected mixture. This facilitates angiographic monitoring of embolization at any stage. The degree of lumen closure is associated with the location of the vessel. Supratentorial and cortical locations are most advantageous. Dense and plexiform structure of AVM nidus as well as a low number of supplying vessels and a single superficial drainage vein are usually advantageous for Onyx administration. Unfavorable factors include nidus drainage into multiple compartments as well as multiarterial supply of the AVM, particularly from meningeal arteries, en-passant arteries or perforating feeders. Onyx appears to be a safe and efficient material for embolization of cerebral AVMs, also in cases of intracranial bleeding associated with AVM. Curative embolization of small cerebral AVMs is an efficient and safe alternative to neurosurgical and radiosurgical methods. Careful angiographic assessment of individual arteriovenous malformations should be performed before each Onyx administration

  5. Limestone Caverns

    Science.gov (United States)

    Powell, Richard L.

    1970-01-01

    Describes the origin of limestone caverns, using Mammoth Cave as an example, with particular reference to the importance of groundwater information of caverns, the present condition of groundwater, and how caverns develop within fluctuating groundwater zones. (BR)

  6. Clinical and pathological changes in cerebral arteriovenous malformations after stereotactic radiosurgery failure

    Institute of Scientific and Technical Information of China (English)

    LIU Wei-ming; YE Xun; ZHAO Yuan-li; WANG Shuo; ZHAO Ji-zong

    2008-01-01

    Background Stereotactic radiosurgery is an alternative to resection of intracraniaI cerebral arteriovenous malformations (AVMs),while it will failin some cases.This study aimed to evaluate the changes after stereotactic radiosurgery for AVMs.Methods Nineteen cases with cerebral AVMs had failure after stereotactic radiosurgery therapy.The symptoms and angiography were assessed.All patients underwent microsurgery.Pathologic examination was performed for all cases and electron microscopic examination was carried out in 6 patients.Reaults Seven cases had hemorrhage from 12 to 98 months after stereotactic radiosurgery,5 had headache.4 had refractory encephalon edema,2 had epilepsy as a new symptom and 1 had a pressure cyst 5 years after radiosurgery.Angiography in 18 cases,8-98 months after radiation therapy,demonstrated no significant changes in 5 cases.slight reduction in 9,near complete obliteration in 1 and complete obliteration in 3.An abnormal vessel was found on pathologic examination in 17 cases,even one case had obliterated in angiography.Electron microscopy examination showed vessel wall weakness,but the vessels remained open and blood circulated.One case died because of a moribund state before surgery.The other 18 cases had no new neurological deficiencies,seizure control and no hemorrhage occurred after microsurgery at an average follow-up of 3 years.Conclusion Stereotactic radiotherapy for AVMs should have a long period follow-up.If serious complications occur,microsurgery can be performed as salvage treatment.

  7. MRI - a noninvasive tool for evaluating therapeutic embolisation of cerebral arteriovenous malformations

    International Nuclear Information System (INIS)

    Of 86 patients with whose cerebral arteriovenous malformations (AVMs) were embolised in the period 1985-1990 29 were examined by high-field spin-echo (SE) magnetic resonance imaging (MRI) after endovascular therapy with histoacryl-lipiodol. Embolisation-related changes in the nidus of the AVM and in the surrounding brain parenchyma were assessed. Results were compared with pretreatment MR and CT, and with follow-up angiograms in all patients. In accordance with angiographic findings, complete obliteration of pathological vessels was noted in 7 patients (24.1%) and partial occlusion in 22 (75.9%); small ischaemic infarcts were observed in 8 patients (27.6%) and extravascular deposits of blood breakdown products were seen in 3 (10.3%). MRI is a valuable noninvasive technique for assessing morphology and haemodynamics of cerebral AVMs before and after treatment. However, following embolotherapy, variable effects on signal intensity in vascular lumina caused by flowing blood, thrombosis and the embolisation agent have to be carefully analysed. To assess the exact site of histoacryl-lipiodol in embolised nidus territories or small areas of possible intracerebral hemorrhage, the time interval between endovascular therapy and MR examinations may have to be modified. (orig.)

  8. Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Murugesan, C.; Saravanan, Sundararaj; Rajkumar, John; Prasad, Jagadish; Banakal, Sanjay; Muralidhar, Kanchi [Narayana Hrudayalaya Institute of Medical Sciences, Bangalore (India)

    2008-05-15

    Acute respiratory distress syndrome (ARDS) is characterized by sudden onset of respiratory distress, infiltrates on radiographs consistent with pulmonary oedema, hypoxaemia and increased work in breathing. Infiltrates on radiographs are bilateral, but may be patchy or diffuse and fluffy or dense. It is associated with absence of left heart failure and a PaO{sub 2}/FiO{sub 2} ratio of {<=}200. Ethylene vinyl alcohol copolymer dissolved in dimethyl sulfoxide (DMSO), which was approved by the US FDA in July 2005, is used as an embolic agent for cerebral arteriovenous malformation (AVM). It is a biocompatible liquid polymer that precipitates and solidifies on contact with blood, thus forming a soft and spongy embolus. We report a case of ARDS following therapeutic embolization with ethylene vinyl alcohol copolymer for cerebral AVM under general anaesthesia. Experienced perioperative physicians adopted standard anaesthetic technique and monitoring for this procedure. Acute respiratory distress and hypoxaemia developed in the patient following extubation of the trachea. Infiltrates seen on postprocedural chest radiographs were consistent with pulmonary oedema. DMSO, the solvent for the ethylene vinyl alcohol copolymer, is excreted via the lungs after administration and we postulate that DMSO was the possible cause of ARDS in this patient. Monitoring of haemodynamic parameters (invasive blood pressure, electrocardiography) and ventilatory parameters (ETCO{sub 2}, SpO{sub 2}, airway pressure monitoring) are important in the recognition of this possible event. One should be vigilant and anticipate this complication following therapeutic embolization with ethylene vinyl alcohol polymer for the treatment of cerebral AVM. (orig.)

  9. Curative effect and surgical techniques of microsurgery for cerebral arteriovenous malformation: a report of 65 cases

    Directory of Open Access Journals (Sweden)

    Sheng-bao WANG

    2015-04-01

    Full Text Available Objective To assess the safety and efficacy of microsurgical resection of cerebral arteriovenous malformation (AVM.  Methods A total of 65 patients with cerebral AVMs were treated with microsurgical resections from April to August 2010 in our hospital. Of the 65 patients, 26 were male and 39 were female with age ranging from 4 to 72 years (average 42 years. Initial symptoms included cerebral hemorrhage in 32 cases, seizures in 10 cases, headache in 6 cases, neurological dysfunction in 14 cases, and the left 3 cases were diagnosed in health examination. According to Spetzler-Martin grades, there were 7 cases in Grade Ⅰ, 20 in Grade Ⅱ, 23 in Grade Ⅲ, 10 in Grade Ⅳ and 5 in Grade Ⅴ. The diameter of nidi ranged from 2 to 7 cm (on average of 3.50 cm. The lesions were located in the surface of cerebral cortex (31 cases and deep brain (34 cases, including frontal lobe (19 cases, temporal lobe (12 cases, parietal lobe (16 cases, occipital lobe (9 cases, cerebellum (3 cases, basal ganglia (2 cases and lateral cleft (4 cases. Feeding arteries included anterior cerebral artery (ACA and its branches in 11 cases, middle cerebral artery (MCA in 29 cases, posterior cerebral artery (PCA in 15 cases, both ACA and MCA in 2 cases, both ACA and PCA in 5 cases, and vertebral artery (VA in 3 cases. There were superficial vein drainage in 29 cases, deep vein drainage in 15 cases, and both superficial and deep vein drainage in 21 cases. All of those patients underwent surgical resections, including simple excisions in 45 cases and excisions combined with evacuation of hematoma in 20 cases. Among all of those operations, 6 were performed through single-frontal approach, 3 orbitozygomatic approach, 2 transcortical approach, 8 frontal-parietal approach, 10 pterional approach, 3 subtemporal approach, 4 temporal-parietal approach, 7 single-parietal approach, 7 interhemispheric approach, 8 parietal-occipital approach, 3 suboccipital approach, and 4 transcortical

  10. Diagnostic value of contrast-enhanced intraoperative Doppler sonography for cerebral arteriovenous malformations compared with angiography

    Institute of Scientific and Technical Information of China (English)

    XU Hong-zhi; QIN Zhi-yong; GU Yu-xiang; ZHOU Ping; CHEN Xian-cheng

    2010-01-01

    Background Intraoperative Doppler sonography has been used in the neurosurgical operating room for the localization and description of cerebral arteriovenous malformations (AVMs). This study aimed to investigate the clinical value of contrast-enhanced intraoperative Doppler sonography, including its ability to assess the location and identify of feeding arteries in patients with AVMs and to compare this method with angiography.Methods Twenty-three patients with cerebral AVMs who were diagnosed using angiography, were examined with contrast-enhanced intraoperative Doppler sonography. As an echo-enhancing agent, Sulphur Hexafluoride Microbubbles for Injection ("SonoVue") was administered intravenously in all patients. Sonogram results were reviewed and correlated with angiographic findings. For statistical analysis, the Wilcoxon signed-rank test was applied.Results Angiography identified 20 AVM lesions in the anterior or middle fossa and 3 in the posterior fossa.Contrast-enhanced intraoperative Doppler was somewhat less sensitive for only detecting 21/23 (91.3%) of the AVM lesions. Additionally, contrast-enhanced intraoperative Doppler slightly underestimated AVM size compared with angiographic findings but showed feeding arteries with sufficient acoustic properties. In 15 patients, angiography revealed a coincidental blood supply from another intracranial vessel, which was missed by contrast-enhanced intraoperative Doppler sonography.Conclusions In a limited group of patients with AVMs, contrast-enhanced intraoperative Doppler sonography was a less sensitive but useful and simple method for the detection of AVMs in contrast to angiography. No specific untoward effects were attributed to the use of "SonoVue" as a contrast-enhancing substance.

  11. Gene expression signatures in the peripheral blood after radiosurgery of human cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Zabel-du Bois, Angelika [Dept. of Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); Dept. of RadioOncology, Univ. of Heidelberg (Germany); Wagner-Ecker, Mechthild; Schwager, Christian; Wirkner, Ute; Huber, Peter E. [Dept. of Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); Milker-Zabel, Stefanie; Debus, Juergen [Dept. of RadioOncology, Univ. of Heidelberg (Germany); Abdollahi, Amir [Dept. of Radiation Oncology, German Cancer Research Center, Heidelberg (Germany); Dept. of RadioOncology, Univ. of Heidelberg (Germany); Center of Cancer Systems Biology, Tufts Univ. School of Medicine, Boston, MA (United States)

    2010-02-15

    Purpose: To unravel biological mechanisms potentially resulting in the obliteration process after radiosurgery (RS) of human cerebral arteriovenous malformations (AVMs) by investigating molecular signatures on the transcriptomic level in peripheral blood of patients. Patients and Methods: Venous blood samples were obtained at definite points of time before and after RS. The samples were tested for radiation-induced changes regarding biological markers (mRNA) using cDNA and oligo-microarray technology. The corresponding expression profiles were correlated with clinical data and obliteration signs in radiologic imaging. Results: The proof of principle that RS outcome can be successfully correlated with transcriptomics of cellular blood components as disease parameter was demonstrated. The authors identified 76 differentially regulated genes (p < 0.001) after RS. Interestingly, in particular genes with known roles in antiangiogenic and procoagulative pathways were identified as potentially relevant. In particularly, the authors found a significant downregulation of neuropilin-2, protein C inhibitor and cyclin-dependent kinase 6. They also found that low pretreatment blood mRNA levels of TLR4 (toll-like receptor 4) and STAT3 (signal transducer and activator of transcription 3) correlated with fast obliteration of AVMs. Conclusion: The authors report on a novel technique for molecular biological analysis of blood from patients with cerebral AVM treated with RS. Differential regulation of genes in peripheral blood was successfully correlated with RS and time to obliteration of AVMs. The identified genes indicate a potential new methodology to monitor RS, which may result in an individualized therapy and optimized follow-up. (orig.)

  12. Proposal for a New Prognostic Score for Linac-Based Radiosurgery in Cerebral Arteriovenous Malformations

    International Nuclear Information System (INIS)

    Purpose: We evaluate patient-, angioma-, and treatment-specific factors for successful obliteration of cerebral arteriovenous malformations (AVM) to develop a new appropriate score to predict patient outcome after linac-based radiosurgery (RS). Methods and Materials: This analysis in based on 293 patients with cerebral AVM. Mean age at treatment was 38.8 years (4–73 years). AVM classification according Spetzler-Martin was 55 patients Grade I (20.5%), 114 Grade II (42.5%), 79 Grade III (29.5%), 19 Grade IV (7.1%), and 1 Grade V (0.4%). Median maximum AVM diameter was 3.0 cm (range, 0.3–10 cm). Median dose prescribed to the 80% isodose was 18 Gy (range, 12–22 Gy). Eighty-five patients (29.1%) had prior partial embolization; 141 patients (51.9%) experienced intracranial hemorrhage before RS. Median follow-up was 4.2 years. Results: Age at treatment, maximum diameter, nidus volume, and applied dose were significant factors for successful obliteration. Under presumption of proportional hazard in the dose range between 12 and 22 Gy/80% isodose, an increase of obliteration rate of approximately 25% per Gy was seen. On the basis of multivariate analysis, a prediction score was calculated including AVM maximum diameter and age at treatment. The prediction error up to the time point 8 years was 0.173 for the Heidelberg score compared with the Kaplan-Meier value of 0.192. An increase of the score of 1 point results in a decrease of obliteration chance by a factor of 0.447. Conclusion: The proposed score is linac-based radiosurgery–specific and easy to handle to predict patient outcome. Further validation on an independent patient cohort is necessary.

  13. Using a Machine Learning Approach to Predict Outcomes after Radiosurgery for Cerebral Arteriovenous Malformations.

    Science.gov (United States)

    Oermann, Eric Karl; Rubinsteyn, Alex; Ding, Dale; Mascitelli, Justin; Starke, Robert M; Bederson, Joshua B; Kano, Hideyuki; Lunsford, L Dade; Sheehan, Jason P; Hammerbacher, Jeffrey; Kondziolka, Douglas

    2016-01-01

    Predictions of patient outcomes after a given therapy are fundamental to medical practice. We employ a machine learning approach towards predicting the outcomes after stereotactic radiosurgery for cerebral arteriovenous malformations (AVMs). Using three prospective databases, a machine learning approach of feature engineering and model optimization was implemented to create the most accurate predictor of AVM outcomes. Existing prognostic systems were scored for purposes of comparison. The final predictor was secondarily validated on an independent site's dataset not utilized for initial construction. Out of 1,810 patients, 1,674 to 1,291 patients depending upon time threshold, with 23 features were included for analysis and divided into training and validation sets. The best predictor had an average area under the curve (AUC) of 0.71 compared to existing clinical systems of 0.63 across all time points. On the heldout dataset, the predictor had an accuracy of around 0.74 at across all time thresholds with a specificity and sensitivity of 62% and 85% respectively. This machine learning approach was able to provide the best possible predictions of AVM radiosurgery outcomes of any method to date, identify a novel radiobiological feature (3D surface dose), and demonstrate a paradigm for further development of prognostic tools in medical care.

  14. Single-Fraction Proton Beam Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Hattangadi-Gluth, Jona A. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California (United States); Chapman, Paul H. [Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts (United States); Kim, Daniel; Niemierko, Andrzej; Bussière, Marc R.; Stringham, Alison; Daartz, Juliane [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Ogilvy, Christopher [Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts (United States); Loeffler, Jay S. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Shih, Helen A., E-mail: hshih@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-06-01

    Purpose/Objective(s): To evaluate the obliteration rate and potential adverse effects of single-fraction proton beam stereotactic radiosurgery (PSRS) in patients with cerebral arteriovenous malformations (AVMs). Methods and Materials: From 1991 to 2010, 248 consecutive patients with 254 cerebral AVMs received single-fraction PSRS at our institution. The median AVM nidus volume was 3.5 cc (range, 0.1-28.1 cc), 23% of AVMs were in critical/deep locations (basal ganglia, thalamus, or brainstem), and the most common prescription dose was 15 Gy(relative biological effectiveness [RBE]). Univariable and multivariable analyses were performed to assess factors associated with obliteration and hemorrhage. Results: At a median follow-up time of 35 months (range, 6-198 months), 64.6% of AVMs were obliterated. The median time to total obliteration was 31 months (range, 6-127 months), and the 5-year and 10-year cumulative incidence of total obliteration was 70% and 91%, respectively. On univariable analysis, smaller target volume (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.86-0.93, P<.0001), smaller treatment volume (HR 0.93, 95% CI 0.90-0.96, P<.0001), higher prescription dose (HR 1.16, 95% CI 1.07-1.26, P=.001), and higher maximum dose (HR 1.14, 95% CI 1.05-1.23, P=.002) were associated with total obliteration. Deep/critical location was also associated with decreased likelihood of obliteration (HR 0.68, 95% CI 0.47-0.98, P=.04). On multivariable analysis, critical location (adjusted HR [AHR] 0.42, 95% CI 0.27-0.65, P<.001) and smaller target volume (AHR 0.81, 95% CI 0.68-0.97, P=.02) remained associated with total obliteration. Posttreatment hemorrhage occurred in 13 cases (5-year cumulative incidence of 7%), all among patients with less than total obliteration, and 3 of these events were fatal. The most common complication was seizure, controlled with medications, both acutely (8%) and in the long term (9.1%). Conclusions: The current series is the largest

  15. Lemierre syndrome complicated by cavernous sinus thrombosis, the development of subdural empyemas, and internal carotid artery narrowing without cerebral infarction. Case report.

    Science.gov (United States)

    Westhout, Franklin; Hasso, Anton; Jalili, Mehrdad; Afghani, Behnoosh; Armstrong, William; Nwagwu, Chiedozie; Ackerman, Laurie L

    2007-01-01

    Lemierre syndrome is an extremely rare complication of mild-to-moderate pharyngeal infections. The authors present an unusual case of Lemierre syndrome in a 16-year-old boy with cavernous sinus thrombosis and right internal carotid artery narrowing without neurological sequelae, right subdural empyema, and cerebritis in the right temporal and occipital lobes. Neuroimaging also demonstrated right jugular vein thrombosis. Cultures of samples from the blood proved positive for the presence of Fusobacterium necrophorum. The patient underwent unilateral tonsillectomy, drainage of the peritonsillar abscess, and a myringotomy on the right side. Postoperatively the patient was treated conservatively with antibiotic therapy resulting in an excellent outcome. PMID:17233314

  16. Planned Two-Fraction Proton Beam Stereotactic Radiosurgery for High-Risk Inoperable Cerebral Arteriovenous Malformations

    International Nuclear Information System (INIS)

    Purpose: To evaluate patients with high-risk cerebral arteriovenous malformations (AVMs), based on eloquent brain location or large size, who underwent planned two-fraction proton stereotactic radiosurgery (PSRS). Methods and Materials: From 1991 to 2009, 59 patients with high-risk cerebral AVMs received two-fraction PSRS. Median nidus volume was 23 cc (range, 1.4–58.1 cc), 70% of cases had nidus volume ≥14 cc, and 34% were in critical locations (brainstem, basal ganglia). Median AVM score based on age, AVM size, and location was 3.19 (range, 0.9–6.9). Many patients had prior surgery or embolization (40%) or prior PSRS (12%). The most common prescription was 16 Gy radiobiologic equivalent (RBE) in two fractions, prescribed to the 90% isodose. Results: At a median follow-up of 56.1 months, 9 patients (15%) had total and 20 patients (34%) had partial obliteration. Patients with total obliteration received higher total dose than those with partial or no obliteration (mean dose, 17.6 vs. 15.5 Gy (RBE), p = 0.01). Median time to total obliteration was 62 months (range, 23–109 months), and 5-year actuarial rate of partial or total obliteration was 33%. Five-year actuarial rate of hemorrhage was 22% (95% confidence interval, 12.5%–36.8%) and 14% (n = 8) suffered fatal hemorrhage. Lesions with higher AVM scores were more likely to hemorrhage (p = 0.024) and less responsive to radiation (p = 0.026). The most common complication was Grade 1 headache acutely (14%) and long term (12%). One patient developed a Grade 2 generalized seizure disorder, and two had mild neurologic deficits. Conclusions: High-risk AVMs can be safely treated with two-fraction PSRS, although total obliteration rate is low and patients remain at risk for future hemorrhage. Future studies should include higher doses or a multistaged PSRS approach for lesions more resistant to obliteration with radiation.

  17. Hypofractionated stereotactic radiotherapy for large or involving critical organs cerebral arteriovenous malformations

    International Nuclear Information System (INIS)

    The treatment of large arteriovenous malformations (AVMs) or AVMs involving eloquent regions of the brain remains a challenge. For inoperable lesions, observation, volume-staged radiosurgery or hypofractionated stereotactic radiotherapy (HFSRT) are proposed. The aim of our study was to assess the safety and efficiency of HFSRT for large AVMs located in eloquent areas of the brain. An analysis of records of 49 patients irradiated for cerebral AVMs with a mean dose of 19.9 Gy (12–28 Gy) delivered in 2–4 fractions with planned gap (at least one week) between fractions. Actuarial obliteration rates and annual bleeding hazard were calculated using Kaplan-Meier survival analysis and life tables. Annual bleeding hazard rates were 4.5% and 1.6% after one and two years of the follow-up, respectively. Actuarial total obliteration rates were 7%, 11%, and 21% and total response rate (total and partial obliterations) 22%, 41%, and 55% after one, two and three years of the follow-up, respectively. There was a trend towards larger total obliteration rate in patients irradiated with fraction dose ≥ 8 Gy and total dose > 21 Gy for lesions of volume ≤ 8.18 cm3 which was not observed in case of partial obliterations. HFSRT results with relatively low obliteration rate but is not associated with a significant risk of permanent neurological deficits if both total and fraction doses are adjusted to size and location of the lesion. Predictive factors for total and partial obliterations can be different; this observation, however, is not firmly supported and requires further studies

  18. Impact on cognitive functions following gamma knife radiosurgery for cerebral arteriovenous malformations

    Directory of Open Access Journals (Sweden)

    A Raghunath

    2016-01-01

    Full Text Available Background: Radiosurgery is an alternative to surgical resection of arteriovenous malformation (AVM. Very few studies have addressed the concern of radiation injury to the brain and its attendant adverse effects on cognitive function. Materials and Methods: This prospective study included all patients who underwent gamma knife radiosurgery (GKRS at our institute for cerebral AVM between 2006 and December 2008 (n = 34. All patients underwent neuropsychological evaluation before the procedure. Neuropsychological evaluation was repeated in eighteen patients 2 years following GKRS. Clinical outcome, AVM obliteration, and factors influencing outcome were analyzed in these eighteen patients. Results: Before GKRS, more than 50% had significant impairment of neuropsychological functions compared to normal population norms. 66.6% achieved the excellent radiosurgical outcome. At 2 years follow-up, patients showed varied improvement in neuropsychological function in various categories. Pretherapeutic median value for percentage perseverative responses was 26.5 and at follow-up, it reduced to 18.2 (P = 0.039. Set shifting improved in 11 patients (61.1%, remained same in 5 patients (27.7%, and deteriorated in two patients (11.1%. Patients with a higher Spetzler-Martin grade AVM demonstrated a significantly more favorable shift in follow-up test values for set shifting function (P = 0.021. Patients with postradiation imaging changes had lesser tendency to improve in neuropsychological performance at follow-up. Conclusions: GKRS has no clinically harmful effect on cognitive and neuropsychological functioning in patients with brain AVM. On the contrary, there is an improvement in majority of patients at 2 years following radiosurgery when nidus is obliterated.

  19. Extraosseous, Epidural Cavernous Hemangioma with Back Pain

    Science.gov (United States)

    Ozkal, Birol; Yaldiz, Can; Yaman, Onur; Ozdemır, Nail; Dalbayrak, Sedat

    2015-01-01

    Summary Background Cavernous malformations are characterized by enlarged vascular structures located in benign neural tissues within the cerebellum and spinal cord of the central nervous system. Cavernous hemangiomas (CHs) account for 5% to 12% of all spinal vascular malformations. Case Report We removed a hemorrhagic thoracic mass in a 40-year-old male patient who presented with progressive neurological deficits. Conclusions We found it appropriate to present this case due to its rarity. PMID:25960818

  20. Functional Magnetic Resonance Imaging in the Presurgical Evaluation of Brain Vascular Malformations

    International Nuclear Information System (INIS)

    Objective: To describe our experience in presurgical evaluation of intracranial vascular malformations by means of functional magnetic resonance (fMRI). Method: To evaluate eight patients with cerebral vascular malformations (seven arterio-venous malformation [AVM ] and one cavernous malformation) to send to the eloquent cortex with RMf pre-surgical mapping is assessed. Used a technique that is dependent on the level of oxygen (BOLD) to locate these areas in the cerebral vascular malformation, by applying different paradigms. Results: We found one AVM at the right temporal lobe with activation of the parahipocampal gyrus at the contralateral side using a memory paradigm; another patient with an AVM at the right mesotemporal lobe showed activation of visual and spatial memory of the contralateral hippocampus and parahippocampus. One patient with an AVM at the left parietal lobe without compromise of sensorial and motor cortex; a cavernous malformation at the left angular gyrus with hemispheric language dominance in that side; one right thalamic AVM, one periventricular AVM bilateral language dominance; one left occipital AVM with decreased activation in visual association cortex; one temporoccipital AVM with left language dominance and neurovascular uncoupling. Conclusion: fMRI can delineate anatomically the relationship between the lesion and eloquent cortex, providing useful information for presurgical planning and allowing risk estimation of intervention.

  1. 脑静脉畸形的MRI诊断%MRI diagnosis of cerebral venous malformation (CVM)

    Institute of Scientific and Technical Information of China (English)

    解明; 宋段; 柴宇宁; 马占姝; 吴冠和

    2011-01-01

    目的 探讨MRI对脑静脉畸形(CVM)的诊断价值.方法 收集我院9例CVM患者资料进行回顾性分析.3例行CT平扫检查,9例行MRI T1WI、T2WI、T2FLAIR、T1WI增强扫描,其中有3例行3D TOF MRA扫描,2例行VEN BOLD SENSE 扫描.结果 CVM位于幕下5例,幕上4例.3例CT平扫均未见CVM直接征象,其中2例发现异常病灶,1例未见异常.5例MRI平扫显示髓静脉呈长T1长T2信号,中央静脉干呈长T1短T2 信号或长T1长T2信号,FLAIR上髓静脉为稍高信号,中央静脉干为稍低信号或稍高信号,增强呈典型的"水母"征或"树根"征表现.2例MRI平扫显示条管状流空低信号,增强呈条状高信号.1例MRI平扫显示类圆形等长T1、等长T2信号,中心可见流空信号.增强MRA显示髓静脉呈放射状汇入中央静脉并见引流入上矢状窦.1例术前只诊断为血管畸形,未能明确分型.结论 MRI多序列成像对脑静脉畸形绝大多数可明确诊断,MRI增强及VEN BOLD SENSE 序列是发现脑静脉畸形最敏感的方法,应做为CVM的首选检查方法.%Objective To investigate the value of MRI in diagnosis of cerebral venous malformation (CVM).Methods 9 cases in our hospital patients with CVM data were analyzed retrospectively.3 routine CT scan examination, 9 routine MRI T1WI, T2WI,T2FLAIR, T1WI enhanced scan, of which three routine 3D TOF MRA scans, two routine VEN BOLD SENSE scan.Results 5 cases were the infratentorial, 4 cases of supratentorial.3 cases CT scan showed no direct signs of CVM, including two cases of unusual lesions, 1 case was normal.MRI scan showed five cases of medullar veins elongated T1 long T2 signal, the central vein stem elongated T1 and short T2 signal or long T1 long T2 signal, FLAIR signal slightly higher on the medullar vein, the central vein was slightly lower or slightly higher signal , enhancing showed a typical "Jellyfish" sign or the "root" sign performance.MRI scan showed two cases of tubular flow void of low signal to enhance

  2. Complications following linear accelerator based stereotactic radiation for cerebral arteriovenous malformations

    DEFF Research Database (Denmark)

    Skjøth-Rasmussen, Jane; Roed, Henrik; Ohlhues, Lars;

    2010-01-01

    Primarily, gamma knife centers are predominant in publishing results on arteriovenous malformations (AVM) treatments including reports on risk profile. However, many patients are treated using a linear accelerator-most of these at smaller centers. Because this setting is different from a large...... gamma knife center, the risk profile at Linac departments could be different from the reported experience. Prescribed radiation doses are dependent on AVM volume. This study details results from a medium sized Linac department center focusing on risk profiles....

  3. Developmental malformations of the cerebral cortex; Heterotopie, Polymikrogyrie, Lissenzephalie und Co. Malformationen der kortikalen Hirnentwicklung

    Energy Technology Data Exchange (ETDEWEB)

    Reiss-Zimmermann, Martin [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Leipzig AoeR (Germany); Weber, D.; Sorge, I.; Hirsch, W. [Abt. Paediatrische Radiologie, Universitaetsklinikum Leipzig AoeR (Germany); Merkenschlager, A. [Universitaetsklinik und Poliklinik fuer Kinder und Jugendliche, Universitaetsklinikum Leipzig AoeR (Germany)

    2010-06-15

    Migration disorders (MD) are increasingly recognized as an important cause of epilepsy and developmental delay. Up to 25% of children with refractory epilepsy have a cortical malformation. MD encompass a wide spectrum with underlying genetic etiologies and clinical manifestations. Research regarding the delineation of the genetic and molecular basis of these disorders has provided greater insight into the pathogenesis of not only the malformation but also the process involved in normal cortical development. Diagnosis of MD is important since patients who fail three antiepileptic medications are less likely to have their seizures controlled with additional trials of medications and therefore epilepsy surgery should be considered. Recent improvements in neuroimaging have resulted in a significant increase in the recognition of MD. Findings can be subdivided in disorders due to abnormal neurogenesis, neuronal migration, neuronal migration arrest and neuronal organization resulting in different malformations like microcephaly, lissencephaly, schizencephaly and heterotopia. The examination protocol should include T1-w and T2-w sequences in adequate slice orientation. T1-w turbo-inversion recovery sequences (TIR) can be helpful to diagnose heterotopia. Contrast agent is needed only to exclude other differential diagnoses. (orig.)

  4. Cognitive function in patients with cerebral arteriovenous malformations after radiosurgery: prospective long-term follow-up

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term cognitive function of patients with cerebral arteriovenous malformations (AVMs) after radiosurgery. Methods and Materials: The data of 95 AVM patients were prospectively assessed up to 3 years after radiosurgery. Of these patients, 39 had a follow-up of at least 2 years. Radiosurgery was performed using a modified linear accelerator (minimal doses to the target volume 15-22 Gy, median dose 20). The neuropsychological evaluation included testing of intelligence, attention, and memory. The effect of a preexisting intracranial hemorrhage, as well as AVM occlusion, on cognitive functions was analyzed after 1 and 2 years. Results: No cognitive declines were observed during follow-up. Instead significant improvements occurred in intelligence (1 year, +6.1 IQ points; 2 years, +5.1 IQ points), memory (1 year, +18.3 percentile score; 2 years, +12.2 percentile score), and attention (1 year, +19 percentile score; 2 years, +18 percentile score). Patients without previous intracranial hemorrhage improved more than patients with intracranial hemorrhage, although this difference was not statistically significant. The role of AVM occlusion on cognitive function is not clear at present. Conclusion: Radiosurgery does not induce measurable deterioration of cognitive function in patients with cerebral AVMs

  5. Simultaneous cerebral and spinal fluid pressure recordings in surgical indications of the Chiari malformation without myelodysplasia.

    Science.gov (United States)

    Häckel, M; Benes, V; Mohapl, M

    2001-09-01

    Patients with Chiari's malformation without myelodysplasia often suffer from another associated spinal cord lesion--syringomyelia. A condition entirely overriding the clinical picture, affecting adversely the results of surgery as well as the prognosis of this congenital developmental defect. Proceeding from the results of their surgical treatment of 40 patients with hindbrain malformation, the authors recommend, in accordance with the literature, a different approach to and classification of patients depending on the presence of syringomyelia (A/B classification; A: syringomyelia on MR--present, B: absent). The pathological development of the syrinx is caused by obstruction to the natural CSF circulation in the subarachnoid spaces of the craniocervical junction (Williams' dissociation theory). The authors are convinced that routine (static) imaging methods (CT, MR) cannot prove the presence or behaviour of a CSF block, and that they cannot help choose reliably the optimum type of treatment. In contrast, direct measurement (and monitoring) of CSF pressure in different compartments of the CSF pathways (intracranial/intraspinal compartment, i.e., in front of and beyond the suspected block) are a method which can help ascertain with precision the presence and behaviour of a CSF circulatory block, and which also provides dynamic information on such a block during the diurnal rhythm for a period of several days. The authors present the results of a prospective study of 25 patients with hindbrain malformation and describe a technique of parallel monitoring of the two CSF compartments using an adaptation of the Williams method, as well as two different types of dissociation tests designed to prove the presence of a CSF block. CSF flow obstruction was found in 11 patients, in 14 patients it could not be proved. In 8 out of 9 patients with a fully developed syrinx (group A) the block was found as expected. It was, however, diagnosed also in 3 patients until then without any

  6. Cerebral hemodynamics and the role of transcranial Doppler applications in the assessment and management of cerebral arteriovenous malformations.

    Science.gov (United States)

    Busch, Kathryn J; Kiat, Hosen; Stephen, Michael; Simons, Mary; Avolio, Alberto; Morgan, Michael Kerin

    2016-08-01

    Dramatic hemodynamic changes occur following resection of brain arteriovenous malformations (AVM). Transcranial Doppler (TCD) records non-invasive velocity and pulsatility parameters. We undertook a systematic review to assess AVM hemodynamics including the time course of changes in velocity and pulsatility in patients undergoing AVM resection. The review employed the Embase and Medline databases. A search strategy was designed. An initial title search for clinical series on AVM and TCD was performed followed by a search for reports on AVM and TCD. A total of 283 publications were selected. Full text analysis produced 54 studies with extractable data regarding AVM, velocity and pulsatility. Two TCD techniques were utilized: conventional "blind" TCD (blind TCD); and transcranial color duplex Doppler (TCCD). Of these, 23 publications reported on blind TCD and seven on TCCD. The presence of high velocity and low pulsatility within AVM feeding arteries preoperatively followed by a postoperative decrease in velocity and subsequent increase in pulsatility of feeding arteries is established. The time sequence of hemodynamic changes following AVM resection using TCD remains uncertain, confounded by variations in methodology and timing of perioperative measurements. Of the two techniques, TCCD reported qualitative aspects including improved differentiation of feeding arteries from draining veins. However, there are a limited number of studies supporting this conclusion. Furthermore, none report reproducible changes with time from treatment. TCCD appears to be a useful technique to analyze the hemodynamic changes occurring following treatment of AVM, however little data is available. This is a field of research that is appropriate to pursue. PMID:27178113

  7. Occult cerebral vascular malformation: High-field (2.0 T) MR imaging and comparison with CT

    International Nuclear Information System (INIS)

    Extensive experience with CT has led to the recognition of criteria for the diagnosis of occult cerebral vascular malformation. MR demonstrated all lesions as hemorrhage foci. The most common and typical MR findings of OVCM was circumscribed thick hypointense rim on T2-weighted images (T2-Wls) representing hemosiderin deposit with various central intensities suggesting the presence of hematomas in different stages (11 lesions). Among these. the recurrent hemorrhage in small amount produced the characteristic 'a bunch of grape' appearance. But, small OCVM less than 1 cm in diameter was identified as a small homogeneous hypointense nodule on T2-Wls with sharp (6 lesions) or fade-out (1 lesions) border. There were 2 lesions showing atypical findings such as dense hemosiderin rin with central lacuma or bilobed subacute hematoma. As the associated MR findings which strongly suggest the diagnosis of OCVM signal void due to feeding or draining vessels was found in 4, lesions and the surrounding focal cortical atrophy or leukomalacia in 2 lesions. The predilection site of OCVM was subcortical (8 lesions) and periventricular (6 cases) location. CT depicted 16 of the 20 lesions, but missed 4 lesions of small OCVM. CT alone did not permit definitive diagnosis of OCVM is most cases. Fifteen lesions demonstrated on CT contained somewhat hyperdense area in central or peripheral locations. Peripheral hyperdense area corresponded to the dense hemosiderin deposit on MR and central one to the hematoma formed by recent hemorrhage. Low density area on CT usually corresponded to liquefied subacute hematoma on MR

  8. Non-enhanced MR imaging of cerebral arteriovenous malformations at 7 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Wrede, Karsten H.; Dammann, Philipp [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Neurosurgery, Essen (Germany); Johst, Soeren; Maderwald, Stefan [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); Moenninghoff, Christoph; Forsting, Michael [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schlamann, Marc [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); University Hospital Giessen, Department of Neuroradiology, Giessen (Germany); Sandalcioglu, I.E. [University Hospital Essen, Department of Neurosurgery, Essen (Germany); Nordstadtkrankenhaus Hannover, Department of Neurosurgery, Hannover (Germany); Ladd, Mark E. [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology (E020), Heidelberg (Germany); Sure, Ulrich [University Hospital Essen, Department of Neurosurgery, Essen (Germany); Umutlu, Lale [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2016-03-15

    To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA). Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts. A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings. This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA. (orig.)

  9. Non-enhanced MR imaging of cerebral arteriovenous malformations at 7 Tesla

    International Nuclear Information System (INIS)

    To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA). Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts. A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings. This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA. (orig.)

  10. Radiosurgery with a linear accelerator in cerebral arteriovenous malformations Radiocirurgia com acelerador linear em malformações arteriovenosas cerebrais

    Directory of Open Access Journals (Sweden)

    Sérgio Carlos Barros Esteves

    2008-04-01

    Full Text Available OBJECTIVE: To evaluate results achieved with radiosurgery and complications of the procedure when treating arteriovenous malformations with linear accelerator. METHODS: This retrospective study was conducted between October 1993 and December 1996. Sixty-one patients with arteriovenous malformations were treated with radiosurgery utilizing a 6MV energy linear accelerator. Ages of the 32 female and 29 male patients ranged from 6 to 54 years (mean: 28.3 years. The most frequent initial symptom was cephalea (45.9%, followed by neurological deficit (36.1%. Cerebral hemorrhage diagnosed by image was observed in 35 patients (57.3%. Most arteriovenous malformations (67.2% were graded Spetzler III and IV. Venous stenosis (21.3% and aneurysm (13.1% were the most frequent angioarchitecture changes. The dose administered varied from 12 to 27.5Gy in the periphery of the lesion. RESULTS: Out of twenty-eight patients that underwent conclusive angiography control, complete obliteration was achieved in 18 (72% and treatment failed in 7 (absence of occlusion with more than 3 years of follow-up. Four were submitted to a second radiosurgery, and one of these has shown obliteration after 18 months of follow-up. DISCUSSION: Several factors were analyzed regarding the occlusion rate (gender, age, volume, localization, Spetzler, flow, embolization, total of isocenters, prescribed dose and chosen isodose and complications (total of isocenters, localization, volume, maximum dose, prescribed dose and chosen isodose. Analyzed variables showed no statistical significance for obliteration of the vessel, as well as for treatment complications. The largest diameter of the arteriovenous malformation, its volume and the dose administered did not influence time of obliteration. CONCLUSION: Radiosurgery is effective in the treatment of arteriovenous malformations and can be an alternative for patients with clinical contraindication or with lesions in eloquent areas. In the studied

  11. Vascular tumors and malformations of the colon

    Institute of Scientific and Technical Information of China (English)

    Israel Fernandez-Pineda

    2009-01-01

    The term "hemangioma" refers to the common tumor of infancy that exhibits rapid postnatal growth and slow regression during childhood. It may cause confusion with venous malformations that are often incorrectly called "cavernous hemangioma". Venous malformations comprise abnormally formed channels that are lined by quiescent endothelium. Accurate diagnosis is required for selecting the appropriate treatment.

  12. Occult cerebral vascular malformation: High-field (2.0 T) MR imaging and comparison with CT

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Kee Hyun; Chung, Jin Wook; Han, Moon Hee; Kang, Heung Sik; Han, Man Chung; Kim, Chu Wan [Seoul National Unversity College of Medicine, Seoul (Korea, Republic of)

    1989-02-15

    Extensive experience with CT has led to the recognition of criteria for the diagnosis of occult cerebral vascular malformation. MR demonstrated all lesions as hemorrhage foci. The most common and typical MR findings of OVCM was circumscribed thick hypointense rim on T2-weighted images (T2-Wls) representing hemosiderin deposit with various central intensities suggesting the presence of hematomas in different stages (11 lesions). Among these. the recurrent hemorrhage in small amount produced the characteristic 'a bunch of grape' appearance. But, small OCVM less than 1 cm in diameter was identified as a small homogeneous hypointense nodule on T2-Wls with sharp (6 lesions) or fade-out (1 lesions) border. There were 2 lesions showing atypical findings such as dense hemosiderin rin with central lacuma or bilobed subacute hematoma. As the associated MR findings which strongly suggest the diagnosis of OCVM signal void due to feeding or draining vessels was found in 4, lesions and the surrounding focal cortical atrophy or leukomalacia in 2 lesions. The predilection site of OCVM was subcortical (8 lesions) and periventricular (6 cases) location. CT depicted 16 of the 20 lesions, but missed 4 lesions of small OCVM. CT alone did not permit definitive diagnosis of OCVM is most cases. Fifteen lesions demonstrated on CT contained somewhat hyperdense area in central or peripheral locations. Peripheral hyperdense area corresponded to the dense hemosiderin deposit on MR and central one to the hematoma formed by recent hemorrhage. Low density area on CT usually corresponded to liquefied subacute hematoma on MR.

  13. Color-coded digital subtraction angiography in the management of a rare case of middle cerebral artery pure arterial malformation. A technical and case report.

    Science.gov (United States)

    Feliciano, Caleb E; Pamias-Portalatin, Eva; Mendoza-Torres, Jorge; Effio, Euclides; Moran, Yadira; Rodriguez-Mercado, Rafael

    2014-12-01

    The advent of flow dynamics and the recent availability of perfusion analysis software have provided new diagnostic tools and management possibilities for cerebrovascular patients. To this end, we provide an example of the use of color-coded angiography and its application in a rare case of a patient with a pure middle cerebral artery (MCA) malformation. A 42-year-old male chronic smoker was evaluated in the emergency room due to sudden onset of severe headache, nausea, vomiting and left-sided weakness. Head computed tomography revealed a right basal ganglia hemorrhage. Cerebral digital subtraction angiography (DSA) showed a right middle cerebral artery malformation consisting of convoluted and ectatic collateral vessels supplying the distal middle cerebral artery territory-M1 proximally occluded. An associated medial lenticulostriate artery aneurysm was found. Brain single-photon emission computed tomography with and without acetazolamide failed to show problems in vascular reserve that would indicate the need for flow augmentation. Twelve months after discharge, the patient recovered from the left-sided weakness and did not present any similar events. A follow-up DSA and perfusion study using color-coded perfusion analysis showed perforator aneurysm resolution and adequate, albeit delayed perfusion in the involved vascular territory. We propose a combined congenital and acquired mechanism involving M1 occlusion with secondary dysplastic changes in collateral supply to the distal MCA territory. Angiographic and cerebral perfusion work-up was used to exclude the need for flow augmentation. Nevertheless, the natural course of this lesion remains unclear and long-term follow-up is warranted.

  14. Radiosurgery with a linear accelerator in cerebral arteriovenous malformations Radiocirurgia com acelerador linear em malformações arteriovenosas cerebrais

    OpenAIRE

    Sérgio Carlos Barros Esteves; Wladimir Nadalin; Ronie Leo Piske; Salomon Benabou; Evandro de Souza MD; Antonio Carlos Zuliani de Oliveira

    2008-01-01

    OBJECTIVE: To evaluate results achieved with radiosurgery and complications of the procedure when treating arteriovenous malformations with linear accelerator. METHODS: This retrospective study was conducted between October 1993 and December 1996. Sixty-one patients with arteriovenous malformations were treated with radiosurgery utilizing a 6MV energy linear accelerator. Ages of the 32 female and 29 male patients ranged from 6 to 54 years (mean: 28.3 years). The most frequent initial symptom ...

  15. 儿童脑动静脉畸形出血危险因素分析%Rick Factors for Cerebral Arteriovenous Malformation Hemorrhage in Pediatric Patients

    Institute of Scientific and Technical Information of China (English)

    陈晓霖; 马力; 王书磊; 赵元立

    2015-01-01

    Objective To investigate the clinical and morphological features of cerebral arteriovenous malformation (CAVM) in children and to assess its risk factors of hemorrhage in pediatric patients. Methods The clinical data of pediatric patients admitted to Beijing Tiantan Hospital for CAVMs between 2012 and 2014 were retrospectively analyzed. All patients were diagnosed using digital subtraction angiography. The effects of demographic characteristics and CAVM morphological characteristics on hemorrhage presentation were studied using univariate and multivariate Logistic regression analysis. The characteristics including the gender, age, deep location, malformation diameter, AVM side, venous drainage, associated aneurysms. Results Seventy-three pediatric CAVM cases were identified, 49 (67.1%) cases presented with hemorrhage. The malformation diameter had signiifcant difference on the malformation, (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93~0.99,P<0.05). The gender, age, AVM side, deep location, deep venous drainage, associated aneurysms, venous drainage did not have significant difference on the malformation. Conclusion Hemorrhagic brain arteriovenous malformations relate with the malformation diameter, and the malformations with small AVM diameter should be treated early to reduce morbidity and mortality.%目的:研究儿童脑动静脉畸形(cerebral arteriovenous malformation,CAVM)临床特点及形态特点,评估其破裂出血的相关因素。方法回顾性分析2012年1月~2014年12月首都医科大学附属北京天坛医院收治年龄小于14岁CAVM患者73例,均经数字减影血管造影(digital subtraction angiography,DSA)检查明确诊断。采用单变量及多变量Logistic回归分析儿童入院时CAVM破裂出血与患者性别、年龄、CAVM侧别、DSA最大径、是否合并动脉瘤、病变是否位于深部、是否纯深静脉引流及静脉引流类型(浅静脉、深静脉及浅静脉合并深静脉)

  16. Rick Factors for Cerebral Arteriovenous Malformation Hemorrhage in Pediatric Patients%儿童脑动静脉畸形出血危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈晓霖; 马力; 王书磊; 赵元立

    2015-01-01

    目的:研究儿童脑动静脉畸形(cerebral arteriovenous malformation,CAVM)临床特点及形态特点,评估其破裂出血的相关因素。方法回顾性分析2012年1月~2014年12月首都医科大学附属北京天坛医院收治年龄小于14岁CAVM患者73例,均经数字减影血管造影(digital subtraction angiography,DSA)检查明确诊断。采用单变量及多变量Logistic回归分析儿童入院时CAVM破裂出血与患者性别、年龄、CAVM侧别、DSA最大径、是否合并动脉瘤、病变是否位于深部、是否纯深静脉引流及静脉引流类型(浅静脉、深静脉及浅静脉合并深静脉)等因素的关系。结果共73例儿童CAVM患者纳入研究,其中49例入院时合并出血,出血率为67.1%。CAVM直径小是儿童CAVM出血的独立危险因素[比值比(odds ratio,OR)0.96,95%可信区间(confidence interval,CI)0.93~099,P<0.05]。结论儿童CAVM破裂出血与动静脉畸形大小有关。%Objective To investigate the clinical and morphological features of cerebral arteriovenous malformation (CAVM) in children and to assess its risk factors of hemorrhage in pediatric patients. Methods The clinical data of pediatric patients admitted to Beijing Tiantan Hospital for CAVMs between 2012 and 2014 were retrospectively analyzed. All patients were diagnosed using digital subtraction angiography. The effects of demographic characteristics and CAVM morphological characteristics on hemorrhage presentation were studied using univariate and multivariate Logistic regression analysis. The characteristics including the gender, age, deep location, malformation diameter, AVM side, venous drainage, associated aneurysms. Results Seventy-three pediatric CAVM cases were identified, 49 (67.1%) cases presented with hemorrhage. The malformation diameter had signiifcant difference on the malformation, (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93~0.99,P<0.05). The gender, age

  17. Cerebral arteriovenous malformation

    Science.gov (United States)

    ... an AVM that is bleeding are: Confusion Ear noise/buzzing (also called pulsatile tinnitus) Headache in one or more parts of the head, may seem like a migraine Problems walking Seizures Symptoms due to ...

  18. ATLAS Cavern baseplate

    CERN Multimedia

    It-UDS-Audiovisual Services

    2002-01-01

    This video shows the incredible amounth of iron used for ATLAS cavern. Please look at the related links and also videos that are concerning the civil engineering where you can see even more detailed cavern excavation work.

  19. Preliminary results of linac-based radiosurgery in arteriovenous malformations and cerebral tumours in the Oncology Centre in Bydgoszcz

    OpenAIRE

    Sokal, Paweł; Lebioda, Andrzej; Harat, Maciej; Furtak, Jacek; Grzela, Monika; Kabacińska, Renata; Makarewicz, Roman; Zieliński, Piotr; Windorbska, Wiesława

    2013-01-01

    Aim of the study Efficacy of stereotactic radiosurgery (SRS) in the treatment in cerebral AVM's, mennigiomas, metastases, acoustic neuromas and recurrent anaplastic gliomas is well documented. The object of this work was the analysis of the results of the treatment of AVM and selected cerebral lesions with linear accelerator-based stereotactic radiosurgery. Material and methods The lesions included: 12 AVMs, 2 cavernomas, 27 meningiomas, 16 metastases, 5 acoustic neuromas, 16 gliomas in 78 pa...

  20. Endothelial gene expression and molecular changes in response to radiosurgery in in vitro and in vivo models of cerebral arteriovenous malformations.

    Science.gov (United States)

    Tu, Jian; Hu, Zhiqiang; Chen, Zhongbin

    2013-01-01

    Radiosurgery for cerebral arteriovenous malformations (AVMs) is limited to 2-year latency. There is no early marker to monitor whether the lesion is responsive to radiosurgery. In this study, we examined endothelial gene expression and molecular changes in response to radiosurgery. Gene expression of E- and P-selectin, ICAM-1, PECAM-1, VCAM-1, tissue factor, and vWF in human cerebral microvascular endothelial cells was quantified by RT-qPCR at different radiation doses and time points. Soluble E- and P-selectin, ICAM-1, VCAM-1, and tissue factor in an animal model of AVMs were quantified by ELISA at different time after radiosurgery. We found that gene expression of E- and P-selectin, ICAM-1, PECAM-1, and VCAM-1 was upregulated by radiation in a dose-dependent manner (P rat model of AVMs (P < .05). Thus, a combination of these molecules measured at different time points may serve as an early predictor of responsiveness of AVMs to radiosurgery.

  1. Spontaneous obliteration highlights the dynamic nature of cerebral arteriovenous malformations: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Su Lone Lim

    2016-01-01

    Conclusion: In our center′s 20-year experience of treatment of cerebral AVMs (approximately 600 cases, this is the only case that has been aborted due to spontaneous obliteration leading us to infer that the incidence of spontaneous AVM obliteration is <1%. Spontaneous obliteration of AVM is a rare but well-established phenomenon that bears testimony to the dynamics of this vascular disorder.

  2. Postoperative visual loss following cerebral arteriovenous malformation surgery: a case report [v2; ref status: indexed, http://f1000r.es/308

    Directory of Open Access Journals (Sweden)

    Nicolai Goettel

    2014-03-01

    Full Text Available We report the case of a 46 year-old woman presenting with unilateral postoperative visual loss after right frontal craniotomy for resection of an arteriovenous malformation in the supine position. The intraoperative course was uneventful with maintenance of hemodynamic stability. Blood loss was 300 ml; postoperative hemoglobin was 12.4 g/dl. In the recovery room, the patient reported loss of vision in her right eye. Ophthalmologic examination revealed decreased visual acuity, color vision, and visual field. Assessment of the retina was normal, but the patient showed a relative afferent pupillary defect consistent with the clinical diagnosis of ischemic optic neuropathy. Postoperative computer tomogram showed normal perfusion of ophthalmic artery and vein, no hemorrhage or signs of cerebral ischemia or edema. The patient recovered most of her vision 3 months after surgery. Anesthesiologists should be aware that this condition may follow uncomplicated intracranial surgeries in the supine position, and should obtain prompt ophthalmologic consultation when a patient develops postoperative visual loss.

  3. 对脑动静脉畸形的若干思考%Contemplations on present cerebral arteriovenous malformation

    Institute of Scientific and Technical Information of China (English)

    刘建民

    2006-01-01

    1895年,Steinheil首先描述了脑动静脉畸形(cerebral arteriovenous malformation,CAVM)。此后随着影像学技术、工艺材料的发展和临床经验的积累,现代医学对CAVM的流行病学、自然病史、发生机制、病理学、临床表现以及治疗学已有更深刻的认识。而对现代意义的CAVM的认识始于Cushing和Dandy,他们在逻辑上将脑血管畸形进行了分类,并制定了相应的治疗策略。脑血管畸形可分为多种类型,临床上以CAVM最为常见。

  4. Advantages of T2 reversed fast spin-echo image and enhanced three-dimensional surface MR angiography for the diagnosis of cerebral arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Tanabe, Sumiyoshi; Honmou, Osamu; Minamida, Yoshihiro; Hashi, Kazuo [Sapporo Medical Univ. (Japan). School of Medicine

    2001-09-01

    Although the anatomical investigation of cerebral arteriovenous malformation (AVM) with conventional neuro-imagings considerably supports the preoperative evaluation, it is still hard to dissect the detailed anatomical conformations of AVMs such as location of nidus, identification of feeding arteries or draining veins, and the three-dimensional configuration of nidus in sulci or gyri. In this study, we investigated the efficacy of enhanced three-dimensional surface MR angiography (surface MRA) and T2 reversed image (T2R image) in the diagnosis and surgical planning for cerebral AVMs. The diagnostic accuracy was studied in twelve AVMs: four AVMs closed to motor area, one to Broca area, one to Wernicke area, four in temporal lobe, and two in occipital lobe. Images were obtained with a SIGNA HORIZON LX 1.5T VER 8.2. To construct T2R, the brain is scanned by fast SE method with long TR and was displayed with the reversed gray scale, which seemed similar to T1WI. Surface MRA is a fusion image of MRA and surface image in the workstation. The original data was obtained by enhanced 3D-SPGR method. MRA image was reconstructed with MIP method, and surface image was manipulated with a volume rendering method. T2R images demonstrated seven sulcal AVMs, three gyral AVMs, and two sulco-gyral AVMs; five AVMs located on cortex, four extended to subcortex, and three to paraventricular brain. The images clearly showed six AVMs had hypervascular network such as modja-modja vascular formation. Surface MRA represented nidus adjacent to eloquent area. They were present in central sulcus, precentral sulcus, intraparietal sulcus, inferior frontal sulcus, sylvian fissure, superior temporal sulcus, inferior temporal sulcus, superior temporal gyrus, inferior temporal gyrus, medial temporal gyrus, premotor area and superior frontal sulcus, precuneus and parieto-occipital sulcus. It was easy to identify the point of feeding arteries going down into the sulcus and the junction-point of nidus

  5. Advantages of T2 reversed fast spin-echo image and enhanced three-dimensional surface MR angiography for the diagnosis of cerebral arteriovenous malformations

    International Nuclear Information System (INIS)

    Although the anatomical investigation of cerebral arteriovenous malformation (AVM) with conventional neuro-imagings considerably supports the preoperative evaluation, it is still hard to dissect the detailed anatomical conformations of AVMs such as location of nidus, identification of feeding arteries or draining veins, and the three-dimensional configuration of nidus in sulci or gyri. In this study, we investigated the efficacy of enhanced three-dimensional surface MR angiography (surface MRA) and T2 reversed image (T2R image) in the diagnosis and surgical planning for cerebral AVMs. The diagnostic accuracy was studied in twelve AVMs: four AVMs closed to motor area, one to Broca area, one to Wernicke area, four in temporal lobe, and two in occipital lobe. Images were obtained with a SIGNA HORIZON LX 1.5T VER 8.2. To construct T2R, the brain is scanned by fast SE method with long TR and was displayed with the reversed gray scale, which seemed similar to T1WI. Surface MRA is a fusion image of MRA and surface image in the workstation. The original data was obtained by enhanced 3D-SPGR method. MRA image was reconstructed with MIP method, and surface image was manipulated with a volume rendering method. T2R images demonstrated seven sulcal AVMs, three gyral AVMs, and two sulco-gyral AVMs; five AVMs located on cortex, four extended to subcortex, and three to paraventricular brain. The images clearly showed six AVMs had hypervascular network such as modja-modja vascular formation. Surface MRA represented nidus adjacent to eloquent area. They were present in central sulcus, precentral sulcus, intraparietal sulcus, inferior frontal sulcus, sylvian fissure, superior temporal sulcus, inferior temporal sulcus, superior temporal gyrus, inferior temporal gyrus, medial temporal gyrus, premotor area and superior frontal sulcus, precuneus and parieto-occipital sulcus. It was easy to identify the point of feeding arteries going down into the sulcus and the junction-point of nidus

  6. Plasticity of motor function and surgical outcomes in patients with cerebral arteriovenous malformation involving primary motor area:insight from fMRI and DTI

    Institute of Scientific and Technical Information of China (English)

    Lijun Wang; Fuxin Lin; Jun Wu; Yuming Jiao; Yong Cao; Yuanli Zhao; Shuo Wang

    2016-01-01

    Background:Patients who have a cerebral arteriovenous malformation (cAVMs) in the motor cortex can have displaced function. The finding and its relationship to recovery from surgery is not known. Methods:We present the five cases with cAVMs involving precentral knob and/or paracentral lobule and without preoperative motor deficits. We used motor activation areas derived from Functional functional MRI (fMRI) as a region of interesting (ROI) to launch the plasticity of cerebrospinal tracts (CST). All the results were incorporated into the neuronavigation platform for surgical treatment. Intraoperative electric cortical stimulation (ECS) was used to map motor areas. Modified Rankin Scale (mRS) of hands and feets were performed on postoperative day 2, 7 and at month 3, 6 during follow-up period. All the patients suffered from motor deficits regardless of cortical activation patterns. Results:Three patients showed functionally seeded CST in or around the AVM, and were validated by intraoperative electrical stimulation (ECS). Patient 4 had two aberrant functionally seeded fiber tracts away from the lesion, but were proved to be non-functional by postoperative motor deficits. Patient 3 with motor cortex and fiber tract within a diffuse AVMs nidus, complete paralysis of upper extremity after operation and has a persistent motor deficit during 6-month follow-up period. Conclusions:The plasticity of motor cortex on fMRI doesn’t prevent post-operative motor deficits. Functionally mapped fiber tract within or abutting AVM nidus predicts transient and persistent motor deficit.

  7. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  8. Surveying the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    The cathedral-like cavern into which the ATLAS experiment will be lowered and installed forms a vital part of the engineering work at CERN in preparation for the new LHC accelerator. This cavern, being measured by surveyors in these images, will have one of the largest spans of any man-made underground structure. The massive 46X25X25 cubic metre detector will be the largest of its type in the world when it is completed for the LHC start-up in 2008.

  9. Clinical study on CyberKnife for treating giant cavernous hemangioma in cavernous sinus region

    Directory of Open Access Journals (Sweden)

    Lu SUN

    2015-10-01

    Full Text Available Objective To investigate the efficacy and safety of CyberKnife for giant cavernous hemangioma in cavernous sinus. Methods The data of 7 cases of giant cavernous hemangioma in cavernous sinus region confirmed by imaging examination and treated with CyberKnife were collected. The tumor volume was 11.86-70.12 cm3 (median 23.30 cm3. CT and MRI were acquired and fused by MIM 6.5.4 software. The acquired data sets were imported into a CyberKnife Robotic Radiosurgery System (Multiplan 4.0.2 and used to delineate the target organs at risk. The irradiation doses received by the lesions were 21 Gy/3 times in 5 cases, 25 Gy/5 times in one case and 30 Gy/3 times in one case. The exposure field was 109-155, and target volume reached over 95%. Patients maintained at supine positionduring treatment and utilized a 6D-skull trace mode specific to CyberKnife. Changes of clinical symptoms and imaging immediately after treatment and during follow-up period were observed to evaluate the efficacy and safety of this therapeutic method. Results Patients were followed-up for 6-18 months, and the meanfollow-up period was 9.37 months. Volumes of lesions were calculated after operation. All of these patients showed decrease in tumor volume (35.48% to 84.03% and improvement in symptoms (including visual impairment, visual field defect and headaches after therapy. Postoperative MRI revealed the tumor volume was 6.75-28.35 cm3 (median 10.50 cm3, which were significantly lower than that of before treatment [11.86-70.12 cm3 (median 23.30 cm3; Z = -2.366, P = 0.018]. Only one case presented radioactive cerebral edema, and the symptom was disappeared after 5-day treatment with mannitol and dexamethasone. Conclusions CyberKnife is an effective treatment method for giant cavernous hemangioma in cavernous sinus region. It is suggested to be the first selection for patients with giant cavernous hemangioma in cavernous sinus, who are not suitable for traditional surgeries and general

  10. Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Thinda Sumeer

    2012-07-01

    Full Text Available Abstract Background Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the external or internal carotid arteries. Although rare, closure of carotid cavernous fistulas can lead to immediate ocular complications. To our knowledge, our case represents the first report of worsening angle closure glaucoma and choroidal detachments over an extended period of two months subsequent to closure of a carotid cavernous fistula. Case presentation A 70-year-old female with a history of primary angle closure glaucoma presented with 4 mm of proptosis, resistance to retropulsion, tortuous corkscrew blood vessels and an orbital bruit of the right eye. Diagnostic cerebral angiogram showed a small indirect Barrow type D right carotid cavernous fistula. Transarterial embolization was planned but repeat cerebral angiography prior to the procedure demonstrated spontaneous partial closure of the carotid cavernous fistula and the procedure was aborted. One month later, our patient was noted to have worsening vision and choroidal detachments of the right eye. She declined further testing and was thus started on self-administered manual carotid jugular compressions. One month later, she developed progressive worsening of her choroidal detachments and angle closure. She eventually opted for surgical intervention but repeat cerebral angiography showed significant thrombosis of the carotid cavernous fistula and no intervention was warranted. Examination two months later showed complete resolution of the choroidal detachments and open angles of both eyes. Conclusions Our patient demonstrated worsening angle closure glaucoma and choroidal detachments after spontaneous closure of her carotid cavernous fistula had been noted. Ocular complications, including acute angle closure, have been reported to occur immediately after closure of carotid cavernous fistulas, but not over months as in our patient. It is imperative that individuals who have

  11. Gastrointestinal malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Loane, Maria; Dolk, Helen;

    2007-01-01

    of mortality for the prenatally diagnosed infants. Clinicians need to balance the risk of early delivery against the benefits of clinical convenience when making case management decisions after prenatal diagnosis. Very few studies have been able to show benefits of prenatal diagnosis of congenital...... malformations for liveborn infants. This may be because the benefits of prenatal diagnosis are outweighed by the problems arising from a lower GA at birth....

  12. Penile cavernous hemangioma

    Directory of Open Access Journals (Sweden)

    Abdelmoughit ECHCHAOUI

    2015-06-01

    Full Text Available Hemangiomas are benign lesions that occur in any part of the body in newborns or in young patients, they are typically capillary or cavernous. Cavernous hemangioma of the penis is extremely rare; and its etiology is not completely understood. Treatment options (surgical excision, laser therapy or sclerotherapy… are controversial and are required if pain, cosmetic defect and/or bleeding during intercourse.                                                  We report a case of a 26 years old man presented with a five years history of a painless lesion on his penis. Physical examination showed an ovoid, solid, 1 x 2 mm in size on the dorsum of penis (Panel A and two elevated irregular lesions on the ventral side (Panel B. The lesions were compressive, nonpulsatile and bluish-red in color with strawberry like appearance. Biopsy and histopathological examination of the lesion revealed a gaping and communicating vessels proliferated in the superficial and medium dermis which is pathognomonic for cavernous hemangioma (Panel C and D. Given the small size, the large number of the lesions, the young age, and the ulceration risk during intercourse if skin graft after excision, Neodymium: YAG laser coagulation was recommended to get a good cosmetic results and sexual function satisfaction.

  13. Traumatic Persistent Trigeminal Artery - Cavernous Sinus Fistula Treated by Transcatheter Arterial Embolization: A Case Report

    OpenAIRE

    Asai, K.; Hasuo, K; Hara, T.; Miyagishima, T.; Terano, N.

    2010-01-01

    We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation.

  14. Spontaneous occlusion of traumatic carotid-cavernous fistula - the effect of angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stampfel, G.

    1984-08-01

    In two patients with a traumatic carotid-cavernous fistula, permanent occlusion of the lesion was observed following cerebral angiography and confirmed by further angiography. A delay is therefore recommended between performing angiography and carrying out further treatment, which may carry some risk. Possibly the use of ionic contrast media, which irritate the vessels, compression of the carotid artery, which reduces flow through the fistula, and general anaesthesia, which may drop the blood pressure, initiate thrombosis in the cavernous sinus. 3 figs.

  15. Traumatic Persistent Trigeminal Artery - Cavernous Sinus Fistula Treated by Transcatheter Arterial Embolization

    Science.gov (United States)

    Asai, K.; Hasuo, K.; Hara, T.; Miyagishima, T.; Terano, N.

    2010-01-01

    Summary We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation. PMID:20377986

  16. Traumatic persistent trigeminal artery--cavernous sinus fistula treated by transcatheter arterial embolization. A case report.

    Science.gov (United States)

    Asai, K; Hasuo, K; Hara, T; Miyagishima, T; Terano, N

    2010-03-01

    We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation. PMID:20377986

  17. Carotid Cavernous Fistula Subsequent to Nasal Septoplasty; A Case Report

    Directory of Open Access Journals (Sweden)

    H Moin

    2005-03-01

    Full Text Available Carotid cavernous fistula (CCF is a rare and lethal condition; it can be spontaneous, traumatic or iatrogenic. This report Presents a case of CCF subsequent to nasal septoplasty who was a 24 years old lady with proptosis and severe decreased visual acuity. After cerebral angiography, trapping and embolization of fistula was performed with good recovery. Like our case, review of articles shows that the patients are signs and symptoms free after embolization.

  18. Aneurysmal Malformation of Galen Vein: A Case Report

    OpenAIRE

    A. Alizadeh; Sh. Yousefzadeh

    2008-01-01

    Introduction: Vein of Galen aneurismal malformation (VGAM) is a rare congenital vascular malformation Characterized by shunting of arterial flow into en-larged cerebral vein, dorsal to the tectum that consti-tute approximately 1% of all intracranial vascular le-sions, however they represent 30% of vascular mal-formations in the pediatric groups."nCase Presentation: A Ten-month old male infant pre-sented to the pediatric physician by increase in the head circumference. There were no sympt...

  19. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  20. Ceremony for ATLAS cavern

    CERN Multimedia

    2003-01-01

    Wednesday 4 June will be a special day for CERN. The President of the Swiss Confederation, Pascal Couchepin, will officially inaugurate the huge ATLAS cavern now that the civil engineering works have ended. The inauguration ceremony will be held in the ATLAS surface building, with speeches by Pascal Couchepin and CERN, ATLAS and civil engineering personalities. This ceremony will be Webcast live. To access the Webcast on 4 June at 18h00 go to CERN Intranet home page or the following address : http://webcast.cern.ch/live.php

  1. B超对眶部血管畸形的诊断%B-ultrasound diagnosis in ophthalmic orbital vascular malformation

    Institute of Scientific and Technical Information of China (English)

    穆秀云; 蔡晓松; 刘杰

    2008-01-01

    Objective To explore the B-ultrasonographic diagnostie value in orbital vascular malformations Methods Features of orbital vascular malformations verified with B-ultrasonography specially for ophthalmology and other assistant exarnination were analyzed retrospectively in 21 cases.Results In 21 cases with orbital vascular malformation,carotid-cavernous sinus fistuls were in 12 cases,11 in whom were examined with cerebral angiography,1 scanned with NMR because of too young,9 with orbital varix scanned with color Doppler and CT and all the 21 cases were verified.Conclusions Ultrasonography iconological features of orbital vascular malformation were typical.it is a valuable assistant examination method of other examination.%目的 探讨眼科专用B超对眶部血管畸形的诊断价值.方法 回顾分析了对眼科专用B超诊断并经过其他辅助检查证实的21例眶部血管畸形患者声像图特征.结果 21例眶部血管畸形,颈动脉海绵窦瘘12例,其中11例行脑血管造影检查,1例因患儿太小行核磁共振检查.眶静脉曲张9例,均行彩色多普勒超声、CT检查得到证实.结论 眼眶部血管畸形具有较典型的超声图像特征,B超是一种有价值的辅助检查

  2. CNS Cavernous Hemangioma; Imaging, Clinical Presentation and Related Anatomophysiology

    Directory of Open Access Journals (Sweden)

    Jalal Jalal Shokouhi

    2009-01-01

    Full Text Available "nClinical and imaging judgement or decision: "n- Is it a CH “CM, CA“? "n- Is it solitary, multiple or familial? "n- Is there an associated venous malformation? "n- Are there risks and consequences of hemorrhage? "n- Is the anatomic location critical and life threatening? "nCavernous malformation is a low pressure, slow flowing malformation and composes 10 – 15 % of vascular malformations. Cavernous angioma consists of enlarged sinusoidal vascular spaces, a compact mass in the brain and spinal cord, the endothelial lining is weak and blood element leakage is frequent.Calcification is possible "X – ray CT ". 75% located in the brain and 25 % in the posterior fossa and brain stem. "nAll 50% of cases are multiple and this form is familial in 80 % of cases “possibility combined with cord cavernoma“. "nExtra – medullary and extra – paranchymal forms are rare. "n- 40-60 % of the patients demonstrate seizure because of hemorrhage inside the cavernoma. "n10 – 15 % of complicated patients show significant clinical signs especially in the brain stem."n Imaging: "n1- X-ray CT: Isodense or hyperdense with frequent and heavy calcification . "nEnhanced CT may show the degree of enhancement. "n2 – By MRI: T1 may be isointense but in case of hemorrhage there is bright methemoglobin inside. By T2 and flair a thin capsule and a rim of hemosiderin – ferritin "popcorn or mulberries" and shows enhancement "GD-GRE-MRI pulse". "nCompanion of venous angioma and cavernoma is possible. "nBleeding is more likely from cavernous malformations during pregnancy. "nConclusion: CT and MRI demonstrate all forms and sites of brain and spinal cord cavernomas. "nAttention is necessary for brain stem lesions especially during pregnancy."n Treatment: 1- Medial and serial MRI controls. "n2- Radiosurgery "Gama-knife", rare. "n3- Microsurgery, very rare Multiple forms of these lesions are demonstratable in 55 patients.  

  3. Amphibian malformations and inbreeding

    OpenAIRE

    Williams, Rod N.; Bos, David H; Gopurenko, David; DeWoody, J. Andrew

    2008-01-01

    Inbreeding may lead to morphological malformations in a wide variety of taxa. We used genetic markers to evaluate whether malformed urodeles were more inbred and/or had less genetic diversity than normal salamanders. We captured 687 adult and 1259 larval tiger salamanders (Ambystoma tigrinum tigrinum), assessed each individual for gross malformations, and surveyed genetic variation among malformed and normal individuals using both cytoplasmic and nuclear markers. The most common malformations...

  4. A dural arteriovenous fistula in cavernous sinus developed from viral meningitis.

    Science.gov (United States)

    Hai, Jian; Zhang, Lin; Wan, Jue-Feng; Su, Shao-Hua; Wang, Fei; Zhang, Gui-Yun

    2011-06-01

    Although hormonal influences, inflammation, trauma, sinus thrombosis, venous hypertension, and congenital origin have been proposed as sources of dural arteriovenous fistulas (DAVFs) in cavernous and sigmoid sinuses, the etiology of these lesions remains controversial. We present a case with a cavernous sinus DAVF developed from viral meningitis which has not been previously described. A 24-year-old male was admitted to our institute because of periorbital pain, decreased vision, pulsatile tinnitus, chemosis, and exophthalmos on the right side after he had suffered viral meningitis four months before. Cerebral angiography demonstrated a cavernous sinus DAVF, which was successfully obliterated with several platinum coils using a transvenous approach. The viral meningitis most likely caused the inflammation, that may be responsible for the occurrence of the cavernous sinus DAVF. Prompt treatment for inflammation may help to prevent the development of DAVFs.

  5. Magnetic Resonance Angiography in the Diagnosis of Cerebral Arteriovenous Malformation and Dural Arteriovenous Fistulas: Comparison of Time-Resolved Magnetic Resonance Angiography and Three Dimensional Time-of-Flight Magnetic Resonance Angiography

    Science.gov (United States)

    Cheng, Yu-Ching; Chen, Hung-Chieh; Wu, Chen-Hao; Wu, Yi-Ying; Sun, Ming-His; Chen, Wen-Hsien; Chai, Jyh-Wen; Chi-Chang Chen, Clayton

    2016-01-01

    Background Traditional digital subtraction angiography (DSA) is currently the gold standard diagnostic method for the diagnosis and evaluation of cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (dAVF). Objectives The aim of this study was to analyze different less invasive magnetic resonance angiography (MRA) images, time-resolved MRA (TR-MRA) and three-dimensional time-of-flight MRA (3D TOF MRA) to identify their diagnostic accuracy and to determine which approach is most similar to DSA. Patients and Methods A total of 41 patients with AVM and dAVF at their initial evaluation or follow-up after treatment were recruited in this study. We applied time-resolved angiography using keyhole (4D-TRAK) MRA to perform TR-MRA and 3D TOF MRA examinations simultaneously followed by DSA, which was considered as a standard reference. Two experienced neuroradiologists reviewed the images to compare the diagnostic accuracy, arterial feeder and venous drainage between these two MRA images. Inter-observer agreement for different MRA images was assessed by Kappa coefficient and the differences of diagnostic accuracy between MRA images were evaluated by the Wilcoxon rank sum test. Results Almost all vascular lesions (92.68%) were correctly diagnosed using 4D-TRAK MRA. However, 3D TOF MRA only diagnosed 26 patients (63.41%) accurately. There were statistically significant differences regarding lesion diagnostic accuracy (P = 0.008) and venous drainage identification (P < 0.0001) between 4D-TRAK MRA and 3D TOF MRA. The results indicate that 4D-TRAK MRA is superior to 3D TOF MRA in the assessment of lesions. Conclusion Compared with 3D TOF MRA, 4D-TRAK MRA proved to be a more reliable screening modality and follow-up method for the diagnosis of cerebral AVM and dAVF.

  6. Coexistent arteriovenous malformation and hippocampal sclerosis.

    Science.gov (United States)

    Prayson, Richard A; O'Toole, Elizabeth E

    2016-06-01

    Cavernous angiomas or cavernomas have been occasionally described in patients presenting with medically intractable epilepsy. Reports of cavernomas associated with a second pathology potentially causative of seizures have rarely been documented; most commonly, the second pathology is focal cortical dysplasia or less frequently, hippocampal sclerosis. To our knowledge, cases of arteriovenous malformation arising in this clinical setting and associated with hippocampal sclerosis have not been previously described. We report a 56-year-old woman who initially presented at age 24years with staring spells. Imaging studies revealed an arteriovenous malformation in the right parietal lobe. At age 51years, she represented with signs and symptoms related to a hemorrhage from the malformation. The patient underwent Gamma Knife radiosurgery (Elekta AB, Stockholm, Sweden) of the lesion. She subsequently developed seizures, refractory to medical management. MRI studies showed atrophy in the right hippocampus. She underwent resection of the right parietal lobe and hippocampus. Histopathologic examination of the right parietal lesion revealed an arteriovenous malformation marked by focally prominent vascular sclerosis, calcification and adjacent hemosiderin deposition. The hippocampus was marked by prominent neuronal loss and gliosis in the CA1 region, consistent with CA1 sclerosis or hippocampal sclerosis International League Against Epilepsy type 2. PMID:26899356

  7. Surgical Treatment of Cerebral Cavernous Malformation Presenting Epileptic Seizures%以癫痫发作为主的脑内海绵状血管畸形的手术治疗

    Institute of Scientific and Technical Information of China (English)

    周峰; 吴俊; 彭磊; 王硕; 桑林; 郑重; 解飞; 葛留锁; 马延山

    2014-01-01

      结论对于合并癫痫的海绵状血管畸形患者应早期进行手术。术中应完整切除海绵状血管畸形病灶(包括病灶周边的胶质瘢痕层和含铁血黄素层),同时行皮层热灼术。

  8. Extradural spinal cavernous angiomas: report of seven cases.

    Science.gov (United States)

    Santoro, Antonio; Piccirilli, Manolo; Bristot, Roberto; di Norcia, Valerio; Salvati, Maurizio; Delfini, Roberto

    2005-10-01

    The authors describe seven cases of extradural spinal cavernous angioma. Although cavernoma itself is not rare, the extradural spinal localization is uncommon and makes preoperative differential diagnosis difficult. Routine MRI investigation has aided neurosurgeons in evaluating the true incidence of these vascular malformations, which was understimated in the past. The data published so far have not entirely clarified the treatment of choice for these lesions. Considering their rarity in this site, their presenting symptoms and the difficulties involved in neuroradiological diagnosis, the authors discuss the role of surgery as the principal form of treatment and review the relevant literature. Seven patients (4 male, 3 female) were admitted to our Institute of Neurosurgery between 1992 and 2004, with a 5-6 month history (range=2-365 days) of low back pain or radicular pain, sometimes associated with paresthesia. All patients had a CT scan, as well as MRI with gadolinium when possible, which detected an extradural roundish lesion: differential diagnosis was very difficult, especially between neurinoma and cavernoma. Treatment was always surgical and resection of the lesion radical. Postoperatively, all patients presented complete regression of clinical symptoms. In all cases histological diagnosis was cavernous angioma. Postoperative MRI with gadolinium or CT scan with IV contrast, performed before discharge, confirmed radical removal of the vascular malformation in all cases. Our experience confirms that surgery should be the treatment of choice for these lesions, in view of both their tendency to bleed and their straightforward surgical removal.

  9. Spinal extradural cavernous angioma

    International Nuclear Information System (INIS)

    The clinical case of a white 57 year-old patient is presented, with clinical pattern of dorsal medullary compression, reason why a laminectomy of D5-D7 was carried out, with resection of an extradural, rounded, wine colored lesion, of 3x2x2 cm. The results of the biopsy confirmed the diagnosis of an angiomatous malformation (cavernoma). Surgery is the ideal treatment for these types of lesions and the spine magnetic resonance is an useful study to diagnose and to treat those affected

  10. ATLAS Cavern - Sainte-Barbe evening

    CERN Multimedia

    2002-01-01

    The December at cavern of ATLAS was full of surprises, while during the iron mounting and concrete work the cavern got its new purpose for being the restaurant under little while -Live music and happy people.

  11. The huge ATLAS cavern now fully excavated

    CERN Multimedia

    2002-01-01

    Excavation of the ATLAS cavern is now complete! At the end of two years' work involving a tremendous technical challenge, the civil engineering contractors have succeeded in digging out one of the biggest experimental caverns in the world. Bravo!

  12. Constructing the ATLAS experimental cavern

    CERN Multimedia

    Laurent Guiraud

    2001-01-01

    The huge cavern that will house the ATLAS experiment on the LHC at CERN is seen in these images during construction. The site, located 100 m underground near the France-Swiss border, has one of the longest underground spans ever built at 35 m. The 1380 square metre cavern that will hold the 46X25X25 cubic metre detector (the largest of its type in the world) requires its ceiling to be held by ground anchors installed from galleries excavated laterally from the access shafts.

  13. 3D磁敏感加权成像在脑静脉畸形诊断中的价值%The role of 3D susceptibilitv weighted imaging in the evaluation of cerebral venous malformation

    Institute of Scientific and Technical Information of China (English)

    祁鸣; 王德杭

    2011-01-01

    Objective To discuss the value of 3D susceptibility weighted imaging(SWI) in the diagnosis of cerebral venous malformation (CVM). Methods Thirty CVM patients were examined with a 3. OT MRI scanner. The sequences included the conventional MRI, 3D SWI and contrast enhanced T1WL Comparisons were made among SWI, contrast enhanced T1W1 and conventional sequences. The image quality of CVM was graded. Results SWI could demonstrate conspicuously both numerous deep medullary veins and collector veins as the contrast enhanced MRI did, which were hardly visible on Tl-weighted images or T2-weighted images. Conclusion SWI is a sensitive sequence for detecting CVMs. It allows better visualization of CVMs without contrast agents.%目的 探讨3D磁敏感加权成像(SWI)技术对脑静脉畸形(CVM)的诊断价值.方法 30例CVM形患者采用3.0T磁共振常规MRI序列(T1WI、T2WI)、3D SWI及T1WI增强扫描,根据CVM血管显影情况对常规MRI序列、3D SWI及T1WI增强扫描进行分级比较.结果 SWI能显著显示常规T1WI、T2WI很难显示的髓静脉及引流静脉,并与增强扫描图像有很好的对应.结论 SWI是检出CVM较为敏感的序列,在不用造影剂情况下使静脉畸形血管获得较好的显示.

  14. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part I: Differences in epidemiologic, morphologic, and clinical characteristics, permanent complications, and bleeding in the latency period

    International Nuclear Information System (INIS)

    Purpose: To compare the epidemiologic, morphologic, and clinical characteristics of 92 children/adolescents (Group A) and 362 adults (Group B) with cerebral arteriovenous malformations (cAVMs) considered suitable for radiosurgery; to correlate radiosurgery-related permanent complication and post-radiosurgery bleeding rates in the 75 children/adolescents and 297 adults available for follow-up. Methods and Materials: Radiosurgery was performed with a model C 201-source Co6 Leksell Gamma Unit (Elekta Instruments, Stockholm, Sweden). Fisher exact two-tailed, Wilcoxon rank-sum, and two-sample binomial exact tests were used for statistical analysis. Results: There were significant differences between the two populations in sex (p = 0.015), clinical presentation (p = 0.001), and location (p = 0.008). The permanent complication rate was lower in younger (1.3%) than in older patients (5.4%), although the difference was not significant (p = 0.213). The postradiosurgery bleeding rate was lower in Group A (1.3%) than in Group B (2.7%) (p = 0.694), with global actuarial bleeding rates of 0.56% per year and 1.15% per year, respectively. Conclusions: The different characteristics of child/adolescent and adult cAVMs suggest that they should be considered two distinct vascular disorders. The similar rates of radiosurgery-related complications and latency period bleeding in the two populations show that gamma knife radiosurgery does not expose young patients to a higher risk of sequelae than that for older patients

  15. Twenty-seven years follow-up of a patient with congenital retinocephalofacial vascular malformation syndrome and additional congenital malformations (Bonnet-dechaume-blanc syndrome or wyburn-mason syndrome

    Directory of Open Access Journals (Sweden)

    Schmidt D

    2010-02-01

    Full Text Available Abstract Purpose Follow-up of vascular changes in a patient with congenital retinocephalofacial vascular malformation syndrome. Methods MRI and cerebral angiography. Results In a 36-year-old man, magnetic resonance im aging of the skull and cerebral angiography revealed left intracranial arteriovenous malformations. Follow-up observation of 27 years revealed no essential change of retinal and cerebral arteriovenous malformations. Additional congenital deficits in this patient were described. Conclusion Patients with retinal arteriovenous malformations should be early examined with neuroradiological methods.

  16. Uterine cavernous haemangioma in a post-menopausal woman: CT and MRI findings mimicking uterine myoma with degeneration

    OpenAIRE

    Lee, E J; Kim, S H; Kim, Y.H.(Center for Underground Physics, Institute for Basic Science (IBS), Daejon, 305-811, Korea)

    2011-01-01

    Cavernous haemangioma is a very rare vascular malformation of the uterus. We describe the CT and MRI findings of a cavernous haemangioma in an 81-year-old female with recurrent menorrhagia. CT showed a well-marginated mass with multifocal calcifications and extensive haemorrhage, as well as necrosis in the anterior wall of the uterus. MRI revealed heterogeneous low- to high-signal intensities of the mass on T1 and T2 weighted images as well as portions with poor enhancement of the mass on con...

  17. Bilateral indirect carotid cavernous fistula post trivial injury- A case report

    Institute of Scientific and Technical Information of China (English)

    Siti Hajar Mat Abu; Hanizasurana Hashim; Tara Mary George; Norfariza Ngah; Adil Hussein

    2013-01-01

    Fifty-seven years old Malay lady, post menopausal with co-morbid of diabetes mellitus and hypertension presented with three months history of bilateral painful red eyes associated with double vision. Examination revealed both eyes proptosis, corkscrew vessels with present of bruit, secondary narrow angle with raised intraocular pressure, 6th cranial nerve palsy, and bilateral venous stasis retinopathy. CT angiogram showed bilateral dilated superior ophthalmic veins with cerebral angiogram findings of bilateral indirect carotid cavernous fistula involving small meningeal vessels. Indirect or dural cavernous sinus Fistula can easily be missed or misdiagnosed. Trivial injury especially in the predisposing patient can initiate the occurrence.

  18. The ALICE cavern and solenoid

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    The ALICE experiment, one of the four major experiments of CERN's LHC project, will be housed in the cavern that once contained the L3 experiment at the LEP accelerator. The huge solenoid is the only remaining piece of the L3 experiment and will be used by ALICE.

  19. Cavernous Sinus Thrombosis in Children

    Directory of Open Access Journals (Sweden)

    Rochelle Sweis

    2016-03-01

    Full Text Available Investigators from the Children’s Hospital of Philadelphia analyzed the clinical and radiographic findings in 12 cases of cavernous sinus thrombosis (CST seen between 2000 and 2013, and conducted a literature search and review of the pooled data.

  20. Stereotactic linac radiosurgery for arteriovenous malformations.

    OpenAIRE

    Kenny, B G; Hitchcock, E. R.; Kitchen, G.; Dalton, A E; Yates, D A; Chavda, S V

    1992-01-01

    Stereotactic linear accelerator (linac) radiosurgery has been in operation in the West Midlands since 1987, the first of its kind in the United Kingdom. Forty two patients with high-flow cerebral arteriovenous malformations have been treated, 26 of whom have been followed up. Angiography one year after treatment showed that five lesions were obliterated, 11 were reduced in size and/or flow rate and 10 were unchanged. Overall results show that nine out of 10 patients reviewed at 24 months had ...

  1. Pulmonary arteriovenous malformations.

    Science.gov (United States)

    Shovlin, Claire L

    2014-12-01

    Within the past decade, pulmonary arteriovenous malformations (PAVMs) have evolved from rare curiosities to not uncommon clinical states, with the latest estimates suggesting a prevalence of ~1 in 2,600. PAVMs provide anatomic right-to-left shunts, allowing systemic venous blood to bypass gas exchange and pulmonary capillary bed processing. Hypoxemia and enhanced ventilatory demands result, although both are usually asymptomatic. Paradoxical emboli lead to strokes and cerebral abscesses, and these commonly occur in individuals with previously undiagnosed PAVMs. PAVM hemorrhage is rare but is the main cause of maternal death in pregnancy. PAVM occlusion by embolization is the standard of care to reduce these risks. However, recent data demonstrate that currently recommended management protocols can result in levels of radiation exposure that would be classified as harmful. Recent publications also provide a better appreciation of the hematologic and cardiovascular demands required to maintain arterial oxygen content and oxygen consumption in hypoxemic patients, identify patient subgroups at higher risk of complications, and emphasize the proportion of radiologically visible PAVMs too small to treat by embolization. This review, therefore, outlines medical states that exacerbate the consequences of PAVMs. Chief among these is iron deficiency, which is commonly present due to concurrent hereditary hemorrhagic telangiectasia: iron deficiency impairs hypoxemia compensations by restricting erythropoiesis and increases the risk of ischemic strokes. Management of periodontal disease, dental interventions, pulmonary hypertension, and pregnancy also requires specific consideration in the setting of PAVMs. The review concludes by discussing to what extent previously recommended protocols may benefit from modification or revision. PMID:25420112

  2. CCM3 Mutations Are Associated with Early-Onset Cerebral Hemorrhage and Multiple Meningiomas

    Science.gov (United States)

    Riant, F.; Bergametti, F.; Fournier, H.-D.; Chapon, F.; Michalak-Provost, S.; Cecillon, M.; Lejeune, P.; Hosseini, H.; Choe, C.; Orth, M.; Bernreuther, C.; Boulday, G.; Denier, C.; Labauge, P.; Tournier-Lasserve, E.

    2013-01-01

    Mutations of CCM3/PDCD10 cause 10-15% of hereditary cerebral cavernous malformations. The phenotypic characterization of CCM3-mutated patients has been hampered by the limited number of patients harboring a mutation in this gene. This is the first report on molecular and clinical features of a large cohort of CCM3 patients. Molecular screening for point mutations and deletions was used to identify 54 CCM3-mutated index patients. Age at referral and clinical onset, type of inaugural events and presence of extra-axial lesions were investigated in these 54 index patients and 22 of their mutated relatives. Mean age at clinical onset was 23.0 ± 16 years. Clinical onset occurred before 10 years in 26% of the patients, and cerebral hemorrhage was the initial presentation in 72% of these patients. Multiple extra-axial, dural-based lesions were detected in 7 unrelated patients. These lesions proved to be meningiomas in 3 patients who underwent neurosurgery and pathological examination. This ‘multiple meningiomas’ phenotype is not associated with a specific CCM3 mutation. Hence, CCM3 mutations are associated with a high risk of early-onset cerebral hemorrhage and with the presence of multiple meningiomas. PMID:23801932

  3. 影响脑动静脉畸形显微手术疗效的临床因素分析%Clinical factors affecting curative effect of microsurgery on patients with cerebral arteriovenous malformations

    Institute of Scientific and Technical Information of China (English)

    胡观成; 邹安琪; 刘小健; 屈家虎

    2012-01-01

    Objective To investigate the clinical factors influencing the treatment efficacy of microsurgery on patients with cerebral arteriovenous malformations (AVMs). Methods One hundred and eleven patients,admitted to our hospitals from January 1,2003 to December 31,2009 and underwent microsurgical cerebral AVMs resection were chosen in our study; their clinical data were retrospectively analyzed.The functional neurological status was classified with modified Rankin scale 7 d and 6 months after surgery. Binary logistic regression models were applied to test the effect of patient gender, age,intra-cerebral hemorrhage,and the size,deep venous drainage pattern and location of AVMs on long-term and short-term treatment efficacy. Results Twenty-nine patients (26.1%) showed new neurological deficits 7 d after the surgery.Univariate analysis and multivariate analysis demonstrated that deep venous drainage, eloquent location and large size of AVMs, high Spetzler-Martin grading aneurysms and no intra-cerebral hemorrhage were significantly associated with new early neurological deficits (P<0.05),while gender and age of the patients had no significant association with new early neurological deficits (P>0.05).The scores of neurological status scale in patients with Spetzler-Martin grading Ⅰ,Ⅱ and Ⅲ were significantly different between 7 d and 6 months after the surgery (P<0.05). Conclusion AVMs patients having deep venous drainage,eloquent location and large size of AVMs,and having aneurysm and intra-cerebral hemorrhage may be the risk factors of new early neurological deficit after microsurgical resection; analyzing the Spetzler-Martin grading before surgery can help to determine the treatment options.%目的 探讨影响脑动静脉畸形显微手术疗效的临床因素. 方法 收集自2003年1月1日至2009年12月31日南昌大学第一附属医院神经外科、张家界市人民医院神经外科显微外科手术治疗的111例脑动静脉畸形

  4. Cavernous hemangioma in the thymus: a case report.

    Science.gov (United States)

    Ose, Naoko; Kobori, Yuko; Takeuchi, Yukiyasu; Susaki, Yoshiyuki; Taniguchi, Seiji; Maeda, Hajime

    2016-12-01

    Cavernous hemangioma is not a neoplasm, but rather a congenital venous malformation with the potential to develop in all parts of the body, though it is very rarely seen in the thymus. We report a case of cavernous hemangioma in the thymus partially resected. A 71-year-old woman presented with pericardial discomfort, and chest computed tomography (CT) showed a left lateral mediastinal mass which was 2.0 × 1.2 × 1.8 cm in size, with border regularity and without calcification. Its interior was partially enhanced. Three-dimensional chest computed tomography image showed a tortuous vessel connecting to the tumor. Surgical resection was performed for the purpose of providing a definitive diagnosis and treatment because a mediastinal tumor such as thymoma or teratoma was suspected. Partial resection of the thymus including the mass was done by utilizing a three-port, left-sided video-assisted thoracic surgery (VATS) approach with hoisting of the third rib with the patient in a spinal position. A wine-colored mass bulging from the surface of the left lobe of the thymus was identified along with the communicating vessel which could only be cut with an energy device. It is considered that thymic partial resection using VATS is a better option for small and non-infiltrative lesions. PMID:26943686

  5. Civil engineering in the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    Work continues in the cathedral-like cavern that will soon contain ATLAS, the largest particle detector of its type in the world. For such a huge detector, an equally giant cavern must be excavated 100 m underground. The roof must be held without any normal rests at the base; instead it will be supported by huge anchors embedded in concrete that will stop the roof from caving in, located in galleries above the cavern.

  6. Reinforcement of the concrete base slab of the ATLAS cavern

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    Photo 02: UX15 cavern, preparation for concreting of base slab first lift. Photo 05: UX15 cavern, placing of reinforcement for base slab first lift. Photo 07: UX15 cavern, preparation for concreting of base slab first lift. Photo 09: UX15 cavern, placing of reinforcement for base slab first lift. Photo 10: UX15 cavern, view into PX14 shaft above. Photo 12: UX15 cavern, temporary access platform of RB16 tunnel. Photo 15: UJ17 chamber, invert excavation.

  7. Cerebral abscesses among Danish patients with hereditary haemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Tørring, P M; Nissen, H;

    2013-01-01

    Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess.......Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess....

  8. Aortic arch malformations

    Energy Technology Data Exchange (ETDEWEB)

    Kellenberger, Christian J. [University Children' s Hospital, Department of Diagnostic Imaging, Zuerich (Switzerland)

    2010-06-15

    Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

  9. Split Cord Malformations

    Directory of Open Access Journals (Sweden)

    Yurdal Gezercan

    2015-06-01

    Full Text Available Split cord malformations are rare form of occult spinal dysraphism in children. Split cord malformations are characterized by septum that cleaves the spinal canal in sagittal plane within the single or duplicated thecal sac. Although their precise incidence is unknown, split cord malformations are exceedingly rare and represent %3.8-5 of all congenital spinal anomalies. Characteristic neurological, urological, orthopedic clinical manifestations are variable and asymptomatic course is possible. Earlier diagnosis and surgical intervention for split cord malformations is associated with better long-term fuctional outcome. For this reason, diagnostic imaging is indicated for children with associated cutaneous and orthopedic signs. Additional congenital anomalies usually to accompany the split cord malformations. Earlier diagnosis, meticuolus surgical therapy and interdisciplinary careful evaluation and follow-up should be made for good prognosis. [Cukurova Med J 2015; 40(2.000: 199-207

  10. Congenital spinal malformations

    International Nuclear Information System (INIS)

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.)

  11. A 12-year cavern abandonment test

    Directory of Open Access Journals (Sweden)

    Brouard B.

    2010-06-01

    Full Text Available In 1997-1998, an abandonment test was performed in a 950-m deep, 8000-m3 salt cavern operated by GDF SUEZ at Etrez, France. In this relatively small brine-filled cavern, which had been kept idle for 15 years before the test, thermal equilibrium was reached. A special system was designed to monitor leaks, which proved to be exceedingly small. In these conditions, brine permeation and cavern creep closure are the only factors to play significant roles in pressure evolution. This test strongly suggested that obtaining an equilibrium pressure such that the effects of these two factors were exactly equal would be reached in the long term. Four years later, pressure monitoring in the closed cavern resumed. Pressure evolution during the 2002-2009 period confirmed that cavern brine pressure will remain constant and significantly smaller than geostatic pressure in the long term, precluding any risk of fracturing and brine seepage to the overburden layers.

  12. Joubert syndrome labeled as hypotonic cerebral palsy

    OpenAIRE

    Dekair, Lubna H.; Kamel, Hussein; El-Bashir, Haitham O.

    2014-01-01

    Joubert syndrome (JS) is a rare autosomal recessive disorder with cerebellar vermis hypoplasia and complex brainstem malformation. The diagnosis of cases can be difficult as the presentation can be similar to cases of cerebral palsy. We present a case of JS in an 18-month-old girl who presented to pediatric rehabilitation with a diagnosis of hypotonic cerebral palsy and abnormal eye movements. The brain MRI confirmed the typical brain malformations.

  13. CAROTID CAVERNOUS FISTULA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Satish Prasad

    2015-01-01

    Full Text Available Carotico - cavernous fistula represent abnormal communication between the carotid circulation and the cavernous sinus. They can be classified as direct or indirect which are separate conditions with different aetiologies. Direct Carotico - cavernous fistulas ( CCFs are often secondary to trauma, and as such the demographics reflect the distribution of head trauma, most commonly seen in the young male patients. Presentation is acute and symptoms develop rapidly. In contrast, indirect CCFs have a predilection for the postmenopausal female patient a nd the onset of symptoms is often insiduous. Other conditions that predispose to increased risk include . Ehlers - Danlos syndrome . Fibromuscular dysplasia .

  14. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  15. ATLAS cavern magnetic field calculations

    International Nuclear Information System (INIS)

    A new approach has been adopted in an attempt to produce a complete ATLAS cavern B-field map using a more precise methodological approach (variable magnetisation, depending on the external field) and the latest design taking into account of the structural elements. The basic idea was to produce a dedicated basic TOSCA model and then to insert a series of ferromagnetic structure elements to monitor the perturbative effect on the basic field map. Eventually, it was found: the bedplate field perturbation is an order of magnitude above the permissible level; manufacturing of the bedplates from nonmagnetic material or careful evaluation of their field contribution in the event reconstruction codes is required; the field value at the rack positions is higher than the permissible one; the final position of racks should be chosen taking into account the detailed magnetic field distribution

  16. Civil Engineering in the ATLAS cavern

    CERN Multimedia

    Laurent Guiraud

    2000-01-01

    Ghostly figures can be seen wandering the cavern that will eventually house the ATLAS experiment, part of the LHC at CERN. Quite fitting since the detector will hunt the illusive 'ghostly' particles, such as the Higgs boson and dark matter. These engineers are excavating the huge cavern that has to be anchored from above as the detector will fill so much space that there is no room for support pillars.

  17. End of construction of the CMS cavern

    CERN Multimedia

    Maximilien Brice

    2005-01-01

    View of the CMS cavern with its impressive dimensions: 53 m long, 27 m wide and 24 m high. The construction of this underground complex has been a spectacular feat of engineering. This second of the new caverns for the LHC experiments is the result of six-and-a-half years of work, and its completion marks the end of the large-scale engineering work for the LHC.

  18. Digging a cavern for a titan

    CERN Multimedia

    Patrice Loiez

    1999-01-01

    Civil engineers work 100 m underground near the France-Swiss border on the cavern that will soon house ATLAS, one of the experiments on CERN's new LHC accelerator. All personnel and equipment must be lowered by crane down the access shaft. When completed this cavern will have one of the largest spans constructed at 35 m, which required the roof to be supported by large steel anchors buried in concrete.

  19. Angiographically occult arteriovenous malformations causing intracerebral hemorrhage

    International Nuclear Information System (INIS)

    We had experienced 5 cases of angiographically occult AVMs led to intracerebral hemorrhage and progressive neurologic deficit and seizure. Cerebral angiography in each case failed to demonstrate the vascular nature of the lesion and conventional skull radiography was no use. Computed tomography (CT), in 4 cases out of 5, showed well demarcated, slightly hyperdense and ovoid masses which turned out resolving hematomas. These lesions had also contained focal areas of high densities. In one case we observed definitively enhanced area in the resolving hematoma and it was corresponded to histopathologically proved AVM. CT appearance of acute hemorrhage at the subcortical region of cerebral hemisphere was showed in another case. We believe that CT can afford important supplementary information regarding an associated hematoma for angiographically occult AVM. Caution is advised in assuming that angiographically avascular lesion demonstrable by CT is not vascular malformation.

  20. Ataxic cerebral palsy and genetic predisposition.

    OpenAIRE

    Miller, G.

    1988-01-01

    It was calculated that in the 962 family members of 36 patients with ataxic cerebral palsy there were 75 (8%) with a history of neurodevelopmental disorder and 31 (3%) with a major congenital malformation. This was not significantly greater than expected, and does not support the hypothesis of a genetic non-Mendelian role in the aetiology of ataxic cerebral palsy.

  1. Rare malformation of glans penis: arteriovenous malformation.

    Science.gov (United States)

    Akin, Y; Sarac, M; Yucel, S

    2013-01-01

    Pediatric glans penis malformations, especially arteriovenous malformations (AVM), are very rare. Herein, we report two rare cases. A 14-year-old boy attended our outpatient clinic with chief complaints of purple swelling and rapidly growing lesion on the glans penis. The lesion was excised surgically after physical and radiological evaluations. Pathology reported AVM and the patient is being followed up. The second case is a 2-year-old boy who was admitted with a big lesion involving glans penis and genital area that has been present since birth. In physical and radiological evaluations, lesion on the glans penis was pulsatile. Parents of the patient did not want any surgery and patient has been in follow-up. Diagnosis of the vascular lesions on glans penis is very easy by physical and radiological examinations today. Long-term follow-up is very important for AVM. Clinicians must make a careful effort to document new glans lesions in the pediatric population and decrease anxiety in the parents of affected children.

  2. Rare malformation of glans penis: arteriovenous malformation.

    Science.gov (United States)

    Akin, Y; Sarac, M; Yucel, S

    2013-01-01

    Pediatric glans penis malformations, especially arteriovenous malformations (AVM), are very rare. Herein, we report two rare cases. A 14-year-old boy attended our outpatient clinic with chief complaints of purple swelling and rapidly growing lesion on the glans penis. The lesion was excised surgically after physical and radiological evaluations. Pathology reported AVM and the patient is being followed up. The second case is a 2-year-old boy who was admitted with a big lesion involving glans penis and genital area that has been present since birth. In physical and radiological evaluations, lesion on the glans penis was pulsatile. Parents of the patient did not want any surgery and patient has been in follow-up. Diagnosis of the vascular lesions on glans penis is very easy by physical and radiological examinations today. Long-term follow-up is very important for AVM. Clinicians must make a careful effort to document new glans lesions in the pediatric population and decrease anxiety in the parents of affected children. PMID:23771468

  3. Recombinant factor VII (NovoSeven) in intraoperative blood saving during neurosurgical treatment of the brain arteriovenous malformation

    OpenAIRE

    Novak Vesna; Petrović Budimir; Čalija Branko; Mitov Ljiljana; Rančić Zoran

    2007-01-01

    Background. Cerebral arteriovenous (AV) malformation causes, due to the increased blood flow through a malformation, a massive intraoperative bleeding complicating, so, surgical treatment. The use of intraoperative blood saving apparatus during surgery and a recombinant factor VII-a (NovoSeven) significantly reduce complications during surgical treatment. Case report. We reported a case of surgical treatment of the patient with AV malformation of IV stage according to the Spetzler-Martin scal...

  4. Bilateral Cerebellar Cortical Dysplasia without Other Malformations: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jung Seok; Ahn Kook Jin; Kim, Jee Young; Lee, Sun Jin; Park, Jeong Mi [Catholic University Yeouido St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of)

    2010-06-15

    Recent advances in MRI have revealed congenital brain malformations and subtle developmental abnormalities of the cerebral and cerebellar cortical architecture. Typical cerebellar cortical dysplasia as a newly categorized cerebellar malformation, has been seen in patients with Fukuyama congenital muscular dystrophy. Cerebellar cortical dysplasia occurs at the embryonic stage and is often observed in healthy newborns. It is also incidentally and initially detected in adults without symptoms. To the best of our knowledge, cerebellar dysplasia without any related disorders is very rare. We describe the MRI findings in one patient with disorganized foliation of both cerebellar hemispheres without a related disorder or syndrome

  5. Cavernous hemangioma of the internal auditory canal encasing the VII and VIII cranial nerve complex: case report and review of the literature.

    Science.gov (United States)

    Mastronardi, Luciano; Carpineta, Ettore; Cacciotti, Guglielmo; Di Scipio, Ettore; Roperto, Raffaelino

    2016-04-01

    Cavernous angiomas originating in the internal auditory canal are very rare. In the available literature, only 65 cases of cavernomas in this location have been previously reported. We describe the case of a 22-year-old woman surgically treated for a cavernous hemangioma in the left internal auditory canal, mimicking on preoperative magnetic resonance imaging MRI an acoustic neuroma. Neurological symptoms were hypoacusia and dizziness. The cavernous angioma encased the seventh and, partially, the eighth cranial nerve complex. A "nearly total" removal was performed, leaving a thin residual of malformation adherent to the facial nerve. Postoperative period was uneventful; hearing was unchanged, but the patient had a moderate inferior left facial palsy (House-Brackmann grade II) slightly improved during the following weeks. On the basis of the observation of this uncommon case, we propose a revision of the literature and discuss clinical features, differential diagnosis, and treatment. PMID:26876892

  6. Anorectal malformations in children

    Directory of Open Access Journals (Sweden)

    Bhargava Pranshu

    2006-01-01

    Full Text Available Background/Purpose: Anorectal malformations are one of the most common congenital defects. This study was undertaken to study the hospital incidence of anorectal malformations (ARM, frequency of various types of defects, their sex distribution and the spectrum of anomalies associated with ARM. The effect of presence of an associated defect on mortality and morbidity was also studied. Materials and Methods: One hundred consecutive children attending the pediatric surgery department were included in this study. A detailed history was taken, and examination was performed for the primary as well as the associated defects. Appropriate investigations like invertogram, cologram were done wherever indicated. Management was as per the standard protocol. The data was recorded and analyzed. Results: Out of the 100 patients, 51 were males and 49 females. One out of every 6.62 admission was for ARM. Twenty percent of the female babies had high, 76% intermediate and 4% had low anomalies, whereas 80.39% males had high, 3.92% intermediate and 15.6% showed low malformations. Ten percent of the patients had pouch colon. Associated anomalies were seen in 33 patients - 20 males and 13 females; 19 in high, 10 in intermediate, 1 in low group and 3 children with cloacal malformations. Associated defects seen were urogenital (17%, cardiovascular (7%, gastrointestinal (9%, genital (5% and limb defects (7%. There were 8 deaths, and complications were seen in 13 patients. Ten patients had two or more defects associated with ARM. Conclusions: Anorectal malformations occurred equally in males and females. Females had intermediate defects more frequently, rectovestibular fistula being the commonest. Males were more likely to have high lesions; anorectal agenesis without fistula was the commonest defect. The most common associated defects seen were vesicoureteric reflux and esophageal atresia. Complications were seen more commonly in males with high lesions. There was a

  7. Familial Chiari malformation: case series.

    Science.gov (United States)

    Schanker, Benjamin D; Walcott, Brian P; Nahed, Brian V; Kahle, Kristopher T; Li, Yan Michael; Coumans, Jean-Valery C E

    2011-09-01

    Chiari malformations (Types I-IV) are abnormalities of the posterior fossa that affect the cerebellum, brainstem, and the spinal cord with prevalence rates of 0.1%-0.5%. Case reports of familial aggregation of Chiari malformation, twin studies, cosegregation of Chiari malformation with known genetic conditions, and recent gene and genome-wide association studies provide strong evidence of the genetic underpinnings of familial Chiari malformation. The authors report on a series of 3 family pairs with Chiari malformation Type I: 2 mother-daughter pairs and 1 father-daughter pair. The specific genetic causes of familial Chiari malformation have yet to be fully elucidated. The authors review the literature and discuss several candidate genes. Recent advances in the understanding of the genetic influences and pathogenesis of familial Chiari malformation are expected to improve management of affected patients and monitoring of at-risk family members.

  8. Case Report: Carotid–cavernous fistula due to aneurysmal rupture in a case of aortoaortitis with bilateral giant internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    Takayasu aortoarteritis (TA) rarely affects the nervous system, but when it does, it usually manifests as cerebral ischemia or stroke. These strokes have mainly been attributed to stenotic extracranial vessels. Stenoses of intracranial vessels, although rare in TA, can occur due to either embolization into the vessel or because of the vasculitic process itself. Intracranial aneurysms are very rare in patients with TA. Bilateral cavernous internal carotid artery (ICA) aneurysms are rarer. They have been reported following radiation therapy and in association with fibromuscular dysplasia and juvenile Paget disease. Bilateral mycotic intracavernous aneurysms also occur. Bilateral giant cavernous ICA aneurysms with carotid-cavernous fistula (CCF) consequent to rupture into the cavernous sinus in a case of TA are extremely unusual. We report a case that fulfilled both American College of Rheumatology and European League against Rheumatology criteria for TA. The patient had bilateral cavernous sinus giant aneurysms and CCF because the right-sided aneurysm had ruptured and was leaking into the cavernous sinus

  9. A lymph nodal capillary-cavernous hemangioma.

    Science.gov (United States)

    Dellachà, A; Fulcheri, E; Campisi, C

    1999-09-01

    A capillary-cavernous hemangioma in an obturator lymph node was found incidentally in a 64 year-old woman who had undergone unilateral salpingo-oophorectomy and lymphadenectomy for an ovarian neoplasm. Vascular tumors of lymph nodes are briefly reviewed including eight previously described nodal capillary-cavernous hemangiomas. The association with other splanchnic hemangiomas is pointed out and the likelihood that the lesion is a hamartoma rather than a true neoplasm is addressed. Despite its rarity, this entity needs to be recognized by lymphologists who image lymph nodes by lymphangiography as well as by lymph nodal pathologists. PMID:10494525

  10. Underground storage of gas in salt caverns

    Energy Technology Data Exchange (ETDEWEB)

    Pantin, C.; Leblanc, B.

    1981-01-01

    In areas lacking geologic formations suitable for aquiferous storage, salt caverns can serve as underground storage reservoirs if (1) the salt layers are thick enough (over 500 ft) and deep enough (1650-5000 ft), (2) the average concentration of insolubles is less than about 25%, (3) the layer of insolubles is less than 3 ft thick, (4) the distribution of insolubles is homogeneous enough, and (5) the brine can be discharged at a 10,600-14,000 ft/sup 3//hr flow rate. The development and operation of a typical salt-cavern storage reservoir, including leaching techniques and control equipment are described.

  11. Cavernous haemangioma mimicking as clitoral hypertrophy

    Directory of Open Access Journals (Sweden)

    Sajid Nayyar

    2014-01-01

    Full Text Available Haemangioma is the most common benign neoplasm of infantile age. It is most commonly located in head and neck region, trunk and extremities but very rarely it can be located at clitoris. However, it is very important to differentiate clitoral haemangioma from enlargement of the clitoris secondary to androgen excess. Only four cases of clitoromegaly caused by cavernous haemangioma have been reported in the literature so far. Herein, we report our experience with a 10-year-old girl who presented with clitoromegaly and normal hormonal assay that turned out to be clitoral cavernous haemangioma after histopathological examination of the clitoral mass.

  12. 流体切应力对脑动静脉畸形内皮细胞增殖与c-myc表达的影响%Effect of flow shear stress on endothelial cell proliferation and c-myc expression in cerebral arteriovenous malformation

    Institute of Scientific and Technical Information of China (English)

    赵明光; 李彦兵; 吕博川; 梁勇; 薛洪利; 赵丽萍; 王丹玲

    2007-01-01

    BACKGROUND:Shear stress can directly mediate the expression of endothelial cells, especially some cytokine genes whose codes are related to angiogenesis. Otherwise, flow shear stress of blood plays an importantly biological role in regulating vascular structure and function.OBJECTIVE: To observe the effects of laminar flow shear stress on the proliferation of vascular endothelial cells and the expression of protooncogene c-myc in human cerebral arteriovenous malformation.DESIGN: Randomized controlled study.SETTING: Department of Neurosurgery, Shenyang General Hospital of Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Neuromedical Institute, General Hospital of Shenyang Military Area Command of Chinese PLA from November 2006 to February 2007. Fresh samples of human cerebral arteriovenous malformation were derived from 20 patients who were of grade Spetzler Ⅱ -Ⅲ and received resection of human cerebral arteriovenous malformation in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA in 2006. All cases were diagnosed with whole-brain angiography before operation. The main reagents and equipments were detailed as follows: M199 culture media (Gilbco BRL), quality fetal bovine serum (HyClone), endothelial cell growth supplement (ECGS; Sigma, USA), CO2 incubator (Forma Scientific, USA), flow cytometry analysis of cell cycle kit (BD Company), flow cytometer (FACS Calibur, BD Company), rat-anti-human c-myc monoclonal antibody (Santa Cruz Company, USA), and reverse transcription polymerase chain reaction (RT-PCR) kit (Promega).METHODS: Tissue explants adherent method was used to culture vascular endothelial cells of human cerebral arteriovenous malformation, and then the cells were classified into 4 groups based on degree of shear stress, including control group, low shear stress group, moderate shear stress group and high shear stress group. Cultured endothelial cells of human cerebral

  13. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  14. Numerical Simulation of Gas Storage Caverns in Qom Region

    CERN Document Server

    Sharifzadeh, Mostafa

    2009-01-01

    The rock mechanical design of gas storage cavern in salt requires the analysis of the stability and the usability of the cavern over the planned operating time period. The design includes the build up of a rock mass model and a numerical model taking into account the geological situation, load condition, geometrical condition, and material parameters. In this paper multiple caverns in salt formation with geological and geomechanical situation in Qom (central part of Iran) was investigated a using creep model. Minimum safe center to center distances (CTCD) of multiple horizontal caverns also were studied. CTCD of caverns interact at less than two times of cavern diameter. With increasing the CTCD to 2.5 times cavern diameters, diminish most interaction.

  15. Prevalence of Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Akhavan Karbasi Sedighah

    2009-05-01

    Full Text Available Congenital malformation (CM will begin to emerge as one of the major childhood health problems .Treatment and rehabilitation of children with congenital malformations are costly and complete recovery is usually impossible. The aim of this study was to determine frequency of CM in Yazd central city of the Islamic Republic of Iran to find out if there has been any difference in the rate and types of CM in this area. This descriptive-observational study carried on 4800 births delivered at all maternity hospitals in Yazd from October 2003 to June 2004. Prevalence of CM was 2.83% (2.86 % in male and 2.68 % in female out of the 136 cases 69(51.88% were males and 64 (48.12% were females and 3 with ambiguous genitalia. Positive family history of CM in sibling was in only 6 cases (4.41%.Overall, musculoskeletal (0.83%, central nerv-ous system (0.47% and genital system (0.37% were accounted as the most common. Frequency of CM was more seen in still birth (12.5% as in comparison to live birth (2.71%. There was not statistical difference be-tween prevalence of CM and neonatal's gender, gestational age, birth order and mother's age, drug ingestion, illness and parental consanguinity. In this study the overall prevalence of congenital malformation among the newborn was higher than those previous reported in Iran and determining the causes of this difference needs more extensive studies.

  16. The ATLAS cavern in the spotlight

    CERN Multimedia

    On Wednesday, 4th June, the President of the Swiss Confederation, Pascal Couchepin, inaugurated the world's largest experimental cavern, which is to house the ATLAS detector in 2007, and announced Switzerland's gift to CERN of the "Palais de l'Equilibre".

  17. Special people visit the ATLAS cavern

    CERN Multimedia

    Muriel

    ATLAS has been host to many important visitors lately. Here are a selected few: Professor Stephen Hawking visits the ATLAS cavern On Tuesday 26 September 2006 the ATLAS Collaboration was honoured by a very special visit to the detector in the underground cavern. We were pleased to guide Professor Stephen Hawking, the famous cosmologist holding the post of Lucasian Professor of Mathematics at Cambridge University (position held by Isaac Newton in the 17th century), on a tour of the ATLAS pit and the LHC tunnel. The visit was accompanied by a few colleagues from the CERN Theory group, and was only possible thanks to the professional assistance of Olga Beltramello and Bernard Lebegue, who had also taken care of all the necessary preparatory work in the cavern. Professor Hawking was very keen to check for himself the status of the detector installation, and he admired, in particular, the spectacular TGC big wheel on side C. (left) Stephen Hawking in the ATLAS cavern side-C (right) and in the LHC tunnel...

  18. Tensile effective stresses in hydrocarbon storage caverns

    CERN Document Server

    Djizanne, Hippolyte; Brouard, Benoît

    2013-01-01

    The "no-tensile effective stress" criterion is discussed. It is proven that effective tensile stresses can be generated at a cavern wall after a rapid increase or decrease in pressure. The Etzel K-102 test, performed in Germany more than 20 years ago, is revisited using the notion of effective tensile stresses.

  19. Tensile effective stresses in hydrocarbon storage caverns

    OpenAIRE

    Djizanne, Hippolyte; Berest, Pierre; Brouard, Benoît

    2013-01-01

    International audience The "no-tensile effective stress" criterion is discussed. It is proven that effective tensile stresses can be generated at a cavern wall after a rapid increase or decrease in pressure. The Etzel K-102 test, performed in Germany more than 20 years ago, is revisited using the notion of effective tensile stresses.

  20. Entrevistando a un cavernísofo

    Directory of Open Access Journals (Sweden)

    Antonio Negrete

    2015-08-01

    Full Text Available Interview with Juan. A. Negrete, annual prize 2014 to the promotion of the philosophy and the culture in Málaga. The award is extended to the network of blogs: Cavernisofía, Cavernética and Cavernisofíasegundaplanta.

  1. Cavernous Hemangioma of the Bony Orbit

    Institute of Scientific and Technical Information of China (English)

    Jianhua Yan; Yu Cai; Zhongyao Wu; Ji Han; Youjian Pang

    2005-01-01

    Purpose: To study the clinical features, diagnosis and management of intraosseous cavernous hemangioma of the orbit.Methods: Five cases of intraosseous cavernous hemangioma seen in our hospital from Jan 1, 1986 to Dec 31, 2000 were reviewed.Results: Among all five cases, two were male and three were female. The mean age was 47.6 years old, ranging from 39.0 to 55.0 years. The left orbit was affected in 4 cases and the right one in 1 case. The bony involvement occurred in frontal bone (two cases),zygomatic bone (two cases) and sphenoid bone (one case). A painless, slowly enlarging hard bony mass fixed to the bone with no pulsations was the main clinical sign. The x-ray and CT appearance of intraosseous cavernous hemangioma of the orbit were characteristic and usually diagnostic. The differential diagnosis of it included fibrous dysplasia,eosinophilic granuloma, multiple myeloma and metastatic carcinoma. Treatment is local removal of the bone containing the tumor.Conclusions: Intraosseous cavernous hemangioma is a rare tumor of the orbit and usually has good surgical result.

  2. Helical CT finding of carotid-cavernous fistula: a sign of early enhancing superior ophthalmic vein

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the diagnostic value of a sign of early enhancing superior ophthalmic vein (SOV), as seen on helical CT images in patients with carotid-cavernous fistula (CCF). This study involved 16 patients with CCF and 28 control patients. Axial CT images with scanning delays of 30 seconds following bolus injection of contrast material (90 mL, 3 mL/sec) were obtained, and this procedure was followed by coronal CT imaging. To determine the presence or absence of early enhancement or, dilatation of the SOV, bulging of the cavernous sinus, and enlargement of extraocular muscle, CT images were analysed by three observers in a blinded, random manner. Early enhancement of SOV was determined to be present where enhancement of the SOV was similar to or stronger than that of the ipsilateral posterior cerebral artery. A sign of early enhancing SOV was seen in 14 of the 16 patients with CCF but in no control patients (88% sensitivity and 100% specificity). The respective sensitivity and specificity of other CT features were 71% and 100% (dilatation of the SOV, as seen on axial images), 60% and 83% (dilatation of the SOV, as seen on coronal images), 71% and 89% (dilatation of the cavernous sinus), and 65% and 98% (enlargement of extraocular muscle). A sign of early enhancing SOV is a characteristic and specific CT finding of CCF, and is useful for the diagnosis of CCF. (author)

  3. Anorectal malformations : A multidisciplinary approach

    NARCIS (Netherlands)

    D. van den Hondel (Desiree)

    2015-01-01

    markdownabstractAbstract The research described in this thesis was performed with the aim to evaluate and improve multidisciplinary treatment of anorectal malformation patients. An overview of current literature on treatment of anorectal malformations is given in the Preface section, which also inc

  4. CNS cavernous haemangioma: 'popcorn' in the brain and spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Hegde, A.N. [Department of Neuroradiology, National Neuroscience Institute (Singapore); Department of Diagnostic Imaging, National University Hospital (Singapore); Mohan, S. [Department of Neuroradiology, National Neuroscience Institute (Singapore); Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia (United States); Lim, C.C.T., E-mail: Tchoyoson_lim@nni.com.sg [Department of Neuroradiology, National Neuroscience Institute (Singapore); Department of Neurology, Duke NUS Graduate Medical School (Singapore)

    2012-04-15

    Cavernous haemangiomas (CH) are relatively uncommon non-shunting vascular malformations of the central nervous system and can present with seizures or with neurological deficits due to haemorrhage. Radiologists can often suggest the diagnosis of CH based on characteristic magnetic resonance imaging (MRI) features, thus avoiding further invasive procedures such as digital subtraction angiography or surgical biopsy. Although typical MRI appearance combined with the presence of multiple focal low signal lesions on T2*-weighted images or the presence of one or more developmental venous anomaly within the brain can improve the diagnostic confidence, serial imaging studies are often required if a solitary CH presents at a time when the imaging appearances had not yet matured to the typical 'popcorn' appearance.

  5. CNS cavernous haemangioma: “popcorn” in the brain and spinal cord

    International Nuclear Information System (INIS)

    Cavernous haemangiomas (CH) are relatively uncommon non-shunting vascular malformations of the central nervous system and can present with seizures or with neurological deficits due to haemorrhage. Radiologists can often suggest the diagnosis of CH based on characteristic magnetic resonance imaging (MRI) features, thus avoiding further invasive procedures such as digital subtraction angiography or surgical biopsy. Although typical MRI appearance combined with the presence of multiple focal low signal lesions on T2*-weighted images or the presence of one or more developmental venous anomaly within the brain can improve the diagnostic confidence, serial imaging studies are often required if a solitary CH presents at a time when the imaging appearances had not yet matured to the typical “popcorn” appearance.

  6. Rare cavernous lymphangioma of the bladder in an adult female:treatment and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Feng Qu; Jinyu Zheng; Yajun Xiao; Yifei Xing; Chuanguo Xiao

    2006-01-01

    Objective: Lymphangioma is a benign tumor representing a congenital malformation of the lymphatic channels. The cavernous lymphangioma of the bladder did not report before. Here we report 1 case of cavernous lymphangioma of the bladder in an adult female and review the literature in order to accumulate the experience of diagnosis and treatment for these diseases. Methods: In our case a 50-year-old woman presented with irritative voiding symptoms and had painless macroscopic hematuria at times. Cystoscopy showed a non-papillary tumor at apex vesicae and mucous membrane hyperaemia between the two orifices within the trigone. The pathologic diagnosis was cystitis glandularis with hyperplasia of urothelium and cavernous lymphangioma in lamina propria. Transurethral resection was performed and then bleomycin A5 was injected into lesion multipoint applying ureteral catheter with puncture needle. Results: Two months after operation the irritative voiding symptoms improved and the urine analysis was normal. Cystoscopy showed no residual tumor. Bleomycin A5 was injected into the lesion area again just like the operation before. All symptoms disappeared completely when the patient was examined a month later. There was no side effect after injection and no recurrence during the follow-up of 1 year. Conclusion: Lymphangioma of the bladder can be diagnosed exactly by cystoscopy and pathological examination. Surgery may be the best treatment. The bleomycin A5 intralesional sclerosant is also an effective therapy for the disease after surgical removal.

  7. Numerical Simulations of Leakage from Underground LPG Storage Caverns

    OpenAIRE

    Yamamoto, Hajime; Pruess, Karsten

    2004-01-01

    To secure a stable supply of petroleum gas, underground storage caverns for liquified petroleum gas (LPG) are commonly used in many countries worldwide. Storing LPG in underground caverns requires that the surrounding rock mass remain saturated with groundwater and that the water pressure be higher than the liquid pressure inside the cavern. In previous studies, gas containment criteria for underground gas storage based on hydraulic gradient and pressure have been discussed, but these s...

  8. Inauguration of the ATLAS cavern, June 2003.

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    Before the inauguration, Pascal Couchepin visited the ATLAS cavern. From left to right: Peter Jenni, ATLAS spokesman; Maurice Bourquin, President of the CERN Council; Carlo Lamprecht, State councillor, Canton of Geneva; Pascal Couchepin, President of the Swiss Confederation; Luciano Maiani, CERN Director-General; Marzio Nessi, ATLAS technical coordinator; Arturo Henniger, ZSCHOKKE-LOCHER AG Director; Benno Baettig, personal advisor of President Couchepin; Jean-Luc Baldy, head of CERN Civil Engineering Group.

  9. Allowable pillar to diameter ratio for strategic petroleum reserve caverns.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Park, Byoung Yoon

    2011-05-01

    This report compiles 3-D finite element analyses performed to evaluate the stability of Strategic Petroleum Reserve (SPR) caverns over multiple leach cycles. When oil is withdrawn from a cavern in salt using freshwater, the cavern enlarges. As a result, the pillar separating caverns in the SPR fields is reduced over time due to usage of the reserve. The enlarged cavern diameters and smaller pillars reduce underground stability. Advances in geomechanics modeling enable the allowable pillar to diameter ratio (P/D) to be defined. Prior to such modeling capabilities, the allowable P/D was established as 1.78 based on some very limited experience in other cavern fields. While appropriate for 1980, the ratio conservatively limits the allowable number of oil drawdowns and hence limits the overall utility and life of the SPR cavern field. Analyses from all four cavern fields are evaluated along with operating experience gained over the past 30 years to define a new P/D for the reserve. A new ratio of 1.0 is recommended. This ratio is applicable only to existing SPR caverns.

  10. Necrotizing Fasciitis of the Nose Complicated with Cavernous Sinus Thrombosis

    Directory of Open Access Journals (Sweden)

    D. Swaminath

    2014-01-01

    Full Text Available Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative.

  11. 104例颅内动脉瘤和脑血管畸形患者氧治疗方案探讨%Observation on the therapeutic effects of different oxygen therapy protocols in the treatment of 104 patients with intracranial aneurysm and cerebral vascular malformations

    Institute of Scientific and Technical Information of China (English)

    卢晓欣; 彭慧平; 汤永建; 房卫红

    2012-01-01

    Objective To observe the therapeutic effects of different oxygen therapy protocols in the treatment of patients with intracranial aneurysm and cerebral vascular malformations. Methods Forty-one cases of intracranial aneurysm and 63 cases of various cerebral vascular malformations (with a total of 104 cases) were treated with different oxygen therapy protocols.High-flow normal pressure oxygen (NPO) therapy outside the chamber was given to 25 patients either with intracranial aneurysm or cerebral vascular malformation,who failed to receive surgical operation or endovascular treatment,or their family members refused to accept hyperbaric oxygen (HBO) therapy.Seventy-nine cases were treated with progressive HBO therapy protocol,i.e.treatment started with high-flow oxygen therapy outside the chamber,HBO therapy started from a lower pressure to a higher pressure,and a therapy protocol with relatively slower compression and decompression rates was adopted (with compression and decompression rates of 3- 4 kPa/min,the therapeutic pressure of 0.175 MPa and oxygen breathing for 60 min at stable pressure).At the same time,vital signs and ECG were analyzed,therapeutic effects and safety of the protocols were evaluated.Results Total effective rate for HBO therapy and high-flow NPO therapy outside the chamber was 97.5% and 40.0%.The therapeutic effectiveness of HBO therapy was superior to that of the high-flow NPO therapy outside the chamber,with statistical significance ( P < 0.05 ). Vital signs and ECG monitoring indicated that heart rate decreased [(83.63±15.80)/min]following HBO therapy,and statistical difference could be noted,when it was compared with those of the patients treated with high-flow NPO therapy outside the chamber.Arterial oxygen saturation all elevated for the two therapy protocols,but without statistical significance.As compared with those before compression,systolic and diastolic pressures all increased,when HBO therapy was implemented (P <0

  12. Radiosurgery for symptomatic cavernous malformations: A multi-institutional retrospective study in Japan

    Directory of Open Access Journals (Sweden)

    Yoshihisa Kida

    2015-01-01

    Conclusion: The risk of hemorrhage is considerably reduced after GK treatment. The HFS as well as annual hemorrhage rate after GK treatment was apparently superior to that after conservative treatment for symptomatic CMs. To optimize the success of GK treatment, it is important to reduce the incidence of complications.

  13. Pericallosal lipoma and middle cerebral artery aneurysm: a coincidence?

    Energy Technology Data Exchange (ETDEWEB)

    Sommet, Julie; Schiff, Manuel; Evrard, Philippe [Hopital Robert Debre, APHP, Department of Paediatric Neurology and Metabolic Diseases, Paris Cedex 19 (France); Blanc, Raphael [Fondation Rothschild, Department of Interventional Radiology, Paris (France); Elmaleh-Berges, Monique [Hopital Robert Debre, Department of Paediatric Radiology, Paris (France)

    2010-08-15

    Intracranial lipomas are rare congenital malformations that can often be seen in association with other brain malformations; agenesis or dysgenesis of the corpus callosum is the most frequently associated brain anomaly. They are usually pericallosal asymptomatic midline lesions. Intracranial lipomas associated with a non-contiguous cerebral aneurysm are extremely rare. We report an infant with partial agenesis of the corpus callosum and pericallosal lipoma associated with cerebral haemorrhage due to a distal middle cerebral artery aneurysm. Such an association is probably not fortuitous and could suggest a pathogenic relationship. (orig.)

  14. Pericallosal lipoma and middle cerebral artery aneurysm: a coincidence?

    International Nuclear Information System (INIS)

    Intracranial lipomas are rare congenital malformations that can often be seen in association with other brain malformations; agenesis or dysgenesis of the corpus callosum is the most frequently associated brain anomaly. They are usually pericallosal asymptomatic midline lesions. Intracranial lipomas associated with a non-contiguous cerebral aneurysm are extremely rare. We report an infant with partial agenesis of the corpus callosum and pericallosal lipoma associated with cerebral haemorrhage due to a distal middle cerebral artery aneurysm. Such an association is probably not fortuitous and could suggest a pathogenic relationship. (orig.)

  15. Cerebellar Malformations and Cognitive Disdorders

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-10-01

    Full Text Available The behavioral developmental profile of 27 children and adults (17 males and 10 females with congenital cerebellar malformations was determined in a clinical, neuroradiological and neuropsychological study at the Scientific Institute 'E Medea', University of Milano, Italy.

  16. Anorectal malformations in neonates

    Directory of Open Access Journals (Sweden)

    Bilal Mirza

    2011-01-01

    Full Text Available Background : Anorectal malformations (ARM are associated with congenital anomalies and other risk factors, yielding a poor prognosis, especially in neonatal life. Objectives: This study was performed to identify the congenital anomalies as a factor of poor prognosis (mortality in such patients. Settings: Department of Pediatric surgery, The Children′s Hospital and The Institute of Child Health, Lahore. Design: Prospective observational study, with statistical support. Materials and Methods: The information on the demography, clinical features, investigations, management performed, and outcome was entered in the designed proforma and analysed with the help of statistical software EpiInfo version 3.5.1. Statistical test: Chi-square test was used to determine statistical significance of the results. Results : Of 100 neonates with ARM, 77 were male and 23, female (3.4:1. The mean age at presentation was 3.4 days (range, 12 hrs to 28 days. In 60 patients (60%, the presentation was imperforate anus without a clinically identified fistula. In 28 patients (28%, associated anomalies were present. The common associated anomalies were urogenital (10%, cardiovascular (8%, and gastrointestinal (6%. Down′s syndrome was present in 8 (8% patients. A total of 15 (15% deaths occurred in this study. In patients having associated congenital anomalies, 11 deaths occurred, whereas, 4 deaths were in patients without associated anomalies (P < 0.5. Conclusion : The mortality is higher in neonates with ARM having associated congenital anomalies.

  17. Study of Congenital Malformations in Central Nervous System AND Gastro- Intestinal Tract

    Directory of Open Access Journals (Sweden)

    Saiyad SS

    2012-04-01

    Full Text Available Introduction: Congenital malformations comprise 8% of the perinatal mortality in India. They rank fifth as a cause of perinatal mortality, after asphyxia, respiratory problems, infections and cerebral trauma. However, the pattern is changing rapidly with improvement in health care and living standards. Material & Method: In the present study, authors have tried to study the cases of congenital malformations specially related to Central nervous system and Gastro-intestinal system. 5240 cases of newborn babies were studied and results were analyzed and classified in to various categories. Findings: The results show that malformations are more common in still birth, more in female babies and more in central nervous system In live born babies the percentage of malformation is0.63 % whereas in still born baby it is6.53 %. Conclusions: Chances of having malformations increases as the age advances. Parity of mother also influences the incidence. Exposure to radiation & drugs also influences malformations. Incidence of congenital malformation is highest in central nervous system. [National J of Med Res 2012; 2(2.000: 121-123

  18. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  19. Calcified cavernous hemangioma of the ovary: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeon Hee [Dankook Univ. College of Medicine, Seoul (Korea, Republic of)

    2000-12-01

    Ovarian hemangiomas are very uncommon and most are of the cavernous type. A few reports have described the radiologic findings of this neoplasm, but as far as the author is aware, the literature contains no description of calcified cavernous hemangioma. A case in which this condition involved the ovary is now reported.

  20. Calcified cavernous hemangioma of the ovary: a case report

    International Nuclear Information System (INIS)

    Ovarian hemangiomas are very uncommon and most are of the cavernous type. A few reports have described the radiologic findings of this neoplasm, but as far as the author is aware, the literature contains no description of calcified cavernous hemangioma. A case in which this condition involved the ovary is now reported

  1. 36 CFR 7.47 - Carlsbad Caverns National Park.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Carlsbad Caverns National Park. 7.47 Section 7.47 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.47 Carlsbad Caverns National Park....

  2. Design of cavern blasting based on controllable parameters

    Institute of Scientific and Technical Information of China (English)

    WANG Shu-li; WANG Shu-ren; ZHU Jian-ming

    2008-01-01

    After a thorough review of some controllable parameters, which included field investigations, cavern dimensions, explosive, rock strength etc., cut, contour, lifters and stoping holes were introduced for blasting cavern of nucleus submarine. These design were conducted using a U. Langefors and B. Kihlstrom theory.

  3. Cerebral Hypoxia

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Hypoxia Information Page Synonym(s): Hypoxia, Anoxia Table of Contents ( ... Trials Organizations Publicaciones en Español What is Cerebral Hypoxia? Cerebral hypoxia refers to a condition in which ...

  4. Optical coherence tomography of the rat cavernous nerves

    Science.gov (United States)

    Fried, Nathaniel M.; Rais-Bahrami, Soroush; Lagoda, Gwen A.; Chuang, Ying; Burnett, Arthur L.; Su, Li-Ming

    2007-02-01

    Improvements in identification, imaging, and visualization of the cavernous nerves during radical prostatectomy, which are responsible for erectile function, may improve nerve preservation and postoperative potency. Optical coherence tomography (OCT) is capable of real-time, high-resolution, cross-sectional, in vivo tissue imaging. The rat prostate serves as an excellent model for studying the use of OCT for imaging the cavernous nerves, as the rat cavernous nerve is a large, visible, and distinct bundle allowing for easy identification with OCT in addition to histologic confirmation. Imaging was performed with the Niris OCT system and a handheld 8 Fr probe, capable of acquiring real-time images with 11-μm axial and 25-μm lateral resolution in tissue. Open surgical exposure of the prostate was performed on a total of 6 male rats, and OCT images of the prostate, cavernous nerve, pelvic plexus ganglion, seminal vesicle, blood vessels, and periprostatic fat were acquired. Cavernous nerve electrical stimulation with simultaneous intracorporeal pressure measurements was performed to confirm proper identification of the cavernous nerves. The prostate and cavernous nerves were also processed for histologic analysis and further confirmation. Cross-sectional and longitudinal OCT images of the cavernous nerves were acquired and compared with histologic sections. The cavernous nerve and ganglion could be differentiated from the surrounding prostate gland, seminal vesicle, blood vessels, bladder, and fatty tissue. We report preliminary results of OCT images of the rat cavernous nerves with histologic correlation and erectile stimulation measurements, thus providing interpretation of prostate structures as they appear in OCT images.

  5. CAVERNOUS HEMANGIOMA OF THE INTERNAL AUDITORY CANAL

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Hekmatara

    1993-06-01

    Full Text Available Cavernous hemangioma is a rare benign tumor of the internal auditory canal (IAC of which fourteen cases have been reported so far."nTinnitus and progressive sensorineural hearing loss (SNHL are the chief complaints of the patients. Audiological and radiological planes, CTScan, and magnetic resonance image (MRI studies are helpful in diagnosis. The only choice of treatment is surgery with elective transmastoid trans¬labyrinthine approach. And if tumor is very large, the method of choice will be retrosigmoid approach.

  6. Arteriovenous Malformation of the Pancreas

    Directory of Open Access Journals (Sweden)

    Alexandros Charalabopoulos

    2011-01-01

    Full Text Available Pancreatic arteriovenous malformation (PAVM is a very rare and mostly congenital lesion, with less than 80 cases described in the English-published literature. It is defined as a tumorous vascular abnormality that is constructed between an anomalous bypass anastomosis of the arterial and venous networks within the pancreas. It represents about 5% of all arteriovenous malformations found in the gastrointestinal tract. Herein, we present a 64-year-old patient with symptomatic PAVM involving the body and tail of the organ, which was successfully treated by transcatheter arterial embolization. The disease spectrum and review of the literature are also presented.

  7. Spinal vascular malformations; Spinale Gefaessmalformationen

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal vascular malformations are a group of rare diseases with different clinical presentations ranging from incidental asymptomatic findings to progressive tetraplegia. This article provides an overview about imaging features as well as clinical and therapeutic aspects of spinal arteriovenous malformations, cavernomas and capillary telangiectasia. (orig.) [German] Spinale Gefaessmalformationen sind eine Gruppe seltener Erkrankungen mit unterschiedlichen klinischen Praesentationen, die vom asymptomatischen Zufallsbefund bis zur progredienten Tetraparese reichen. Dieser Artikel gibt einen Ueberblick ueber radiologische Befunde sowie klinische und therapeutische Aspekte von spinalen arteriovenoesen Malformationen, Kavernomen und kapillaeren Teleangiektasien. (orig.)

  8. Pediatric central nervous system vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Burch, Ezra A. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Orbach, Darren B. [Boston Children' s Hospital, Neurointerventional Radiology, Boston, MA (United States)

    2015-09-15

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  9. Strategic petroleum reserve caverns casing damage update 1997

    Energy Technology Data Exchange (ETDEWEB)

    Munson, D.E.; Molecke, M.A.; Neal, J.T. [and others

    1998-01-01

    Hanging casing strings are used for oil and brine transfer in the domal salt storage caverns of the Strategic Petroleum Reserve (SPR). Damage to these casings is of concern because hanging string replacement is costly and because of implications on cavern stability. Although the causes of casing damage are not always well defined, many events leading to damage are assumed to be the result of salt falls impacting the hanging strings. However, in some cases, operational aspects may be suspected. The history of damage to hanging strings is updated in this study to include the most recent events. Potential general domal and local operational and material factors that could influence the tendency for caverns to have salt falls are examined in detail. As a result of this examination, general factors, such as salt dome anomalies and crude type, and most of the operational factors, such as geometry, location and depressurizations, are not believed to be primary causes of casing damage. Further analysis is presented of the accumulation of insolubles during cavern solutioning and accumulation of salt fall material on the cavern floor. Inaccuracies in sump geometry probably make relative cavern insolubles contents uncertain. However, determination of the salt fall accumulations, which are more accurate, suggest that the caverns with the largest salt fall accumulations show the greatest number of hanging string events. There is good correlation between the accumulation rate and the number of events when the event numbers are corrected to an equivalent number for a single hanging string in a quiescent, operating cavern. The principal factor that determines the propensity for a cavern to exhibit this behavior is thought to be the effect of impurity content on the fracture behavior of salt.

  10. Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause

    OpenAIRE

    Kim, Dong-Han; Kang, Dong-Hun; Park, Jaechan; HWANG, Jeong-Hyun; Park, Seong-Hyun; Son, Won-Soo

    2015-01-01

    Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were...

  11. Ectrodactyly/split hand feet malformation

    OpenAIRE

    Jindal Geetanjali; Parmar Veena; Gupta Vipul

    2009-01-01

    Split-hand/split-foot malformation is a rare limb malformation with median clefts of the hands and feet and aplasia/hypoplasia of the phalanges, metacarpals and metatarsals. When present as an isolated anomaly, it is usually inherited as an autosomal dominant form. We report a case of autosomal recessive inheritance and discuss the antenatal diagnosis, genetic counseling and treatment for the malformation.

  12. The incidence of Arnold–Chiari malformation in neurological practice

    Directory of Open Access Journals (Sweden)

    E. A. Kantimirova

    2015-01-01

    Full Text Available Arnold-Chiari malformation (ACM is a group of congenital hindbrain malformations affecting the structural relationships between the cerebellum, brain stem, top cervical spinal cord, and bones of the skull base. In clinical practice, ACM types 0 and 1 are more common and types 2, 3, and 4 belong to rare severe (often fatal congenital malformations.Objective: to study gender differences in the incidence of ACM types 0 and 1 in outpatient neurological practice.Patients and methods. A total 2039 case records of outpatients who had visited a neurologist of the Krasnoyarsk University clinic in 2008–2014 were analyzed. Neurological and neuroradiological (1.5 Tesla brain magnetic resonance imaging, phase-contrast spinal cerebral fluid flow imaging diagnostic techniques were used. 3.4% (70/2039 of cases were randomized according to the criteria of inclusion and exception. An entire sample included 70 ACM patients (median age, 25 [17; 34] years (30 (42.8–7.1% men and 40 (57.2–7.1% women.Results. There was an increase in the incidence of ACM type 1 in the women than in the men. Conclusion. It is necessary to develop a new strategy for the prophylactic medical examination of patients with ACM to improve primary and specialized outpatient health care.

  13. Arteriovenous Malformation: A Case Report

    International Nuclear Information System (INIS)

    The present case illustrates an arteriovenous malformation of the cheek in a 25-year-old male. The clinical presentation, radiographic findings, differential diagnosis, treatment and histopathologic description are presented. Diagnosis of the lesion was confirmed by angiography, and the lesion was treated by angiographically controlled vascular embolization followed by complete surgical excision.

  14. Arteriovenous malformations in Cowden syndrome.

    Science.gov (United States)

    Turnbull, M M; Humeniuk, V; Stein, B; Suthers, G K

    2005-08-01

    Cowden syndrome (OMIM No 158350) is a pleomorphic, autosomal dominant syndrome characterised by hamartomas in tissues derived from the endoderm, mesoderm, and ectoderm. It is caused by germline mutations in the PTEN gene and is allelic to the Bannayan-Riley-Ruvalcaba and Lhermitte-Duclos syndromes. The three syndromes are defined on clinical grounds but there is overlap in their definitions. The clinical features include trichilemmomas, verrucose lesions of the skin, macrocephaly, intellectual disability, cerebellar gangliocytoma, thyroid adenomas, fibroadenomas of the breast, and hamartomatous colonic polyps. Cutaneous haemangiomas are occasionally noted. Malignancies often arise in the affected tissues. Visceral arteriovenous malformations are a recognised component of the Bannayan-Riley-Ruvalcaba syndrome but have been reported rarely in Cowden syndrome. A family is described with a clinical diagnosis of Cowden syndrome, a familial frameshift mutation in the PTEN gene, and large visceral arteriovenous malformations. The association of these pleomorphic syndromes with arteriovenous malformations can be explained by the putative role of the PTEN gene in suppressing angiogenesis. Recognition of arteriovenous malformations as a clinical feature of Cowden syndrome has implications for the clinical management of patients with this disorder. PMID:16061556

  15. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    OpenAIRE

    Umesh; Sowmya,

    2015-01-01

    BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s)...

  16. Tuberculoma cerebral Cerebral tuberculoma

    OpenAIRE

    ELIZABETH CLARA BARROSO; TÂNIA REGINA BRÍGIDO DE OLIVEIRA; ANA MARIA DANTAS DO AMARAL; VALÉRIA GÓES FERREIRA PINHEIRO; ANA LÚCIA DE OLIVEIRA SOUSA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  17. Dural fistulas of the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Guibert-Tranier, F.; Piton, J.; Caille, J.M.; Lemoine, J.J.

    1984-11-01

    Five cases of dural fistulas of the cavernous sinus are reported. The clinical aspect of this lesion is often misleading in the absence of subjective or objective bruits. The diagnosis is made at angiography which should systematically include the internal and external carotid arteries bilaterally. The goal of this study was to elucidate the great variability of the venous drainage and to correlate it with the clinical symptoms and course. The main problem is to know when and how these fistulas should be treated. Vascular ligatures should not be performed. Therapeutic angiography is the treatment of choice, but should be limited to the following indications: poorly tolerated bruits, severe ophthalmic damage (elevated ocular tension, diminished visual acuity, or oculomotor paralysis), angiographically demonstrated massive arteriovenous shunting, and a high degree of cortical venous reflux. Whatever the indication, the course after embolisation is rarely predictable and in particular the risk of extensive venous thrombosis or recurrence is great.

  18. Dural fistulas of the cavernous sinus

    International Nuclear Information System (INIS)

    Five cases of dural fistulas of the cavernous sinus are reported. The clinical aspect of this lesion is often misleading in the absence of subjective or objective bruits. The diagnosis is made at angiography which should systematically include the internal and external carotid arteries bilaterally. The goal of this study was to elucidate the great variability of the venous drainage and to correlate it with the clinical symptoms and course. The main problem is to know when and how these fistulas should be treated. Vascular ligatures should not be performed. Therapeutic angiography is the treatment of choice, but should be limited to the following indications: poorly tolerated bruits, severe ophthalmic damage (elevated ocular tension, diminished visual acuity, or oculomotor paralysis), angiographically demonstrated massive arteriovenous shunting, and a high degree of cortical venous reflux. Whatever the indication, the course after embolisation is rarely predictable and in particular the risk of extensive venous thrombosis or recurrence is great. (orig.)

  19. [Cavernous hemangioma confined to the tongue].

    Science.gov (United States)

    Galletti, C

    1988-12-01

    The authors relate on a case of an isolated cavernous haemangioma of the body of the tongue characterized by considerable size. Such neoplasms, usually described within the more extensive chapter of the more common angiomatous lesion of the oral cavity, are relatively rare. The authors describe a personal case discussing the diagnostic spects of such lesion and emphasizing the importance of the arteriography of the carotid artery and the of the selective arteriography of the lingual arteries, especially in considering surgery. Biopsies are not recommended. After discussing the histopathological and clinical aspects of such lesions the Authors emphasize the therapeutic ones. Even though radiotherapy, cryotherapy, laser therapy, medical treatment, injection of sclerosing substances and the selective embolization, of the lingual artery seem to have some efficacy, the authors conclude that surgery in the therapy of choice in the isolated vascular lesions of the body of the tongue. PMID:3274631

  20. Underground caverns. a developing storage method

    Energy Technology Data Exchange (ETDEWEB)

    1980-07-15

    A report on papers given at the Rockstore 80 conference held recently in Stockholm covers the obstacles to subsurface storage of oil encountered in South and Central Europe, the US, and the Far East, where the geophysical conditions are not as favorable for the construction of underground structures as in Finland, Norway, and Sweden; the economic and environmental advantages of underground over aboveground storage; the technical problems involved in the creation of Gaz de France's pressure relief-operated gas storages in salt cavities, as well as in aquiferous beds, and the efforts of the company's subsidiary, Sofregaz, to solve these problems; and the design of a storage facility at Mesilat Zion, 20 km west of Jerusalem, which is now under construction for storing 7500 tons of LPG in lined caverns above the water table.

  1. THE DIAGNOSIS OF MAGNETIC RESONANCE IMAGING FOR SPINAL CAVERNOUS ANGIOMAS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To assess the characteristics of magnetic resonance imaging (MRI) for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance (MR) were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.

  2. Pedunculated cavernous hemangioma originating in the olfactory cleft.

    Science.gov (United States)

    Su, Kaiming; Zhang, Weitian; Shi, Haibo; Yin, Shankai

    2014-09-01

    Sinonasal cavernous hemangioma is a rare condition that usually affects the lateral wall of the nasal cavity. We report the case of a 77-year-old man who presented with severe epistaxis, nasal congestion, and olfactory dysfunction. Endoscopic examination of the nasal cavity revealed the presence of a red-blue tumor that had almost completely filled the nasopharynx. Preoperatively, it was difficult to distinguish this lesion from a juvenile nasopharyngeal angiofibroma. During endoscopic surgery, the tumor was found to originate in the left olfactory cleft, and it had a long peduncle that contained blood vessels. Postoperative histopathologic examination indicated that the mass was a cavernous hemangioma. To the best of our knowledge, this is the first case of an olfactory cleft cavernous hemangioma and the first case of olfactory cleft disease associated with a cavernous hemangioma to be reported in the English-language literature. PMID:25255356

  3. ATLAS - End-Cap calorimeter lowered in to the cavern

    CERN Multimedia

    2006-01-01

    The End-cap calorimeter was lowered into the ATLAS cavern at POINT1. This calorimeter will measure the energy of particles close to the beam axis when protons collide. Cooling is important for maximum detector efficiency.

  4. Classification and diagnosis of ear malformations

    Directory of Open Access Journals (Sweden)

    Bartel-Friedrich, Sylva

    2007-01-01

    Full Text Available In the ENT region 50% of the malformations affect the ear. Malformations of the outer and middle ear are predominantly unilateral (ca. 70-90% and mostly involve the right ear. Inner ear malformations can be unilateral or bilateral. The incidence of ear malformations is approximately 1 in 3800 newborns. Ear malformations may be genetic (associated with syndromes or not, with family history, spontaneous mutations or acquired in nature. Malformations can affect the outer ear (pinna and external auditory canal, EAC, middle ear and inner ear, not infrequently in combination. Formal classification is advisable in order to be able to predict the prognosis and compare treatment schedules. Various classifications have been proposed: pinna and EAC malformations according to Weerda [1], middle ear malformations according to Kösling [2], and inner ear malformations according to Jackler [3], [4], to Marangos [5] and to Sennaroglu [6]. Additionally, we describe Altmann’s classification of atresia auris congenita [7] and the Siegert-Mayer-Weerda score [8] for EAC and middle ear malformations, systems of great practicability that are in widespread clinical use. The diagnostic steps include clinical examination, audiological testing, genetic analysis and, especially, CT and MRI. These imaging methods are most usefully employed in combination. Precise description of the malformations by means of CT and MRI is indispensable for the planning and successful outcome of operative ear reconstruction and rehabilitation procedures, including cochlear implantation.

  5. Intraneural Venous Malformations of the Median Nerve

    Science.gov (United States)

    González Rodríguez, Alba; Midón Míguez, José

    2016-01-01

    Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

  6. Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations

    Science.gov (United States)

    Jin, Sung-Chul; Park, Hyun; Choi, Choong-Gon

    2011-01-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  7. Direct carotid cavernous fistula of an adult-type persistent primitive trigeminal artery with multiple vascular variations.

    Science.gov (United States)

    Jin, Sung-Chul; Park, Hyun; Kwon, Do Hoon; Choi, Choong-Gon

    2011-04-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  8. Variants in CUL4B are Associated with Cerebral Malformations

    NARCIS (Netherlands)

    Vulto-van Silfhout, Anneke T.; Nakagawa, Tadashi; Bahi-Buisson, Nadia; Haas, Stefan A.; Hu, Hao; Bienek, Melanie; Vissers, Lisenka E. L. M.; Gilissen, Christian; Tzschach, Andreas; Busche, Andreas; Muesebeck, Joerg; Rump, Patrick; Mathijssen, Inge B.; Avela, Kristiina; Somer, Mirja; Doagu, Fatma; Philips, Anju K.; Rauch, Anita; Baumer, Alessandra; Voesenek, Krysta; Poirier, Karine; Vigneron, Jacqueline; Amram, Daniel; Odent, Sylvie; Nawara, Magdalena; Obersztyn, Ewa; Lenart, Jacek; Charzewska, Agnieszka; Lebrun, Nicolas; Fischer, Ute; Nillesen, Willy M.; Yntema, Helger G.; Jarvela, Irma; Ropers, Hans-Hilger; de Vries, Bert B. A.; Brunner, Han G.; van Bokhoven, Hans; Raymond, F. Lucy; Willemsen, Michel A. A. P.; Chelly, Jamel; Xiong, Yue; Barkovich, A. James; Kalscheuer, Vera M.; Kleefstra, Tjitske; de Brouwer, Arjan P. M.

    2015-01-01

    Variants in cullin 4B (CUL4B) are a known cause of syndromic X-linked intellectual disability. Here, we describe an additional 25 patients from 11 families with variants in CUL4B. We identified nine different novel variants in these families and confirmed the pathogenicity of all nontruncating varia

  9. Variants in CUL4B are associated with cerebral malformations

    NARCIS (Netherlands)

    Vulto-van Silfhout, A.T.; Nakagawa, T.; Bahi-Buisson, N.; Haas, S.A.; Hu, H; Bienek, M.; Vissers, L.E.L.M.; Gilissen, C.F.H.A.; Tzschach, A.; Busche, A.; Musebeck, J.; Rump, P.; Mathijssen, I.B.; Avela, K.; Somer, M.; Doagu, F.; Philips, A.K.; Rauch, A.; Baumer, A.; Voesenek, K.E.J.; Poirier, K.; Vigneron, J.; Amram, D.; Odent, S.; Nawara, M.; Obersztyn, E.; Lenart, J.; Charzewska, A.; Lebrun, N.; Fischer, U.; Nillesen, W.M.; Yntema, H.G.; Jarvela, I.; Ropers, H.H.; Vries, B. de; Brunner, H.G.; Bokhoven, H. van; Raymond, F.L.; Willemsen, M.A.A.P.; Chelly, J.; Xiong, Y.; Barkovich, A.J.; Kalscheuer, V.M.; Kleefstra, T.; Brouwer, A.P.M. de

    2015-01-01

    Variants in cullin 4B (CUL4B) are a known cause of syndromic X-linked intellectual disability. Here, we describe an additional 25 patients from 11 families with variants in CUL4B. We identified nine different novel variants in these families and confirmed the pathogenicity of all nontruncating varia

  10. Endovascular and microsurgical treatment of cerebral arteriovenous malformations: Current recommendations

    Directory of Open Access Journals (Sweden)

    Andrew Conger

    2015-01-01

    Conclusions: These lesions are among the most technically difficult pathological entities handled by the cerebrovascular specialist, and an overview of technical concepts to help systematize this challenging and variable endeavor can improve the safety of their treatment.

  11. Perinatal risk factors including malformation

    International Nuclear Information System (INIS)

    The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG)

  12. Prenatal diagnosis of cloacal malformation.

    Science.gov (United States)

    Peiro, Jose L; Scorletti, Federico; Sbragia, Lourenco

    2016-04-01

    Persistent cloaca malformation is the most severe type of anorectal and urogenital malformation. Decisions concerning the surgical treatment for this condition are taken during the first hours of life and may determine the quality of life of these patients. Thus, prenatal diagnosis becomes important for a prompt and efficient management of the fetus and newborn, and accurate counseling of the parents regarding its consequences and the future of the baby. Careful evaluation by ultrasonography, and further in-depth analysis with MRI, allow prenatal detection of characteristic findings, which can lead to diagnose or at least suspect this condition. We reviewed our experience and the literature in order to highlight the most important clues that can guide the physician in the differential diagnosis. PMID:26969229

  13. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  14. Recombinant factor VII (NovoSeven in intraoperative blood saving during neurosurgical treatment of the brain arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Novak Vesna

    2007-01-01

    Full Text Available Background. Cerebral arteriovenous (AV malformation causes, due to the increased blood flow through a malformation, a massive intraoperative bleeding complicating, so, surgical treatment. The use of intraoperative blood saving apparatus during surgery and a recombinant factor VII-a (NovoSeven significantly reduce complications during surgical treatment. Case report. We reported a case of surgical treatment of the patient with AV malformation of IV stage according to the Spetzler-Martin scale, in the brain. Due to a possible heavy bleeding we used a apparatus for intrasurgical blood recovery, Cell Saver, Sequestra 1 000, Medtronic, U.S.A., and recombinant human factor VIIa (rFVIIa - NovoSeven, NovoNordisk, Denmark to control bleeding and restore an adequate hemostasis. Conclusion. The use of an apparatus for intraoperative blood saving, as well as the NovoSeven preparation in the management of AV malformation of IV stage, showed to be successful.

  15. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    Directory of Open Access Journals (Sweden)

    Umesh

    2015-01-01

    Full Text Available BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s. MATERIAL AND METHODS: 50 cases of anorectal malformations admit ted to Department of Paediatric Surgery , in Medical Coll ege and Research Institute , were included in the study. Data related to the objectives of the study were collected. RESULTS: Commonest mode of presentation was failure to pass meconium 50%. 59% of mal es had high anomalies , while 53% females had intermediate anomalies. The diagnosis of low anomaly was made clinically , while high and intermediate anomalies needed further investigations. Associated anomalies were noted in 46.6% of the cases. 71.42% of the se patients had either a high or intermediate ARM. All patients with high anomalies underwent a 3 stage procedure , while low anomalies underwent a single stage procedure followed by anal dilatations. Rectal mucosal prolapse (2 cases , wound infection (4 ca ses , stenosis (3 cases , retraction of neo anus (1 case was seen. All the patients with low anomalies had a good functional result post operatively , while 57% and 28% of patients with intermediate and high anomalies had good results. CONCLUSION : Anorectal malformations are common congenital anomalies. Males are more commonly affected (1.3:1. Low anomalies are the commonest lesions noted in both the sexes (36.67%. High anomalies are more frequent in males. Invertogram offer an accurate diagnosis for planning management in patients with anorectal malformations. Low anomalies have a better outcome following surgery. For intermediate and high anomalies a staged repair offers better results

  16. Endovascular embolization of pulmonary arteriovenous malformations

    Institute of Scientific and Technical Information of China (English)

    LIU Feng-yong; WANG Mao-qiang; FAN Qing-sheng; DUAN Feng; WANG Zhi-jun; SONG Peng

    2010-01-01

    had persistent blood oxygen saturation between 85% and 90%. Symptoms of hypoxia never recurred in the other cases. Conclusions Endovascular embolization of pulmonary arteriovenous malformations can significantly improve blood oxygen saturation and reduce serious complications such as cerebral infaction. Therefore, this kind of interventional procedure is a safe and effective treatment method with a low complication rate.

  17. Supernova hemorrhage: obliterative hemorrhage of brain arteriovenous malformations following γ knife radiosurgery.

    Science.gov (United States)

    Alexander, Matthew D; Hetts, Steven W; Young, William L; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T; English, Joey D

    2012-09-01

    Hemorrhage represents the most feared complication of cerebral arteriovenous malformations (AVMs) in both untreated patients and those treated with gamma knife radiosurgery. Radiosurgery does not immediately lead to obliteration of the malformation, which often does not occur until years following treatment. Post-obliteration hemorrhage is rare, occurring months to years after radiosurgery, and has been associated with residual or recurrent AVM despite prior apparent nidus elimination. Three cases are reported of delayed intracranial hemorrhage in patients with cerebral AVMs treated with radiosurgery in which no residual AVM was found on catheter angiography at the time of delayed post-treatment hemorrhage. That the pathophysiology of these hemorrhages involves progressive venous outflow occlusion is speculated and the possible mechanistic link to subsequent vascular rupture is discussed. PMID:21990534

  18. Congenital Chiari malformations: A review

    Directory of Open Access Journals (Sweden)

    Vannemreddy Prasad

    2010-01-01

    Full Text Available Chiari malformation is the commonest anomaly of the craniovertebral junction involving both the skeletal as well as the neural structures. This entity has rapidly evolved over the past decade with newer visualization techniques, thus posing new challenges to diagnosis and management. This review includes the developmental theories, the latest nomenclature and existing treatment modalities of this interesting anomaly. Five theories tried to explain the malformation of the hindbrain and the neuraxis but no single theory completes the development of embryonic defects. Several atypical presentations have been reported with either incidental/asymptomatic features resulting in further classifications. The new magnetic resonance imaging flow techniques attempt to substantiate the clinical presentations and correlate with the abnormality which can be subtle in correlation. Surgical correction to improve the cranial volume, decrease the hydrocephalus and improve flow across the foramen magnum is the mainstay but needs to be tailored to a given type of malformation. Further clinical and imageological studies, especially longitudinal natural history, might improve our understanding of the atypical/asymptomatic presentations and the management that is currently available.

  19. ADVANCED UNDERGROUND GAS STORAGE CONCEPTS REFRIGERATED-MINED CAVERN STORAGE

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    Limited demand and high cost has prevented the construction of hard rock caverns in this country for a number of years. The storage of natural gas in mined caverns may prove technically feasible if the geology of the targeted market area is suitable; and economically feasible if the cost and convenience of service is competitive with alternative available storage methods for peak supply requirements. It is believed that mined cavern storage can provide the advantages of high delivery rates and multiple fill-withdrawal cycles in areas where salt cavern storage is not possible. In this research project, PB-KBB merged advanced mining technologies and gas refrigeration techniques to develop conceptual designs and cost estimates to demonstrate the commercialization potential of the storage of refrigerated natural gas in hard rock caverns. Five regions of the U.S.A. were studied for underground storage development and PB-KBB reviewed the literature to determine if the geology of these regions was suitable for siting hard rock storage caverns. Area gas market conditions in these regions were also studied to determine the need for such storage. Based on an analysis of many factors, a possible site was determined to be in Howard and Montgomery Counties, Maryland. The area has compatible geology and a gas industry infrastructure for the nearby market populous of Baltimore and Washington D.C.. As Gas temperature is lowered, the compressibility of the gas reaches an optimum value. The compressibility of the gas, and the resultant gas density, is a function of temperature and pressure. This relationship can be used to commercial advantage by reducing the size of a storage cavern for a given working volume of natural gas. This study looks at this relationship and and the potential for commercialization of the process in a storage application. A conceptual process design, and cavern design were developed for various operating conditions. Potential site locations were considered

  20. Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain

    OpenAIRE

    Patel Pooja; Vyas Rakesh; Bhavsar Devang; Suryanarayan U; Pelagade Satish; Patel Dipak

    2008-01-01

    Background: The goal of treatment in arteriovenous malformation (AVM) is total obliteration of the AVM, restoration of normal cerebral function, and preservation of life and neurological function. Aim: To analyze the results of X-knife and surgery for AVM of the brain. The endpoints for success or failure were as follows: success was defined as angiographic obliteration and failure as residual lesion, requiring retreatment, or death due to hemorrhage from the AVM. Materials and Methods: From ...

  1. Features of Bayou Choctaw SPR caverns and internal structure of the salt dome.

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell E.

    2007-07-01

    The intent of this study is to examine the internal structure of the Bayou Choctaw salt dome utilizing the information obtained from graphical representations of sonar survey data of the internal cavern surfaces. Many of the Bayou Choctaw caverns have been abandoned. Some existing caverns were purchased by the Strategic Petroleum Reserve (SPR) program and have rather convoluted histories and complex cavern geometries. In fact, these caverns are typically poorly documented and are not particularly constructive to this study. Only two Bayou Choctaw caverns, 101 and 102, which were constructed using well-controlled solutioning methods, are well documented. One of these was constructed by the SPR for their use while the other was constructed and traded for another existing cavern. Consequently, compared to the SPR caverns of the West Hackberry and Big Hill domes, it is more difficult to obtain a general impression of the stratigraphy of the dome. Indeed, caverns of Bayou Choctaw show features significantly different than those encountered in the other two SPR facilities. In the number of abandoned caverns, and some of those existing caverns purchased by the SPR, extremely irregular solutioning has occurred. The two SPR constructed caverns suggest that some sections of the caverns may have undergone very regular solutioning to form uniform cylindrical shapes. Although it is not usually productive to speculate, some suggestions that point to the behavior of the Bayou Choctaw dome are examined. Also the primary differences in the Bayou Choctaw dome and the other SPR domes are noted.

  2. Malaria cerebral Cerebral malaria

    Directory of Open Access Journals (Sweden)

    Carlos Hugo Zapata Zapata

    2003-03-01

    Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

  3. Evidence for remotely triggered microearthquakes during salt cavern collapse

    Science.gov (United States)

    Jousset, Philippe; Rohmer, Jérémy

    2016-04-01

    Microseismicity is a good indicator of spatio-temporal evolution of physical properties of rocks prior to catastrophic events like volcanic eruptions or landslides and may be triggered by a number of causes including dynamic characteristics of processes in play or/and external forces. We show evidence of triggered microseismicity observed in the vicinity of an underground salt cavern prone to collapse by a remote M ˜ 7.2 earthquake, which occurred ˜12 000 km away. High-dynamic range broad-band records reveal the strong time-correlation between a dramatic change in the rate of local high-frequency microseismicity and the passage of low-frequency seismic waves, including body, Love and Rayleigh surface waves. Pressure was lowered in the cavern by pumping operations of brine out of the cavern. We demonstrate the near critical state of the cavern before the collapse by means of 2-D axisymmetric elastic finite-element simulations. On this basis, we show that the increment of stress necessary for the failure of the Dolomite layer, which ensures the stability of the whole system, is of the same order of magnitude as the maximum dynamic stress magnitude observed during the passage of the earthquakes waves. This suggests that the stress oscillations due to the seismic waves correlated with the recorded microearthquakes induced damage of the overburden, which eventually led to the collapse of the salt cavern. We show that the contribution of Rayleigh waves is the most efficient to trigger microseismicity at periods close to the natural fundamental frequency of the cavern system found at about 10-20 s by investigating the impulse response of the cavern + overburden + brine system.

  4. Spontaneous ileal perforation complicating low anorectal malformation

    Directory of Open Access Journals (Sweden)

    TiJesuni Olatunji

    2015-01-01

    Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

  5. Ectrodactyly/split hand feet malformation

    Directory of Open Access Journals (Sweden)

    Jindal Geetanjali

    2009-01-01

    Full Text Available Split-hand/split-foot malformation is a rare limb malformation with median clefts of the hands and feet and aplasia/hypoplasia of the phalanges, metacarpals and metatarsals. When present as an isolated anomaly, it is usually inherited as an autosomal dominant form. We report a case of autosomal recessive inheritance and discuss the antenatal diagnosis, genetic counseling and treatment for the malformation.

  6. ECG changes during cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, K.; Nishimura, Y.; Yoshida, M.; Itoh, K.; Hayashi, N.; Aoki, J.; Nakamura, K.; Imai, M.; Ono, T.; Morikawa, S.

    1984-09-01

    We have analyzed HR changes greater than 20% among 334 patients and 942 cerebral angiographies. A tachycardial effect was seen in 14.9% of patients, while a bradycardial effect was seen in 7.1% including two patients having cardiac standstill (0.5%). These two patients were examined without atropine premedication after subarachnoid hemorrhage. Patients under 19 years of age, unpremedicated with atropine sulfate and suffering from subarachnoid hemorrhage secondary to ruptured aneurysm or arteriovenous malformation showed a significantly high incidence of bradycardia. On the other hand, patients with the neoplastic disease and having an initial sinus bradycardia showed a significantly high incidence of a tachycardial effect.

  7. Lunar Holes and Their Associating Subsurface Caverns: From SELENE (Kaguya) to UZUME

    Science.gov (United States)

    Haruyama, J.; Kawano, I.; Nishibori, T.; Iwata, T.; Yamamoto, Y.; Shimada, K.; Yamamoto, K.; Hasenaka, T.; Morota, T.; Nishino, M. N.; Hashizume, K.; Shirao, M.; Komatsu, G.; Hasebe, N.; Shimizu, H.; Kobayashi, K.; Yokobori, S.; Miyake, Y.; Michikawa, Y.; Tsuji, T.; Shinoda, R.

    2016-05-01

    We present a summary of lunar holes and associated caverns. Furthermore, we also introduce the project Unprecedented Zipangu Underworld of the Moon/Mars Exploration (UZUME) to explore the holes and caverns.

  8. Hemiparesis in carotid cavernous fistulas (CCFs):a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    王慧晓; 白如林; 黄承光; 卢亦成; 张光霁

    2004-01-01

    @@ Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low ), or pathogenesis (direct or indirect).

  9. Magnetic resonance imaging features of complex Chiari malformation variant of Chiari 1 malformation

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Hannah E. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Moore, Kevin R. [University of Utah School of Medicine, Department of Radiology, Salt Lake City, UT (United States); Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States)

    2014-11-15

    Complex Chiari malformation is a subgroup of Chiari 1 malformation with distinct imaging features. Children with complex Chiari malformation are reported to have a more severe clinical phenotype and sometimes require more extensive surgical treatment than those with uncomplicated Chiari 1 malformation. We describe reported MR imaging features of complex Chiari malformation and evaluate the utility of craniometric parameters and qualitative anatomical observations for distinguishing complex Chiari malformation from uncomplicated Chiari 1 malformation. We conducted a retrospective search of the institutional imaging database using the keywords ''Chiari'' and ''Chiari 1'' to identify children imaged during the 2006-2011 time period. Children with Chiari 2 malformation were excluded after imaging review. We used the first available diagnostic brain or cervical spine MR study for data measurement. Standard measurements and observations were made of obex level (mm), cerebellar tonsillar descent (mm), perpendicular distance to basion-C2 line (pB-C2, mm), craniocervical angle (degrees), clivus length, and presence or absence of syringohydromyelia, basilar invagination and congenital craniovertebral junction osseous anomalies. After imaging review, we accessed the institutional health care clinical database to determine whether each subject clinically met criteria for Chiari 1 malformation or complex Chiari malformation. Obex level and craniocervical angle measurements showed statistically significant differences between the populations with complex Chiari malformation and uncomplicated Chiari 1 malformation. Cerebellar tonsillar descent and perpendicular distance to basion-C2 line measurements trended toward but did not meet statistical significance. Odontoid retroflexion, craniovertebral junction osseous anomalies, and syringohydromyelia were all observed proportionally more often in children with complex Chiari malformation than in

  10. [Arteriovenous malformation of septum pellucidum in combination with persistent trigeminal neuralgia].

    Science.gov (United States)

    Talanov, A B; Filatov, Iu M; Eliava, Sh Sh; Novikov, A E; Kulishova, Ia G

    2009-01-01

    A 16-year-old boy with arteriovenous malformation (AVM) of septum pellucidum in combination with left side persistent trigeminal artery (PTA) is described. Presentation of AVM included severe intracranial hemorrhage and the lesion was removed surgically. The case deserves interest for two reasons. 1) The observation demonstrates the possibility of increased pressure in the afferent arteries of AVM. It was illustrated by distinctive displacement of the zones of the hemodynamical balance around the circle of Willis. The raised pressure in conditions of shunting can be explained using principles of the constant shear stress in the vascular system. 2) The observation of the features of venous system that may be causative for PTA. These features included presence of the large anastomotic vein between petrosal and cavernous sinuses, enlargement of petrosal sinuses and shrinking of transverse sinus ipsilateral to PTA. PMID:20143612

  11. Efficacy of preoperative partial embolization combined microsurgical resection of Ⅲ-Ⅴgrade cerebral arteriovenous malformations%术前部分栓塞联合显微手术切除Ⅲ至Ⅴ级脑动静脉畸形的疗效分析

    Institute of Scientific and Technical Information of China (English)

    熊启江; 虞正权

    2014-01-01

    目的:回顾总结72例脑动静脉畸形( CAVM)的治疗经验,探讨术前部分栓塞病灶在显微手术切除Ⅲ-Ⅴ级CAVM中的作用,为临床治疗提供参考。方法72例CAVM分为24例栓塞加手术组(Ⅲ-Ⅴ级17例)和48例单纯手术组(Ⅲ-Ⅴ级6例)。对术前资料包括:性别、年龄、Spetzler-Martin分级( S-M分级),术后资料GOS评分进行相关性分析,比较两组病例的治疗效果。结果24例行26次栓塞,平均每次栓塞2支,共52支供血动脉被栓塞,无栓塞相关并发症。全切69例,残留3例。恢复良好61例,轻残6例,重残3例,植物状态1例,术后死亡1例。术后无新增神经功能障碍,癫痫7例6例消失,1例改善。两组治疗效果无显著性差异。结论Ⅰ-Ⅱ级CAVM显微手术切除是主要手段,Ⅲ-Ⅴ级者术前栓塞能降低或改善S-M分级,减少手术风险。显微手术切除联合术前栓塞是对Ⅲ-Ⅴ级CAVM最直接,最有效的治疗方法。%Objective To summarize the treatment experience of 72 cases with cerebral arteriovenous malformation ( CAVM ) and explore the role of preoperative embolization parts of the lesion in the microsurgical resection of Ⅲ-Ⅴ grade of CAVM .Methods 72 patients with CAVM treated in our department for five years whose preoperative data include sex , age, Spetzler-Martin grade ( SM grade ) and postoperative data ( postoperative GOS score ) .Using statistical analysis , we compared the treatment of the embolization-surgery group (Ⅲ-Ⅴ:17/24 ) with surgery-alone group (Ⅲ-Ⅴ:6/48).Results 24 cases were embolized preoperativedly in 26 sessions and a total of 52 feeding artery were embolized .No significant embolic complications were shown in all case .69 total resection and 3 residual .61 good recovery ,6 mild disability ,3 severe disability ,1 vegetative state and 1 died.No new neurological dysfunction , of 7 epilepsy cases, 6 disappeared and 1 improved. Conclusions

  12. Underground hydrogen storage. Final report. [Salt caverns, excavated caverns, aquifers and depleted fields

    Energy Technology Data Exchange (ETDEWEB)

    Foh, S.; Novil, M.; Rockar, E.; Randolph, P.

    1979-12-01

    The technical and economic feasibility of storing hydrogen in underground storage reservoirs is evaluated. The past and present technology of storing gases, primarily natural gas is reviewed. Four types of reservoirs are examined: salt caverns, excavated caverns, aquifers, and depleted fields. A technical investigation of hydrogen properties reveals that only hydrogen embrittlement places a limit on the underground storage by hydrogen. This constraint will limit reservoir pressures to 1200 psi or less. A model was developed to determine economic feasibility. After making reasonable assumptions that a utility might make in determining whether to proceed with a new storage operation, the model was tested and verified on natural gas storage. A parameteric analysis was made on some of the input parameters of the model to determine the sensitivity of the cost of service to them. Once the model was verified it was used to compute the cost of service of storing hydrogen in the four reservoir types. The costs of service for hydrogen storage ranged from 26 to 150% of the cost of the gas stored. The study concludes that it is now both safe and economic to store hydrogen in underground reservoirs.

  13. Acquired Chiari malformation type I associated with a supratentorial fistulous arteriovenous malformation: a case report.

    Science.gov (United States)

    Chen, Kuo-Wei; Kuo, Meng-Fai; Lee, Chung-Wei; Tu, Yong-Kwang

    2015-03-01

    A case of acquired Chiari malformation type I with frontal fistulous arteriovenous malformation (AVM) is presented, and the pathophysiology is discussed. The tonsillar herniation and hydrocephalus both resolved after AVM was excised. This case provides some insight into the complex hemodynamic change exerted by the fistulous AVM and the mechanism of the development of acquired Chiari malformation type I.

  14. Bedded salt in Ontario : geology, solution mining and cavern storage

    Energy Technology Data Exchange (ETDEWEB)

    Carter, T. [Ontario Ministry of Natural Resources, London, ON (Canada). Petroleum Resources Centre

    2009-07-01

    This presentation discussed bedded salt geology in Ontario in relation to cavern storage and solution mining. Ontario's salt basin forms part of the Michigan basin. The salt formed as reefs surrounding the shallow basin restricted the flow of water. Salt then formed as the water evaporated. The bedded salt occurs in several layers underlying up to 16,000 km{sup 2} in the province. Subsurface resources used in the area include salt cavern hydrocarbon storage; oil and gas reservoirs; and natural gas reservoir storage. The Salina Group stratigraphy is comprised of several separate salt beds with a maximum combined thickness of 90 m. The Salina salt beds exhibit evidence of dissolution after deposition. There are currently 20 active solution mining wells in operation in the Windsor and Goderich regions. There are currently 112 wells and 70 caverns used for cavern storage in Ontario that are used to store approximately 27 million bbl of liquefied petroleum gas (LPG) and oil. Non-salt layers in the salt beds can interfere with both solution mining and cavern storage operations. tabs., figs.

  15. Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    TAO Yu-xin; QU Qiu-yi; WANG Zhen-lin; ZHANG Qiu-hang

    2010-01-01

    Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

  16. Cavernous angioma of the optic chiasm--case report.

    Science.gov (United States)

    Iwai, Y; Yamanaka, K; Nakajima, H; Miyaura, T

    1999-08-01

    A 31-year-old female presented with cavernous angioma originating from the optic chiasm manifesting as sudden onset of right retroorbital pain and right visual disturbance. She had a psychomotor seizure 10 years ago. Cavernous angioma at the right basal ganglia had been partially removed at that time. After the operation, the patient had left hemiparesis, but gradually improved. Neurological examination revealed decreased right visual acuity, left homonymous hemianopsia, and left hemiparesis. Magnetic resonance imaging revealed a mixed signal intensity mass at the right optic nerve to the optic chiasm with a low signal intensity rim on T2-weighted imaging, situated at the right basal ganglia where the cavernous angioma had been partially resected. Right frontotemporal craniotomy was performed by the pterional approach. A subpial hematoma was situated at the right optic nerve to the optic chiasm. The hematoma with an angiomatous component was completely resected from the surrounding structure. Histological examination of the specimens confirmed cavernous angioma. Postoperatively, her right visual acuity was slightly improved, but the visual field defect was unchanged. We emphasize the importance of correct diagnosis by magnetic resonance imaging and subsequent resection for preserving and improving the visual function of patients with cavernous angiomas of the optic chiasm. PMID:10487042

  17. Endovascular embolization for the treatment of carotid cavernous fistula: recent progresses in research

    International Nuclear Information System (INIS)

    Carotid cavernous fistula is the abnormal arteriovenous communications, which can be located within the internal carotid cavernous segment itself, or between the cavernous and the internal carotid branches or external carotid meningeal branches. With the development of interventional neuroradiology, endovascular embolization has become the choice of treatment for the carotid cavernous fistula, as the technique is less invasive, simple and reliable. This paper aims to review the recent progresses in this respect in order to further improve its clinical diagnosis and treatment. (authors)

  18. [Trigeminal-cavernous fistula. Report of a case and review of the literature].

    Science.gov (United States)

    Santos Franco, Jorge; Sánchez Olivera, Carlos; Saavedra Andrade, Rafael; Sandoval Balanzario, Miguel Antonio

    2013-01-01

    Persistent primitive trigeminal artery is a rare anatomical variant resulting from the absence of obliteration of the embryonic trigeminal artery. The shunt between the persistent primitive trigeminal artery and the cavernous sinus is called trigeminal-cavernous fistula. We report the case of a woman with a trigeminal-cavernous fistula secondary to head trauma who was treated by transarterial embolization. PMID:24108341

  19. Does the risk of cerebral palsy increase or decrease with increasing gestational age?

    OpenAIRE

    Murphy-Kaulbeck Lynn; Lutfi Samawal; Allen Alexander C; Joseph K S; Vincer Michael J; Wood Ellen

    2003-01-01

    Abstract Background It is generally accepted that the risk of cerebral palsy decreases with increasing gestational age of live born infants. However, recent studies have shown that cerebral palsy often has prenatal antecedents including congenital malformations, vascular insults and maternal infection. Cerebral palsy is therefore better viewed as occurring among fetuses, rather than among infants. We explored the epidemiologic implications of this change in perspective. Methods We used recent...

  20. Case history: blowout at an LPG storage cavern in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Hamberger, Ulrika

    1991-01-01

    A ''blowout'' occurred when an additional well was drilled to secure sufficient water pressure at an underground LPG storage cavern in September 1989. The leak was stopped after 12 hours. By grouting through the drill rod, it was possible to fill up the cavity around the drill bit. It was then possible to grout the hole up to ground level. The 48,000 m{sup 3}-capacity underground storage, which is located in Karlshamn on the south coast of Sweden, has been in operation since April 1990. Storage is accomplished under hydrostatic water conditions. The storage cavern is placed at such a depth so as to guarantee a sufficient groundwater pressure above the whole storage. A ''curtain'' of drill holes, which efficiently spread the groundwater, is placed above the cavern. The groundwater was carefully observed in wells during the excavation period and these observations continue. (author).

  1. Giant hepatic cavernous hemangioma. Findings on computed helical tomography

    International Nuclear Information System (INIS)

    Objective: To describe computed helical tomography characteristics of the giant hepatic cavernous hemangioma. Method: During five years, we evaluated 21 patients with 21 giant hepatic cavernous hemangiomas with computed helical and multislice tomography. We included 18 women (86%) and 3 men (14%) with a mean age of 45 years. Results: The mean size of hemangiomas was 10.4 cm. Non enhanced computed tomography Showed 21 hemangiomas with lower density than adjacent hepatic parenchyma , all hemangiomas showed a central cleft area with low density. None hemangioma showed calcifications neither internal septa. In enhanced helical tomography all lesions demonstrated a globular, peripheral enhancing pattern with centripetal filling that begin in the arterial phase and continued in portal and delayed phases. None of the lesions showed complete filling. Conclusion: giant hepatic cavernous hemangiomas showed low attenuation in non enhanced computed tomography. central cleft area was very frequently seen. The enhancement pattern is characteristic, starting at the periphery with centripetal filling but it was never complete.

  2. Dynamic permeability and quantitative susceptibility

    DEFF Research Database (Denmark)

    Mikati, Abdul Ghani; Tan, Huan; Shenkar, Robert;

    2014-01-01

    Hyperpermeability and iron deposition are 2 central pathophysiological phenomena in human cerebral cavernous malformation (CCM) disease. Here, we used 2 novel MRI techniques to establish a relationship between these phenomena....

  3. Subfascial involvement in glomuvenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Raja; Alomari, Ahmad I.; Chaudry, Gulraiz [Boston Children' s Hospital, Division of Interventional Radiology, Boston, MA (United States); Mulliken, John B. [Boston Children' s Hospital, Division of Plastic Surgery, Boston, MA (United States); Fishman, Steven J. [Boston Children' s Hospital, Department of Surgery, Boston, MA (United States); Kozakewich, Harry P.W. [Boston Children' s Hospital, Department of Pathology, Boston, MA (United States)

    2014-07-15

    Glomuvenous malformation (GVM) is an inherited autosomal dominant trait. The lesions, which appear as bluish nodules or plaque-like cutaneous elevations, are usually tender and more firm than sporadic venous malformations. Conventionally, the lesions are thought to be limited to the cutaneous and subcutaneous tissue planes. The objective was to characterize the depth of involvement of GVM lesions. Magnetic resonance imaging (MRI) findings in GVM were retrospectively evaluated by two radiologists. The signal characteristics, tissue distribution, pattern of contrast enhancement of the lesions in GVM were documented. Thirty patients (19 female) aged 1-35 years (mean 18 years) were diagnosed with GVM based on clinical features (n = 20) and/or histopathological findings (n = 10). The lesions were present in the lower extremity (n = 15), upper extremity (n = 6), cervico-facial region (n = 6), pelvis (n = 2), and chest wall (n = 1). All patients had skin and subcutaneous lesions. Fifty percent of the patients (n = 15) demonstrated subfascial intramuscular (n = 15), intra-osseous (n = 1), and intra-articular involvement (n = 1). Contrary to the conventional belief that GVMs are generally limited to the skin and subcutaneous tissue, deep subfascial extension of the lesions is common. (orig.)

  4. Renal tract malformations: perspectives for nephrologists.

    NARCIS (Netherlands)

    Kerecuk, L.; Schreuder, M.F.; Woolf, A.S.

    2008-01-01

    Renal tract malformations are congenital anomalies of the kidneys and/or lower urinary tract. One challenging feature of these conditions is that they can present not only prenatally but also in childhood or adulthood. The most severe types of malformations, such as bilateral renal agenesis or dyspl

  5. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula

    Science.gov (United States)

    Rajagopal, Rengarajan; Mehta, Neeraj; Saran, Sonal; Khera, Pushpinder S.

    2016-01-01

    Summary Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers. Heuber manoeuver is one of the manoeuvers used to demonstrate the size of the fistula.

  6. CAVERNOUS HAEMANGIOMA WITH RETIFORM HAEMANGIOENDOTHELIOMA - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mamina

    2013-10-01

    Full Text Available ABSTRACT: INTRODUCTION : Retiform hemangioendothelioma is a rare variant of lo w - grade angiosarcoma with an indolent clinical behaviour, with predilection for young adults. Mostly is seen in the extremities, especially the distal lower limbs. CASE REPORT: An eighty year old lady, presented with complaints of a solitary, well defined swelling below the nape of the neck since two years. The swelling was clinically diagnosed as cavernous haemangioma. However the colour of the lesion s was looking like a melanocytic naevus. Excision was done under local anaesthesia and was sent for histopa tho lo gical examination. Histopathological diagnosis was confirmed as “Cavernous haemangioma with Retiform Haemangioendothelioma”

  7. [Ovarian torsion revealing an ovarian cavernous hemangioma in a child].

    Science.gov (United States)

    M'pemba Loufoua-Lemay, A-B; Peko, J-F; Mbongo, J-A; Mokoko, J-C; Nzingoula, S

    2003-11-01

    The authors report one case of cavernous hemangioma of the left ovary, which was revealed by ovarian torsion. Such benign tumors of the blood vessels are rare in ovaries during childhood. This hemangioma was observed in a 13-year-old patient, who presented with abdominal and pelvic pain and vomiting. The pelvic mass was noted and sonography revealed a cystic tumor. An annexectomia was realized. Histology showed narcotized ovary cells, with an increased number of vascular channels composed of thin walled vessels, whose wall consisted of an endothelium. This aspect evoked a cavernous hemangioma of the ovary. PMID:14613693

  8. Ovarian cavernous hemangioma in an 8-year-old girl.

    Science.gov (United States)

    Mirilas, P; Georgiou, G; Zevgolis, G

    1999-04-01

    The case of an ovarian cavernous hemangioma with torsion in an 8-year-old girl is described. Current literature records less than 50 cases of which only 8 are in children. The presenting symptoms of acute abdomen and the ultrasonographic study led to the preoperative diagnosis of torsion of an ovarian tumor. Salpingo-oophorectomy and appendicectomy were performed with an uneventful postoperative course. The histological pattern of the tumor was that of an entirely cavernous hemangioma. The case is reported in view of its rarity. PMID:10342121

  9. Morphological and functional aspects of progenitors perturbed in cortical malformations

    Directory of Open Access Journals (Sweden)

    Sara eBizzotto

    2015-02-01

    Full Text Available In this review, we discuss molecular and cellular mechanisms important for the function of neuronal progenitors during development, revealed by their perturbation in different cortical malformations. We focus on a class of neuronal progenitors, radial glial cells (RGCs, which are renowned for their unique morphological and behavioural characteristics, constituting a key element during the development of the mammalian cerebral cortex. We describe how the particular morphology of these cells is related to their roles in the orchestration of cortical development and their influence on other progenitor types and post-mitotic neurons. Important for disease mechanisms, we overview what is currently known about RGC cellular components, cytoskeletal mechanisms, signalling pathways and cell cycle characteristics, focusing on how defects lead to abnormal development and cortical malformation phenotypes. The multiple recent entry points from human genetics and animal models are contributing to our understanding of this important cell type. Combining data from phenotypes in the mouse reveals molecules which potentially act in common pathways. Going beyond this, we discuss future directions that may provide new data in this expanding area.

  10. Tuberculoma cerebral Cerebral tuberculoma

    Directory of Open Access Journals (Sweden)

    ELIZABETH CLARA BARROSO

    2002-01-01

    Full Text Available Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa 5-15% das formas extrapulmonares e é reconhecida como de alta letalidade. Apresentação tumoral como a relatada é rara, particularmente em imunocompetentes. Quando tratada, pode ter bom prognóstico e deve entrar sempre no diagnóstico diferencial de massas cerebrais.It is reported a case of a previously healthy man with seizures of sudden onset. A contrast head computerized tomogram (CT showed a right frontoparietal expanding lesion suggesting to be metastatic. No prior disease was found on investigation. The histologic exam of the brain revealed tuberculoma. The seizures were controlled with Hidantoin 300 mg/day and antituberculosis chemotherapy for 18 months. Central nervous system tuberculosis (5-15% of the extrapulmonary forms is highly lethal. The case reported herein is specially rare in immunocompetent patients. It may have good prognosis and should be considered in the differential diagnosis of brain tumours.

  11. Cavernous sinus thrombosis and air embolism following surgery for acoustic neurinoma : a case report.

    Directory of Open Access Journals (Sweden)

    Nadkarni T

    2002-04-01

    Full Text Available A 55 year old male patient was operated on for a massive and vascular acoustic neurinoma in a sitting position. The tumor was completely excised. Post-operatively, the patient developed irritability and clinical features suggestive of contralateral cavernous sinus thrombosis. CT scan showed air within the dural walls of the cavernous sinus on the side of surgery. However, there was no radiological evidence of cavernous sinus thrombosis on the contralateral side. Cavernous sinus thrombosis as a post-surgery complication has not been reported. Air within the dural confines of the cavernous sinus has also not been observed or radiologically recorded in the literature.

  12. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  13. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

    Science.gov (United States)

    Karri, Sudhir Babu; Uppin, Megha S.; Rajesh, A.; Ashish, K.; Bhattacharjee, Suchanda; Rani, Y. Jyotsna; Sahu, B. P.; Saradhi, M Vijaya; Purohit, A. K.; Challa, Sundaram

    2016-01-01

    Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS). Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage. PMID:27114659

  14. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Sudhir Babu Karri

    2016-01-01

    Full Text Available Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs of central nervous system (CNS. Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG, Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36 presented with seizures, whereas AVM patients (8/12 had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.

  15. Valuation of gas stored in salt cavern facilities

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Michael A. [St. Mary' s University, TX (United States); Grant, Floyd H. [Purdue University, IN (United States)

    2008-07-01

    Since natural gas production is relatively inelastic towards demand in the short term, underground storage is used as a buffer against periods of high demand. Of the three most common storage facility types, depleted reservoirs, aquifers and manmade salt caverns, the latter is the most costly to develop. The challenge then is to maximize profits through efficient operation, well-timed injection and withdrawal of gas. The valuation of a commodity in storage is a challenging problem and has been the subject of study for decades. We investigate selected existing valuation approaches and look for ways to leverage salt-cavern-specific physical characteristics for financial advantage. The basis for our valuation is the Black-Scholes model for pricing options. Then, applying Monte-Carlo methods and simulation, we model combinations of characteristics in multi-cavern facilities and their impact on profitability. We describe the theory behind our work and our analytical framework and provide numerical results of our analysis. Our approach offers increased efficiency in salt-cavern gas storage facility operations. (author)

  16. Fat deposition in the cavernous sinus in Cushing disease

    Energy Technology Data Exchange (ETDEWEB)

    Bachow, T.B.; Hesselink, J.R.; Aaron, J.O.; Davis, K.R.; Taveras, J.M.

    1984-10-01

    Fat density in the cavernous sinus on computed tomography (CT) is described in 6 out of 16 (37.5%) patients with Cushing disease. This finding may aid in making a specific diagnosis in patients with a pituitary mass. It was not seen in 30 random CT studies of the sella; however, supra seller fat was incidentally noted in the patient with acromegaly.

  17. Lowering End-cap YE-1 in the CMS cavern

    CERN Multimedia

    2008-01-01

    On Tuesday 22 January, the dance of the CMS end-caps came to an end with the lowering of YE-1, the heaviest of them all. After a spectacular lowering operation lsting ten hours, this mammoth component completed the 100-metre descent and was gently placed on the floor of the CMS cavern to the applause of the many onlookers.

  18. Analysis of SPR salt cavern remedial leach program 2013.

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Paula D.; Gutierrez, Karen A.; Lord, David L.; Rudeen, David Keith

    2013-09-01

    The storage caverns of the US Strategic Petroleum Reserve (SPR) exhibit creep behavior resulting in reduction of storage capacity over time. Maintenance of oil storage capacity requires periodic controlled leaching named remedial leach. The 30 MMB sale in summer 2011 provided space available to facilitate leaching operations. The objective of this report is to present the results and analyses of remedial leach activity at the SPR following the 2011 sale until mid-January 2013. This report focuses on caverns BH101, BH104, WH105 and WH106. Three of the four hanging strings were damaged resulting in deviations from normal leach patterns; however, the deviations did not affect the immediate geomechanical stability of the caverns. Significant leaching occurred in the toes of the caverns likely decreasing the number of available drawdowns until P/D ratio criteria are met. SANSMIC shows good agreement with sonar data and reasonably predicted the location and size of the enhanced leaching region resulting from string breakage.

  19. Sensitivity analysis of influencing parameters in cavern stability

    Institute of Scientific and Technical Information of China (English)

    Abolfazl Abdollahipour; Reza Rahmannejad

    2012-01-01

    In order to analyze the stability of the underground rock structures,knowing the sensitivity of geomechanical parameters is important.To investigate the priority of these geomechanical properties in the stability of cavern,a sensitivity analysis has been performed on a single cavern in various rock mass qualities according to RMR using Phase 2.The stability of cavern has been studied by investigating the side wall deformation.Results showed that most sensitive properties are coefficient of lateral stress and modulus of deformation.Also parameters of Hoek-Brown criterion and σc have no sensitivity when cavern is in a perfect elastic state.But in an elasto-plastic state,parameters of Hoek-Brown criterion and σc affect the deformability; such effect becomes more remarkable with increasing plastic area.Other parameters have different sensitivities concerning rock mass quality (RMR).Results have been used to propose the best set of parameters for study on prediction of sidewall displacement.

  20. Orbital cavernous hemangiomas: ultrasound and magnetic resonance imaging evaluation.

    Science.gov (United States)

    Diamantopoulou, A; Damianidis, Ch; Kyriakou, V; Kotziamani, N; Emmanouilidou, M; Goutsaridou, F; Tsitouridis, I

    2010-03-01

    Cavernous hemangioma is the most common intraorbital lesion in adults. The aim of our study was to evaluate the magnetic resonance imaging (MRI) and ultrasound (US) characteristics of cavernous hemangioma and their role in the differential diagnosis of orbital tumors. Eight patients with orbital cavernous hemangiomas, five women and three men with a mean age of 48 years were examined in a period of six years. All patients underwent MRI examination and four patients were also evaluated by US. In all cases MRI depicted a well-defined intraconal tumor. The lesions were homogeneous, isointense to muscle on T1-weighted sequence and hyperintense to muscle on T2-weighted sequence in six patients. In one patient the mass was isointense on T1WI with heterogeneous signal intensity on T2WI and in one patient the lesion had heterogeneous signal intensity on both T1- and T2-weighted sequences. After intravenous contrast medium administration, the tumors showed initial inhomogeneous enhancement with progressive accumulation of contrast material on delayed images in seven patients and initial homogeneous enhancement in one patient. On ultrasonography, the orbital masses appeared slightly hyperechoic, heterogeneous with small areas of slow blood flow. The analysis of imaging characteristics of a well-defined intraconal lesion in an adult patient with painless progressive proptosis can be highly suggestive of the diagnosis of cavernous hemangioma.

  1. Characterization of Live Birth with Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Carlos Acosta Batista

    2015-06-01

    Full Text Available Background: the congenital malformations constitute the first cause of infantile death in developed countries, as well as the second cause of death in Cuba, in younger children of an elderly year. Objective: characterizing the live birth newborns with congenital malformations at Marianao municipality during the year 2011. Methods: descriptive, cross-section study of 30- live birth with congenital malformations at Marianao municipality in Havana, during the year 2011. Some of analyzed variables were: sex, affected system, congenital malformation, type of malformation, severity, birth weight, gestational age, prenatal diagnosis, family history of congenital malformation, maternal age, among others. Results: the masculine sex was the more affected, with 18 cases that represented the 60 %. The Polydactyl was the malformation further frequent, with 23.3 %, followed by the pre-aural appendix, with 10 %. The 20 % was born pre-term and only in the 10 % of the cases was obtained a positive result in the tests of prenatal diagnosis. Conclusions: the live birth with MC were characterized to be males with isolated MC and less severe, full term, normopeso, without family history of the aforementioned affection and with a negative prenatal diagnosis. The majority of mothers belonged to 20-35's age group years, they suffered from hypertension and during pregnancy, the principal diseases that they presented were the sepsis and anemia.

  2. Numerical Simulations of Leakage from Underground LPG Storage Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Hajime; Pruess, Karsten

    2004-09-01

    To secure a stable supply of petroleum gas, underground storage caverns for liquified petroleum gas (LPG) are commonly used in many countries worldwide. Storing LPG in underground caverns requires that the surrounding rock mass remain saturated with groundwater and that the water pressure be higher than the liquid pressure inside the cavern. In previous studies, gas containment criteria for underground gas storage based on hydraulic gradient and pressure have been discussed, but these studies do not consider the physicochemical characteristics and behavior of LPG such as vaporization and dissolution in groundwater. Therefore, while these studies are very useful for designing storage caverns, they do not provide better understanding of the either the environmental effects of gas contamination or the behavior of vaporized LPG. In this study, we have performed three-phase fluid flow simulations of gas leakage from underground LPG storage caverns, using the multiphase multicomponent nonisothermal simulator TMVOC (Pruess and Battistelli, 2002), which is capable of solving the three-phase nonisothermal flow of water, gas, and a multicomponent mixture of volatile organic chemicals (VOCs) in multidimensional heterogeneous porous media. A two-dimensional cross-sectional model resembling an actual underground LPG facility in Japan was developed, and gas leakage phenomena were simulated for three different permeability models: (1) a homogeneous model, (2) a single-fault model, and (3) a heterogeneous model. In addition, the behavior of stored LPG was studied for the special case of a water curtain suddenly losing its function because of operational problems, or because of long-term effects such as clogging of boreholes. The results of the study indicate the following: (1) The water curtain system is a very powerful means for preventing gas leakage from underground storage facilities. By operating with appropriate pressure and layout, gas containment can be ensured. (2

  3. Fracture and Healing of Rock Salt Related to Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Chan, K.S.; Fossum, A.F.; Munson, D.E.

    1999-03-01

    In recent years, serious investigations of potential extension of the useful life of older caverns or of the use of abandoned caverns for waste disposal have been of interest to the technical community. All of the potential applications depend upon understanding the reamer in which older caverns and sealing systems can fail. Such an understanding will require a more detailed knowledge of the fracture of salt than has been necessary to date. Fortunately, the knowledge of the fracture and healing of salt has made significant advances in the last decade, and is in a position to yield meaningful insights to older cavern behavior. In particular, micromechanical mechanisms of fracture and the concept of a fracture mechanism map have been essential guides, as has the utilization of continuum damage mechanics. The Multimechanism Deformation Coupled Fracture (MDCF) model, which is summarized extensively in this work was developed specifically to treat both the creep and fracture of salt, and was later extended to incorporate the fracture healing process known to occur in rock salt. Fracture in salt is based on the formation and evolution of microfractures, which may take the form of wing tip cracks, either in the body or the boundary of the grain. This type of crack deforms under shear to produce a strain, and furthermore, the opening of the wing cracks produce volume strain or dilatancy. In the presence of a confining pressure, microcrack formation may be suppressed, as is often the case for triaxial compression tests or natural underground stress situations. However, if the confining pressure is insufficient to suppress fracture, then the fractures will evolve with time to give the characteristic tertiary creep response. Two first order kinetics processes, closure of cracks and healing of cracks, control the healing process. Significantly, volume strain produced by microfractures may lead to changes in the permeability of the salt, which can become a major concern in

  4. Advanced Imaging of Chiari 1 Malformations.

    Science.gov (United States)

    Fakhri, Akbar; Shah, Manish N; Goyal, Manu S

    2015-10-01

    Type I Chiari malformations are congenital deformities involving cerebellar tonsillar herniation downward through the foramen magnum. Structurally, greater than 5 mm of tonsillar descent in adults and more than 6 mm in children is consistent with type I Chiari malformations. However, the radiographic severity of the tonsillar descent does not always correlate well with the clinical symptomatology. Advanced imaging can help clinically correlate imaging to symptoms. Specifically, cerebrospinal fluid (CSF) flow abnormalities are seen in patients with type I Chiari malformation. Advanced MRI involving cardiac-gated and phase-contrast MRI affords a view of such CSF flow abnormalities. PMID:26408061

  5. Fungal communities on speleothem surfaces in Kartchner Caverns, Arizona, USA

    Directory of Open Access Journals (Sweden)

    Vaughan Michael J.

    2011-01-01

    Full Text Available Kartchner Caverns, located near Benson, Arizona, USA, is an active carbonate cave that serves as the major attraction for Kartchner Caverns State Park. Low-impact development and maintenance have preserved prediscovery macroscopic cavern features and minimized disturbances to biological communities within the cave.. The goal of this study was to examine fungal diversity in Kartchner Caverns on actively-forming speleothem surfaces. Fifteen formations were sampled from five sites across the cave. Richness was assessed using standard culture-based fungal isolation techniques. A culture-independent analysis using denaturing gradient gel electrophoresis (DGGE was used to assay evidence of community homogeneity across the cave through the separation of 18S rDNA amplicons from speleothem community DNA. The culturing effort recovered 53 distinct morphological taxonomic units (MTUs, corresponding to 43 genetic taxonomic units (GTUs that represented 21 genera. From the observed MTU accumulation curve and the projected total MTU richness curve, it is estimated that 51 percent of the actual MTU richness was recovered. The most commonly isolated fungi belonged to the genera Penicillium, Paecilomyces, Phialophora, and Aspergillus.This culture- based analysis did not reveal significant differences in fungal richness or number of fungi recovered across sites. Cluster analysis using DGGE band profiles did not reveal distinctive groupings of speleothems by sample site. However, canonical correspondence analysis (CCA analysis of culture-independent DGGE profiles showed a significant effect of sampling site and formation type on fungal community structure.Taken together, these results reveal that diverse fungal communities exist on speleothem surfaces in Kartchner Caverns, and that these communities are not uniformly distributed spatially. Analysis of sample saturation indicated that more sampling depth is required to uncover the full scale of mycological richness

  6. Cerebral palsy.

    Science.gov (United States)

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  7. Preliminary technical and legal evaluation of disposing of nonhazardous oil field waste into salt caverns

    Energy Technology Data Exchange (ETDEWEB)

    Veil, J.; Elcock, D.; Raivel, M.; Caudle, D.; Ayers, R.C. Jr.; Grunewald, B.

    1996-06-01

    Caverns can be readily formed in salt formations through solution mining. The caverns may be formed incidentally, as a result of salt recovery, or intentionally to create an underground chamber that can be used for storing hydrocarbon products or compressed air or disposing of wastes. The purpose of this report is to evaluate the feasibility, suitability, and legality of disposing of nonhazardous oil and gas exploration, development, and production wastes (hereafter referred to as oil field wastes, unless otherwise noted) in salt caverns. Chapter 2 provides background information on: types and locations of US subsurface salt deposits; basic solution mining techniques used to create caverns; and ways in which salt caverns are used. Later chapters provide discussion of: federal and state regulatory requirements concerning disposal of oil field waste, including which wastes are considered eligible for cavern disposal; waste streams that are considered to be oil field waste; and an evaluation of technical issues concerning the suitability of using salt caverns for disposing of oil field waste. Separate chapters present: types of oil field wastes suitable for cavern disposal; cavern design and location; disposal operations; and closure and remediation. This report does not suggest specific numerical limits for such factors or variables as distance to neighboring activities, depths for casings, pressure testing, or size and shape of cavern. The intent is to raise issues and general approaches that will contribute to the growing body of information on this subject.

  8. Human malformations induced by environmental noxae

    International Nuclear Information System (INIS)

    The paper reviews congenital malformations in humans and presents possible causes. 60% of all malformations are a result of environmental and other factors; i.e. not hereditary or caused by a disease of the mother. The teratogenic effects of ionizing radiation, drugs, alcohol, polyvinyl chloride and trichlorophenol are discussed as well as the effect of the mother's working in certain fields, e.g. clinical laboratories or printing offices; in the latter case the teratogenic noxae are still unknown. Efficient research requires centralized storage of all data on children born with malformations and on the mother's health situation during pregnancy, and the legislator is asked to do so while observing the law on data protection. Foundation of a German Institute of Teratology is recommended. In order to intensify research, it is suggested to set up groups or departments for research on malformations in some major paediatric hospitals. (MG)

  9. Malformed frog survey Dahomey NWR - 2001

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Report contains field data sheets assoicated with malformed frog survey on Dahomey NWR in 2001. Work was done in support of regional sampling on refuges for...

  10. Presenting Symptoms of Chiari Type I Malformation

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-06-01

    Full Text Available Clinical and radiographic predictors of neurologic symptoms were investigated in a population-based retrospective study of 51 children identified with Chiari I malformation at the University of California, and Kaiser Department of Radiology, San Francisco.

  11. What Is an Arteriovenous Malformation (AVM)?

    Science.gov (United States)

    ... T. Quiz 5 Things to Know About Stroke What Is an Arteriovenous Malformation (AVM)? Updated:Jun 20, ... About AVMs Symptoms and Bleeding Diagnosis and Treatment What is a brain AVM? Normally, arteries carry blood ...

  12. Vein of Galen Malformation: Outcome after Embolization

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-12-01

    Full Text Available The neurodevelopmental outcome after endovascular treatment of vein of Galen malformation (VOGM in 27 patients seen between 1983 and 2002 was assessed by chart review and parental questionnaires at the University of California, San Francisco.

  13. Ultrasound evaluation of female genital system malformations

    International Nuclear Information System (INIS)

    An anatomical study of uterine malformation has become quite frequent in obstetrics and gynaecology because of the increasing use of corrective surgery. More than 100 cases were reviewed and the authors discuss some examples in order to present all kinds of uterine malformations which can be detected by ultrasound together with hysterosalpingography. A comparison of the diagnostic data obtained with the two methods shows US to be able to solve several cases. Hysterosalpingography is mandatory in famale infertility when there is a need for examining Fallopian tube patency in addition to the morphological characteristics of the uterine cavity. The results obtained with the two methods in the syudy of uterine malformations allow the formulation of a diagnostic protocol concerning the study of infertile women. First of all, US must be performed, in order to exclude some causes of overian infertility and major uterine malformations. Hysterosalpingography should be performed when US does not prove to be totally reliable

  14. [Central nervous system malformations: neurosurgery correlates].

    Science.gov (United States)

    Jiménez-León, Juan C; Betancourt-Fursow, Yaline M; Jiménez-Betancourt, Cristina S

    2013-09-01

    Congenital malformations of the central nervous system are related to alterations in neural tube formation, including most of the neurosurgical management entities, dysraphism and craniosynostosis; alterations of neuronal proliferation; megalencefaly and microcephaly; abnormal neuronal migration, lissencephaly, pachygyria, schizencephaly, agenesis of the corpus callosum, heterotopia and cortical dysplasia, spinal malformations and spinal dysraphism. We expose the classification of different central nervous system malformations that can be corrected by surgery in the shortest possible time and involving genesis mechanisms of these injuries getting better studied from neurogenic and neuroembryological fields, this involves connecting innovative knowledge areas where alteration mechanisms in dorsal induction (neural tube) and ventral induction (telencephalization) with the current way of correction, as well as the anomalies of cell proliferation and differentiation of neuronal migration and finally the complex malformations affecting the posterior fossa and current possibilities of correcting them.

  15. Congenital pseudoarthrosis associated with venous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N. [Jordan University Hospital, Radiology Department, P.O. Box 340621, Amman (Jordan); Hamamy, H. [Endocrinology and Genetics, National Center for Diabetes, Amman (Jordan); Al-Hadidi, S. [Jordan University Hospital, Departments of Orthopedics, Amman (Jordan)

    2007-06-15

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  16. Terminal hemimyelocystocele associated with Chiari II malformation

    Directory of Open Access Journals (Sweden)

    Umamaheswara Reddy V.

    2014-06-01

    Full Text Available Terminal myelocystocele (TMC results from failure of embryonic CSF to drain outside the neural tube creating CSF reservoir within a dorsal meningocele. Association of Chiari II malformation with diastematomyelia and myelocystocele is extremely rare. Myelocystoceles do not have neural tissue so they have good prognosis after treatment, however when associated with hydromelia and Chiari malformation they present with neurological deficits. We present details of a 2 year old female who presented to us with this rare anomaly.

  17. Syringomyelia associated with Chiari malformation in children

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Hiroaki; Kitano, Shouhei; Nishikawa, Misao; Yasui, Toshihiro [Osaka City General Hospital (Japan); Fujitani, Ken; Hakuba, Akira; Nakanishi, Naruhiko

    1997-02-01

    Among 28 patients with myelomeningocele (MMC group), the myelomeningocele in all patients was repaired shortly after birth, and a shunt was implanted for the associated hydrocephalus in 18 patients. MRI of the group of 28 indicated 20 were afflicted with Chiari II malformation, and the remaining 8 by Chiari I malformation. Among 8 patients lacking myelomeningocele (non-MMC group), seven demonstrated a large syrinx at the cervical and cervico-thoracic level; only one had a syrinx extending from the cervical level down to the lumbar level. None of these patients had hydrocephalus. Surgical decompression to improve cerebrospinal fluid (CSF) flow at the major cistern improved neurological signs in 7 patients. MRI indicated 4 patients were afflicted with Chiari I malformation, and the remaining 4 with Chiari II malformation. In the MMC group, the initial development of the syrinx at the lumbar level may be the result of a combination of occlusion of the caudal end of the central canal brought about by repair of the myelomeningocele and CSF flow into the hydromyelic cavity via the patent proximal portion of the central canal. In the non-MMC group, the syringomyelia may be considered an early onset type of syringomyelia associated with adult type Chiari malformation because the location of the syrinx was quite similar to that found in adult type Chiari malformation, and decompressive surgery was quite effective. In the non-MMC group, turbulence of the CSF now at the major cistern caused by the herniated cerebellum plays an important role in the enlargement of the syringomyelia. To offer greater appropriate management of pediatric Chiari malformation accompanied by syringomyelia, the malformation should be classified not by degree of the herniated brain tissue but by its association with neural tube defect (myelomeningocele). (K.H.)

  18. Cerebral hypoxia

    Science.gov (United States)

    ... the veins ( deep vein thrombosis ) Lung infections (pneumonia) Malnutrition When to Contact a Medical Professional Cerebral hypoxia ... References Bernat JL. Coma, vegetative state, and brain death. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  19. Capillary malformation--arteriovenous malformation syndrome: review of the literature, proposed diagnostic criteria, and recommendations for management.

    Science.gov (United States)

    Orme, Charisse M; Boyden, Lynn M; Choate, Keith A; Antaya, Richard J; King, Brett A

    2013-01-01

    Capillary malformation-arteriovenous malformation syndrome is an autosomal dominant disorder caused by mutations in the RASA1 gene and characterized by multiple small, round to oval capillary malformations with or without arteriovenous malformations. Ateriovenous malformations occur in up to one-third of patients and may involve the brain and spine. Although making the diagnosis is straightforward in some patients, there are other patients for whom diagnostic criteria may be helpful in their evaluation. Here we review the literature regarding capillary malformation-arteriovenous malformation syndrome, propose diagnostic criteria, and discuss the care of patients with this condition.

  20. Lymphangiosarcoma complicating extensive congenital mixed vascular malformations.

    Science.gov (United States)

    Al Dhaybi, Rola; Agoumi, Mehdi; Powell, Julie; Dubois, Josée; Kokta, Victor

    2010-09-01

    Pediatric hepatic angiosarcoma is a very rare malignant vascular tumor. A few cases have shown pediatric hepatic angiosarcoma occurring on a background of preexisting vascular lesions. We report the case of a newborn girl who presented extensive limbs and upper trunk cutaneous mixed vascular malformations at birth. These malformations were associated with thrombocytopenia. Cutaneous biopsies revealed complex vascular malformations with a significant lymphatic component. Compressive body suit therapy led to regression of the limbs' cutaneous vascular malformations. At the age of 9 months, the patient presented multiple heterogeneous hepatosplenic nodules. Aggressive treatment with prednisone, vincristine, and hepatosplenic embolizations resulted in initial improvement of the hepatosplenic lesions for few months, followed by an increase of the lesions with failure of response to treatment despite adding alpha-interferon-2b to treatment. The patient died at the age of 19 months. The autopsy's pathological examination revealed a hepatic-based angiosarcoma with plurimetastatic dissemination to the spleen, lungs, peritoneum, pleura, mesenteric linings as well as the serosa of the stomach and small intestine. Multiple cutaneous and visceral complex capillaro-lymphatico-venous malformations were also identified. We hypothesize that these multiple extensive mixed vascular malformations were associated with chronic lymphedema which probably predisposed to the development of the angiosarcoma in our patient. PMID:20863270

  1. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  2. Cerebral palsy - resources

    Science.gov (United States)

    Resources - cerebral palsy ... The following organizations are good resources for information on cerebral palsy : National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy. ...

  3. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  4. Sensitivity of storage field performance to geologic and cavern design parameters in salt domes.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L. (Sandia National Laboratories, Albuquerque, NM); Park, Byoung Yoon

    2009-03-01

    A sensitivity study was performed utilizing a three dimensional finite element model to assess allowable cavern field sizes for strategic petroleum reserve salt domes. A potential exists for tensile fracturing and dilatancy damage to salt that can compromise the integrity of a cavern field in situations where high extraction ratios exist. The effects of salt creep rate, depth of salt dome top, dome size, caprock thickness, elastic moduli of caprock and surrounding rock, lateral stress ratio of surrounding rock, cavern size, depth of cavern, and number of caverns are examined numerically. As a result, a correlation table between the parameters and the impact on the performance of storage field was established. In general, slower salt creep rates, deeper depth of salt dome top, larger elastic moduli of caprock and surrounding rock, and a smaller radius of cavern are better for structural performance of the salt dome.

  5. Cluster Headache Secondary to Macroprolactinoma with Ipsilateral Cavernous Sinus Invasion

    Directory of Open Access Journals (Sweden)

    M. J. Levy

    2012-01-01

    Full Text Available We present a 25 year-old man with episodic cluster headache that was refractory to all standard pharmacological prophylactic and abortive treatments. Because of the lack of response, an MRI brain was performed which showed a large pituitary tumour with ipsilateral cavernous sinus invasion. The serum prolactin was significantly elevated at 54,700 miU/L (50–400 confirming a macro-prolactinoma. Within a few days of cabergoline therapy the headache resolved. He continues to be headache free several years after starting the dopamine agonist. This case highlights the importance of imaging the pituitary fossa in patients with refractory cluster headache, It also raises the potential anatomical importance of the cavernous sinus in pituitary-associated headache.

  6. Adult primary retroperitoneal cavernous hemangioma: a case report

    Directory of Open Access Journals (Sweden)

    He Hang

    2012-12-01

    Full Text Available Abstract Primary retroperitoneal cavernous hemangioma (PRCH in an adult is extremely rare. We report on the diagnosis and treatment of a patient with PRCH with subtle clinical features and atypical findings on imaging scans. A 38-year-old man was admitted to hospital with a 5-day history of epigastralgia after alcohol drinking. Using various imaging methods, we found a giant cyst-like retroperitoneal mass compressing the surrounding organs. Surgical resection of the tumor was performed, and the mass was found to be a cavernous hemangioma measuring 90 × 80 × 60 mm, with a thick fibrotic wall and extensive intracystic hemorrhage. Physicians should be aware that PRCH may mimic a cystic neoplasm, and that a large tumor size probably indicates intracystic hemorrhage. Surgical resection is a curative approach for PRCH.

  7. Bilateral Persistent Trigeminal Arteries with Unilateral Trigeminal Artery to Cavernous Sinus Fistula: A Case Report

    OpenAIRE

    Chen, David; Chen, Chi-Jen; Chen, Jiann-Jy; Tseng, Ying-Chi; Hsu, Hui-Ling; Ku, Jan-Wen

    2013-01-01

    A 59-year-old man who denied a history of trauma presented with left pulsatile tinnitus and left orbital swelling for six months. Digital subtraction angiography showed a left persistent trigeminal artery (PTA) with a trigeminal artery to cavernous sinus (trigeminal-cavernous sinus) fistula and a right PTA. Transarterial detachable coil embolization of the left trigeminal-cavernous sinus fistula was performed, and the symptoms subsided. There has been no report of bilateral PTAs with a sponta...

  8. Treatment of Cavernous Sinus Tumors with Linear Accelerator Radiosurgery

    OpenAIRE

    Chang, Steven D; Doty, James R; Martin, David P.; Hancock, Steven L.; Adler, John R.

    1999-01-01

    Since 1989, 79 patients with benign or malignant cavernous sinus tumors, have been treated at Stanford University with linear accelerator (linac) radiosurgery. Radiosurgery has been used as (1) a planned second-stage procedure for residual tumor following surgery, (2) primary treatment for patients whose medical conditions preclude surgery, (3) palliation of malignant lesions, and (4) definitive treatment for small, well-localized, poorly accessible tumors. Mean patient age was 52 years (rang...

  9. Configuration of Fibrous and Adipose Tissues in the Cavernous Sinus

    Science.gov (United States)

    Liang, Liang; Gao, Fei; Xu, Qunyuan; Zhang, Ming

    2014-01-01

    Objective Three-dimensional anatomical appreciation of the matrix of the cavernous sinus is one of the crucial necessities for a better understanding of tissue patterning and various disorders in the sinus. The purpose of this study was to reveal configuration of fibrous and adipose components in the cavernous sinus and their relationship with the cranial nerves and vessels in the sinus and meningeal sinus wall. Materials and Methods Nineteen cadavers (8 females and 11 males; age range, 54–89 years; mean age, 75 years) were prepared as transverse (6 sets), coronal (3 sets) and sagittal (10 sets) plastinated sections that were examined at both macroscopic and microscopic levels. Results Two types of the web-like fibrous networks were identified and localized in the cavernous sinus. A dural trabecular network constituted a skeleton-frame in the sinus and contributed to the sleeves of intracavernous cranial nerves III, IV, V1, V2 and VI. A fine trabecular network, or adipose tissue, was the matrix of the sinus and was mainly distributed along the medial side of the intracavernous cranial nerves, forming a dumbbell-shaped adipose zone in the sinus. Conclusions This study revealed the nature, fine architecture and localization of the fine and dural trabecular networks in the cavernous sinus and their relationship with intracavernous cranial nerves and vessels. The results may be valuable for better understanding of tissue patterning in the cranial base and better evaluation of intracavernous disorders, e.g. the growth direction and extent of intracavernous tumors. PMID:24586578

  10. Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis

    OpenAIRE

    Giacomo Pavesi; Francesco Causin; Alberto Feletti

    2014-01-01

    Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients’ behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of t...

  11. Cavernous Hemangioma of the Rib: A Rare Diagnosis

    Directory of Open Access Journals (Sweden)

    Stavros Gourgiotis

    2010-01-01

    Full Text Available Hemangioma of the rib is an uncommon benign vascular tumour. A case of rib hemangioma in a 29-year-old woman is presented. Chest roentgenogram and computed tomography revealed a mass along the inner surface of the 7th left rib with bone destruction. She underwent resection of the 7th rib. The pathologic diagnosis was cavernous hemangioma. Hemangiomas of the rib are rare tumours but should be kept in mind in the differential diagnosis of rib tumours.

  12. Structural analysis of the West Hackbery No. 6 SPR storage cavern

    Energy Technology Data Exchange (ETDEWEB)

    Benzley, S.E.

    1980-08-01

    Four separate structural analyses of the West Hackberry No. 6 SPR storage cavern are presented. One analysis covers the creep response of the cavern beginning shortly before the time when an accidental fire occurred and proceeding through the cavern recertification pressure test. The second analysis models the surface uplife that is expected during the same pressure test. The third and fourth numerical studies investigate the structural response of West Hackberry No. 6 to slabbing and a rapid pressure drop. All analyses indicate that this cavern should be structurally stable for the conditions assumed.

  13. Bilateral Persistent Trigeminal Arteries with Unilateral Trigeminal Artery to Cavernous Sinus Fistula

    Science.gov (United States)

    Chen, David; Chen, Chi-Jen; Chen, Jiann-Jy; Tseng, Ying-Chi; Hsu, Hui-Ling; Ku, Jan-Wen

    2013-01-01

    Summary A 59-year-old man who denied a history of trauma presented with left pulsatile tinnitus and left orbital swelling for six months. Digital subtraction angiography showed a left persistent trigeminal artery (PTA) with a trigeminal artery to cavernous sinus (trigeminal-cavernous sinus) fistula and a right PTA. Transarterial detachable coil embolization of the left trigeminal-cavernous sinus fistula was performed, and the symptoms subsided. There has been no report of bilateral PTAs with a spontaneous fistula connected from one PTA to the ipsilateral cavernous sinus. This paper reports such a rare circumstance. PMID:24070083

  14. Bilateral persistent trigeminal arteries with unilateral trigeminal artery to cavernous sinus fistula. A case report.

    Science.gov (United States)

    Chen, David; Chen, Chi-Jen; Chen, Jiann-Jy; Tseng, Ying-Chi; Hsu, Hui-Ling; Ku, Jan-Wen

    2013-09-01

    A 59-year-old man who denied a history of trauma presented with left pulsatile tinnitus and left orbital swelling for six months. Digital subtraction angiography showed a left persistent trigeminal artery (PTA) with a trigeminal artery to cavernous sinus (trigeminal-cavernous sinus) fistula and a right PTA. Transarterial detachable coil embolization of the left trigeminal-cavernous sinus fistula was performed, and the symptoms subsided. There has been no report of bilateral PTAs with a spontaneous fistula connected from one PTA to the ipsilateral cavernous sinus. This paper reports such a rare circumstance. PMID:24070083

  15. The role of Tc-99m RBC scintigraphy in the differential diagnosis of orbital cavernous hemangioma.

    Science.gov (United States)

    Sayit, E; Durak, I; Capakaya, G; Yilmaz, M; Durak, H

    2001-04-01

    The cavernous hemangioma is the most common benign orbital tumor in adults. Its presentation is during the forth to fifth decades with a slowly progressive unilateral proptosis. Intraconal cavernous hemangiomas may be difficult to differentiate from other intraconal lesions such as schwannomas, meningiomas and hemangiopericytomas. We report a case of orbital cavernous hemangioma diagnosed by Tc-99m RBC scintigraphy. Tc-99m RBC scintigraphy revealed a typical scintigraphic pattern in which there is intense focally increased uptake on the delayed image. We conclude that Tc-99m RBC scintigraphy can be a useful method in the differential diagnosis of orbital cavernous hemangioma as in hepatic hemangioma. PMID:11448074

  16. Construction of cavern-type gas storage reservoirs and the related problems

    Energy Technology Data Exchange (ETDEWEB)

    Sames, P.

    1980-09-01

    Analysis of the operation of an aquiferous cavern-type gas storage reservoir that uses water pressure to maintain a constant gas pressure in the cavern shows the inadequacy of this method. Because of the large amount of storage gas absorbed by the sealing water and the gas's later desorption in the exit-waterline running from the cavern to the holding tank, this arrangement cannot perform its intended function. The cavern is also threatened by the danger of blowout during the injection cycle.

  17. Outcome of LINAC radiosurgery for a cavernous angioma

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Se Mie; Chie, Eui Kyu; Kim, Il Han; Ha, Sung Whan; Park, Charn Il [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Park, Suk Won [College of Medicine, Halym Univ., Seoul (Korea, Republic of)

    2003-03-01

    To establish the role of stereotactic radiosurgery using a linear accelerator for the treatment of patients with cavernous angioma. Between February 1995 and May 1997, 11 patients with cavernous angioma were treated with stereotactic radiosurgery using a linear accelerator. Diagnoses were based on the magnetic resonance imaging in 8 patients, and the histological in 3. The vascular lesions were located in the brainstem (5 cases), cerebellum (2 cases) thalamus (1 case) and cerebrum (3 cases), The clinical presentation at onset included previous intracerebral hemorrhages (9 cases) and seizures (2 cases). All patients were treated with a linac-based radiosurgery. The median dose of radiation delivered was 16 Gy ranging from 14 to 24 Gy, which was typically prescribed to the 80% isodose surface (range 50-80%), corresponding to the periphery of the lesion with a single isocenter. Ten patients were followed-up. The median follow-up was 49 months ranging from 8 to 73 months, during which time two patients developed an intracerebral hemorrhage, 1 at 8 months, with the other at 64 months post radiosurgery. One patient developed neurological deficit after radiosurgery, and two developed an edema on the T2 weighted images of the MRI surrounding the radiosurgical target. The use of stereotactic radiosurgery in the treatment of a cavernous angioma may be effective in the prevention of rebleeding, and can be safely delivered. However, a longer follow-up period will be required.

  18. Role of radiosurgery in the management of cavernous sinus meningiomas

    International Nuclear Information System (INIS)

    Objective - To provide our early experience and philosophy in the utility of radiosurgery in the management of cavernous sinus meningiomas. Methods - Twenty-five consecutive cases with cavernous sinus meningiomas treated between 1990 and 1995 were reviewed. Three cases were treated with gamma-knife radiosurgery, 15 with preceding surgery and gamma knife, 7 with surgery. Mean follow-up following radiosurgery and surgery were 34.8 and 25.4 months, respectively. Results - The 5-year actuarial tumor control rate following radiosurgery was 85.7% and tumor remission rate was 61.4%. Permanent neurological deterioration after radiosurgery was seen in 1 case (5.9%), whereas newly developed or worsened neurological deficits permanently persisted in 59.1% of patients after surgery. There was a clear correlation between surgical radiocality and postoperative morbidity rate. Conclusions - Gamma-knife radiosurgery is a valuable addition to surgical removal in the treatment of cavernous sinus meningiomas. Combination of non-radical resection and subsequent radiosurgery in recommended to improve treatment-associated morbidity. (au)

  19. Gas hydrates in gas storage caverns; Gashydrate bei der Gaskavernenspeicherung

    Energy Technology Data Exchange (ETDEWEB)

    Groenefeld, P. [Kavernen Bau- und Betriebs-GmbH, Hannover (Germany)

    1997-12-31

    Given appropriate pressure and temperature conditions the storage of natural gas in salt caverns can lead to the formation of gas hydrates in the producing well or aboveground operating facilities. This is attributable to the stored gas becoming more or less saturated with water vapour. The present contribution describes the humidity, pressure, and temperature conditions conducive to gas hydrate formation. It also deals with the reduction of the gas removal capacity resulting from gas hydrate formation, and possible measures for preventing hydrate formation such as injection of glycol, the reduction of water vapour absorption from the cavern sump, and dewatering of the cavern sump. (MSK) [Deutsch] Bei der Speicherung von Erdgas in Salzkavernen kann es unter entsprechenden Druck- und Temperaturverhaeltnissen zur Gashydratbildung in den Foerdersonden oder obertaegigen Betriebseinrichtungen kommen, weil sich das eingelagerte Gas mehr oder weniger mit Wasserdampf aufsaettigt. Im Folgenden werden die Feuchtigkeits-, Druck- und Temperaturbedingungen, die zur Hydratbildung fuehren erlaeutert. Ebenso werden die Verringerung der Auslagerungskapazitaet durch die Hydratbildung, Massnahmen zur Verhinderung der Hydratbildung wie die Injektion von Glykol, die Verringerung der Wasserdampfaufnahme aus dem Kavernensumpf und die Entwaesserung der Kavernensumpfs selbst beschrieben.

  20. Carotid Cavernous Fistula Associated with Persistent Trigeminal Artery

    Science.gov (United States)

    Hurst, Robert W.; Howard, Robert S.; Zager, Eric

    1998-01-01

    Carotid-cavernous fistula (CCF) associated with persistent trigeminal artery (PTA) is a rare but important clinical entity. We present a case treated by microcoil embolization with preservation of internal carotid, PTA, and hasilar artery flow following embolization. A 62-year-old female developed pulsatile tinnitus followed by left eye proptosis and diplopia. Examination revealed a cranial nerve VI palsy and an objective bruit over the left orbit. Angiographic evaluation revealed a carotid cavernous fistula originating from a persistent trigeminal artery. Placement of a detachable balloon across the fistula site while preserving the PTA proved impossible, and the fistula was treated with microcoils following placement of a microcatheter across the fistula into the cavernous sinus. Complete closure of the fistula was followed by resolution of the patient's symptoms. Preservation of all major vessels including the PTA was accomplished through the use of coil embolization. Careful evaluation of the angiogram is necessary to identify PTA associated with a CCF. Previous reports have described treatment of CCF with PTA by surgical or balloon ocolusion, some involving sacrifice of the PTA. Examination of the relevant embryology and anatomy reveals, however, that occlusion of the PTA must be approached with caution due to potential supply to the posterior circulation. ImagesFigure 1 PMID:17171071

  1. Bryan Mound SPR cavern 113 remedial leach stage 1 analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Rudeen, David Keith [GRAM, Inc., Albuquerque, NM; Weber, Paula D.; Lord, David L.

    2013-08-01

    The U.S. Strategic Petroleum Reserve implemented the first stage of a leach plan in 2011-2012 to expand storage volume in the existing Bryan Mound 113 cavern from a starting volume of 7.4 million barrels (MMB) to its design volume of 11.2 MMB. The first stage was terminated several months earlier than expected in August, 2012, as the upper section of the leach zone expanded outward more quickly than design. The oil-brine interface was then re-positioned with the intent to resume leaching in the second stage configuration. This report evaluates the as-built configuration of the cavern at the end of the first stage, and recommends changes to the second stage plan in order to accommodate for the variance between the first stage plan and the as-built cavern. SANSMIC leach code simulations are presented and compared with sonar surveys in order to aid in the analysis and offer projections of likely outcomes from the revised plan for the second stage leach.

  2. THE ANALYSIS OF FORENSIC PATHOLOGY OF CEREBROVAS CULAR MALFORMATIONS CAUSING SUDDEN DEATH%脑血管畸形致猝死的法医病理分析

    Institute of Scientific and Technical Information of China (English)

    刘萨日娜; 苏丽娟; 贾富全; 武彦

    2012-01-01

    Objective: We aim to study the forensic pathological characteristics of sudden death caused by cerebral vascular malformation. Methods: We analyzed 39 cases of cerebral vascular malformation. The samples were collected from Inner Mongolia Medical College between 1998 and 2010. Results:34 cases were young men in our samples(91. 89% ). Thus young men were the major people died of the lesion. Fight and wound was the main remote cause of the lesion. 24 cases (61. 54% ) belonged to this situation. Vascular rupture and bleeding was the most death cause of subjected people. Arteriovenous malformation was the most common pathological type of cerebral vascular malformation. The malformation type occupied 92.30% ( 36cases ). Cerebral vascular malformation often occurred in brain bottom, subarachnoid, lateral ventricles, cerebellum and brain stem. The subarachnoid was the most bleeding position which wasl6cases(41. 00% ). Conclusion:The identification of cerebral vascular malformation was very difficult. It was probably to make the objective,comprehensive and accurate identification conclusions combining forensic pathological characteristics with other examinations ( MRI, cerebral angiography and so on).%目的:探讨脑血管畸形致猝死的法医病理学特点.方法:对1998 ~2010年间内蒙古医学院法医学教研室39例脑血管畸形案例进行分析.结果:脑血管畸形猝死以青壮年男性为主,有34例(占91.9%),斗殴外伤为明显诱因,有24例(61.54%),破裂出血是主要死因.脑血管畸形的病理类型以脑动静脉畸形最为常见,有36例(92.3%),常发生于脑底部、蛛网膜下腔、侧脑室、小脑及脑干.出血类型以蛛网膜下腔出血最为常见,有16例(41%).结论:脑血管畸形的鉴定比较困难,根据其法医病理学特点,结合其他检查方法(如头部MRI,脑血管造影),才能做出客观、全面、准确的鉴定结论.

  3. Recurrence of a paediatric arteriovenous malformation 9 years postcomplete excision: case report and review of literature.

    LENUS (Irish Health Repository)

    McCarthy, Claire

    2012-01-01

    Cerebral arteriovenous malformations (AVMs) are a common congenital vascular anomaly, which often present in both children and adults. Surgery is considered curative once postoperative angiography confirms the absence of vessels. We describe a 6-year-old girl, who had a Spetzler-Martin Grade II AVM resected successfully, in which a recurrent AVM was detected on routine follow-up over 9 years post excision. The aetiopathogenesis of this rare occurrence with a review of literature is discussed. Long-term postoperative follow-up in the form of MRI\\/MR angiogram is recommended for all fully resected AVMs in the paediatric age group, anticipating the possibility of future recurrence.

  4. Ethanol sclerotherapy of peripheral venous malformations

    International Nuclear Information System (INIS)

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur

  5. Spectrum of urorectal septum malformation sequence.

    Science.gov (United States)

    Shah, Krupa; Nayak, Shalini S; Shukla, Anju; Girisha, Katta M

    2016-05-01

    Urorectal septum malformation sequence (URSMS) is a rare spectrum of malformations involving various organ systems. Here, we present eight cases of URSMS, noted in autopsy, with different degrees of complexity, seven being the complete type and one being the partial type. All cases had gastrointestinal tract malformation in the form of the imperforate anus and indeterminate genitalia. Other gastrointestinal tract anomalies were anal agenesis in two cases, anorectal agenesis in two cases, and malformed lower intestinal tract in four cases. The associated renal abnormality was noted in five cases, which were unilateral renal agenesis, dysplastic kidney, hydronephrosis, horseshoe kidney, and unilateral hypoplastic ectopic kidney. External genital malformation, present in both male and female fetuses, included a knob-like structure at perineum in female fetuses, genital fold hypoplasia and penile aplasia or hypoplasia in male fetuses. Skeletal abnormalities included two cases of sacral agenesis and one case of lumbosacral dysraphism. Other anomalies included a case with alobar holoprosencephaly, truncus arteriosus with hypoplastic lungs in one case, and three cases with abdominal wall defects. It is our attempt to delineate a spectrum of abnormalities associated with URSMS. PMID:26663027

  6. Ethanol sclerotherapy of peripheral venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, U. E-mail: rimonu@sheba.health.gov.il; Garniek, A.; Galili, Y.; Golan, G.; Bensaid, P.; Morag, B

    2004-12-01

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur.

  7. Tuberculoma cerebral

    OpenAIRE

    BARROSO ELIZABETH CLARA; OLIVEIRA TÂNIA REGINA BRÍGIDO DE; AMARAL ANA MARIA DANTAS DO; PINHEIRO VALÉRIA GÓES FERREIRA; SOUSA ANA LÚCIA DE OLIVEIRA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  8. Interventional treatment of pulmonary arteriovenous malformations

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette Drøhse

    2010-01-01

    Pulmonary arteriovenous malformations (PAVM) are congenital vascular communications in the lungs. They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered. These patients are typically hypoxaemic with exercise intolerance and are at high...... risk of paradoxical emboli to the brain and other organs. These malformations are most commonly seen in hereditary haemorrhagic telangiectasia (HHT) (Mb. Osler-Weber-Rendu syndrome). Nowadays, the generally accepted treatment strategy of first choice is embolization of the afferent arteries...... the functional level. Embolization is a well-established method of treating PAVM, with a significant effect on oxygenation of the blood. Screening for PAVM in patients at risk is recommended, especially in patients with HHT....

  9. Imaging of head and neck venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Flis, Christine M.; Connor, Stephen E. [King' s College Hospital, Neuroradiology Department, London (United Kingdom)

    2005-10-01

    Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team. (orig.)

  10. Cirurgia estereotáxica guiada para angiomas cavernosos Stereotactic-guided surgery for cavernous angioma

    Directory of Open Access Journals (Sweden)

    MURILO S. MENESES

    2000-03-01

    Full Text Available Os angiomas cavernosos intracerebrais são lesões que podem causar hemorragias, crises convulsivas e déficits neurológicos. Essa patologia passou a ter diagnóstico mais precoce com o advento da ressonância magnética. A remoção radical por cirurgia é o melhor método de tratamento. Devido a frequente localização subcortical ou profunda, a utilização de métodos de localização por imagem como a estereotaxia apresentam várias vantagens como: menor incisão de pele, craniotomia e manipulação do tecido cerebral, consequentemente com menor morbidade. Apresentamos uma série de nove angiomas cavernosos tratados por ressecção cirúrgica radical guiada por estereotaxia. Em todos os casos o diagnóstico foi realizado por ressonância magnética e houve confirmação anátomo-patológica. A média de idade dos pacientes foi 30 anos, variando entre 20 e 54 anos. Como morbidade transitória, um paciente teve uma crise convulsiva no 3° dia pós-operatório e uma paciente apresentou disfasia e hemiparesia no 2° dia pós-operatório, com recuperação total na evolução. No total, a remoção foi radical em todos os casos e os pacientes permanecem sem nenhum déficit neurológico relacionado à cirurgia.Intracerebral cavernous angiomas may cause hemorrhage, epileptic seizures and neurological deficits. The diagnosis of these lesions became easier with the advent of the magnetic resonance image (MRI. Radical resection is the treatment of choice. Due to frequent subcortical or deep location, image-guided techniques, such as stereotactic-guided surgery, offer many advantages as smaller skin incision and craniotomy, less brain manipulation with consequently lower morbidity. We present a series of nine cavernous angiomas treated by stereotactic-guided radical surgical resection. The diagnosis was done by MRI and confirmed by pathologic studies in all cases. Mean age of patients was 30 years old (range 20-54 years. Postoperative morbidity

  11. Feasibility analysis of using abandoned salt caverns for large-scale underground energy storage in China

    International Nuclear Information System (INIS)

    Highlights: • A method is proposed for the evaluation of using an abandoned salt cavern for energy (natural gas) storage. • A feasibility analysis is given of China’s first UGS (Underground Gas Storage) facility using an abandoned salt cavern. • Numerical modeling has been used to investigate mechanical safety of a gas pressurized cavern. • Chinese abandoned salt caverns show good feasibility of being converted to UGSs. • China’s bedded rock salt can meet the requirements for UGS. - Abstract: Rock salt in China is primarily bedded salt, usually composed of many thin salt layers and interlayers (e.g. anhydrite, mudstone, and glauberite). Thus, the feasibility analysis of abandoned salt caverns located in salt beds to be used as Underground Gas Storage (UGS) facilities is full of challenges. In this paper, we introduce the feasibility analysis of China’s first salt cavern gas storage facility using an abandoned salt cavern. The cavern is located in Jintan city, Jiangsu province, China. The mechanical properties and permeability of the bedded salts are obtained by experiments. Based on the results of the analyses, it appears to be quite feasible to convert the abandoned salt caverns of Jintan city to UGS facilities. The stability of the cavern is evaluated by the 3D geomechanical numerical simulations, and the operating parameters are proposed accordingly. Results indicate that the maximum volume shrinkage of the cavern is less than 25% and the maximum deformations are less than 2% of the caverns’ maximum diameters after operating for 20 years. It is recommended that the weighted average internal gas pressure be maintained as 11 MPa to control the extent of the plastic zones to a safe level. Safety factors decrease with operating time, especially those of the interface between rock salt and mudstone layers decrease significantly. Effective strain is generally greater than 2%, and locally is greater than 3% after operating 20 years. The maximum

  12. Geomechanical Analysis and Design Considerations for Thin-Bedded Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Michael S. Bruno

    2005-06-15

    The bedded salt formations located throughout the United States are layered and interspersed with non-salt materials such as anhydrite, shale, dolomite and limestone. The salt layers often contain significant impurities. GRI and DOE have initialized this research proposal in order to increase the gas storage capabilities by providing operators with improved geotechnical design and operating guidelines for thin bedded salt caverns. Terralog has summarized the geologic conditions, pressure conditions, and critical design factors that may lead to: (1) Fracture in heterogeneous materials; (2) Differential deformation and bedding plane slip; (3) Propagation of damage around single and multiple cavern; and (4) Improved design recommendations for single and multiple cavern configurations in various bedded salt environments. The existing caverns within both the Permian Basin Complex and the Michigan and Appalachian Basins are normally found between 300 m to 1,000 m (1,000 ft to 3,300 ft) depth depending on local geology and salt dissolution depth. Currently, active cavern operations are found in the Midland and Anadarko Basins within the Permian Basin Complex and in the Appalachian and Michigan Basins. The Palo Duro and Delaware Basins within the Permian Basin Complex also offer salt cavern development potential. Terralog developed a number of numerical models for caverns located in thin bedded salt. A modified creep viscoplastic model has been developed and implemented in Flac3D to simulate the response of salt at the Permian, Michigan and Appalachian Basins. The formulation of the viscoplastic salt model, which is based on an empirical creep law developed for Waste Isolation Pilot Plant (WIPP) Program, is combined with the Drucker-Prager model to include the formation of damage and failure. The Permian salt lab test data provided by Pfeifle et al. 1983, are used to validate the assumptions made in the material model development. For the actual cavern simulations two

  13. Review of applicable technology: solution mining of caverns in salt domes to serve as repositories for radioactive wastes

    International Nuclear Information System (INIS)

    There is an abundance of salt domes in the Gulf Coastal region. Advances in leaching technology and cavern shape control make it possible to build large caverns with configurations approaching teardrops, cylinders, and spheres. Fenix and Scisson has designed and constructed several dozen caverns in sizes up to three million barrels (16.8 million cubic feet). It is now within current technological bounds to evacuate the brine left in the cavern following construction, dehumidify the cavern atmosphere and supply conditioned cavern ventilation. The state-of-the-art in drilling large diameter holes has advanced to the point that it is now possible to drill 120-in. holes as deep as 6,000 ft and 144-in. holes to lesser depths. Additional research is needed in the area of cavern stability. Cavern shrinkage rates are known to increase with depth because of lower salt strengths at higher pressures and temperatures

  14. Risk assessment of nonhazardous oil-field waste disposal in salt caverns.

    Energy Technology Data Exchange (ETDEWEB)

    Elcock, D.

    1998-03-05

    In 1996, Argonne National Laboratory (ANL) conducted a preliminary technical and legal evaluation of disposing of nonhazardous oil-field wastes (NOW) into salt caverns. Argonne determined that if caverns are sited and designed well, operated carefully, closed properly, and monitored routinely, they could be suitable for disposing of oil-field wastes. On the basis of these findings, Argonne subsequently conducted a preliminary evaluation of the possibility that adverse human health effects (carcinogenic and noncarcinogenic) could result from exposure to contaminants released from the NOW disposed of in domal salt caverns. Steps used in this evaluation included the following: identifying potential contaminants of concern, determining how humans could be exposed to these contaminants, assessing contaminant toxicities, estimating contaminant intakes, and calculating human cancer and noncancer risk estimates. Five postclosure cavern release scenarios were assessed. These were inadvertent cavern intrusion, failure of the cavern seal, failure of the cavern through cracks, failure of the cavern through leaky interbeds, and a partial collapse of the cavern roof. Assuming a single, generic, salt cavern and generic oil-field wastes, potential human health effects associated with constituent hazardous substances (arsenic, benzene, cadmium, and chromium) were assessed under each of these scenarios. Preliminary results provided excess cancer risk and hazard index (referring to noncancer health effects) estimates that were well within the US Environmental Protection Agency (EPA) target range for acceptable exposure risk levels. These results led to the preliminary conclusion that from a human health perspective, salt caverns can provide an acceptable disposal method for nonhazardous oil-field wastes.

  15. Major and minor arterial malformations in patients with cutaneous vascular abnormalities.

    Science.gov (United States)

    Pascual-Castroviejo, Ignacio; Pascual-Pascual, Samuel I; Viaño, Juan; López-Gutierrez, Juan C; Palencia, Rafael

    2010-05-01

    The association of persistent embryonic arteries and the absence of 1 carotid or vertebral arteries with facial or neck hemangioma or vascular malformation have been frequently described. The abnormalities can involve major or minor vessels. Of 22 patients of our series with this neurocutaneous syndrome, 20 had the origin of both anterior cerebral arteries from the same internal carotid artery. Thirteen patients showed absence or hypoplasia of 1 carotid artery and 10 of 1 vertebral artery; 10 showed persistence of the trigeminal artery; 3 had persistent proatlantal artery; 6 showed the absence of the posterior communicating artery; and 4 had hypoplastic posterior cerebral artery. Other less frequent abnormalities were found in 7 patients. Intellectual level of most patients was either borderline or below normal. Abnormalities in the vascularization and perfusion of the frontal lobes may contribute to the borderline or lower mental level of these patients. PMID:19808986

  16. Analysis of cavern and well stability at the West Hackberry SPR site using a full-dome model.

    Energy Technology Data Exchange (ETDEWEB)

    Sobolik, Steven R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-08-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve (SPR) West Hackberry site. The cavern field comprises 22 caverns. Five caverns (6, 7, 8, 9, 11) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 17 caverns (101-117) were leached according to SPR standards in the mid-1980s and have tall cylindrical shapes. The history of the caverns and their shapes are simulated in a three-dimensional geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios corresponding to oil drawdowns using fresh water are also simulated by increasing the volume of the caverns. Cavern pressures are varied in the model to capture operational practices in the field. The results of the finite element model are interpreted to provide information on the current and future status of subsidence, well integrity, and cavern stability. The most significant results in this report are relevant to Cavern 6. The cavern is shaped like a bowl with a large ceiling span and is in close proximity to Cavern 9. The analyses predict tensile stresses at the edge of the ceiling during repressurization of Cavern 6 following workover conditions. During a workover the cavern is at low pressure to service a well. The wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension around the edge of the large ceiling span. With time, these stresses relax to a compressive state because of salt creep. However, the potential for salt fracture and propagation exists, particularly towards Cavern 9. With only 200 feet of salt between the caverns, the operational consequences must be examined if the two caverns become connected. A critical time may be during a workover of Cavern 9 in part because of the operational vulnerabilities, but also because dilatant damage

  17. Papilloedema due to Chiari I malformation.

    Science.gov (United States)

    Zhang, Jason Chao; Bakir, Belal; Lee, Andrew; Yalamanchili, Sushma S

    2011-10-16

    The Chiari I malformation is a congenital abnormality characterised by downward displacement of the cerebellar tonsils through the foramen magnum into the cervical spine. It presents clinically most often in young adult women. Known ocular manifestations linked to Chiari I consist primarily of oculomotor paresis with cranial nerve VI palsy and convergence/divergence abnormalities. Papilloedema is a rare manifestation of Chiari I with a clinical presentation often similar to that of idiopathic intracranial hypertension. To highlight this unusual complication, the authors report a 64-year-old female who developed papilloedema as the only presenting neurological symptom resulting from a Chiari I malformation.

  18. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

    2013-06-15

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  19. Total knee arthroplasty in vascular malformation

    Directory of Open Access Journals (Sweden)

    Harish Bhende

    2015-01-01

    Full Text Available In Klippel–Trenaunay syndrome, vascular malformations are not only in skin and superficial soft tissues but also in deep tissues like muscles bones and joints. It is well documemted that these recurrent intraarticular bleeds can cause early arthritis and joint pain. Performing arthroplasty in such patients is difficult and fraught with complications. We describe such a case where navigated total knee arthroplasty was performed with success to avoid the problems of intra medullary alignment used in the presence of intra medullary vascular malformations. We also suggest certain measures when knee arthroplasty is considered in such patients.

  20. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    International Nuclear Information System (INIS)

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  1. VASCULAR MALFORMATION OF CHEEK: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Faiz

    2015-02-01

    Full Text Available Vascular lesions are among the most common congenital and neonatal abnormalities. Most of the congenital vascular malformations are often misdiagnosed and left untreated. These lesions are the result of an embryonic abnormality of the vascular system. This is a case report of 13 year male patient who came with a chief complaint of swelling on the right side of face since birth. It was diagnosed as vascular malformations of buccal mucosa of right side. It is emphasized that the management of these cases requ ires a multidisciplinary approach. Laser therapy, embolization followed by surgical excision is the favourable treatment modalities.

  2. Cerebral Arteriosclerosis

    Science.gov (United States)

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  3. Features of West Hackberry SPR Caverns and Internal Structure Of the Salt Dome

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell Eugene [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Underground Storage Technology Dept.

    2006-09-01

    The intent of this report is to examine the internal structure of the West Hackberry salt dome utilizing the information from the geometric configuration of the internal cavern surfaces obtained from graphical representations of sonar survey data. In a general sense, the caverns of West Hackberry are remarkable in the symmetry of their shapes. There are only rather moderate deviations from what would be considered an ideal cylindrical solution mining geometry in these caverns. This finding is in marked contrast to the directional solutioning found in the elliptical cross sectioned, sometimes winged, caverns of Big Hill. None of the persistent lineaments prevalent in Big Hill caverns are evident in West Hackberry caverns. Irregularities of the West Hackberry caverns are restricted to preferential solution formed pits and protuberances with moderate dimensions. In fact, the principal characteristic of West Hackberry caverns is the often large sections of smooth and cylindrical cavern wall. Differences in the cavern characteristics between West Hackberry and Big Hill suggest that the former dome is quite homogeneous, while the latter still retains strong remnants of the interbeds of the original bedded Louann salt. One possible explanation is that the source of the two domes, while both from the Louann mother salt, differs. While the source of the Big Hill dome is directly from the mother salt bed, it appears that the West Hackberry arises from a laterally extruded sill of the mother salt. Consequently, the amount of deformation, and hence, mixing of the salt and interbed material in the extruded sill is significantly greater than would be the case for the directly formed diapir. In West Hackberry, remnants of interbeds apparently no longer exist. An important aspect of the construction of the West Hackberry caverns is the evidence of an attempt to use a uniform solutioning construction practice. This uniformity involved the utilization of single well solutioning and

  4. Effect of Pingyangmycin on human venous malformation endothelial cells

    Institute of Scientific and Technical Information of China (English)

    Yi Fang Zhao; Zhi Jun Sun; Yu Lin Jia; Jun Jia; Ya Meng Si; Ji Hong Zhao; Wen Feng Zhang

    2008-01-01

    @@ Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.

  5. Arteriovenous malformation in the cerebellopontine angle presenting as trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Paulo C. Figueiredo

    1989-03-01

    Full Text Available A case of arteriovenous malformation of the left cerebellopontine angle causing symptoms of ipsilateral trigeminal neuralgia is reported. Pain relief followed microsurgical removal of the malformation. The authors review the literature on the subject.

  6. Metachronous occurrence of nonradiation-induced brain cavernous hemangioma and medulloblastoma in a child with neurofibromatosis type I phenotype

    Directory of Open Access Journals (Sweden)

    Luciano L Furlanetti

    2012-01-01

    Full Text Available Cavernous hemangioma (CH is a sporadic vascular malformation occurring either as an autosomal dominant condition or as a well-known complication of radiation exposure. Medulloblastoma is a primitive neuroectodermal tumor common in children and currently treated with surgical resection, chemotherapy, and radiotherapy. Neurofibromatosis is the most common single-gene disorder of the central nervous system. Posterior fossa malignant tumors in the context of neurofibromatosis type I (NF1 are very infrequent. This is the first documented case of an unusual metachronous occurrence of non-radiation-induced CH and medulloblastoma in a child with NF1 phenotype. We report the case of a 13-month-old boy with cafι-au-lait skin lesions associated with NF1-like phenotype who underwent surgical resection of a single CH in the temporal lobe due to recurrent seizures. Four years later he presented with signs of raised intracranial pressure associated with a posterior fossa tumor and hydrocephalus, thus requiring gross total resection of the lesion. Histological analysis revealed a medulloblastoma. After being treated with radiotherapy and chemotherapy, he achieved total remission. Six years later a massive recurrence of the tumor was observed and the child eventually died. The interest in this case lies in the rarity of NF1-like phenotype associated with a non-radiation-induced brain CH and medulloblastoma in a child.

  7. CEREBRAL VENOUS THROMBOSIS AND TURNER SYNDROME: A RARE REPORTED ASSOCIATION.

    Science.gov (United States)

    Guler, A; Alpaydin, S; Bademkiran, F; Sirin, H; Celebisoy, N

    2015-01-01

    Turner Syndrome is the only known viable chromosomal monosomy, characterised by the complete or partial absence of an X chromosome. It's the most common chromosomal abnormality in females. Apart from the well known dysmorphic features of the syndrome, it has been associated with a number of vascular pathologies; mainly involving the cardiovascular, renovascular, peripheral vascular and cerebrovascular system. It seems striking that thromboembolism is not considered as a feature of the syndrome. Most of the thromboembolism cases are related to the arterial vascular system; except for some rare reported portal venous thrombosis cases, peripheral venous thrombosis cases and to the best of our knowledge a single case of cerebral venous thrombosis with Dandy Walker malformation and polymicrogyria. We herein report a cerebral venous thrombosis case with Turner Syndrome. With no other found underlying etiology, we want to highlight that Turner Syndrome, itself, may have a relationship not only with the cerebral arterial vascular system pathologies but also with the cerebral venous thrombosis.

  8. Microcephaly; Correlation between cerebral CT index and developmental quotient

    Energy Technology Data Exchange (ETDEWEB)

    Azuma, Ototaka; Onozaki, Michihiko; Hidano, Fumio; Mizuguchi, Susumu; Kodama, Kimio (Akita Medical Center for Disabled Children, Kawajiri (Japan)); Komatsu, Eiko; Sakemi, Kikuo; Yamashita, Jun; Sawaishi, Ukio

    1991-09-01

    Thirty one children with microcephaly were referred to Akita Medical Center for Disabled Chilren. Of these children, 28 underwent cerebral computed tomography (CT). Cerebral CT indices were examined in relation to developmental quotient and underlying diseases. Mental retardation, cerebral palsy, epilepsy, and congenital malformations were associated with microcephaly. The most common abnormal CT finding was the ventricular-brain ratio (92.9%, 26/28). CT indices, including Evans' index, the caudal nuclei ratio, transverse width of the third ventricle, the ventricular/intracranial area ratio, the brain/intracranial area ratio, the basal cistern ratio, width of the cerebral longitudinal fissure, and integrated brain CT index, were all significantly correlated with developmental quotient. (N.K.).

  9. Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations.

    Science.gov (United States)

    Mitsuhashi, Yutaka; Hayasaki, Koji; Kawakami, Taichiro; Nagata, Takashi; Kaneshiro, Yuta; Umaba, Ryoko; Ohata, Kenji

    2016-06-15

    The cavernous sinus (CS) is one of the cranial dural venous sinuses. It differs from other dural sinuses due to its many afferent and efferent venous connections with adjacent structures. It is important to know well about its complex venous anatomy to conduct safe and effective endovascular interventions for the CS. Thus, we reviewed previous literatures concerning the morphological and functional venous anatomy and the embryology of the CS. The CS is a complex of venous channels from embryologically different origins. These venous channels have more or less retained their distinct original roles of venous drainage, even after alterations through the embryological developmental process, and can be categorized into three longitudinal venous axes based on their topological and functional features. Venous channels medial to the internal carotid artery "medial venous axis" carry venous drainage from the skull base, chondrocranium and the hypophysis, with no direct participation in cerebral drainage. Venous channels lateral to the cranial nerves "lateral venous axis" are exclusively for cerebral venous drainage. Venous channels between the internal carotid artery and cranial nerves "intermediate venous axis" contribute to all the venous drainage from adjacent structures, directly from the orbit and membranous skull, indirectly through medial and lateral venous axes from the chondrocranium, the hypophysis, and the brain. This concept of longitudinal venous axes in the CS may be useful during endovascular interventions for the CS considering our better understandings of its functions in venous drainage. PMID:27063146

  10. Combined Lymphedema and Capillary Malformation of the Lower Extremity

    OpenAIRE

    Maclellan, Reid A.; Chaudry, Gulraiz; Greene, Arin K.

    2016-01-01

    Background: Primary lymphedema and capillary malformation are independent vascular malformations that can cause overgrowth of the lower extremity. We report a series of patients who had both types of malformations affecting the same leg. The condition is unique but may be confused with other types of vascular malformation overgrowth conditions (eg, Klippel–Trenaunay and Parkes Weber). Methods: Our Vascular Anomalies Center and Lymphedema Program databases were searched for patients with both ...

  11. [Lymphatic malformations in the head and neck area].

    Science.gov (United States)

    Wiegand, S; Werner, J A

    2016-02-01

    Lymphatic malformations are congenital malformations of the lymphatic system. They are mainly located in the head and neck area, and grow proportional to the patients' body growth. Depending on the morphology, it can be distinguished between macrocystic, microcystic and mixed lymphatic malformations. Due to their infiltrative growth, microcystic lymphatic malformations are particularly difficult to treat. Therapeutic approaches include conventional surgical resection, laser therapy, sclerotherapy and systemic drug therapies. PMID:26820157

  12. Clinical presentations and MRI findings of angiographically occult vascular malformations

    International Nuclear Information System (INIS)

    Various clinical features as well as MRI findings of AOVM (angiographically occult vascular malformation) were studied. Amongst out patients, since January 1988, there have been 30 cases of symptomatic AOVM (20 males, 10 females) including 4 cases with multiple lesions. The age ranged from 3 to 60 years of age, with a mean of 33.4 years. The locations of symptomatic lesions were in the cerebral hemisphere (15), the thalamus (4), the brain stem (8) and in the cerebellum (3). The initial presentations of these 30 cases were either by hemorrhage (18), convulsive seizure (9) or by progressive neurological deficits (3). The initial presentation was not related to the patient's age and the size of the lesion, but apparently related to the location of AOVM. Most of the lesions in the cerebral hemisphere presented seizures, but all of the lesions in the thalamus, the brain stem and the cerebellum disclosed hemorrhage as an initial presentation. In fact it was noticed that brain stem lesions tend to cause repetitive hemorrhage in a relatively short period. AOVM lesions were clearly visualized with T2-weighted MRI images, consisting of high intensity cores with surrounding low intensity rims. Most of the symptomatic lesions were partially enhanced by Gd-DTPA with varied intensity. Dynamic changes in size and enhancement pattern on MRI were occasionally seen, usually accompanied with episodes such as hemorrhage or neurological deterioration. Although AOVMs were angiographically negative some strands indicating draining veins were observed on MRI in several cases. In contrast, none of the nonsymptomatic lesions (22 lesions) demonstrated enhancement effects with Gd-DTPA. (author)

  13. A STUDY OF POSTERIOR FOSSA MALFORMATIONS: MR IMAGING

    Directory of Open Access Journals (Sweden)

    Ravi

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: The aim of our study is to describe the imaging findings of various posterior fossa malformations and to evaluate the supratentorial abnormalities associated with posterior fossa malformations. MATERIALS AND METHODS: MR images of 30 patients wi th posterior fossa malformations detected in the department of Radiodiagnosis, BMCRI over a period of two years, from December 2012 to December 2014 were evaluated retrospectively. The various posterior fossa malformations were evaluated. Associated suprat entorial abnormalities were noted. RESULTS: 30 patients with posterior fossa malformations were included in the study. The age group of patients ranged from 1year to 53years. There were 18 males and 12 females. The various posterior fossa malformations det ected were Dandy Walker malformation (1 case, Dandy Walker variant (2 cases, mega cisterna magna (8 cases, arachnoid cysts (5 cases, Chiari 1 malformation (5 cases, Chairi 2 malformation (2 cases, Joubert malformation (1 case, lipoma (2 cases, verm ian and/or cerebellar hypoplasia without posterior fossa CSF collection or cyst (4 cases. Associated supratentorial abnormalities were seen in 8 cases . CONCLUSION: MRI is the imaging modality of choice in the evaluation of posterior fossa malformations. I t is very important to know the imaging findings of these malformations and to have knowledge about the various supratentorial and spinal abnormalities associated with them so as to provide an accurate diagnosis which is very essential for predicting the p rognosis and planning further management.

  14. [Successful treatment using detachable coils for traumatic carotid cavernous fistula as a complication of transsphenoidal surgery for a pituitary adenoma: a case report].

    Science.gov (United States)

    Kobayashi, N; Abe, T; Furuya, H; Dohi, K; Shimazu, M; Sasaki, K; Izumiyama, H; Matsumoto, K; Ohki, S; Nemoto, S

    2000-02-01

    We report a case of a patient with traumatic carotid cavernous fistula (CCF) caused by transnasal-transsphenoidal surgery, who was successfully treated using detachable coils. A 47-year-old man was admitted to our hospital because of severe headache. He was confirmed to have a nonfunctioning pituitary adenoma with presellar-type sphenoid sinus. Cerebral angiography initially disclosed no vascular lesions. A transnasal-transsphenoidal adenomectomy was performed. When the anterior wall of the sphenoid sinus was dissected with a chisel, the chisel deeply stuck into the posterolateral part of the sinus. Profuse arterial bleeding was observed through the sphenoid sinus. The bleeding was stopped easily by compression and packing with bone wax. The operation was continued, the sellar floor was opened widely and the tumor was removed subtotally. The medial wall of the cavernous sinus was intact. Histological examination revealed a pituitary adenoma. Immediately after surgery, the patient noticed a bruit. He developed chemosis and abducent palsy on the right side. Cerebral angiography displayed a high-flow CCF, which was attributed to the carotid artery injury caused by the transnasal-transsphenoidal surgery. The CCF disappeared after two-staged embolization using detachable coils, 1st transvenous and 2nd transarterial. Ten months later, cerebral angiography showed persistent occlusion of the fistula, and the patient experienced no tumor recurrence. It is suggested that drilling is a safer procedure than using a chisel for dissection of a sphenoid sinus with incomplete pneumatization. Endovascular treatment using detachable coils proved useful to manage the CCF, an unusual complication of transsphenoidal surgery.

  15. Risk assessment of nonhazardous oil-field waste disposal in salt caverns.

    Energy Technology Data Exchange (ETDEWEB)

    Elcock, D.

    1998-03-10

    Salt caverns can be formed in underground salt formations incidentally as a result of mining or intentionally to create underground chambers for product storage or waste disposal. For more than 50 years, salt caverns have been used to store hydrocarbon products. Recently, concerns over the costs and environmental effects of land disposal and incineration have sparked interest in using salt caverns for waste disposal. Countries using or considering using salt caverns for waste disposal include Canada (oil-production wastes), Mexico (purged sulfates from salt evaporators), Germany (contaminated soils and ashes), the United Kingdom (organic residues), and the Netherlands (brine purification wastes). In the US, industry and the regulatory community are pursuing the use of salt caverns for disposal of oil-field wastes. In 1988, the US Environmental Protection Agency (EPA) issued a regulatory determination exempting wastes generated during oil and gas exploration and production (oil-field wastes) from federal hazardous waste regulations--even though such wastes may contain hazardous constituents. At the same time, EPA urged states to tighten their oil-field waste management regulations. The resulting restrictions have generated industry interest in the use of salt caverns for potentially economical and environmentally safe oil-field waste disposal. Before the practice can be implemented commercially, however, regulators need assurance that disposing of oil-field wastes in salt caverns is technically and legally feasible and that potential health effects associated with the practice are acceptable. In 1996, Argonne National Laboratory (ANL) conducted a preliminary technical and legal evaluation of disposing of nonhazardous oil-field wastes (NOW) into salt caverns. It investigated regulatory issues; the types of oil-field wastes suitable for cavern disposal; cavern design and location considerations; and disposal operations, closure and remediation issues. It determined

  16. Idiopathic hepatic arterial malformation: a case report

    Institute of Scientific and Technical Information of China (English)

    郑蔚巍; 周康荣; 王佩芬; 陈祖望

    2003-01-01

    @@ Hepatic arterial malformation is a rare disorder which either origi nates idiopathically or may be associated with hereditary hemorrhagic telangiect asia (also known as Osler-Weber-Rendu disease). Although previous reports presented only descriptions of sonographic and angiographic findings,1-6 we present a case of splenic infarct caused by this disorder with CT and CTA findi ngs.

  17. Fetal MRI clues to diagnose cloacal malformations

    Energy Technology Data Exchange (ETDEWEB)

    Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Patel, Manish N.; Kraus, Steven [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Levitt, Marc A.; Pena, Alberto [Cincinnati Children' s Hospital Medical Center, Colorectal Center for Children, Pediatric Surgery, Cincinnati, OH (United States); Lim, Foong-Yen; Crombleholme, Timothy M. [Cincinnati Children' s Hospital Medical Center, Fetal Care Center of Cincinnati, Pediatric Surgery, Cincinnati, OH (United States); Linam, Leann E. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States)

    2011-09-15

    Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis. To define the prenatal MRI findings in cloacal malformations. We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses. The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos. Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified. (orig.)

  18. Congenital spinal malformations; Kongenitale spinale Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Ertl-Wagner, B.B.; Reiser, M.F. [Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie

    2001-12-01

    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.) [German] Kongenitale spinale Malformationen stellen eine komplexe Gruppe an Stoerungen dar, deren Genese sich am einfachsten aus der Embryologie heraus erklaeren laesst. Bei der klinisch-radiologischen Begutachtung ist zunaechst ihre korrekte Klassifikation im Rahmen der Erstdiagnose wichtig. Im weiteren Verlauf ist es jedoch zudem entscheidend, moegliche Komplikationen wie beispielsweise eine Hydromyelie oder ein Wiederanheften des Myelons nach Operation einer Spina bifida aperta zu erkennen. Zudem sollte bei der Diagnosestellung einer kongenitalen spinalen Malformation immer auch auf assoziierte Fehlbildungen, wie z.B. die Diastematomyelie oder das intraspinale Lipom bei der Spina bifida aperta, sowie auf eine moegliche syndromale Einordnung wie beispielsweise beim OEIS-oder VACTERL-Syndrom geachtet werden. (orig.)

  19. Spontaneous pneumothorax in cystic adenomatoid malformation

    International Nuclear Information System (INIS)

    Spontaneous pneumothorax as the initial manifestation of cystic adenomatoid malformation of the lung is rare. Only four cases have been reported in the English literature. We add one more case, and review the clinical and roentgenographic findings. All the patients presented later in infancy or childhood and the cyst type appear to belong to Madewell's dominant cyst type. (orig.)

  20. Spontaneous pneumothorax in cystic adenomatoid malformation

    Energy Technology Data Exchange (ETDEWEB)

    Gaisie, G.; Sang Oh, K.

    1983-07-01

    Spontaneous pneumothorax as the initial manifestation of cystic adenomatoid malformation of the lung is rare. Only four cases have been reported in the English literature. We add one more case, and review the clinical and roentgenographic findings. All the patients presented later in infancy or childhood and the cyst type appear to belong to Madewell's dominant cyst type.

  1. New concepts on posterior fossa malformations

    Energy Technology Data Exchange (ETDEWEB)

    Jaspan, Tim [Imaging Centre, University Hospital, Nottingham (United Kingdom)

    2008-06-15

    A full description of the embryology of the posterior fossa (PF) is beyond the scope of this review; several recent publications are recommended. Specific aspects of the processes involved are, however, reviewed as a background to malformations that involve defects or errors occurring at critical stages during the embryogenesis of the PF structures. (orig.)

  2. [A woman with a rare vascular malformation

    NARCIS (Netherlands)

    Koning, G.G.; Vries, M. de

    2015-01-01

    A 30-year-old woman with trisomy 8 syndrome and coagulopathy was diagnosed with a malformation of the vena cava superior. This is a rare anatomical variation, which originates from a non-development of Marshall's ligament during the 8th week of gestation (prevalence: 0.3%).

  3. Sex and congenital malformations: An international perspective

    NARCIS (Netherlands)

    Lisi, A.; Botto, L.D.; Rittler, M.; Castilla, E.; Botting, B.; De Walle, H.; Erickson, J.D.; Gatt, M.; De Vigan, C.; Irgens, L.; Johnson, W.; Lancaster, P.; Merlob, P.; Mutchinick, O.M.; Ritvanen, A.; Robert, 28033; Scarano, G.; Stoll, C.; Mastroiacovo, P.

    2005-01-01

    The study evaluated the sex distribution of major isolated malformations and common trisomies among a large and geographically varied sample. Eighteen registries from 24 countries contributed cases, which were centrally reviewed and classified in three clinical types as isolated, associated, or synd

  4. Communicating bronchopulmonary foregut malformation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Yeol; Goo Hyun Woo; Kim, Hyun Joo; Choi, Soo Jung; Cho, Yong Soo; Lee, Jean Hwa; Yoon, Chong Hyun; Lim, Tae Hwan [Asan Medical Center, College of Medicine, University of Ulsan, Seoul (Korea, Republic of)

    2000-07-01

    Communicating bronchopulmonary foregut malformations are rare tracheobronchial anomalies characterized by a fistula between an isolated portion of respiratory tissue and the esophagus or stomach. We describe a case of CBFM in which chest radiography revealed total haziness in the right lung field. The diagnosis was confirmed by esophagography. (author)

  5. Communicating bronchopulmonary foregut malformation: a case report

    International Nuclear Information System (INIS)

    Communicating bronchopulmonary foregut malformations are rare tracheobronchial anomalies characterized by a fistula between an isolated portion of respiratory tissue and the esophagus or stomach. We describe a case of CBFM in which chest radiography revealed total haziness in the right lung field. The diagnosis was confirmed by esophagography. (author)

  6. Lymphatic malformations: a proposed management algorithm.

    LENUS (Irish Health Repository)

    Oosthuizen, J C

    2012-02-01

    OBJECTIVE: The aim of this study was to develop a management algorithm for cervicofacial lymphatic malformations, based on the authors\\' experience in managing these lesions as well as current literature on the subject. STUDY DESIGN AND METHODS: A retrospective medical record review of all the patients treated for lymphatic malformations at our institution during a 10-year period (1998-2008) was performed. DATA COLLECTED: age at diagnosis, location and type of lesion, radiologic investigation performed, presenting symptoms, treatment modality used, complications and results achieved. RESULTS: 14 patients were identified. Eight (57%) male and six (43%) female. There was an equal distribution between the left and right sides. The majority (71%) of cases were diagnosed within the first year of life. The majority of lesions were located in the suprahyoid region. The predominant reason for referral was an asymptomatic mass in 7 cases (50%) followed by airway compromise (36%) and dysphagia (14%). Management options employed included: observation, OK-432 injection, surgical excision and laser therapy. In 5 cases (36%) a combination of these were used. CONCLUSION: Historically surgical excision has been the management option of choice for lymphatic malformations. However due to the morbidity and high complication rate associated this is increasingly being questioned. Recent advances in sclerotherapy e.g. OK-432 injection have also shown significant promise. Based on experience in managing these lesions as well as current literature the authors of this paper have developed an algorithm for the management of cervicofacial lymphatic malformations.

  7. MR findings of congenital anorectal malformation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo Kyung; Kim, Hyae Young; Kwag, Hyon Joo; Chung, Eun Chul; Lee, Jung Sik; Suh, Jeong Soo [Ewha Womens University, medical College, Seoul (Korea, Republic of)

    1995-05-15

    To assess the usefulness of MRI in preoperative diagnosis of congenital anorectal malformation. MR findings of 11 cases with surgically proved anorectal malformations were retrospectively reviewed and compared with operative findings, according to the level of atresia, the development of sphincter muscle, fistula and associated anomalies of other organs. Four of 11 cases were low type of anorectal atresia, 3 cases were intermediate type, and 3 cases were high type. There was one case of Currarino triad with low type of anorectal stenosis. MRI demonstrated the levels of atresia correctly in all cases and revealed fistulas in all high type of anomalies. Degrees of the development of the sphincter muscles were good in all cases of low types and fair in a case of intermediate type and an anorectal stenosis, whereas the development was poor in 2 cases of intermediate type and all 4 cases of high type. The associated anomalies in anorectal malformation were renal agenesis, congenital hip dysplasia and sacral defect with presacral teratoma in Currarino triad. MRI was a simple and useful study to confirm the level of atresia, fistula and associated anomalies in the diagnosis of the congenital anorectal malformation.

  8. Fibrosis of corpus cavernosum in animals following cavernous nerve ablation

    Institute of Scientific and Technical Information of China (English)

    Wan-LiHu; Li-QuanHu; jianSong; Shi-WenLi; Xin-MinZheng; BeiCheng; Bing-ChunTian

    2004-01-01

    t Aim: To investigate alterations of smooth muscle cells and collagen fibers in corpus cavernosum following cavernous neurectomy and its relation to the expression of transforming growth factor-β1 (TGF-β1). Methods: Ten adult male SD rats (neurectomy group) were subject to a bilateral cavernous nerve (CN) resection aseptically under an operating microscope, with 6 sham-operated rats as the control. Fifteen weeks after the operation, the penile specimens were collected and prepared for quantitative-analyzing of ratio of smooth muscle to collagen fibers in corpus cavernosum with confocal microscopy, and for detecting the expression of TGF-β1 by RT-PCR and westernblot.Results: Smooth muscle cells that show red color after fluorescent-labeling with tetramethylrhodamine isothiocyanatephalloidin and collagen fibers that produce green autofluorescence after paraformaldehyde fixation were clearly identified under the confocal microscope. Quantification of fluorescent intensity showed that the ratio of smooth muscle to collagen fibers in corpus cavernosum in neurectomy group was 0.265± 0.125, which was significantly lower than that in sham-operated group (0.760±0.196, P<0.01). RT-PCR and western-blot analyses revealed a significantlyhigher expression of TGF-β1 in the penile tissues of the neurectomy animals than that in sham-operated group.Conclusion: Bilateral ablation of CN can lead to fibrosis of corpus cavernosum, which may be related to an increased expression of TGF-β1 induced by hypoxia in cavernous tissue after denervation.

  9. Specific recognition of arteriovenous malformations using xenon-133 RCBF technique

    International Nuclear Information System (INIS)

    With respect to the methodology of the atraumatic xenon-133 technique the problem whether or not the proposed and introduced arterial artifact (AA) truely represents radiation from intravascular volume and to what extent it affects regional cerebral blood flow (rCBF) calculation is unresolved. We performed rCBF measurements in 22 patients with angiomas to clarify this issue in those patients known to have pathologically enlarged intracranial vessels. P4 - the parameter suggested to represent the AA - as well as the conventional blood flow parameter for gray matter (F1) were compared to those of 50 volunteers using four criteria of abnormality: 1. Intrahemispheric distribution, 2. interhemispheric differences of homologous detector pairs, 3 differences of mean hemispheric values, 4. visual evaluation of CBF maps. 19 of the 22 patients with angioma fulfilled at least two of the four criteria of abnormality, in comparison to 1 of 50 volunteers. P 4's sensitivity for detecting angiomas proved to be higher (86%) than the perfusion parameters of gray matter. Focal increase of P4 proved to be highly specific for the presence of arteriovenous malformation (AVM, specifity 98%). A true arterial artifact exists in most instances in the presence of an AVM. Disregarding AA in the algorithm for calculation rCBF leads to an artificial overestimation of tissue flow in the region of the AVM

  10. Congenital frontonasal masses: developmental anatomy, malformations, and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hedlund, Gary [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States)

    2006-07-15

    The newborn, infant, or young child who presents with a midline frontonasal mass often poses a diagnostic challenge to the clinician. The most pressing issue is whether the mass extends intracranially. The development of the frontonasal region or anterior neuropore is complex. Aberrant embryogenesis leads to three main types of anomalies: nasal dermal sinus, anterior cephalocele, and nasal glioma. Understanding the developmental anatomy of the anterior neuropore and postnatal maturation will serve the radiologist well when it comes to imaging frontonasal masses. Pitfalls particularly common to CT imaging interpretation include the evolving ossification of the frontal, nasal and ethmoid bones in the first year of life, morphology and size of the foramen cecum, and the natural intumescence of the anterior nasal septum. Determination of the presence of a connection between the frontonasal mass and the anterior cranial fossae is crucial in the imaging assessment and clinical management. In the case of the nasal dermal sinus, failure to appreciate the intracranial components of the malformation can lead to fatal meningitis. MR imaging is the modality of choice for assessing the pediatric frontonasal region. Its advantages include multiplanar imaging, distinguishing the interface among cartilage, bone, brain and fluid, diffusion imaging to detect epidermoid tumors, and the capacity to evaluate the brain for associated cerebral anomalies. (orig.)

  11. Phosphorus magnetic resonance spectroscopy in malformations of cortical development

    Directory of Open Access Journals (Sweden)

    Celi Santos Andrade

    2013-07-01

    Full Text Available Introduction Malformations of cortical development (MCD result from disruptions in the dynamic process of cerebral corticogenesis and are important causes of epilepsy, motor deficits and cognitive impairment. Objectives The aim of this study was to evaluate phospholipids metabolism in vivo in a series of patients with epilepsy and MCD. Methods Thirty-seven patients with MCD and 31 control subjects were studied using three-dimensional phosphorus magnetic resonance spectroscopy (31P-MRS at a 3.0 T scanner. Quantification methods were applied to the following resonances: phosphoethanolamine (PE, phosphocholine (PC, glycerophosphoethanolamine (GPE, glycerophosphocholine (GPC, inorganic phosphate (Pi, phosphocreatine (PCr, and a-, b-, and g-adenosine triphosphate (ATP. The magnesium (Mg2+ levels and pH were calculated based on PCr, Pi and b-ATP chemical shifts. Results Compared to controls, the MCD lesions exhibited lower pH values and higher Mg2+ levels (p<0.05. The lesions also presented significant reduction of GPC and PDE, and an increased PME/PDE ratio. The otherwise normal appearing parenchyma also demonstrated lower pH values in the frontoparietal cortex and bilateral centrum semiovale. Conclusions Our data support the idea that metabolic impairments occur in the lesions of MCD, with propagation to remote normal appearing parenchyma. The results also suggest that there are membrane turnover disturbances in MCD lesions.

  12. Gamma Knife radiosurgery for the treatment of cavernous sinus hemangiomas

    OpenAIRE

    Xu, Qingsheng; Shen, Jian; Feng, Yiping; ZHAN, Renya

    2015-01-01

    The present retrospective study aimed to analyze the outcome of patients with cavernous sinus hemangioma (CSH) treated with Gamma Knife radiosurgery (GKS). Between August 2011 and April 2014, 7 patients with CSHs underwent GKS. GKS was performed as the sole treatment option in 5 patients, whilst partial resection had been performed previously in 1 patient and biopsy had been performed in 1 patient. The mean volume of the tumors at the time of GKS was 12.5±10.2 cm3 (range, 5.3–33.2 cm3), and t...

  13. Cavernous Angioma of the Corpus Callosum Presenting with Acute Psychosis

    Directory of Open Access Journals (Sweden)

    Giacomo Pavesi

    2014-01-01

    Full Text Available Psychiatric symptoms may occasionally be related to anatomic alterations of brain structures. Particularly, corpus callosum lesions seem to play a role in the change of patients’ behavior. We present a case of a sudden psychotic attack presumably due to a hemorrhagic cavernous angioma of the corpus callosum, which was surgically removed with complete resolution of symptoms. Although a developmental defect like agenesis or lipoma is present in the majority of these cases, a growing lesion of the corpus callosum can rarely be the primary cause. Since it is potentially possible to cure these patients, clinicians should be aware of this association.

  14. Congenital vascular malformations in scintigraphic evaluation

    International Nuclear Information System (INIS)

    Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression

  15. Virus-induced congenital malformations in cattle.

    Science.gov (United States)

    Agerholm, Jørgen S; Hewicker-Trautwein, Marion; Peperkamp, Klaas; Windsor, Peter A

    2015-01-01

    Diagnosing the cause of bovine congenital malformations (BCMs) is challenging for bovine veterinary practitioners and laboratory diagnosticians as many known as well as a large number of not-yet reported syndromes exist. Foetal infection with certain viruses, including bovine virus diarrhea virus (BVDV), Schmallenberg virus (SBV), blue tongue virus (BTV), Akabane virus (AKAV), or Aino virus (AV), is associated with a range of congenital malformations. It is tempting for veterinary practitioners to diagnose such infections based only on the morphology of the defective offspring. However, diagnosing a virus as a cause of BCMs usually requires laboratory examination and even in such cases, interpretation of findings may be challenging due to lack of experience regarding genetic defects causing similar lesions, even in cases where virus or congenital antibodies are present. Intrauterine infection of the foetus during the susceptible periods of development, i.e. around gestation days 60-180, by BVDV, SBV, BTV, AKAV and AV may cause malformations in the central nervous system, especially in the brain. Brain lesions typically consist of hydranencephaly, porencephaly, hydrocephalus and cerebellar hypoplasia, which in case of SBV, AKAV and AV infections may be associated by malformation of the axial and appendicular skeleton, e.g. arthrogryposis multiplex congenita. Doming of the calvarium is present in some, but not all, cases. None of these lesions are pathognomonic so diagnosing a viral cause based on gross lesions is uncertain. Several genetic defects share morphology with virus induced congenital malformations, so expert advice should be sought when BCMs are encountered. PMID:26399846

  16. The clinical significance of cerebral microbleed and its diagnostic criteria

    International Nuclear Information System (INIS)

    Cerebral microbleed (CMB) on gradient-echo T2*-weighted MR imaging (T2*-w MR imaging) is associated with microangiopathy. Number of CMBs and new appeared CMBs are markers for stroke recurrence and the performance state. After CMB was reviewed in this manuscript, criterion for CMB is proposed as below. Only microbleed associated with microangiopathies related to primary intracerebral hemorrhage or lacunar infarction is diagnosed as CMB. A low intensity (round or oval shape, 2*-w MR imaging defined as a CMB. Exception: Micro-bleedings associated with trauma (cerebral concussion), brain tumor, cavernous angioma, or moyamoya disease are excluded. Calcifications or vascular flow voids were excluded by CT or other MR imagings. Reference: CMB is rarely correlated to a focal neurological sign. CMB is associated with risk factors including hypertension, diabetes mellitus, or high age. CMB is very rare in patients less than 40 years old. (author)

  17. Comparative study of sclerotherapy of venous malformation in children using absolute ethanol and pingyangmycin

    International Nuclear Information System (INIS)

    Objective: To evaluate and compare the curative effect and the safety of sclerotherapy of venous malformation in children using absolute ethanol and pingyangmycin. Methods: Eighty children with venous malformation were treated by sclerotherapy with absolute ethanol or pingyangmycin under general anesthesia during February of 2009 to May of 2011. Diagnostic criteria included the presence of a blue-colored lesion at birth, with gradual increase in its size associated with a positive postural test. MRI showed characteristic imaging features. Eighty patients were divided into two groups by randomization. Forty patients were treated with absolute ethanol, and the remaining 40 patients with pingyangmycin. The therapeutic effects and side effects were observed and recorded during a follow-up period of 6 to 24 months (average 15 months). Treatment results were divided into four categories: cure, basic cure, effective, and ineffective, and the former three categories were considered effective in treatment. Chi-square test was used to compare the rate of effective treatment and rate of complications in these two groups. Results: The effective patients treated with absolute ethanol was 38 (95.0%, 38/40), and the effective patients with pingyangmycin was 26 (65.0%, 26/40), χ2 test (χ2=11.25, P<0.01) difference was statistically significant. Eight patients developed skin necrosis; 4 patients serious local swelling, 2 patients muscle fibrosis, 1 patient cerebral embolism in the absolute alcohol group. Two patients developed postoperative fever and vomiting and 2 skin necrosis in the pingyangmycin group,the difference was statistically significant (χ2=12.29, P<0.01). Conclusions: Sclerotherapy is effective for the treatment of venous malformations in children. Absolute ethanol is more effective, but associated with more complications, such as skin necrosis or as serious as cerebral embolism, than pingyangmycin. (authors)

  18. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  19. [Brainstem auditory evoked potentials and somatosensory evoked potentials in Chiari malformation].

    Science.gov (United States)

    Moncho, Dulce; Poca, María A; Minoves, Teresa; Ferré, Alejandro; Rahnama, Kimia; Sahuquillo, Juan

    2013-06-16

    Introduccion. La malformacion de Chiari (MC) incluye una serie de anomalias congenitas que tienen como comun denominador la ectopia de las amigdalas del cerebelo por debajo del foramen magno, lo que puede condicionar fenomenos compresivos del troncoencefalo, la medula espinal alta y los nervios craneales, alterando las respuestas de los potenciales evocados auditivos del tronco cerebral (PEATC) y de los potenciales evocados somatosensoriales (PESS). Sin embargo, las indicaciones de ambas exploraciones en las MC han sido motivo de estudio en un numero limitado de publicaciones, centradas en series cortas y heterogeneas de pacientes. Objetivo. Revisar los hallazgos de los PEATC y los PESS en los estudios publicados en pacientes con MC tipo 1 (MC-1) o tipo 2 (MC-2), y su indicacion en el diagnostico, tratamiento y seguimiento, especialmente en la MC-1. Desarrollo. Es un estudio de revision realizado mediante analisis de los estudios publicados en Medline desde 1966, localizados mediante PubMed, utilizando combinaciones de las palabras clave 'Chiari malformation', 'Arnold-Chiari malformation', 'Chiari type 1 malformation', 'Arnold-Chiari type 1 malformation', 'evoked potentials', 'brainstem auditory evoked potentials' y 'somatosensory evoked potentials', asi como informacion de pacientes con MC-1 valorados en los servicios de neurocirugia y neurofisiologia clinica del Hospital Universitari Vall d'Hebron. Conclusiones. Los hallazgos mas comunes de los PESS son la reduccion en la amplitud cortical para el nervio tibial posterior, la reduccion o ausencia del potencial cervical del nervio mediano y el aumento del intervalo N13-N20. En el caso de los PEATC, los hallazgos mas frecuentes descritos son el aumento del intervalo I-V y la alteracion periferica o coclear.

  20. Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma

    Institute of Scientific and Technical Information of China (English)

    Yan Cui; Hong-Wen Zhang; Li-Yan Zhou; Man-Ku Dong; Ping Wang; Min Ji; Xiao-Ou Li; Chang-Wei Chen; Zi-Pei Liu; Yong-Jie Xu

    2003-01-01

    AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH.

  1. Nitrogen Monitoring of West Hackberry 117 Cavern Wells.

    Energy Technology Data Exchange (ETDEWEB)

    Bettin, Giorgia; Lord, David

    2015-02-01

    U.S. Strategic Petroleum Reserve (SPR) oil storage cavern West Hackberry 117 was tested under extended nitrogen monitoring following a successful mechanical integrity test in order to validate a newly developed hydrostatic column model to be used to differentiate between normal "tight" well behavior and small-leak behavior under nitrogen. High resolution wireline pressure and temperature data were collected during the test period and used in conjunction with the hydrostatic column model to predict the nitrogen/oil interface and the pressure along the entire fluid column from the bradenhead flange nominally at ground surface to bottom of brine pool. Results here and for other SPR caverns have shown that wells under long term nitrogen monitoring do not necessarily pressurize with a relative rate (P N2 /P brine) of 1. The theoretical relative pressure rate depends on the well configuration, pressure and the location of the nitrogen-oil interface and varies from well to well. For the case of WH117 the predicted rates were 0.73 for well A and 0.92 for well B. The measured relative pressurization rate for well B was consistent with the model prediction, while well A rate was found to be between 0.58-0.68. A number of possible reasons for the discrepancy between the model and measured rates of well A are possible. These include modeling inaccuracy, measurement inaccuracy or the possibility of the presence of a very small leak (below the latest calculated minimum detectable leak rate).

  2. A rare case of Chiari type-1 malformation accompanied by symptomatic cerebrospinal fluid hypovolemia: comparison of congenital Chiari type-1 malformation and acquired Chiari malformation secondary to cerebrospinal fluid hypovolemia: case report.

    Science.gov (United States)

    Hatae, Ryusuke; Kohri, Ryusuke; Maeda, Kazushi; Miyazono, Masayuki

    2014-01-01

    A 23-year-old woman was injured in a rear-end collision. She had general malaise and posterior neck pain, which were more severe when she was in an upright position. Magnetic resonance imaging (MRI) revealed the presence of cerebellar tonsil descensus and syringomyelia in the spinal cord. Radioisotope (RI) cisternography showed signs of an early accumulation of RI in the bladder, and a delayed accumulation of RI in the cerebral fornix. We considered the possibilities of cerebrospinal fluid (CSF) hypovolemia and congenital Chiari type-1 malformation as being responsible for her headache. To obtain a definitive diagnosis, we performed gadolinium (Gd)-enhanced MR cisternography and found evidence of CSF leakage. We performed an epidural blood patch (EBP), and her symptoms resolved. In 2 years since the episode, her symptoms have not recurred, and additional treatment has not been required. In addition, MRI performed 2 years after the EBP did not reveal any changes. There seems no previous report which described successful differentiation of pre-existing congenital Chiari type-1 malformation from the acquired one caused by symptomatic CSF hypovolemia. Because treatment protocols differ between these two conditions, the establishment of a correct diagnosis is important.

  3. [Familial syndrome combining short small intestine, intestinal malrotation, pyloric hypertrophy and brain malformation. 3 anatomoclinical case reports].

    Science.gov (United States)

    Nezelof, C; Jaubert, F; Lyon, G

    1976-01-01

    Anatomoclinical study of 3 cases of an exceptional malformative condition characterized by: --extreme shortness of the small intestine, --mesenterium commune, --hypertrophic pylorus, --malformation of the central nervous system (heterotopia, absence of operculum temporale). Clinically this malformative condition is characterized by failure and inertia of the intestinal peristalsis producing at intervals of 10-15 days episodes of subocclusion, the repetition of which causes death. The syndrome is familial and seems to be of autosomal recessive inheritance. The absence of mechanical obstruction, the repeated failure of colostomy and ileostomy, the normal aspect of the myenteric plexuses verified by cytoenzymatic and silver stains allow to individualize this anatomoclinical syndrome and to rule out the hypothesis of Hirschsprung's disease, Chagas' disease, idiopathic megacolon or hypoplasia of the myenteric plexuses. The association of cerebral malformations leads to consider the responsibility of a lack of synthesis of a same specific intermediate factor which is up to now poorly determined, implicated in the neuronal migration and neuromuscular transmission. PMID:1023783

  4. A NOVEL PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LNG

    Energy Technology Data Exchange (ETDEWEB)

    Michael M. McCall; William M. Bishop; Marcus Krekel; James F. Davis; D. Braxton Scherz

    2005-05-31

    This cooperative research project validates use of man made salt caverns to receive and store the cargoes of LNG ships in lieu of large liquid LNG tanks. Salt caverns will not tolerate direct injection of LNG because it is a cryogenic liquid, too cold for contact with salt. This research confirmed the technical processes and the economic benefits of pressuring the LNG up to dense phase, warming it to salt compatible temperatures and then directly injecting the dense phase gas into salt caverns for storage. The use of salt caverns to store natural gas sourced from LNG imports, particularly when located offshore, provides a highly secure, large scale and lower cost import facility as an alternative to tank based LNG import terminals. This design can unload a ship in the same time as unloading at a tank based terminal. The Strategic Petroleum Reserve uses man made salt caverns to securely store large quantities of crude oil. Similarly, this project describes a novel application of salt cavern gas storage technologies used for the first time in conjunction with LNG receiving. The energy industry uses man made salt caverns to store an array of gases and liquids but has never used man made salt caverns directly in the importation of LNG. This project has adapted and expanded the field of salt cavern storage technology and combined it with novel equipment and processes to accommodate LNG importation. The salt cavern based LNG receiving terminal described in the project can be located onshore or offshore, but the focus of the design and cost estimates has been on an offshore location, away from congested channels and ports. The salt cavern based terminal can provide large volumes of gas storage, high deliverability from storage, and is simplified in operation compared to tank based LNG terminals. Phase I of this project included mathematical modeling that proved a salt cavern based receiving terminal could be built at lower capital cost, and would have significantly higher

  5. Literature Survey Concerning the Feasibility of Remedial Leach for Select Phase I Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Paula D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Flores, Karen A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lord, David L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-09-01

    Bryan Mound 5 ( BM5 ) and West Hackberry 9 ( WH9 ) have the potential to create a significant amount of new storage space should the caverns be deemed "leach - ready". This study discusses the original drilling history of the caverns, surrounding geology, current stability, and, based on this culmination of data, makes a preliminary assessment of the leach potential for the cavern. The risks associated with leaching BM5 present substantial problems for the SPR . The odd shape and large amount of insoluble material make it difficult to de termine whether a targeted leach would have the desired effect and create useable ullage or further distort the shape with preferential leaching . T he likelihood of salt falls and damaged or severed casing string is significant . In addition, a targeted le ach would require the relocation of approximately 27 MMB of oil . Due to the abundance of unknown factors associated with this cavern, a targeted leach of BM5 is not recommended. A targeted leaching of the neck of WH 9 could potentially eliminate or diminis h the mid - cavern ledge result ing in a more stable cavern with a more favorable shape. A better understanding of the composition of the surrounding salt and a less complicated leaching history yields more confidence in the ability to successfully leach this region. A targeted leach of WH9 can be recommended upon the completion of a full leach plan with consideration of the impacts upon nearby caverns .

  6. [Plea for a unifying concept of the cavernous sinus and the trigeminal cavity].

    Science.gov (United States)

    Bataille, B; Sakka, M; Lapierre, F

    The object of this study is a scientific research in human and compared anatomy of the cavernous sinus and Meckel's cave. The observations made in the foetus and human adult are compared to these made in non human primates and domestic mammals, the cavernous sinus and the Meckel's cave contribute to realize a entirety that we call "a morphological and functional anatomical system". The human cavernous sinus and Meckel's cave are described as an indissociable parasellar space representing a heavy traffic area for vascular and nervous structures. In the human and non human primates, the authors observe a parasellar space which agreed with the concept of "trigeminal-cavernous anatomical system". In the cat, the same observations are made and an osseous outline closing the roof of the parasellar space is observed; this is the evidence of a more ancient osseous or cartilaginous wall. The authors demonstrate in the last part of this study that the morphogenesis of this trigeminal-cavernous system is in relation with the phylogenic development of its morphological and functional environment, that we call the "externation". This study is of interest: to a best understanding of the tumors involving the cavernous sinus, to a semantic point of view: an attempt to a review of the terminology applied to the cavernous sinus and Meckel's cave. PMID:7729219

  7. Computerized tomographic studies in cerebral palsy

    International Nuclear Information System (INIS)

    Computed tomographic (CT) findings in 200 children with cerebral palsy (CP) were analysed from the viewpoint of clinical manifestations, disease complications and etiological factors. CT scans of 135 cases (67.5%) were found to be abnormal and there were 14 (7%) borderline cases. The major abnormality found on CT scans was cerebral atrophy. Other important changes included focal or diffuse low density area in the brain tissue, congenital malformation, and cerebellar atrophy. From the clinical point of view, a large number of patients with spastic tetraplegia and spastic diplegia showed highly abnormal CT scans. On the other hand, in patients with spastic monoplegia, spastic paraplegia, and athetotic type, CT findings were normal or revealed only minor cerebral atrophy. Most children showing asymmetric clinical symptoms had corresponding asymmetric CT abnormalities which included ventricular enlargement, low density area in the brain tissue, and hemispherical volume. There was a significant correlation between the severity of physical impairment and the extent of CT abnormalities. Severely affected children had grossly abnormal CT scans such as hydranencephaly, polycystic change, and extensive cerebral atrophy. In the patients complicated with epilepsy, the incidence and severity of abnormal CT were higher than those of non-epileptic patients. Mentally retarded patients had variable enlargement of the subarachnoidal space depending on the severity of their mental retardation. Patients with suspected postnatal etiology also had high incidence of severe CT abnormality. CT scan is a valuable tool for evaluating patients with CP and in some cases, possible etiology of the disease may be discovered. (author)

  8. Combined spinal intramedullary arteriovenous malformation and lipomyelomeningocele

    Energy Technology Data Exchange (ETDEWEB)

    Weon, Y.C.; Roh, H.G.; Byun, H.S. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Seoul (Korea); Chung, J.I. [Medimoa Hospital, Department of Radiology, Seoul (Korea); Eoh, W. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea)

    2005-10-01

    Combined spinal arteriovenous malformation and lipomyelomeningocele are extremely rare. We present a rare combined case of a lipomyelomeningocele with an intramedullary arteriovenous malformation (AVM) occurred at the L3-L4 level in a 30-year-old man who suffered from low back pain radiating to the lower extremities, dysuria, and frequency for 5 years. The MR studies showed an intradural mass with high-signal intensity on both T1-weighted and T2-weighted images, intermingled with multiple signal-void structures. The mass extended extradurally toward a subcutaneously forming fatty mass on the patient's back. Spinal angiography showed an AVM supplied by the radiculopial branches of the lumbar arteries and drained by tortuous, dilated, perimedullary veins. Endovascular embolization and surgical resection were performed. (orig.)

  9. Arteriovenous Malformation Detected by Small Bowel Endoscopy

    Directory of Open Access Journals (Sweden)

    Takaaki Fujii

    2014-10-01

    Full Text Available Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine.

  10. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  11. Management of arteriovenous malformations: A surgical perspective

    Directory of Open Access Journals (Sweden)

    Nakaji Peter

    2005-01-01

    Full Text Available The management strategies for arteriovenous malformations (AVMs continue to evolve, spurred by advancing technology and improved understanding of the natural history of these lesions. In general, intervention is reserved for Spetzler-Martin Grade I-III lesions or for those with certain high-risk features. Grade IV-V AVMs, in contrast, are usually managed conservatively. Although multimodality therapy incorporating endovascular and/or radiosurgical techniques is increasingly common, microsurgical removal remains the definitive form of treatment.

  12. Clinical Outcome Measures in Chiari I Malformation.

    Science.gov (United States)

    Yarbrough, Chester K; Greenberg, Jacob K; Park, Tae Sung

    2015-10-01

    Chiari malformation type 1 (CM-I) is a common and often debilitating neurologic disease. Reliable evaluation of treatments has been hampered by inconsistent use of clinical outcome measures. A variety of outcome measurement tools are available, although few have been validated in CM-I. The recent development of the Chicago Chiari Outcome Scale and the Chiari Symptom Profile provides CM-I-specific instruments to measure outcomes in adults and children, although validation and refinement may be necessary.

  13. Vascular malformations of the mandible (intraosseous haemangiomas)

    Energy Technology Data Exchange (ETDEWEB)

    Guibert-Tranier, F.; Piton, J.; Caille, J.M.; Riche, M.C.; Merland, J.J.

    1982-11-01

    Haemangiomas of the mandible are relatively rare arteriovenous malformations: 85 cases have been described since 1849. The severe risk of bleeding during tooth extraction or biopsy led us to describe the radiological and angiographic features of this condition. The afferent vessles are the inferior dental, the lingual and the facial arteries. Preoperative embolization reduces the risk of bleeding at operation. Surgical treatment must assure the complete removal of the lesion. Radiotherapy and vascular ligatures are useless and dangerous.

  14. Vascular malformations of the mandible (intraosseous haemangiomas)

    International Nuclear Information System (INIS)

    Haemangiomas of the mandible are relatively rare arteriovenous malformations: 85 cases have been described since 1849. The severe risk of bleeding during tooth extraction or biopsy led us to describe the radiological and angiographic features of this condition. The afferent vessles are the inferior dental, the lingual and the facial arteries. Preoperative embolization reduces the risk of bleeding at operation. Surgical treatment must assure the complete removal of the lesion. Radiotherapy and vascular ligatures are useless and dangerous. (orig.)

  15. Chiari I malformation: classification and management.

    Science.gov (United States)

    Bindal, A K; Dunsker, S B; Tew, J M

    1995-12-01

    Considerable debate exists about which surgical options are best for the management of the Chiari I malformation. We present a classification system for the Chiari I malformation that improves the prediction of outcome and guides the selection of surgical treatment. Twenty-seven adult patients with Chiari I malformations were grouped on the basis of the presence of signs and symptoms of brain stem compression, syringomyelia, or both. To objectively assess changes in clinical status postoperatively, a scale was developed to quantify the signs and symptoms, which were statistically analyzed by the paired t test. Five patients were asymptomatic and underwent no treatment. Ten patients had symptoms of brain stem compression without associated syringomyelia and underwent brain stem decompression, including anterior decompression in one patient with basilar invagination; all 10 patients had significant improvement at 4-year mean follow-up visits (P syringomyelia, 5 were symptomatic from syringomyelia only, 6 were symptomatic from both brain stem compression and syringomyelia, and 1 was symptomatic from brain stem compression only. The median length of symptoms before presentation was longer for patients with syringomyelia than for patients without (2 yr versus 9 mo; P syringomyelia, symptoms from brain stem compression dramatically improved with surgical decompression (P syringomyelia less dramatically improved or stabilized. The slight improvement or stabilization of syrinx symptoms represents a successful result, given the documented progressive nature of syringomyelia in this group. We conclude that surgical treatment for the Chiari I malformation can stabilize or slightly improve the symptoms attributed to syringomyelia and dramatically relieve the symptoms of brain stem compression. Furthermore, early diagnosis and treatment are critical in obtaining the best outcome for the patient. PMID:8584146

  16. PET in malformations of cortical development; La tomographie d'emission de positons (TEP) dans les malformations corticales de developpement

    Energy Technology Data Exchange (ETDEWEB)

    Bouilleret, V.; O' Brien, T.J. [Department of medicine, the Royal Melbourne Hospital, Royal Parade, Parkville, 3005 Victoria (Australia); Bouilleret, V. [Unite de neurophysiologie clinique et d' epileptologie, AP-HP, CHU Bicetre, 94275 Paris (France); Bouilleret, V.; Chiron, C. [Service hospitalier Frederic-Joliot, DRM, CEA, 4, place du General-Leclerc, 91401 Orsay cedex (France); Chiron, C. [Inserm U663, AP-HP, hopital Necker, 75015 Paris (France); University Paris-Descartes, 11, rue Pierre-et-Marie-Curie, 75005 Paris (France)

    2009-01-15

    Within the group of malformations of cortical development, focal cortical dysplasia (FCD) are an increasingly recognized cause of intractable epilepsy that can be cured by surgery. The success of cortical resection for intractable epilepsy is highly dependent on the accurate pre-surgical delineation of the regions responsible for generating seizures. [{sup 18}F]-FDG PET, which images cerebral metabolism studying brain glucose uptake, is the most established functional imaging modality in the evaluation of patients with epilepsy. The aim of this article is to review [{sup 18}F]-FDG PET usefulness as a pre-surgical tool in the evaluation of medically refractory partial epilepsy. It has an established place in assisting in the localisation and definition of FCD in patients with no lesion, or only a subtle abnormality, on MRI. The role of FDG-PET in defining the extent of the surgical resection is still uncertain and needs to be the focus of future research. (authors)

  17. Giant Arteriovenous Malformation of the Neck

    Directory of Open Access Journals (Sweden)

    P. A. Dieng

    2015-01-01

    Full Text Available Arteriovenous malformations (AVM have a wide range of clinical presentations. Operative bleeding is one of the most hazardous complications in the surgical management of high-flow vascular malformations. In the cervical region, the presence of vital vascular structures, such as the carotid artery and jugular vein, may increase this risk. This is a case of massive arteriovenous malformation deforming the neck and the face aspect of this aged lady and growing for several years. A giant mass of the left neck occupied the carotid region and the subclavian region. The AVM was developed between the carotid arteries, jugular veins, and vertebral and subclavian vessels, with arterial and venous flux. The patient underwent surgery twice for the cure of that AVM. The first step was the ligation of the external carotid. Seven days later, the excision of the mass was done. In postoperative period the patient presented a peripheral facial paralysis which completely decreased within 10 days. The first ligation of the external carotid reduces significantly the blood flow into the AVM. It permitted secondarily the complete ablation of the AVM without major bleeding even though multiple ligations were done.

  18. Rhombencephalosynapsis – isolated anomaly or complex malformation?

    International Nuclear Information System (INIS)

    Rhombencephalosynapsis (RES) is a rare malformation of the posterior cranial fossa, characterized by fusion of the cerebellar hemispheres, medial cerebellar peduncles and dentate nuclei. Over the period of 7 years 8 cases of this anomaly have been diagnosed in two pediatric centers in Warsaw including one on the prenatal magnetic resonance imaging (MRI). Material consists of involves one fetus examined at the gestational age of 27 and 33 weeks and 7 children (5 girls and 2 boys) aged 8 months – 16 years. All of them underwent brain MRI with the use of 1.5T scanners. In 1 case RES was an isolated anomaly, in 1 case it was accompanied by hydrocephalus only, in the remaining 6 cases RES was an element of a complex malformation. The additional anomalies were as follows: callosal hypoplasia in 3 children, abnormalities of gyration in 2, brainstem hypoplasia in 2, isolated fourth ventricle in 1, abnormal white matter signal intensity in 4 (in 2 cases in supratentorial compartment, in 1 in the cerebellum and in 1 in the pons), abnormally dilated extraaxial fluid collections in 2, syringohydromyelia in 2. In 5 cases RES was total, in 3 – partial. Rhombencephalosynapsis has a very characteristic appearance on magnetic resonance imaging which allows diagnosis of this malformation at any age, including prenatal period

  19. Abortion, premature delivery, stillborn, and malformations

    International Nuclear Information System (INIS)

    Since A-bomb disaster in Hiroshima and Nagasaki, genetic effects of A-bomb radiation have been investigated in the offspring of A-bomb survivors. This paper outlines the results of the previous studies in the context of the historical backgrounds. An earlier survey using a cohort of 71,280 children of Hiroshima and Nagasaki A-bomb survivors and a suitable control population of non-exposed 55,870 persons have dealt with the stillborn, neonate death, 9-month-old infant death, malformations at birth and 9 months after birth, and sex ratio in F1 offspring; it was found that there was no significant difference in these items between the exposed and non-exposed groups. The other survey using fetal and neonatal autopsy cases has revealed that the incidence of malformations was significantly higher in children born to A-bomb survivors than those of the control population (18.5% vs 11.0%); however, there was no evidence of genetic abnormalities specific to the group of A-bomb survivors. Until now, no definitive conclusions of the sex ratio at birth have been drawn. Regarding height in F1 offspring, no significant difference existed between the exposed and non-exposed groups. Nor was there significant difference in malformations in F1 and F2 offspring between the group of A-bomb survivors and the suitable control group. (N.K.)

  20. Malformations of cortical development and neocortical focus.

    Science.gov (United States)

    Luhmann, Heiko J; Kilb, Werner; Clusmann, Hans

    2014-01-01

    Developmental neocortical malformations resulting from abnormal neurogenesis, disturbances in programmed cell death, or neuronal migration disorders may cause a long-term hyperexcitability. Early generated Cajal-Retzius and subplate neurons play important roles in transient cortical circuits, and structural/functional disorders in early cortical development may induce persistent network disturbances and epileptic disorders. In particular, depolarizing GABAergic responses are important for the regulation of neurodevelopmental events, like neurogenesis or migration, while pathophysiological alterations in chloride homeostasis may cause epileptic activity. Although modern imaging techniques may provide an estimate of the structural lesion, the site and extent of the cortical malformation may not correlate with the epileptogenic zone. The neocortical focus may be surrounded by widespread molecular, structural, and functional disturbances, which are difficult to recognize with imaging technologies. However, modern imaging and electrophysiological techniques enable focused hypotheses of the neocortical epileptogenic zone, thus allowing more specific epilepsy surgery. Focal cortical malformation can be successfully removed with minimal rim, close to or even within eloquent cortex with a promising risk-benefit ratio.

  1. Magnetic Resonance Imaging of Malformations of Midbrain-Hindbrain.

    Science.gov (United States)

    Abdel Razek, Ahmed Abdel Khalek; Castillo, Mauricio

    2016-01-01

    We aim to review the magnetic resonance imaging appearance of malformations of midbrain and hindbrain. These can be classified as predominantly cerebellar malformations, combined cerebellar and brain stem malformations, and predominantly brain stem malformations. The diagnostic criteria for the majority of these morphological malformations are based on neuroimaging findings. The predominantly cerebellar malformations include predominantly vermian hypoplasia seen in Dandy-Walker malformation and rhombencephalosynapsis, global cerebellar hypoplasia reported in lissencephaly and microlissencephaly, and unilateral cerebellar hypoplasia seen in PHACES, vanishing cerebellum, and cerebellar cleft. Cerebellar dysplasias are seen in Chudley-McCullough syndrome, associated with LAMA1 mutations and GPR56 mutations; Lhermitte-Duclos disease; and focal cerebellar dysplasias. Cerebellar hyperplasias are seen in megalencephaly-related syndromes and hemimegalencephaly with ipsilateral cerebellomegaly. Cerebellar and brain stem malformations include tubulinopathies, Joubert syndrome, cobblestone malformations, pontocerebellar hypoplasias, and congenital disorders of glycosylation type Ia. Predominantly brain stem malformations include congenital innervation dysgenesis syndrome, pontine tegmental cap dysplasia, diencephalic-mesencephalic junction dysplasia, disconnection syndrome, and pontine clefts.

  2. Detecting cerebral vascular diseases by transcranial Doppler ultrasound and dolor Doppler flow imaging in comparison with digital subtracted angiography%经颅多普勒及彩色多普勒超声与数字减影脑血管造影对脑血管病检测的比较研究

    Institute of Scientific and Technical Information of China (English)

    张小征; 吕健; 李俊; 胡军民; 龚杰; 徐国政; 马廉亭; 陈欣林

    2000-01-01

    目的 评价经颅多普勒(TCD)在脑血管病诊断、疗效评估中的应用价值.方法 应用TCD检测脑血管疾病患者306例,其中脑动静脉畸形170例,颈动脉海绵窦瘘(CCF)69例,颅内动脉瘤67例,并与数字减影脑血管造影(DSA)、彩色多普勒血流显像(CDFI)进行对比研究.结果 以DSA脑血管造影为金指标,TCD检出脑动静脉畸形93%,检出CCF 100%,判断CCF静脉回流方式96%,检出颅内动脉瘤67%.对颅内较大动脉瘤(>1.5 cm)的检测有特征性表现,提出"动脉瘤样频谱"的新概念.结论 TCD能实时、准确反映颅内血流动力学改变及侧支循环代偿情况,对脑血管病诊断、疗效评估有重要价值.%Objective To evaluate the effect of transcranial Doppler(TCD)on detecting cerebral vascular diseases.Methods One hundred and seventy patients with cerebral arterovenous malformation(AVM),69 carotid cavernous fistula (CCF)and 67 intracranial aneurysms were examined early or late by TCD, digital subtracted angiography(DSA)and color Dopplor flow imaging.The results of their examination were compared and analyzed.Results If the results of DSA examination was regarded as a golden criterion of diagnosing the cerebral vascular dNease,93%of the 170 patients with AVMs,100% of the 69 patients with CCFS and 67%of the 67 patients with the aneurysms were detected by TCD respectively.It was found that the relative larger aneurysm(diameter>1.5 crn)had a special TCD manifestation, the SO-called ”aneurysm-like spectrum”. Conclusion TCD is necessary for detecting the cerebral vascular lesions because it can reveal accurately a change in the intracranial hemodynamics and a condition of the collateral circulation.

  3. Cerebral malaria.

    Science.gov (United States)

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

    Malaria, the most significant parasitic disease of man, kills approximately one million people per year. Half of these deaths occur in those with cerebral malaria (CM). The World Health Organization (WHO) defines CM as an otherwise unexplained coma in a patient with malarial parasitemia. Worldwide, CM occurs primarily in African children and Asian adults, with the vast majority (greater than 90%) of cases occurring in children 5 years old or younger in sub-Saharan Africa. The pathophysiology of the disease is complex and involves infected erythrocyte sequestration, cerebral inflammation, and breakdown of the blood-brain barrier. A recently characterized malarial retinopathy is visual evidence of Plasmodium falciparum's pathophysiological processes occurring in the affected patient. Treatment consists of supportive care and antimalarial administration. Thus far, adjuvant therapies have not been shown to improve mortality rates or neurological outcomes in children with CM. For those who survive CM, residual neurological abnormalities are common. Epilepsy, cognitive impairment, behavioral disorders, and gross neurological deficits which include motor, sensory, and language impairments are frequent sequelae. Primary prevention strategies, including bed nets, vaccine development, and chemoprophylaxis, are in varied states of development and implementation. Continuing efforts to find successful primary prevention options and strategies to decrease neurological sequelae are needed. PMID:23829902

  4. Observations on vapor pressure in SPR caverns : sources.

    Energy Technology Data Exchange (ETDEWEB)

    Munson, Darrell Eugene

    2010-05-01

    The oil of the Strategic Petroleum Reserve (SPR) represents a national response to any potential emergency or intentional restriction of crude oil supply to this country, and conforms to International Agreements to maintain such a reserve. As assurance this reserve oil will be available in a timely manner should a restriction in supply occur, the oil of the reserve must meet certain transportation criteria. The transportation criteria require that the oil does not evolve dangerous gas, either explosive or toxic, while in the process of transport to, or storage at, the destination facility. This requirement can be a challenge because the stored oil can acquire dissolved gases while in the SPR. There have been a series of reports analyzing in exceptional detail the reasons for the increases, or regains, in gas content; however, there remains some uncertainty in these explanations and an inability to predict why the regains occur. Where the regains are prohibitive and exceed the criteria, the oil must undergo degasification, where excess portions of the volatile gas are removed. There are only two known sources of gas regain, one is the salt dome formation itself which may contain gas inclusions from which gas can be released during oil processing or storage, and the second is increases of the gases release by the volatile components of the crude oil itself during storage, especially if the stored oil undergoes heating or is subject to biological generation processes. In this work, the earlier analyses are reexamined and significant alterations in conclusions are proposed. The alterations are based on how the fluid exchanges of brine and oil uptake gas released from domal salt during solutioning, and thereafter, during further exchanges of fluids. Transparency of the brine/oil interface and the transfer of gas across this interface remains an important unanswered question. The contribution from creep induced damage releasing gas from the salt surrounding the cavern is

  5. Sonographic Findings of Cavernous Hemangioma in Fatty Liver

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, Jin Kyeung; Kim, Ki Whang; Yoon, Sang Wook; Kim, Tae Hoon; Lee, Jong Tae; Yoo, Hyung Sik; Kim, Myung Jin [Yonsei University College of Medicine, Seoul (Korea, Republic of); Ji, Hoon [Aju Univeristy, College of Medicine, Suwon (Korea, Republic of)

    1995-06-15

    Typical cavernous hemangioma presents no diagnostic difficulty at sonography. However, in cases of atypical hemangioma, further evaluation is needed to differentiate it from malignancy. On the other hand, thcechogenicity of the lesion may be iso echo or hypoecho when it occurs in association with fatty liver. We analyzed the sonographic features of hemangioma in fatty liver. We reviewed the sonograms of 22 lesions from 19 patients. We divided the lesions into two groups; the lesion measuring less than 3cm in diameter (group I) and the lesions measuring same or greater than 3cm (group II). The lesions of each group were analyzed in terms of location, shape, distinction of margin, internal echogenicity, posterior enhancement, lateral shadowing, and peritumoral hypoechoic halo. The lesions were located in subcapsular or perivascular areain 86%. They strowed round or lobulated shape with well defined margin in 82%. Internal echo of the lesions was hypoechoic in 82% and homogeneous in 64%. Posterior enhancement was seen in 77%. The posterior wall of the lesion was distinct in 68%. There was no statistical difference in incidence of each finding described above between the two groups except the internal echogenicity(p<0.05). All of the four hyperechoic lesions measured greater than 3cmin diameter, and three of them showed uneven thickness of echogenic rind. Definitive diagnosis of hemangioma could be obtained in 82%. In remaining 18% of hemangioma, the lesions showed peripheral hypoechoic halo and lateral shadowing that made the diagnosis of hemangioma difficult. However, the possibility of hemangioma could be suggested because they showed haemangiomas internal eye-catching and posterior enhancement. Hepatic cavernous hemangioma presents with variable eye-catching as compared to the surrounding tissue when it is associated with fatty liver disease, Thus, in differentiating hemangiomas from other localized hepatic mass, other characteristics such as homogeneity of the

  6. Bilateral Carotid-Cavernous Fistulas: An Uncommon Cause of Pituitary Enlargement and Hypopituitarism

    Science.gov (United States)

    Lechan, Ronald M.

    2016-01-01

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

  7. Transient behaviour of deep underground salt caverns; Comportement transitoire des cavites salines profondes

    Energy Technology Data Exchange (ETDEWEB)

    Karimi-Jafari, M

    2007-11-15

    This work deals with the transient behaviour of deep underground salt caverns. It has been shown that a cavern is a complex system, in which there are mechanical, thermal, chemical and hydraulic evolutions. The importance of the transient evolutions, particularly the role of the 'reverse' creep in the interpretation of the tightness test in a salt cavern is revealed. Creep is characterized by a formulation of the behaviour law which presents the advantage, in a practical point of view, to only have a reduced number of parameters while accounting of the essential of what it is observed. The initiation of the rupture in the effective traction in a salt cavern rapidly pressurized is discussed. A model fitted to a very long term behaviour (after abandonment) is developed too. In this case too, a lot of phenomena, more or less coupled, occur, when the existing literature took only into account some phenomena. (O.M.)

  8. [Anatomical study of the cavernous nerve in relation to nerve sparing operation].

    Science.gov (United States)

    Hanawa, K

    1994-08-01

    Recently, nerve sparing radical prostatectomy has became widely considered as the primary goal for maintaining a high standard of quality of life (QOL). However, anatomical localization of the cavernous nerve has not yet been precisely clarified in terms of the terminal end in the corpus cavernous penis distal to the urogenital membrane. Here in attempt to demonstrate the precise localization of the cavernous nerve, in six adult male cadaver. The cavernous nerves ran between the prostatic capsule and the prostatic fascia, through the capsule of the seminal vesicle. The nerves penetrated the membranous urethra at 8 mm from the margin of the urethra at the position of 5 and 7 o'clock. Therefore, the following procedures are critical to achieve successful nerve sparing: 1) meticulous division of the seminal-vesicle, 2) precise separation of the neurovascular bundle between the prostatic capsule and fascia, and 3) the careful transaction of the membranous urethra.

  9. Diagnosis and management of trigemino-cavernous fistulas: case reports and review of the literature.

    Science.gov (United States)

    Miller, Timothy R; Jindal, Gaurav; Mohan, Suyash; Fortes, Manuel; Hurst, Robert; Pukenas, Bryan; Gandhi, Dheeraj

    2015-01-01

    Although usually asymptomatic, a persistent trigeminal artery (PTA) can rarely be associated with a direct fistula to the cavernous sinus (ie, trigemino-cavernous fistula). We present three patients with trigemino-cavernous fistulas; two were subsequently treated using modern endovascular techniques while the third initially declined therapy. We then review the literature of reported cases of this unusual entity. The aberrant anatomy associated with a PTA presents unique challenges to the management of these lesions, and must be well delineated prior to treatment. Finally, conservative management of trigemino-cavernous fistulas, either de novo or recurrent, may be considered if they demonstrate no evidence of cortical venous reflux and patient symptoms are tolerable. PMID:24394154

  10. Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

    Directory of Open Access Journals (Sweden)

    Şehnaz Arıcı

    2015-04-01

    Full Text Available Indirect (dural carotid cavernous fistula is formed by the connection between meningeal branches of the internal carotid artery and the cavernous sinüs, and low flow circulation with low pressure is occured. Proptosis, ophtalmoplegia, headache, scleral and conjuctival hyperemia expanding around the eyeball can be observed. A forty-eight year old female patient with a background of diabetes mellitus and hypertension was admitted with complaints of double vision. Isolated oculomotor nerve palsy was found in neurological examination and an indirect carotid cavernous fistula was revealed by digital subtraction angiography. Our case with carotid cavernous fistula as a rare cause of isolated oculomotor nerve palsy is worth to be reported.

  11. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

    Science.gov (United States)

    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  12. Cranial CT signs of the Chiari II malformation

    International Nuclear Information System (INIS)

    Serial CT scans of 32 patients with proved Chiari II malformations and 19 patients with hydrocephalus and meningomyelocele (presumed to have Chiari II malformation) were reviewed and compared with CT scans from 30 patients with non-chiari aqueductal stenosis to develop criteria for identifying the Chiari II malformation and for differentiating it from other forms of hydrocephalus. Correlation with post-mortem specimens of Chiari II brains provided a pathologic basis for the CT signs observed. (orig.)

  13. Genetic causes of congenital brain malformations in epilepsy patients

    DEFF Research Database (Denmark)

    Møller, Rikke Steensbjerre

    2008-01-01

    The search for genetic causes of congenital brain malformations, severe epilepsy and mental retardation plays an important role in neuropediatrics and neurology. Disclosure of the aetiology of the intellectual disabilities, seizures and the underlying brain malformation may be of psychological...... genes for developmental brain defects. The overall aim of the present study has been to identify new candidate genes or predisposing factors involved in congenital brain malformations in epilepsy patients....

  14. EXAMINE AND EVALUATE A PROCESS TO USE SALT CAVERNS TO RECEIVE SHIP BORNE LIQUEFIED NATURAL GAS

    Energy Technology Data Exchange (ETDEWEB)

    Michael M. McCall; William M. Bishop; D. Braxton Scherz

    2003-04-24

    The goal of the U.S. Department of Energy cooperative research project is to define, describe, and validate, a process to utilize salt caverns to receive and store the cargoes of LNG ships. The project defines the process as receiving LNG from a ship, pumping the LNG up to cavern injection pressures, warming it to cavern compatible temperatures, injecting the warmed vapor directly into salt caverns for storage, and distribution to the pipeline network. The performance of work under this agreement is based on U.S. Patent 5,511,905, and other U.S. and Foreign pending patent applications. The cost sharing participants in the research are The National Energy Technology Laboratory (U.S. Department of Energy), BP America Production Company, Bluewater Offshore Production Systems (U.S.A.), Inc., and HNG Storage, L.P. Initial results indicate that a salt cavern based receiving terminal could be built at about half the capital cost, less than half the operating costs and would have significantly higher delivery capacity, shorter construction time, and be much more secure than a conventional liquid tank based terminal. There is a significant body of knowledge and practice concerning natural gas storage in salt caverns, and there is a considerable body of knowledge and practice in handling LNG, but there has never been any attempt to develop a process whereby the two technologies can be combined. Salt cavern storage is infinitely more secure than surface storage tanks, far less susceptible to accidents or terrorist acts, and much more acceptable to the community. The project team developed conceptual designs of two salt cavern based LNG terminals, one with caverns located in Calcasieu Parish Louisiana, and the second in Vermilion block 179 about 50 miles offshore Louisiana. These conceptual designs were compared to conventional tank based LNG terminals and demonstrate superior security, economy and capacity. The potential for the development of LNG receiving terminals

  15. Cerebral cysticercosis

    International Nuclear Information System (INIS)

    Two cases of histologically proven cerebral cysticercosis are presented. In both cases subcutaneous tissue nodules, a rare feature, were present. Several disease patterns are apparent - meningeal, parenchymatous and ventricular, spinal cord lesions and mixed patterns. Epilepsy is by far the major presenting symptom of cysticercosis, which in turn plays a significant role in the causation of adult-onset epilepsy in Blacks. Despite its drawbacks, the haemag-glutination inhibition test remains the most satisfactory serological method at present available for the diagnosis of cysticercosis; it is positive in up to 85% of cases of proven cysticercosis. With the advent of computed tomography many cases of unsuspected cysticercosis (symptomatic or asymptomatic) are being discovered

  16. Light and scanning electron microscopical study of the cavernous sinus of the monkey, Macaca fascicularis.

    OpenAIRE

    Rajendran, K.; Ling, E A

    1985-01-01

    The cavernous sinus of Macaca fascicularis is in many respects similar to the human sinus. It consists predominantly of one main venous channel that, together with the internal carotid artery, occupies a meningo-endocranial compartment lateral to the pituitary gland. Trabeculae are few and do not in any way cause the sinus to appear cavernous. They are mostly flattened in the direction of the main venous channel. Cranial nerves three, four, six and the ophthalmic division of five are all loca...

  17. TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion: Targeted Approach

    OpenAIRE

    Natanel Jourabchi; Justin Pryce McWilliams; Edward Wolfgang Lee; Steven Sauk; Stephen Thomas Kee

    2013-01-01

    Purpose. We report a novel technique which aided recanalization of an occluded portal vein for transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with symptomatic portal vein thrombosis with cavernous transformation. Some have previously considered cavernous transformation a contraindication to TIPS. Case Presentation. 62-year-old man with chronic pancreatitis, portal vein thrombosis, portal hypertension and recurrent variceal bleeding presents with melena and hemateme...

  18. Diagnosis of orbital cavernous hemangioma with Tc-99m RBC SPECT.

    Science.gov (United States)

    Ki, W W; Shin, J W; Won, K S; Ryu, J S; Yang, S O; Lee, H K; Kim, Y J

    1997-08-01

    The authors report two cases of orbital cavernous hemangioma diagnosed by Tc-99m RBC SPECT. Tc-99m RBC SPECT showed a typical scintigraphic pattern commonly seen in hepatic hemangioma in which there is intense focally increased uptake on delayed SPECT images. Tc-99m RBC SPECT in orbital cavernous hemangioma may be as useful a diagnostic modality as in hepatic hemangioma. PMID:9262901

  19. Dandy-Walker Malformation Presenting with Psychological Manifestations

    Science.gov (United States)

    Dahanayake, Dulangi Maneksha Amerasinghe

    2016-01-01

    Dandy-Walker malformation, which is a congenital malformation of the cerebellum, is documented in literature to be associated with psychotic symptoms, obsessive compulsive symptoms, mood symptoms, hyperactivity, and impulsive behavior. The pathogenesis of psychiatric symptoms in Dandy-Walker malformation is thought to be due to disruption of the corticocerebellar tracts, resulting in what is known as cerebellar cognitive affective syndrome. We present a case of Dandy-Walker malformation presenting with psychiatric symptoms. This case highlights the necessity to be aware of psychiatric manifestations of cerebellar disease as it has an impact on the diagnosis and treatment. PMID:27493822

  20. Anaesthetic management of a child with massive extracranial arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2012-01-01

    Full Text Available Vascular tumors affect the head and neck commonly but arteriovenous malformations are rare. Vascular malformations are often present at birth and grow with the patient, usually only becoming significant later in childhood. Embolization has been the mainstay of treatment in massive and complex arteriovenous malformations. We present a case of massive extracranial arteriovenous malformation in a 7-year-old boy causing significant workload on right heart and respiratory distress. The management of angioembolization under general anaesthesia and anaesthetic concerns are presented.

  1. Congenital malformations in twins in England and Wales.

    OpenAIRE

    Doyle, P E; Beral, V.; Botting, B; Wale, C J

    1991-01-01

    STUDY OBJECTIVE--The aim was to compare congenital malformation rates in twin births with those in singleton births. DESIGN--The study was an analysis of malformation rates in singleton and twin births using data from the Office of Population Censuses and Survey's Congenital Malformation Notification Scheme. SETTING--This was a national survey of births in England and Wales in 1979-1980 and 1982-1985. PARTICIPANTS--The data comprised 95,510 reported malformations in 3.7 million singleton birt...

  2. Risk analyses for disposing nonhazardous oil field wastes in salt caverns

    Energy Technology Data Exchange (ETDEWEB)

    Tomasko, D.; Elcock, D.; Veil, J.; Caudle, D.

    1997-12-01

    Salt caverns have been used for several decades to store various hydrocarbon products. In the past few years, four facilities in the US have been permitted to dispose nonhazardous oil field wastes in salt caverns. Several other disposal caverns have been permitted in Canada and Europe. This report evaluates the possibility that adverse human health effects could result from exposure to contaminants released from the caverns in domal salt formations used for nonhazardous oil field waste disposal. The evaluation assumes normal operations but considers the possibility of leaks in cavern seals and cavern walls during the post-closure phase of operation. In this assessment, several steps were followed to identify possible human health risks. At the broadest level, these steps include identifying a reasonable set of contaminants of possible concern, identifying how humans could be exposed to these contaminants, assessing the toxicities of these contaminants, estimating their intakes, and characterizing their associated human health risks. The contaminants of concern for the assessment are benzene, cadmium, arsenic, and chromium. These were selected as being components of oil field waste and having a likelihood to remain in solution for a long enough time to reach a human receptor.

  3. Deformation and Failure Characteristics of the Rock Masses around Deep Underground Caverns

    Directory of Open Access Journals (Sweden)

    Chong Zhang

    2015-01-01

    Full Text Available The deformation and failure characteristics of deep rock masses are the focus of this study on deep rock mass engineering. The study identifies the deformation and failure characteristics of a deep cavern under different ground stress conditions using model test and theoretical analysis methods. First, the similarity theory for model tests is introduced, and then the scale factors used in the present study are calculated according to the Froude criterion. Based on the study objectives, the details of the study methods (the similarity coefficient, the loading conditions, the test steps, etc. are introduced. Finally, the failure characteristics of the deep cavern and the strain distribution characteristics surrounding the caverns under different ground stress conditions are identified using the model test. It was found that compared with shallow rock masses the rock masses of the deep cavern have a much greater tensile range, which reaches 1.5 times the diameter of the cavern under the conditions established in the present study. Under different ground stress conditions, there are differences in failure characteristics and the reasons of the differences were analyzed. The implication of the test results on the design of support system for deep caverns was presented.

  4. Hazard assessment of the stability of a cavern roof along the coastline

    Science.gov (United States)

    Reina, A.; Lollino, P.

    2009-04-01

    This work concerns the hazard assessment about the stability of a large shallow depth cavern, located along the coastline rocky sector of Polignano town (Apulia, Southern Italy) under an intensely urbanised area. This cavern, which lies at the sea level, has been created by a prolonged process of sea erosion within a rock mass formed of a lower stratified limestone mass and an upper Gravina Calcarenite mass. The thickness of the cavern roof, which has a dome shape, is less than 10 metres in the centre. Important buildings, as hotels and private houses, are located just above the top of the roof. Erosion processes have been observed to be still active along the whole cavern due to climate factors and, in particular, to sea salt weathering and sea spray effects. In 2007 a large calcarenite block, 3 m large, fell down from the cavern roof and consequently a field investigation campaign was carried out for a rational stabilization plan in order to understand the current stability conditions of the roof and the potential failure mechanism. Therefore, a thorough geo-structural survey has firstly been carried out, together with laboratory and in-situ testing for measuring the physical and mechanical properties of the calcarenite rock and of the corresponding joints. A monitoring system has also been planned and installed in order to measure the erosional rate and the block displacements in the cavern.

  5. Transvenous embolization of indirect carotid-cavernous fistula via upper ophthalmic/facial vein - Case report and literature review

    International Nuclear Information System (INIS)

    Indirect carotid-cavernous fistula or dural arterio-venous fistula of cavernous sinus is relatively rare pathologic finding. Different classifications of carotid-cavernous fistulae are proposed. Now days more and more they are treated by endovascular approach. A case of authors' practice of transvenous embolization of carotid-cavernous fistula via upper ophthalmic vein in 52 year old female is presented with review of the literature. A week later ocular symptoms of the patient regressed. Control angiography at the third month follow up does not visualize fistula. The transvenous approach in management of carotid cavernous fistulae is safe and effective in cases direct arterial approach is absent or technically impossible. Key words: Indirect Carotid-Cavernous Fistula. Embolization. Transvenous Approach

  6. Malformations of the tooth root in humans

    Directory of Open Access Journals (Sweden)

    Hans Ulrich eLuder

    2015-10-01

    Full Text Available The most common root malformations in humans arise from either developmental disorders of the root alone or disorders of radicular development as part of a general tooth dysplasia. The aim of this review is to relate the characteristics of these root malformations to potentially disrupted processes involved in radicular morphogenesis. Radicular morphogenesis proceeds under the control of Hertwig's epithelial root sheath (HERS which determines the number, length, and shape of the root, induces the formation of radicular dentin, and participates in the development of root cementum. Formation of HERS at the transition from crown to root development appears to be very insensitive to adverse effects, with the result that rootless teeth are extremely rare. In contrast, shortened roots as a consequence of impaired or prematurely halted apical growth of HERS constitute the most prevalent radicular dysplasia which occurs due to trauma and unknown reasons as well as in association with dentin disorders. While odontoblast differentiation inevitably stops when growth of HERS is arrested, it seems to be unaffected even in cases of severe dentin dysplasias such as regional odontodysplasia and dentin dysplasia type I. As a result radicular dentin formation is at least initiated and progresses for a limited time. The only condition affecting cementogenesis is hypophosphatasia which disrupts the formation of acellular cementum through an inhibition of mineralization. A process particularly susceptible to adverse effects appears to be the formation of the furcation in multirooted teeth. Impairment or disruption of this process entails taurodontism, single-rooted posterior teeth, and misshapen furcations. Thus even though many characteristics of human root malformations can be related to disorders of specific processes involved in radicular morphogenesis, precise inferences as to the pathogenesis of these dysplasias are hampered by the still limited knowledge on

  7. Laser treatment of oral vascular malformations

    Science.gov (United States)

    Romeo, U.; Gaimari, G.; Mohsen, M.; Tenore, G.; Palaia, G.

    2014-01-01

    Oral Vascular Malformations (OVM) are congenital anomalies characterized by morph-structural and/or functional changes of nature in severity and extension. OVM can affect any type of vessels arterial, venous or lymphatic and any capillary or anatomical. They are divided into two categories: low and high flow. In this study were treated 40 patients with OVM with a range size from 2 mm to 44 mm; they were subjected to clinical examination supported by Colour-Doppler Ultrasound instrumental examination and only for doubt cases the Magnetic Resonance Imaging (MRI) was prescribed. Only low flow venous and capillary malformations were treated by GaAlAs laser (Wiser®, Lambda, Brindole,Italy, 980nm) and KTP laser (SmartLite®, DEKA, Florence, Italy, 532nm) with two different techniques: the Transmucosal Thermophotocoagulation (TMT) and the Intralesional Photocoagulation (ILP). These techniques permitted a good control of haemostasis, avoiding bleeding both during surgery and in the postoperative. It is obtained an excellent and good healing respectively in 10% and 60% of cases, a moderate and poor resolution respectively in 22.5% and 7.5% of cases. A clear diagnosis allowed the management of Venous malformations (VM) by laser devices with wavelengths highly absorbed in haemoglobin in safety and efficacy and according to the principles of minimal invasive surgery. The aim of this study was to verify if the laser is effective in the treatment of OVM for the purpose of the clinical findings and the postoperative course. The Authors concluded that the laser can be considered the "gold standard" for treating OVM.

  8. Japan's exploration of vertical holes and subsurface caverns on the Moon and Mars

    Science.gov (United States)

    Haruyama, J.; Kawano, I.; Kubota, T.; Yoshida, K.; Kawakatsu, Y.; Kato, H.; Otsuki, M.; Watanabe, K.; Nishibori, T.; Yamamoto, Y.; Iwata, T.; Ishigami, G.; Yamada, T. T.

    2013-12-01

    Recently, gigantic vertical holes exceeding several tens of meters in diameter and depth were discovered on the Moon and Mars. Based on high-resolution image data, lunar holes and some Martian pits (called 'holes' hereafter) are probably skylights of subsurface caverns such as lava tubes or magma chambers. We are starting preparations for exploring the caverns through the vertical holes. The holes and subsurface caverns have high potential as resources for scientific studies. Various important geological and mineralogical processes could be uniquely and effectively observed inside these holes and subsurface caverns. The exposed fresh lava layers on the vertical walls of the lunar and Martian holes would provide information on volcanic eruption histories. The lava layers may also provide information on past magnetic fields of the celestial bodies. The regolith layers may be sandwiched between lava layers and may preserve volatile elements including solar wind protons that could be a clue to understanding past solar activities. Water molecules from solar winds or cometary/meteorite impacts may be stored inside the caverns because of mild temperatures there. The fresh lava materials forming the walls and floors of caverns might trap endogenic volatiles from magma eruptions that will be key materials for revealing the formation and early evolution of the Moon and Mars. Furthermore, the Martian subsurface caverns are highly expected to be life cradles where the temperatures are probably stable and that are free from ultra-violet and other cosmic rays that break chemical bonds, thus avoiding polymerization of molecules. Discovering extraterrestrial life and its varieties is one of our ultimate scientific purposes for exploring the lunar and Martian subsurface caverns. In addition to scientific interests, lunar and Martian subsurface caverns are excellent candidates for future lunar bases. We expect such caverns to have high potential due to stable temperatures; absence

  9. Prevalence of Chiari I Malformation and Syringomyelia.

    Science.gov (United States)

    Kahn, Elyne N; Muraszko, Karin M; Maher, Cormac O

    2015-10-01

    Chiari I malformation (CM) is a common neurosurgical diagnosis and spinal cord syrinx is frequently found in patients with CM. Asymptomatic CM is a common imaging finding. Symptomatic CM is less common. Variation in prevalence estimates may be attributed to differences in sensitivity of CM detection between studies as well as differences in the populations being analyzed. The prevalence of low tonsil position and CM on MRI is higher in children and young adults compared with older adults. Studies that include a large number of older adults find a lower prevalence compared with analyses of children.

  10. Oral vascular malformations: laser treatment and management

    Science.gov (United States)

    Romeo, U.; Rocchetti, F.; Gaimari, G.; Tenore, G.; Palaia, G.; Lo Giudice, G.

    2016-03-01

    Vascular malformations are a very heterogeneous group of circulatory system's diseases that can involve different kind of vessels: arterial, venous or lymphatic ones. Many treatments, such as conventional surgery, embolization, steroid therapy and laser therapy, are available for vascular lesions. The laser approach relies more therapeutic techniques: the transmucosal thermophotocoagulation, intralesional photocoagulation, the excisional biopsy. Today laser is demonstrated to be the gold standard technique to treat vascular lesions that allows a safe and efficient treatment and a lower post-operative healing time. The only disadvantage is the risk of carbonization that could be avoided by using the multiple-spot single pulsed wave technique.

  11. Cauda equina cavernous angioma presenting as acute low back pain and sciatica. A report of two cases and literature review.

    Science.gov (United States)

    Khalatbari, M R; Hamidi, M; Moharamzad, Y; Taheri, B

    2011-08-31

    Spinal cavernous angiomas are rare vascular lesions occurring mainly in the vertebral bodies extending secondary into the extradural space. Only 3% of these lesions are intradural, usually localized within the spinal cord. Rarely, cavernous angioma has been reported to occur in the cauda equina. We describe clinical, diagnostic imaging, and surgical procedures of two cases of cavernous angioma of the cauda equina who presented with acute back pain and sciatica. The relevant literature is also reviewed. PMID:24059723

  12. Advanced Underground Gas Storage Concepts: Refrigerated-Mined Cavern Storage, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    none

    1998-09-30

    Over the past 40 years, cavern storage of LPG's, petrochemicals, such as ethylene and propylene, and other petroleum products has increased dramatically. In 1991, the Gas Processors Association (GPA) lists the total U.S. underground storage capacity for LPG's and related products of approximately 519 million barrels (82.5 million cubic meters) in 1,122 separate caverns. Of this total, 70 are hard rock caverns and the remaining 1,052 are caverns in salt deposits. However, along the eastern seaboard of the U.S. and the Pacific northwest, salt deposits are not available and therefore, storage in hard rocks is required. Limited demand and high cost has prevented the construction of hard rock caverns in this country for a number of years. The storage of natural gas in mined caverns may prove technically feasible if the geology of the targeted market area is suitable; and economically feasible if the cost and convenience of service is competitive with alternative available storage methods for peak supply requirements. Competing methods include LNG facilities and remote underground storage combined with pipeline transportation to the area. It is believed that mined cavern storage can provide the advantages of high delivery rates and multiple fill withdrawal cycles in areas where salt cavern storage is not possible. In this research project, PB-KBB merged advanced mining technologies and gas refrigeration techniques to develop conceptual designs and cost estimates to demonstrate the commercialization potential of the storage of refrigerated natural gas in hard rock caverns. DOE has identified five regions, that have not had favorable geological conditions for underground storage development: New England, Mid-Atlantic (NY/NJ), South Atlantic (DL/MD/VA), South Atlantic (NC/SC/GA), and the Pacific Northwest (WA/OR). PB-KBB reviewed published literature and in-house databases of the geology of these regions to determine suitability of hard rock formations for siting

  13. Stenogyria - not only in Chiari II malformation.

    Science.gov (United States)

    Bekiesinska-Figatowska, Monika; Duczkowska, Agnieszka; Brągoszewska, Hanna; Duczkowski, Marek; Mierzewska, Hanna

    2014-12-15

    Stenogyria, meaning multiple small compacted gyri separated by shallow sulci, is reported in the literature in association with Chiari II malformation (CM II) which in turn is reported in association with myelomeningocele (MMC). The authors present five cases of stenogyria (and other abnormalities found in CM II, like callosal hypoplasia/dysplasia, agenesis of the anterior commissure, hypoplasia of the falx cerebri) in children without the history of MMC or any other form of open spinal dysraphism. In these cases stenogyria was associated with Chiari I malformation, rhombencephalosynapsis and spina bifida. Stenogyria, which is not a true neuronal migration disorder, should not be mistaken for polymicrogyria which is also present in CM II. It is histologically different from polymicrogyria because the cortex is normally organized. Also on MRI, the general sulcal pattern is preserved in stenogyria, while it is completely distorted in polymicrogyria. The authors conclude that features traditionally attributed to CM II, like stenogyria, occur not only in the population of patients with MMC as opposed to the widely accepted theory.

  14. Vein of galen aneurysmal malformation: prognostic markers depicted on fetal MRI.

    Science.gov (United States)

    Wagner, Matthias W; Vaught, Arthur J; Poretti, Andrea; Blakemore, Karin J; Huisman, Thierry A G M

    2015-02-01

    Fetal magnetic resonance imaging (MRI) serves a dual role in the prenatal diagnostic work up of a vein of Galen aneurysmal malformation (VGAM). First, it may confirm the prenatal ultrasound findings and secondly it may identify prognostically important secondary complications of the VGAM. Progressive heart failure with development of fetal hydrops and hemispheric white matter injuries are associated with a poor outcome in children with a VGAM. We present the prenatal findings using both ultrasound and MRI of a fetus with VGAM including bilateral injury of the cerebral hemispheres, severe dilatation of the jugular veins, cardiomegaly, and hydrops fetalis. The neonate died within 30 minutes after delivery. Moreover, fetal MRI revealed complete placenta praevia, uterine fibroids, and wrapping of the umbilical cord around the fetal neck. This additional information is unrelated to the fetal pathology, but could have been of importance to plan the delivery. PMID:25924177

  15. Pathogenesis and Cerebrospinal Fluid Hydrodynamics of the Chiari I Malformation.

    Science.gov (United States)

    Buell, Thomas J; Heiss, John D; Oldfield, Edward H

    2015-10-01

    This article summarizes the current understanding of the pathophysiology of the Chiari I malformation that is based on observations of the anatomy visualized by modern imaging with MRI and prospective studies of the physiology of patients before and after surgery. The pathogenesis of a Chiari I malformation of the cerebellar tonsils is grouped into 4 general mechanisms.

  16. Craniovertebral Junction Instability in the Setting of Chiari I Malformation.

    Science.gov (United States)

    Goldstein, Hannah E; Anderson, Richard C E

    2015-10-01

    This article addresses the key features, clinical presentation, and radiographic findings associated with craniovertebral junction instability in the setting of Chiari I malformation. It further discusses surgical technique for treating patients with Chiari I malformation with concomitant craniovertebral junction instability, focusing on modern posterior rigid instrumentation and fusion techniques.

  17. Valproic acid monotherapy in pregnancy and major congenital malformations

    DEFF Research Database (Denmark)

    Jentink, Janneke; Loane, Maria A; Dolk, Helen;

    2010-01-01

    The use of valproic acid in the first trimester of pregnancy is associated with an increased risk of spina bifida, but data on the risks of other congenital malformations are limited.......The use of valproic acid in the first trimester of pregnancy is associated with an increased risk of spina bifida, but data on the risks of other congenital malformations are limited....

  18. NPHP4 variants are associated with pleiotropic heart malformations

    NARCIS (Netherlands)

    V.M. French (Vanessa); I.M.B.H. van de Laar (Ingrid); M.W. Wessels (Marja); C.F. Rohe; J.W. Roos-Hesselink (Jolien); G. Wang (Guangliang); I.M.E. Frohn-Mulder (Ingrid); E.A.W.F.M. Severijnen (Lies-Anne); B.M. de Graaf (Bianca); R. Schot (Rachel); G.J. Breedveld (Guido); E.J. Mientjes (Edwin); M. van Tienhoven (Marianne); E. Jadot (Elodie); Z. Jiang (Zhengxin); A. Verkerk; S.M.A. Swagemakers (Sigrid); H. Venselaar (Hanka); Z. Rahimi (Zohreh); H. Najmabadi (Hossein); E.J. Meijers-Heijboer (Hanne); E. de Graaff (Esther); W.A. Helbing (Willem); R. Willemsen (Rob); K. Devriendt (Koenraad); J.W. Belmont (John); B.A. Oostra (Ben); J.D. Amack (Jeffrey); A.M. Bertoli Avella (Aida)

    2012-01-01

    textabstractRationale: Congenital heart malformations are a major cause of morbidity and mortality, especially in young children. Failure to establish normal left-right (L-R) asymmetry often results in cardiovascular malformations and other laterality defects of visceral organs. Objective: To identi

  19. NPHP4 variants are associated with pleiotropic heart malformations.

    NARCIS (Netherlands)

    French, V.M.; Laar, I.M. van de; Wessels, M.W.; Rohe, C.; Roos-Hesselink, J.W.; Wang, G.; Frohn-Mulder, I.M.; Severijnen, L.A.; Graaf, B.M. de; Schot, R.; Breedveld, G.; Mientjes, E.; Tienhoven, M. van; Jadot, E.; Jiang, Z.; Verkerk, A.; Swagemakers, S.; Venselaar, H.; Rahimi, Z.; Najmabadi, H.; Meijers-Heijboer, H.; Graaff, E. de; Helbing, W.A.; Willemsen, R.; Devriendt, K.; Belmont, J.W.; Oostra, B.A.; Amack, J.D.; Bertoli-Avella, A.M.

    2012-01-01

    RATIONALE: Congenital heart malformations are a major cause of morbidity and mortality, especially in young children. Failure to establish normal left-right (L-R) asymmetry often results in cardiovascular malformations and other laterality defects of visceral organs. OBJECTIVE: To identify genetic m

  20. Congenital Malformation Prevalence in Cluj District between 2003-2007

    Directory of Open Access Journals (Sweden)

    Ştefan I. ŢIGAN

    2009-12-01

    Full Text Available Introduction: Congenital anomalies represent a significant cause of premature birth, of child morbidity and mortality. From 200000 new born per year, over 10000 presented malformations. Epidemiologic studies have shown that the incidence of malformations is increasing and varies upon geographic features, race and gender. Perinatal mortality is generated in 66.66% of cases by congenital malformations, illnesses from perinatal period and the rest of them is generated by the birth. Material and Method: The study was retrospective and was carried on for a period of five years (2003-2007 based on medical records and on laboratory results, (especially those for TORCH screening: toxoplasmosis, rubella, cytomegalovirus, and herpes virus. Results: Major structural anomalies were present at 39.51% (388 cases of 982 patients which were registered in Genetic Pathology Center from Pediatric Clinics I, Cluj-Napoca. Diagnosed abnormalities included: congenital malformations of circulatory, respiratory, digestive, central nervous system, congenital malformations of skeletal system, Down syndrome, which is consistent with results of other studies showing that the most common are heart abnormalities (33.06%, followed in descending order of frequency by urinary, genital, CNS, skin, oral-facial cleft and digestive anomalies. Conclusions: Early detection of major malformation during early pregnancy can indicate for medical termination of pregnancy to reduce the high morbidity and mortality of neonates due to congenital malformations. So proper and timely counselling, regular antenatal care with folate supplementation especially during the most sensitive period of embryogenesis is essential to avoid major congenital malformation for future pregnancy.

  1. Abernethy malformation with portal vein aneurysm in a child

    Directory of Open Access Journals (Sweden)

    Sheragaru H Chandrashekhara

    2011-01-01

    Full Text Available Abernethy malformation is an extremely rare anomaly of the splanchnic venous system. We describe multidetector computed tomography findings of an incidentally detected Abernethy malformation with portal vein aneurysm in a two-and-half-year old child. The computed tomography scan was performed for the evaluation of respiratory distress, poor growth, and loss of appetite.

  2. Urogenital tract anomalies in children with congenital anorectal malformation

    NARCIS (Netherlands)

    J.W. Hoekstra

    1991-01-01

    textabstractThe term 'imperforate anus' covers a variety of congenital anorectal malformations ranging in severity from anal stenosis to cloacal exstrophy. The clinical picture of the anorectal malformation has been known for thousands of years, during which many attempts have been made to find an e

  3. Timing in neural maturation: arrest, delay, precociousness, and temporal determination of malformations.

    Science.gov (United States)

    Sarnat, Harvey B; Philippart, Michel; Flores-Sarnat, Laura; Wei, Xing-Chang

    2015-05-01

    Timing is primordial in initiating and synchronizing each developmental process in tissue morphogenesis. Maturational arrest, delay, and precociousness all are conducive to neurological dysfunction and may determine different malformations depending on when in development the faulty timing occurred, regardless of the identification of a specific genetic mutation or an epigenetic teratogenic event. Delay and arrest are distinguished by whether further progressive development over time can be expected or the condition is static. In general, retardation of early developmental processes, such as neurulation, cellular proliferation, and migration, leads to maturational arrest. Retardation of late processes, such as synaptogenesis and myelination, are more likely to result in maturational delay. Faulty timing of neuronal maturation in relation to other developmental processes causes neurological dysfunction and abnormal electroencephalograph maturation in preterm neonates. Precocious synaptogenesis, including pruning to provide plasticity, may facilitate prenatal formation of epileptic circuitry leading to severe postnatal infantile epilepsies. The anterior commissure forms 3 weeks earlier than the corpus callosum; its presence or absence in callosal agenesis is a marker for the onset of the initial insult. An excessively thick corpus callosum may be due to delayed retraction of transitory collateral axons. Malformations that arise at different times can share a common pathogenesis with variations on the extent: timing of mitotic cycles in mosaic somatic mutations may distinguish hemimegalencephaly from focal cortical dysplasia type 2. Timing should always be considered in interpreting cerebral dysgeneses in both imaging and neuropathological diagnoses.

  4. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine [Hopital Saint Vincent de Paul, Service de Radiopediatrie, Paris (France); Flunker, Sabrina; Couture, Alain [Hopital Arnaud de Villeneuve, Service de Radiopediatrie, Montpellier cedex 5 (France); Eurin, Danielle [Hopital Charles Nicolle, Service de Radiopediatrie, Rouen (France); Grange, Gilles [Hopital Cochin, Service de Gyneco-Obstetrique, Maternite Port-Royal, Paris (France); Garel, Catherine [Hopital Armand Trousseau, Service de Radiopediatrie, Paris (France); Richter, Brigitte [Hopital Clemenceau, Service de Radiopediatrie, Caen (France); Geissler, Frederic [Centre Hospitalier Universitaire, Service de Radiopediatrie, Clermont Ferrand (France)

    2008-04-15

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n = 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  5. Gamma knife radiosurgery for arteriovenous malformations located in eloquent regions of the brain

    Directory of Open Access Journals (Sweden)

    Javalkar Vijayakumar

    2009-12-01

    Full Text Available Background : Stereotactic radiosurgery is an effective treatment strategy for selected group of patients with cerebral arteriovenous malformations (AVMs. Aim : The aim of this study was to evaluate the obliteration rates, complications, and patient outcomes after Gamma knife radiosurgery for cerebral arteriovenous malformations (AVMs located in eloquent regions of the brain with an emphasis on neurological morbidity. Materials and Methods : Between 2000 and December 2005, 37 patients with AVMs in eloquent locations (sensory, motor, speech, visual cortex, basal ganglia, and brain stem underwent stereotactic radiosurgery. We retrospectively reviewed the clinical data of these patients to asses the outcomes. Of the 37 patients, only two patients had prior embolization. Three underwent prospective staged volume radiosurgery. Two patients needed redo-radiosurgery for residual AVM. Mean target volume was 9.1 cc. Three lesions had nidus volume more than 20 cc. Average marginal dose was 18.75 Gy. The median duration of follow-up was 23 months (range, 6-60 months. 15 patients had follow-up of more than 36 months. Results : A total of 15 patients had follow-up of more than 36 months, thus available for evaluation of angiographic obliteration rates. Complete angiographic obliteration was documented in seven patients (46.7%. Four patients experienced hemorrhage during the latency period. One patient who had subsequent hemorrhage on follow-up developed worsening of neurological deficit. One patient developed significant sensory symptoms which resolved after steroids. No additional clinical deterioration related to treatment was noted in rest of the patients. Conclusions : AVMs located in eloquent and in deep locations can be treated safely with stereotactic radiosurgery with acceptable obliteration rates and minimal morbidity.

  6. United Cerebral Palsy

    Science.gov (United States)

    ... be sure to follow us on Twitter . United Cerebral Palsy UCP educates, advocates and provides support services to ... Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 Washington, DC ...

  7. Cerebral palsy and epilepsy

    OpenAIRE

    Knežević-Pogančev Marija

    2010-01-01

    Introduction. Cerebral palsy is the most common cause of physical disability in early childhood. Epilepsy is known to have a high association with cerebral palsy. All types of epileptic seizures can be seen in patients with cerebral palsy. Complex partial and secondary generalized ones are the most frequent seizure types. In persons with cerebral palsy and mental retardation, the diagnosis of epilepsy presents unique difficulties. Generally they are not able to describe the epileptic ev...

  8. Gamma Knife radiosurgery for the treatment of cavernous sinus hemangiomas

    Science.gov (United States)

    XU, QINGSHENG; SHEN, JIAN; FENG, YIPING; ZHAN, RENYA

    2016-01-01

    The present retrospective study aimed to analyze the outcome of patients with cavernous sinus hemangioma (CSH) treated with Gamma Knife radiosurgery (GKS). Between August 2011 and April 2014, 7 patients with CSHs underwent GKS. GKS was performed as the sole treatment option in 5 patients, whilst partial resection had been performed previously in 1 patient and biopsy had been performed in 1 patient. The mean volume of the tumors at the time of GKS was 12.5±10.2 cm3 (range, 5.3–33.2 cm3), and the median prescription of peripheral dose was 14.0 Gy (range, 10.0–15.0 Gy). The mean follow-up period was 20 months (range, 6–40 months). At the last follow-up, the lesion volume had decreased in all patients, and all cranial neuropathies observed prior to GKS had improved. There were no radiation-induced neuropathies or complications during the follow-up period. GKS appears to be an effective and safe treatment modality for the management of CSHs. PMID:26893777

  9. Chlorophyll f-driven photosynthesis in a cavernous cyanobacterium.

    Science.gov (United States)

    Behrendt, Lars; Brejnrod, Asker; Schliep, Martin; Sørensen, Søren J; Larkum, Anthony W D; Kühl, Michael

    2015-09-01

    Chlorophyll (Chl) f is the most recently discovered chlorophyll and has only been found in cyanobacteria from wet environments. Although its structure and biophysical properties are resolved, the importance of Chl f as an accessory pigment in photosynthesis remains unresolved. We found Chl f in a cyanobacterium enriched from a cavernous environment and report the first example of Chl f-supported oxygenic photosynthesis in cyanobacteria from such habitats. Pigment extraction, hyperspectral microscopy and transmission electron microscopy demonstrated the presence of Chl a and f in unicellular cyanobacteria found in enrichment cultures. Amplicon sequencing indicated that all oxygenic phototrophs were related to KC1, a Chl f-containing cyanobacterium previously isolated from an aquatic environment. Microsensor measurements on aggregates demonstrated oxygenic photosynthesis at 742 nm and less efficient photosynthesis under 768- and 777-nm light probably because of diminished overlap with the absorption spectrum of Chl f and other far-red absorbing pigments. Our findings suggest the importance of Chl f-containing cyanobacteria in terrestrial habitats.

  10. Second Barrel Toroid Coil Installed in ATLAS Cavern

    CERN Multimedia

    Tappern, G.

    The second barrel toroid coil was lowered into the ATLAS Cavern on Friday, 26 November. The operation takes approximately five hours of precision crane and winch operations. Before lowering, several checks are made to ensure that no loose items have been left on the coil which would fall during the lowering down the shaft. This is a very difficult, but very important check, with the first coil in position, and partly below the shaft. After changing the winch tooling on Wednesday December 1st, the coil was lifted, rotated and placed into the feet. The girders which support the coil and the Z direction stops had all been pre-set before putting the coil in the feet. The angle is controlled by an inclinometer. When the final adjustments of position have been made, which will locate the coils at the plus/minus two mm level, the connection beams (voussoirs and struts) will be put in place; this requires a complex shimming procedure. This will lock together the two coils into the feet and forms the foundation for th...

  11. Treatment Outcome Of Seizures Associated With Intracranial Cavernous Angiomas

    Directory of Open Access Journals (Sweden)

    Nievera Conrad C

    1999-01-01

    Full Text Available Seizures are among the typical presentations of intracranial cavernous angiomas (ICA. Twenty-one patients (age range: 2 to 53 years treated for seizures associated with ICA between 1983 and 1997 were restrospectively studied to evaluate their outcome following medical or surgical intervention. The mean interval between seizure onset and initial presentation at our institution was 7.6 years. Seizures were simple partial in 3 patients, complex partial in 15 and secondarily generalized tonic-clonic in 13. The commonest site of the lesion was the temporal lobe (52%. Multiple angiomas were observed in 5 (24% patients. Seven (32% patients were medically-managed with antiepileptic therapy and 14 (68% underwent either lesionectomy with resection of the epileptogenic zone (9 patients or temporal lobectomy (5 patients. Mean follow-up time was 4 years (range: 3 months to 14 years. Of the medically-managed patients, 3 (43% remained seizure-free whereas 4 (57% continued to have seizures with an average frequency of one per day. Of the surgically-managed patients, 12 (86% became seizure-free and 2 (14% had no more than two seizures per year. Surgery appears to be extremely effective in the management of seizures associated with ICA and should receive a strong and early consideration in patients who fail medical therapy.

  12. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

    International Nuclear Information System (INIS)

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  13. A study on the structural behaviour of rock caverns for underground radioactive waste repository(II)

    International Nuclear Information System (INIS)

    The objective of this study is to develope the basic technology necessary for the assurance of structural safety of rock caverns for a permanent radioactive waste repository. The structural analysis of rock caverns subjected to external loads, especially seismic loads, is performed to make sure of the structural integrity of the underground radioactive repository, and finally seeking the sufficient isolation of radioactive wastes from the human life environment during the hazardous lifetime of radionuclides. It is generally known that the structural behavior of rock caverns is greatly influenced by the type of structures and material properties of rock masses around the cavern. In order to develop seismic analysis techniques of underground structures such as the radioactive waste repository, the followings should be studied: depth and site dependence of earthquake characteristics, dynamic material properties of rock, modelling the behavior of rock discontinuities, and structural analysis methods. This study reviews the present status of the research on the aforementioned areas and includes the dynamic structural analysis of the underground cavern subjected to earthquake loading in order to assess the structural stability of an underground radioactive waste repository. (Author)

  14. Pretreatment imaging of peripheral vascular malformations

    Directory of Open Access Journals (Sweden)

    Johnson JB

    2014-10-01

    Full Text Available Joshua B Johnson, Petrice M Cogswell, Michael A McKusick, Larry A Binkovitz, Stephen J Riederer, Phillip M Young Department of Radiology, Mayo Clinic, Rochester, MN, USA Abstract: Peripheral vascular malformations (VMs are complex and diverse vascular lesions which require individualized pretreatment planning. Pretreatment imaging using various modalities, especially magnetic resonance imaging and time-resolved magnetic resonance angiography, is a valuable tool for classifying peripheral VMs to allow proper diagnosis, demonstrate complete extent, identify the nidus, and distinguish between low-flow and high-flow dynamics that determines the treatment approach. We discuss pretreatment imaging findings in four patients with peripheral VMs and how diagnostic imaging helped guide management. Keywords: time-resolved MRA, cartesian acquisition with projection-like reconstruction, endovascular treatment, magnetic resonance angiography

  15. Management of patients with brain arteriovenous malformations

    International Nuclear Information System (INIS)

    Arteriovenous malformations (AVMs) of the brain, which are probably genetically determined, are errors in the development of the vasculature that, together with the effects of blood flow, may lead to a focal arteriovenous shunt. Clinically, the adult patient may present with acute or chronic neurological symptoms--fixed or unstable--such as deficits, seizures or headache. Sometimes the lesion is an incidental finding. In about half of the patients, the revealing event is an intracranial haemorrhage. The prevalence of AVM in the western world is probably 10 ml could benefit from targeted partial embolisation followed by radiosurgery or surgery, depending on the angioarchitecture; and (IV) AVMs >20 ml nidus volume usually have a high treatment risk with any treatment modality and are not obvious targets for treatment at all

  16. Pulmonary arteriovenous malformations and their mimics

    International Nuclear Information System (INIS)

    Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between the pulmonary arteries and veins, which result in a right-to-left (R–L) shunt with resultant hypoxemia, the severity of which will depend upon the size and number of lesions. Most PAVMs occur in individuals with hereditary haemorrhagic telangiectasia (HHT) and are a cause of serious morbidity and mortality largely related to cerebrovascular complications secondary to paradoxical embolization. The importance of their recognition and treatment by embolization, even in the absence of symptoms, is well known. Their appearances on chest radiographs are often, but not always, characteristic and the CT appearances are diagnostic; however, there are a number of both vascular and non-vascular diseases that can cause confusion. This review serves to highlight these PAVM “mimics”

  17. Neurogenic dysphagia resulting from Chiari malformations.

    Science.gov (United States)

    Pollack, I F; Pang, D; Kocoshis, S; Putnam, P

    1992-05-01

    Between 1980 and 1989, 15 of 46 patients (11 children, 4 adults) who underwent suboccipital craniectomy and cervical laminectomy for symptomatic Chiari malformations presented with manifestations of neurogenic dysphagia. Each of these patients had normal swallowing function before the development of dysphagic symptoms. Dysphagia was progressive in all 15 and, in most cases, preceded the onset of other severe brain stem signs. The rate of symptom progression varied depending on the age of the patient. Whereas the six infants (all Chiari II) deteriorated rapidly after the onset of initial symptoms, the five older children (two Chiari I, three Chiari II) and four adults (all Chiari I) showed a more gradual deterioration. In 11 patients with severe dysphagia, barium video esophagograms, pharyngoesophageal motility studies, continuous esophageal pH monitoring, and appropriate scintigraphic studies were useful in defining the scope of the swallowing impairment and determining whether perioperative nasogastric or gastrostomy feedings, gastric fundoplication, and/or tracheostomy were needed to maintain adequate nutrition and avoid aspiration. These patients all had widespread dysfunction of the swallowing mechanism, with a combination of diffuse pharyngoesophageal dysmotility, cricopharyngeal achalasia, nasal regurgitation, tracheal aspiration, and gastroesophageal reflux. The pathophysiology of these swallowing impairments and their relation to the hindbrain malformation is discussed. Postoperative outcome with regard to swallowing function correlated with the severity of preoperative symptoms. The four patients with mild dysphagia showed rapid improvement in swallowing function after surgery. Seven patients with more severe impairment but without other signs of severe brain stem compromise, such as central apnea or complete bilateral vocal cord paralysis, also improved, albeit more slowly. In contrast, the outcome in the four patients who developed other signs of severe

  18. Pulmonary arteriovenous malformations: overview and transcatheter embolotherapy

    International Nuclear Information System (INIS)

    The majority of pulmonary arteriovenous malformations (pAVMs) are found in people with hereditary hemorrhagic telangiectasia (HHT), a condition also known as Osler-Weber-Rendu syndrome. HHT is a clinically heterogeneous autosomal dominant disorder in which abnormal blood vessels cause bleeding and arteriovenous shunting. The 2 basic lesions of HHT - telangiectasias and arteriovenous malformations (AVMs) - are closely related. Multisystem involvement leads to a staggering array of clinical manifestations, making HHT one of medicine's less familiar 'great pretenders'. Telangiectasias are dilated blood vessels, typically located in mucocutaneous surfaces (i.e., skin, conjunctiva, respiratory tract, gastrointestinal tract, urinary tract). Small telangiectasias are simply dilated post-capillary venules, whereas larger telangiectasias are made up of dilated arterioles and venules, often with no intervening capillary. They are, in essence, diminutive AVMs. These tiny lesions are visible as punctate bright red spots on skin and mucosal surfaces (Fig. 1). Their fragility and superficial location account for the disabling epistaxis and chronic gastrointestinal bleeding, which are so common with HHT. Hematuria (caused by urothelial telangiectasias) occurs occasionally but is not a prominent feature of the disease. Although tracheobronchial telangiectasias do occur and may cause hemoptysis, severe hemoptysis is typically related to pAVM rupture. AVMs are direct artery-to-vein connections. Though larger and far more impressive radiologically than telangiectasias, AVMs are more likely to be clinically silent until they either declare themselves in a catastrophic fashion or are detected by screening tests. In contrast to telangiectasias, which are generally found in epithelial surfaces, AVMs tend to develop within organs, most commonly the lung and brain. As screening methods evolve, liver involvement with both telangiectasias and complex AVMs is being recognized with increasing

  19. Maternal Hypothyroidism in Early Pregnancy and Infant Structural Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Bengt Källén

    2014-01-01

    Full Text Available Background. The question is debated on whether maternal hypothyroidism or use of thyroxin in early pregnancy affects the risk for infant congenital malformations. Objectives. To expand the previously published study on maternal thyroxin use in early pregnancy and the risk for congenital malformations. Methods. Data from the Swedish Medical Birth Register were used for the years 1996–2011 and infant malformations were identified from national health registers. Women with preexisting diabetes or reporting the use of thyreostatics, anticonvulsants, or antihypertensives were excluded from analysis. Risk estimates were made as odds ratios (ORs or risk ratios (RRs after adjustment for year of delivery, maternal age, parity, smoking, and body mass index. Results. Among 23 259 infants whose mothers in early pregnancy used thyroxin, 730 had a major malformation; among all 1 567 736 infants, 48012 had such malformations. The adjusted OR was 1.06 (95% CI 0.98–1.14. For anal atresia the RR was 1.85 (95% CI 1.00–1.85 and for choanal atresia 3.14 (95% CI 1.26–6.47. The risk of some other malformations was also increased but statistical significance was not reached. Conclusions. Treated maternal hypothyroidism may be a weak risk factor for infant congenital malformations but an association with a few rare conditions is possible.

  20. HISTOLOGICAL STUDY OF NEONATAL BOWEL IN ANORECTAL MALFORMATIONS

    Directory of Open Access Journals (Sweden)

    Amrish Tiwari

    2014-06-01

    Full Text Available Anorectal malformations are the congenital condition, seen in approximately 1 in 5000 live births. It affects male and female in the ratio of 1.3:1. Anorectal malformations include a wide range of malformations, that not only involves the anus and rectum, but it also involves urinary and genital tract. Aims and objectives of the study, was to understand the structures involved in anorectal malformations by histological study of surgically excised segments of involved part of neonatal intestine and to understand the degree and cause of possible structural impairment in different segments of involved parts of neonatal bowel that may help in the surgical management of anorectal malformations. Present study was conducted on surgically excised segments of fifteen cases of anorectal malformations, that have been collected from Department of Paediatrics Surgery, IMS, BHU. After that processing of the samples have been done and blocks have been prepared. Then after sectioning and staining with Hematoxyline and Eosin, findings have been noted under the microscope. Histopathological examination revealed the abnormalities of varying degrees. To conclude this study supports that the malformed segments should be excised, regarding controversial issue of preserving or excising the distal segment of anorectum for better functional outcome.

  1. Congenital malformations and perinatal morbidity associated with intestinal neuronal dysplasia.

    Science.gov (United States)

    Berger, S; Ziebell, P; OFFsler, M; Hofmann-von Kap-herr, S

    1998-09-01

    A close relation between different forms of dysganglionosis such as intestinal neuronal dysplasia (IND) type B and aganglionosis has been established. No systematic analysis of other malformations and diseases accompanying IND has been made as yet. Congenital malformations and perinatal morbidity were analyzed in 109 patients with IND seen at the Department of Pediatric Surgery in Mainz from 1977 to 1996. IND was associated with Hirschsprung's disease in 47 cases; 22 children with IND had other abdominal malformations, including anal atresia, rectal stenosis, sigmoidal stenosis, ileal atresia, pyloric stenosis, and esophageal atresia. A cystic bowel duplication, a choledochal cyst, and a persisting urachus were also found. Extra-abdominal malformations such as Down's syndrome, congenital diaphragmatic hernia, aortic stenosis, and malformations of vertebral bodies were seen. Twin siblings of children with IND were either healthy (n=3) or died in utero (n=1). Seventeen children with IND developed severe intra-abdominal complications during the perinatal period such as necrotizing enterocolitis (NEC), meconium ileus, or bowel perforations. NEC was frequently associated with preterm birth. Bowel perforations were seen in mature and preterm newborns with IND. Taken together, IND is found in a variety of obstructive bowel diseases. This may support the hypothesis that IND is a secondary phenomenon or that congenital atresias and stenoses of the digestive tract have a pathogenesis similar to that of intestinal innervation disturbances. IND may also be a part of complex malformation patterns since it occurs with a number of extraintestinal and non-obstructive intestinal malformations. PMID:9716673

  2. Cerebral microangiopathies; Zerebrale Mikroangiopathien

    Energy Technology Data Exchange (ETDEWEB)

    Linn, Jennifer [Klinikum der Universitaet Muenchen (Germany). Abt. fuer Neuroradiologie

    2011-03-15

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  3. Bow-tie risk assessment combining causes and effects applied to gasoil storage in an abandoned salt cavern,

    NARCIS (Netherlands)

    Visser, K; Hendriks, D.; Wildenborg, T.; Duijne, H.

    2014-01-01

    A semi-quantitative risk assessment is presented for the storage of gas oil in depleted salt caverns in the Twente region, the Netherlands. It is based on a bow-tie model, in which an incident, leakage of gas oil from the storage system (cavern and wells), is evaluated by assessing its possible caus

  4. Fetal magnetic resonance imaging of thoracic and abdominal malformations

    International Nuclear Information System (INIS)

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.)

  5. Spine and spinal cord vascular malformations: pictorial essay

    International Nuclear Information System (INIS)

    Spine and spinal cord vascular malformations are an uncommon cause of acute, subacute, episodic or progressive myelopathy. They affect all age groups and constitute important clinical entities because of the high morbidity and even mortality associated with them if they are left untreated. These malformations are classified according to their anatomic location and angioarchitecture (Table 1). Today, magnetic resonance imaging (MRI) is the initial radiologic screening procedure of choice for acute or progressive myelopathy. This pictorial essay reviews the radiologic work-up and the imaging features of spinal vascular malformations, as well as the clinical presentation, the probable pathophysiology and the different treatment modalities. (author)

  6. Role of sodium tetradecyl sulfate in venous malformations

    Directory of Open Access Journals (Sweden)

    Saraf Sanjay

    2006-01-01

    Full Text Available Venous malformations are one of the commonest anomalies of the vascular tree and their management has always remained a major challenge. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence and complication rate. The author retrospectively analyzed 40 patients of venous malformations who underwent sclerotherapy with sodium tetradecyl sulfate solely or as an adjunct to surgery. The purpose of the study was to evaluate the efficacy and safety of sodium tetradecyl sulfate sclerotherapy in the treatment of venous malformations.

  7. Cavernous sinus thrombosis secondary to aspergillus granuloma: A case report and review of the literature.

    Science.gov (United States)

    Brenet, Esteban; Boulagnon-Rombi, Camille; N'guyen, Yohan; Litré, Claude-Fabien

    2016-10-01

    Cavernous sinus thrombosis is a rare but serious complication of sphenoid aspergillosis. The rarity of this pathology makes its diagnostic very difficult on a clinical, biological and radiological sense. The authors present a case of cavernous sinus thrombosis with ipsilateral internal carotid artery thrombosis secondary to a non-invasive sphenoid aspergillosis in an immunocompetent host, responsible of a cavernous syndrome associated to a Claude Bernard Horner syndrome. One year after surgery, the patient is still asymptomatic without recurrence. Diagnostic modalities are detailed and several management of this pathology are compared. Surgery is essential in a diagnostic and therapeutic sense. There is no evidence of the interest of adjuvant therapies such as antibiotic and anticoagulation. Concerning the antifungal treatment, the attitude towards a non-invasive sphenoid aspergillosis in an immunocompetent host is unclear. PMID:26860234

  8. Extrapulmonary tuberculosis presenting as a cavernous sinus syndrome: Case report with review of existing literature

    Directory of Open Access Journals (Sweden)

    Shashi Kapadia M.D.

    2014-01-01

    Full Text Available Tuberculoma involving the cavernous sinus is a rare presentation of CNS disease, with only twelve cases reported in previous literature. We report a case of a 48 year old woman who presented with a right cavernous sinus syndrome of 2 months duration. MRI showed a mass in the right cavernous sinus, and serologic workup revealed an elevated sedimentation rate and positive Quantiferon®-GOLD testing. 18-FDG PET-CT demonstrated a hypermetabolic 3 cm subcarinal lymph node, and lymph node biopsy showed caseating granuloma. Culture of lymphatic tissue grew drug-sensitive M. tuberculosis. The patient was treated with a non-standard 4-drug regimen and prednisone, with rapid improvement of symptoms and radiologic abnormalities. Total length of treatment was 12 months. In addition, we review the 12 cases found in literature, and discuss clinical features, diagnostic dilemmas, and approaches to treatment.

  9. Spectacular test of the fire extinguishing system in the underground cavern of the CMS experiment

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    The enormous rumbling heard 100 m under the earth on Friday, 12 May, was not the start of a foam party at CMS. The Safety Team looked on from the second tier of the CMS underground cavern as it reechoed to the sound of water rushing through the two huge pipes overhead and the air was filled with a mixture of water and foam. A minute later it was a winter wonderland, as fluffy puffs of foam came shooting out of the twelve foam blowers lining the upper cavern walls on both sides. In less than two minutes 7 m3 of water mixed with a small percentage of foaming liquid, was transformed into 5600 m3 of foam and discharged into the cavern.

  10. The return of an old worm: cerebral paragonimiasis presenting with intracerebral hemorrhage.

    Science.gov (United States)

    Koh, Eun Jung; Kim, Seung-Ki; Wang, Kyu-Chang; Chai, Jong-Yil; Chong, Sangjoon; Park, Sung-Hye; Cheon, Jung-Eun; Phi, Ji Hoon

    2012-11-01

    Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.

  11. Call-Fleming Syndrome (Reversible Cerebral Artery Vasoconstriction and Aneurysm Associated with Multiple Recreational Drug Use

    Directory of Open Access Journals (Sweden)

    Doniel Drazin

    2013-01-01

    Full Text Available Drug abuse represents a significant health issue. Evidence suggests that recreational drug use has a direct effect on the cerebral vasculature and is of greater concern in those with undiagnosed aneurysms or vascular malformations. The authors report a case of thunderclap headache with a negative head CT and equivocal lumbar puncture after a drug-fueled weekend. The patient underwent diagnostic cerebral angiogram which demonstrated multisegmental, distal areas of focal narrowing of the middle, anterior, posterior, and posterior inferior cerebral artery and an incidental aneurysm. It is often difficult to determine the exact origin of symptoms; thus we were left with a bit of a chicken or the egg debate, trying to decipher which part came first. Either the aneurysm ruptured with associated concomitant vasospasm or it is a case of Call-Fleming syndrome (reversible cerebral artery vasoconstriction with an incidental aneurysm. The authors proposed their management and rationale of this complex case.

  12. Call-fleming syndrome (reversible cerebral artery vasoconstriction) and aneurysm associated with multiple recreational drug use.

    Science.gov (United States)

    Drazin, Doniel; Alexander, Michael J

    2013-01-01

    Drug abuse represents a significant health issue. Evidence suggests that recreational drug use has a direct effect on the cerebral vasculature and is of greater concern in those with undiagnosed aneurysms or vascular malformations. The authors report a case of thunderclap headache with a negative head CT and equivocal lumbar puncture after a drug-fueled weekend. The patient underwent diagnostic cerebral angiogram which demonstrated multisegmental, distal areas of focal narrowing of the middle, anterior, posterior, and posterior inferior cerebral artery and an incidental aneurysm. It is often difficult to determine the exact origin of symptoms; thus we were left with a bit of a chicken or the egg debate, trying to decipher which part came first. Either the aneurysm ruptured with associated concomitant vasospasm or it is a case of Call-Fleming syndrome (reversible cerebral artery vasoconstriction) with an incidental aneurysm. The authors proposed their management and rationale of this complex case.

  13. Cavernous sinus sampling in patients with Cushing's disease.

    Science.gov (United States)

    Burkhardt, Till; Flitsch, Jörg; van Leyen, Philine; Sauer, Nina; Aberle, Jens; Grzyska, Ulrich; Lüdecke, Dieter K

    2015-02-01

    OBJECT Correct diagnosis and precise localization of adenomas in patients with Cushing's disease are essential for avoiding unsuccessful transsphenoidal pituitary exploration. In addition to the well-established inferior petrosal sinus sampling, preoperative cavernous sinus sampling (CSS) was introduced as a potentially improved way to predict adenoma lateralization. The authors present their results with CSS in a consecutive series of patients with Cushing's disease. METHODS During 1999-2014, transsphenoidal surgeries were consecutively performed in 510 patients with Cushing's disease. For most patients, suppression of cortisol in high-dose dexamethasone tests and stimulation of adrenocorticotropic hormone and cortisol after administration of corticotropin-releasing hormone were sufficient to prove the diagnosis of adrenocorticotropic hormone-dependent hypercortisolism. Of the 510 patients, 67 (13%) were referred to the department of neuroradiology for CSS according to the technique of Teramoto. The indications for CSS were unclear endocrine test results or negative MRI results. Data for all patients were retrospectively analyzed. RESULTS A central/peripheral gradient was found in 59 patients; lateralization to the left or right side was found in 51. For 8 patients with a central/peripheral gradient, no left/right gradient could be determined. For another 8 patients with equivocal test results, no central/peripheral gradient was found. No severe CSS-associated complications were encountered. Of the 51 patients who underwent transsphenoidal surgery, the predicted lateralization was proven correct for 42 (82%). CONCLUSIONS As MRI techniques have improved, the number of potential candidates for this invasive method has decreased in the past decade. However, because detecting minute adenomas remains problematic, CSS remains a useful diagnostic tool for patients with Cushing's disease.

  14. Manifestations of hepatic cavernous hemangioma in carbon dioxidedigital subtraction angiography

    Institute of Scientific and Technical Information of China (English)

    LU Wei; LI Yan-ha0; HE Xiao-feng; CHEN Yong; ZENG Qing-le

    2002-01-01

    Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL)presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the diagnosis of CHL. Methods: Both CO2-DSA and iodinated contrast DSA (IC-DSA) were performed in all 16 patients with CHL, and the angiographic manifestations in the same patients were compared. The image quality was rated by three experienced angiographers, and the complications were also assessed. Results; There was good correlation between angiographers on image quality (R=0. 73). Diagnostic images were obtained with both CO2-DSA and IC-DSA in all CHL patients. No difference was noted between IC-DSA and CO2-DSA in visualizing the proper hepatic arteries and its branches (P>0. 05). CO2-DSA produced better images that clearly described the tumor size, shape and margination than those by IC-DSA (P<0. 05), but both demonstrated characteristic appearances of early opacification and persistent contrast enhancement of the tumors. The portal vein branches near the tumors were constantly demonstrated by CO2-DSA in 15 cases (15/16) but only in 2 cases (2/16) by IC-DSA. Conclusion: CO2-DSA is sensitive in CHL diagnosis, and in patients with contraindications to IC or with unsatisfactory imaging results by IC-DSA,CO2-DSA is a good alternative. As show in most cases by CO2-DSA, the portal veins might act as the main drainage vein of CHLs.

  15. Neuroimaging in Cerebral Palsy – Report from North India

    Directory of Open Access Journals (Sweden)

    Anju AGGARWAL

    2013-11-01

    Full Text Available How to Cite This Article: Aggarwal A, Mittal H, Debnath SKR, Rai A. Neuroimaging in Cerebral Palsy–Report from North India. Iran J Child Neurol. 2013 Autumn; 7(3:41- 46. ObjectiveOnly few Indian reports exist on neuroimaging abnormalities in children with cerebral palsy (CP from India. Materials & MethodsWe studied the clinico-radiological profile of 98 children diagnosed as CP at a tertiary centre in North India. Relevant investigations were carried out to determine the etiology. ResultsAmong the 98 children studied, 80.5% were males and 22.2% were premature. History of birth asphyxia was present in 41.9%. Quadriplegic CP was seen in 77.5%, hemiplegic in 11.5%, and diplegic in 10.5%. Other abnormalities were microcephaly (60.5%, epilepsy (42%, visual abnormality (37%, and hearing abnormality (20%. Neuroimaging was abnormal in 94/98 (95.91%.Abnormalities were periventricular white matter abnormalities (34%, deep grey matter abnormalities (47.8%, malformations (11.7%, and miscellaneous lesions (6.4%. Neuroimaging findings did not relate to the presence of birth asphyxia, sex, epilepsy, gestation, type of CP, or microcephaly. ConclusionsNeuroimaging is helpful for etiological diagnosis, especially malformations.  ReferencesSinghi PD, Ray M, Suri G. Clinical spectrum of cerebral palsy in north India-an analysis of 1000 cases. J Trop Pediatr 2002 48(3; 162-6.Sharma P, Sharma U, Kabra A. Cerebral Palsy-Clinical Profile and Predisposing Factors. Indian Pediatr 1999;36(10:1038-42.Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986 315(2:81-6.Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Dev Med Child Neurol 2007; 49(2:144-51.Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007

  16. Clitoromegaly caused by cavernous hemangioma: A rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bita Geramizadeh

    2012-01-01

    Full Text Available Hemangioma is a common benign neoplasm, but a location such as the clitoris is very rare. However, it is very important to differentiate clitoral hemangioma from enlargement of the clitoris secondary to androgen excess. To the best of our knowledge, only three cases of clitoromegaly caused by cavernous hemangioma have been reported in the English literature. Herein, we report our experience with a 16-year-old girl who presented with clitoromegaly and normal hormonal assay that turned out to be clitoral cavernous hemangioma after pathologic examination of the clitoral mass.

  17. Treatment of traumatic trigeminal-cavernous fistula by coil embolization and compression of carotid artery

    Directory of Open Access Journals (Sweden)

    Yang Xinjian

    2007-01-01

    Full Text Available We report a case of a traumatic cavernous fistula supplied by a persistent primitive trigeminal artery. The process of treatment was unique in this case. Fistula was subcompletely occluded by coiling from primitive trigeminal artery. Residual fistula was helped to form thrombosis by compression of the carotid artery with hand in the procedure. Long-term follow-up was satisfactory. Traumatic cavernous fistula supplied by a persistent primitive trigeminal artery could be treated by embolization and temporal compression of the parent artery might be useful for residual minimal fistula.

  18. Ultimate storage in salt caverns / status report; Endverwahrung von Salzkavernen / Stand der Entwicklung

    Energy Technology Data Exchange (ETDEWEB)

    Crotogino, F.; Schmidt, U. [Kavernen Bau- und Betriebs-GmbH, Hannover (Germany)

    1998-12-31

    The contribution reviews the state of knowledge on final storage in salt caverns. The long-term effects of a hermetically sealed, brine-filled cavern are discussed. So far, there are no valid predictions. (orig.) [Deutsch] In dem Beitrag wird der derzeitige Kenntnis- und Diskussionsstand zur Endverwahrung von Salzkavernen zusammengefasst. Aufbauend auf den bisher vorliegenden Vorstellungen zur Soleimpraegnation bei einem Innendruck, der nahezu dem Ueberlagerungsdruck entspricht, werden die denkbaren langfristigen Auswirkungen einer vollstaendig abgeschlossenen solegefuellten Kaverne skizziert; belastbare Prognosen sind derzeit noch nicht moeglich. (orig.)

  19. Adult onset segmental cavernous hemangioma, varicose veins and limb atrophy (klippel-trenaunay-Weber syndrome variant

    Directory of Open Access Journals (Sweden)

    Sawhney MPS

    1990-01-01

    Full Text Available A 22 year-old woman presented with multiple soft, compressible, protuberant, bluish cutaneous lesions as well as firm, non-compressible, subcutaneous masses and varicose veins affecting the right upper limb of three years duration. There was atrophy of soft tissue of forearm by 2.5 cm. X-ray showed soft tissue densities, multiple phleboliths and hypoplastic forearm bones. Histopathological examination from cutaneous lesions revealed cavernous hemangioma. Adult onset cavernous hemangioma involving one upper limb and breast with multiple phleboliths and limb atrophy is a very unusual presentation of Klippel-Trenaunay-Weber syndrome.

  20. Simulation of Mechanical Processes in Gas Storage Caverns for Short-Term Energy Storage

    Science.gov (United States)

    Böttcher, Norbert; Nagel, Thomas; Kolditz, Olaf

    2015-04-01

    In recent years, Germany's energy management has started to be transferred from fossil fuels to renewable and sustainable energy carriers. Renewable energy sources such as solar and wind power are subjected by fluctuations, thus the development and extension of energy storage capacities is a priority in German R&D programs. This work is a part of the ANGUS+ Project, funded by the federal ministry of education and research, which investigates the influence of subsurface energy storage on the underground. The utilization of subsurface salt caverns as a long-term storage reservoir for fossil fuels is a common method, since the construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to solution mining. Another advantage of evaporate as host material is the self-healing behaviour of salt rock, thus the cavity can be assumed to be impermeable. In the framework of short-term energy storage (hours to days), caverns can be used as gas storage reservoirs for natural or artificial fuel gases, such as hydrogen, methane, or compressed air, where the operation pressures inside the caverns will fluctuate more frequently. This work investigates the influence of changing operation pressures at high frequencies on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. The salt behaviour is described by well-known constitutive material models which are capable of predicting creep, self-healing, and dilatancy processes. Our simulations include the thermodynamic behaviour of gas storage process, temperature development and distribution on the cavern boundary, the deformation of the cavern geometry, and the prediction of the dilatancy zone. Based on the numerical results, optimal operation modes can be found for individual caverns, so the risk of host rock damage