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Sample records for familial cerebral cavernous

  1. Detection of Novel Mutation in Ccm3 Causes Familial Cerebral Cavernous Malformations.

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    Scimone, Concetta; Bramanti, Placido; Ruggeri, Alessia; Katsarou, Zoe; Donato, Luigi; Sidoti, Antonina; D'Angelo, Rosalia

    2015-11-01

    Cerebral cavernous malformations are vascular lesions that usually involve brain micro-vessels. They can occur both in a sporadic form and familial one. Causes of familial forms are mutations at three loci: CCM1/KRIT1, CCM2/MGC4607, and CCM3/PDCD10. Here, we describe a novel CCM3 missense mutation (c.422T>G) detected in two Greek brothers showing multiple lesions at magnetic resonance imaging; to date, only the youngest is symptomatic. Bioinformatics tools showed this novel variant causes a loss of function in Pdcd10 protein due to its localization in the eighth helix and, particularly, affects Leu141, a highly conserved amino acid. Roles of Pdcd10 in angiogenesis regulation and its association with early development of cerebral cavernous malformations were also considered.

  2. 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.

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

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    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.

  4. A novel CCM2 gene mutation associated with family cerebral cavernous malformation

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    Wen-Qing Huang

    2016-09-01

    Full Text Available Background: Cerebral cavernous malformations (CCMs are common vascular malformations that predominantly arise in the central nervous system and are mainly characterized by enlarged vascular cavities without intervening brain parenchyma. Familial CCMs (FCCMs is inherited in an autosomal dominant pattern with incomplete penetrance and variable symptoms. Methods: Mutations of three pathogenic genes, CCM1, CCM2 and CCM3, were investigated by direct DNA sequencing in a Chinese family with multiple CCM lesions. Results: Four heterozygous variants in the CCM2 gene, including one deletion (c.95delC, a missense mutation (c.358G>A, p.V120I, one silent mutation (c.915G>A, p.T305T, and a substitution (c. *1452 T>C, were identified in the subjects with multiple CCM lesions, but not in a healthy sibling. Among these variants, the c.95delC deletion is a novel mutation which is expected to cause a premature termination codon. It is predicted to produce a truncated CCM2 protein lacking the PTB and C-terminal domains, thus disrupting the molecular functions of CCM2. Conclusions: The novel truncating mutation in the CCM2 gene, c.95delC, may be responsible for multiple CCM lesions in a part of FCCM. In addition, it may represent a potential genetic biomarker for early diagnosis of FCCM.

  5. Genetically diagnosed Birt-Hogg-Dubé syndrome and familial cerebral cavernous malformations in the same individual: a case report.

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    Whitworth, James; Stausbøl-Grøn, Brian; Skytte, Anne-Bine

    2017-01-01

    When faced with an unusual clinical feature in a patient with a Mendelian disorder, the clinician may entertain the possibilities of either the feature representing a novel manifestation of that disorder or the co-existence of a different inherited condition. Here we describe an individual with a submandibular oncocytoma, pulmonary bullae and renal cysts as well as multiple cerebral cavernous malformations and haemangiomas. Genetic investigations revealed constitutional mutations in FLCN, associated with Birt-Hogg-Dubé syndrome (BHD) and CCM2, associated with familial cerebral cavernous malformation. Intracranial vascular pathologies (but not cerebral cavernous malformation) have recently been described in a number of individuals with BHD (Kapoor et al. in Fam Cancer 14:595-597, 10.1007/s10689-015-9807-y , 2015) but it is not yet clear whether they represent a genuine part of that conditions' phenotypic spectrum. We suggest that in such instances of potentially novel clinical features, more extensive genetic testing to consider co-existing conditions should be considered where available. The increased use of next generation sequencing applications in diagnostic settings is likely to lead more cases such as this being revealed.

  6. Cerebral Cavernous Malformation and Hemorrhage

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    ... moderately, but avoid strenuous activities such as heavy weightlifting that can cause acute spikes in blood pressure ... angioma story See More Videos » Cavernous Angioma and Children Dr. Issam Awad at the Angioma Alliance Family ...

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

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    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

  8. 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.

  9. Vascular permeability in cerebral cavernous malformations

    DEFF Research Database (Denmark)

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

    2015-01-01

    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 observ......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...

  10. Vascular permeability in cerebral cavernous malformations.

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    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.

  11. Cerebral cavernous malformations: clinical insights from genetic studies.

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    Mindea, Stefan A; Yang, Benson P; Shenkar, Robert; Bendok, Bernard; Batjer, H Hunt; Awad, Issam A

    2006-07-15

    Familial disease is responsible for one third to one half of cerebral cavernous malformation (CCM) cases presenting to clinical attention. Much has been learned in the past decade about the genetics of these cases, which are all inherited in an autosomal dominant pattern, at three known chromosome loci. Unique features of inherited CCMs in Hispanic-Americans of Mexican descent have been described. The respective genes for each locus have been identified and preliminary observations on disease pathways and mechanisms are coming to light, including possible explanations for selectivity of neural milieu and relationships to endothelial layer abnormalities. Mechanisms of lesion genesis in cases of genetic predisposition are being investigated, with evidence to support a two-hit model emerging from somatic mutation screening of the lesions themselves and from lesion formation in transgenic murine models of the disease. Other information on potential inflammatory factors has emerged from differential gene expression studies. Unique phenotypic features of solitary versus familial cases have emerged: different associations with venous developmental anomaly and the exceptionally high penetrance rates that are found in inherited cases when high-sensitivity screening is performed with gradient echo magnetic resonance imaging. This information has changed the landscape of screening and counseling for patients and their families, and promises to lead to the development of new tools for predicting, explaining, and modifying disease behavior.

  12. Cerebral cavernous malformations as a disease of vascular permeability: from bench to bedside with caution.

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    Yadla, Sanjay; Jabbour, Pascal M; Shenkar, Robert; Shi, Changbin; Campbell, Peter G; Awad, Issam A

    2010-09-01

    Tremendous insight into the molecular and genetic pathogenesis of cerebral cavernous malformations (CCMs) has been gained over the past 2 decades. This includes the identification of 3 distinct genes involved in familial CCMs. Still, a number of unanswered questions regarding the process from gene mutation to vascular malformation remain. It is becoming more evident that the disruption of interendothelial junctions and ensuing vascular hyperpermeability play a principal role. The purpose of this review is to summarize the current understanding of CCM genes, associated proteins, and functional pathways. Promising molecular and genetic therapies targeted at identified molecular aberrations are discussed as well.

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

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    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.

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

    NARCIS (Netherlands)

    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

    2016-01-01

    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

  15. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS

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    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Wyrwicz, Alice M.; Zhao, Jin-cheng; Shi, Changbin; Akers, Amy; Marchuk, Douglas A.; Awad, Issam A.

    2008-01-01

    Objective We sought to assess the appearance of cerebral cavernous malformations (CCMs) on magnetic resonance (MR) imaging in murine Ccm1 and Ccm2 gene knockout models, and to develop a technique of lesion localization for correlative pathobiologic studies Methods Brains from eighteen CCM mutant mice (Ccm1+/-Trp53-/- and Ccm2+/-Trp53-/-) and 28 controls were imaged by gradient recalled echo (T2*)-weighted MR at 4.7 T and 14.1 T in vivo and/or ex vivo. After MR imaging, the brains were removed and stained with hematoxylin and eosin and cells were laser microdissected for molecular biologic studies. Results T2*-weighted MR imaging of brains in vivo and ex vivo revealed lesions similar to human CCMs in mutant mice, but not in control animals. Stereotactic localization and hematoxylin and eosin-staining of correlative tissue sections confirmed lesion histology, and revealed other areas of dilated capillaries in the same brains. Some lesions were identified by MR imaging at 14.1 T, but not at 4.7 T. PCR amplification from Ccm1 and β-actin genes was demonstrated from nucleic acids extracted from laser microdissected lesional and perilesional cells. Conclusions The high field MR imaging techniques offer new opportunities for further investigation of disease pathogenesis in vivo, and the localization, staging and histobiologic dissection of lesions, including the presumed earliest stages of CCM lesion development. PMID:18981891

  16. Evaluation of cerebral oximetry during endovascular treatment of carotid-cavernous fistula

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    Dujovny, Manuel; Misra, Mukesh; Alp, M. Serdar; Debrun, Gerard; Charbel, F. T.; Aletich, Victor; Ausman, James I.

    1997-08-01

    Endovascular treatment of carotid cavernous fistula is done routinely in our institution. We have been monitoring these patients with transcranial cerebral oximetry. The transcranial cerebral oximeter is a reliable, low-cost, non-invasive device that provides real-time evaluation of regional brain oxygen saturation during and after endovascular treatment of cerebrovascular diseases. We used the INVOS 3100A (Somanetics, Troy, MI) in our study. We discuss seven patients with carotid-cavernous fistulas treated by endovascular balloon occlusion, each monitored continuously before, during, and after the procedure with transcranial cerebral oximetry. The cerebral oxygen saturation depicted was directly related to the side of the venous drainage of the fistula, with the brain oxygen saturation 15 - 20% higher on the side of the venous drainage. Following endovascular occlusion of the fistula, oxygen saturation gradually became equal on both sides. In our patients treated for carotid-cavernous fistula, we evaluated the sensitivity and usefulness of cerebral oximetry as an important non-invasive monitoring tool for the endovascular treatment of carotid-cavernous fistula.

  17. Update on Novel CCM Gene Mutations in Patients with Cerebral Cavernous Malformations.

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    Scimone, Concetta; Bramanti, Placido; Alafaci, Concetta; Granata, Francesca; Piva, Francesco; Rinaldi, Carmela; Donato, Luigi; Greco, Federica; Sidoti, Antonina; D'Angelo, Rosalia

    2017-02-01

    Cerebral cavernous malformations (CCMs) are lesions affecting brain microvessels. The pathogenesis is not clearly understood. Conventional classification criterion is based on genetics, and thus, familial and sporadic forms can be distinguished; however, classification of sporadic cases with multiple lesions still remains uncertain. To date, three CCM causative genes have been identified: CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10. In our previous mutation screening, performed in a cohort of 95 Italian patients, with both sporadic and familial cases, we identified several mutations in CCM genes. This study represents further molecular screening in a cohort of 19 Italian patients enrolled by us in the few last years and classified into familial, sporadic and sporadic with multiple lesions cases. Direct sequencing and multiplex ligation-dependent probe amplification (MLPA) analysis were performed to detect point mutations and large genomic rearrangements, respectively. Effects of detected mutations and single-nucleotide polymorphisms (SNPs) were evaluated by an in silico approach and by western blot analysis. A novel nonsense mutation in CCM1 and a novel missense mutation in CCM2 were detected; moreover, several CCM2 gene polymorphisms in sporadic CCM patients were reported. We believe that these data enrich the mutation spectrum of CCM genes, which is useful for genetic counselling to identify both familial and sporadic CCM cases, as early as possible.

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

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    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.

  19. Quantitative Susceptibility Mapping and Dynamic Contrast Enhanced Quantitative Perfusion in Cerebral Cavernous Angiomas

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    Mikati, Abdul Ghani; Tan, Huan; Shenkar, Robert; Li, Luying; Zhang, Lingjiao; Guo, Xiaodong; Shi, Changbin; Liu, Tian; Wang, Yi; Shah, Akash; Edelman, Robert; Christoforidis, Gregory; Awad, Issam

    2015-01-01

    Background Hyperpermeability and iron deposition are two central pathophysiological phenomena in human cerebral cavernous malformation (CCM) disease. Here we used two novel magnetic resonance imaging (MRI) techniques to establish a relationship between these phenomena. Methods Subjects with CCM disease (4 sporadic and 18 familial) underwent MRI imaging using the Dynamic Contrast Enhanced Quantitative Perfusion (DCEQP) and Quantitative Susceptibility Mapping (QSM) techniques that measure hemodynamic factors of vessel leak and iron deposition respectively, previously demonstrated in CCM disease. Regions of interest encompassing the CCM lesions were analyzed using these techniques Results Susceptibility measured by QSM was positively correlated with permeability of lesions measured using DCEQP (r=0.49, p=<0.0001). The correlation was not affected by factors including familial predisposition, lesion volume, the contrast agent and the use of statin medication. Susceptibility was correlated with lesional blood volume (r=0.4, p=0.0001), but not with lesional blood flow. Conclusion The correlation between QSM and DCEQP suggests that the phenomena of permeability and iron deposition are related in CCM; hence “more leaky lesions” also manifest a more cumulative iron burden. These techniques might be used as biomarkers to monitor the course of this disease and the effect of therapy. PMID:24302484

  20. Cerebral cavernous malformations proteins inhibit Rho kinase to stabilize vascular integrity.

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    Stockton, Rebecca A; Shenkar, Robert; Awad, Issam A; Ginsberg, Mark H

    2010-04-12

    Endothelial cell-cell junctions regulate vascular permeability, vasculogenesis, and angiogenesis. Familial cerebral cavernous malformations (CCMs) in humans result from mutations of CCM2 (malcavernin, OSM, MGC4607), PDCD10 (CCM3), or KRIT1 (CCM1), a Rap1 effector which stabilizes endothelial cell-cell junctions. Homozygous loss of KRIT1 or CCM2 produces lethal vascular phenotypes in mice and zebrafish. We report that the physical interaction of KRIT1 and CCM2 proteins is required for endothelial cell-cell junctional localization, and lack of either protein destabilizes barrier function by sustaining activity of RhoA and its effector Rho kinase (ROCK). Protein haploinsufficient Krit1(+/-) or Ccm2(+/-) mouse endothelial cells manifested increased monolayer permeability in vitro, and both Krit1(+/-) and Ccm2(+/-) mice exhibited increased vascular leak in vivo, reversible by fasudil, a ROCK inhibitor. Furthermore, we show that ROCK hyperactivity occurs in sporadic and familial human CCM endothelium as judged by increased phosphorylation of myosin light chain. These data establish that KRIT1-CCM2 interaction regulates vascular barrier function by suppressing Rho/ROCK signaling and that this pathway is dysregulated in human CCM endothelium, and they suggest that fasudil could ameliorate both CCM disease and vascular leak.

  1. Sporadic Cerebral Cavernous Malformations: Report of Further Mutations of CCM Genes in 40 Italian Patients

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    Rosalia D’Angelo

    2013-01-01

    Full Text Available Cerebral cavernous malformations (CCMs are vascular lesions characterized by abnormally enlarged capillary cavities, affecting the central nervous system. CCMs can occur sporadically or as a familial autosomal dominant condition with incomplete penetrance and variable clinical expression attributable to mutations in three different genes: CCM1 (K-Rev interaction trapped 1 (KRIT1, CCM2 (MGC4607, and CCM3 (PDCD10. CCMs occur as a single or multiple malformations that can lead to seizures, focal neurological deficits, hemorrhagic stroke, and headache. However, patients are frequently asymptomatic. In our previous mutation screening, performed in a cohort of 95 Italian patients, both sporadic and familial, we have identified several mutations in CCM genes, three of which in three distinct sporadic patients. In this study, representing further molecular screening of the three CCM genes, in a south Italian cohort of CCM patients enrolled by us in the last three years, we report the identification of other four new mutations in 40 sporadic patients with either single or multiple CCM.

  2. Sporadic Cerebral Cavernous Malformations: Report of Further Mutations of CCM Genes in 40 Italian Patients

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    D'Angelo, Rosalia; Alafaci, Concetta; Scimone, Concetta; Ruggeri, Alessia; Salpietro, Francesco Maria; Bramanti, Placido; Tomasello, Francesco; Sidoti, Antonina

    2013-01-01

    Cerebral cavernous malformations (CCMs) are vascular lesions characterized by abnormally enlarged capillary cavities, affecting the central nervous system. CCMs can occur sporadically or as a familial autosomal dominant condition with incomplete penetrance and variable clinical expression attributable to mutations in three different genes: CCM1 (K-Rev interaction trapped 1 (KRIT1)), CCM2 (MGC4607), and CCM3 (PDCD10). CCMs occur as a single or multiple malformations that can lead to seizures, focal neurological deficits, hemorrhagic stroke, and headache. However, patients are frequently asymptomatic. In our previous mutation screening, performed in a cohort of 95 Italian patients, both sporadic and familial, we have identified several mutations in CCM genes, three of which in three distinct sporadic patients. In this study, representing further molecular screening of the three CCM genes, in a south Italian cohort of CCM patients enrolled by us in the last three years, we report the identification of other four new mutations in 40 sporadic patients with either single or multiple CCM. PMID:24058906

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

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    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.

  4. Novel, mutable site in the cerebral cavernous malformation-1 gene in Chinese sporadic intracranial cavernous malformation patients

    Institute of Scientific and Technical Information of China (English)

    Rong Xie; Xiancheng Chen

    2009-01-01

    BACKGROUND: A cerebral cavernous malformation-1 (CCM1) gene mutation might result in functional loss of KREV interaction trapped-1 (KRIT1), which is related to onset of cavernous malformations (CM). However, data addressing sporadic CM in Chinese patients remains limited to date.OBJECTIVE: To analyze CCM1 mutation of Chinese patients with sporadic intracranial CM.DESIGN, TIME AND SETTING: Genetics experiment was performed in the Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University between January 2004 and December 2005.PARTICIPANTS: Ninety patients with sporadic CM served as the CM group, and 30 healthy subjects were considered to be the control group.METHODS: Peripheral blood was collected from patients with CM and from control group subjects.Genomic DNA was extracted, and exons 8, 9, 11, 12, 13, 15, 16, 17, and 18, as well as the related introns, were amplified using polymerase chain reaction. DNA sequences were compared with GeneBank.MAIN OUTCOME MEASURES: Abnormal mutable site of CCM1 gene in the two groups.RESULTS: Four exclusive mutations of CCM1 were detected in the CM group, with a sporadic CM mutational rate of 32% (6/19). Of the four exclusive mutations, there was one missense mutation [exon 12, 1172C→T (S391F)], one insertion mutation [exon 8, 704insT (K246stop)], one intervening sequence mutation (IVS12-4C→T), and one synonymous mutation (exon 17,1875C→T). With the exception of 1875C→T, all mutations detected in the CM group led to functional changes of the KRIT1 protein, which was encoded by the CCM1 gene. Gene mutations were not detected in the control group.CONCLUSION: Four exclusive mutations of the CCM1 gene were determined in Chinese patients with sporadic CM, which led to functional changes or loss of the encoding KRIT1 protein. KRIT1 protein is considered to be the genetic basis of CM occurrence.

  5. ADVANCED MAGNETIC RESONANCE IMAGING OF CEREBRAL CAVERNOUS MALFORMATIONS: I. HIGH FIELD IMAGING OF EXCISED HUMAN LESIONS

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    Shenkar, Robert; Venkatasubramanian, Palamadai N.; Zhao, Jin-cheng; Batjer, H. Hunt; Wyrwicz, Alice M.; Awad, Issam A.

    2008-01-01

    Objectives We hypothesized that structural details would be revealed in cerebral cavernous malformations (CCMs) through the use of high field magnetic resonance (MR) and confocal microscopy, which have not been described previously. The structural details of CCMs excised from human patients were sought by examination with high field MR imaging, and correlated with confocal microscopy of the same specimens. Novel features of CCM structure are outlined, including methodological limitations, venues for future research and possible clinical implications. Methods CCM lesions excised from four patients were fixed in 2% paraformaldehyde and subjected to high resolution MR imaging at 9.4 or 14.1 Tesla by spin-echo and gradient recalled echo methods. Histological validation of angioarchitecture was conducted on thick sections of CCM lesions using fluorescent probes to endothelium under confocal microscopy. Results Images of excised human CCM lesions were acquired with proton density-weighted, T1-weighted, T2-weighted spin echo and T2*-weighted gradient-recalled echo MR. These images revealed large “bland” regions with thin walled caverns, and “honeycombed” regions with notable capillary proliferation and smaller caverns surrounding larger caverns. Proliferating capillaries and caverns of various sizes were also associated with the wall of apparent larger blood vessels in the lesions. Similar features were confirmed within thick sections of CCMs by confocal microscopy. MR relaxation times in different regions of interest suggested the presence of different states of blood breakdown products in areas with apparent angiogenic proliferative activity. Conclusions The high field MR imaging techniques demonstrate novel features of CCM angioarchitecture, visible at near histological resolution, including regions with apparently different biologic activity. These preliminary observations will motivate future research, correlating lesion biologic and clinical activity with

  6. Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

    Directory of Open Access Journals (Sweden)

    Vagner Moyses Vilela

    2013-06-01

    Full Text Available The present report describes the case of a 43-year-old diabetic patient with facial pain, protruding eyes, nasal congestion and decreased right vision (involvement of the ipsilateral cranial nerves III, IV and V. Computed tomography showed diffuse sinusitis at right, cribriform plate erosion and presence of a hypodense collection in the frontal lobe with peripheral enhancement. Magnetic resonance imaging confirmed the presence of a cerebral abscess. Samples were collected from the lesion, confirming hyphae compatible with mucormycosis.

  7. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations.

    Science.gov (United States)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A; Tan, Huan; Mikati, Abdul Ghani; Shi, Changbin; Jesselson, Michael; Shenkar, Robert; Wu, Meijing; Cao, Ying; Hobson, Nicholas; Larsson, Henrik B W; Christoforidis, Gregory A; Awad, Issam A

    2016-08-05

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2.4-31.27 months). Based on clinical and imaging features, cases/lesions were classified as stable, unstable, or recovering. Associated and predictive changes in quantitative permeability and susceptibility were investigated. RESULTS Lesional mean permeability and QSM values were not significantly different in stable versus unstable lesions at baseline. Mean lesional permeability in unstable CCMs with lesional bleeding or growth increased significantly (+85.9% change; p = 0.005), while mean permeability in stable and recovering lesions did not significantly change. Mean lesional QSM values significantly increased in unstable lesions (+44.1% change; p = 0.01), decreased slightly with statistical significance in stable lesions (-3.2% change; p = 0.003), and did not significantly change in recovering lesions. Familial cases developing new lesions during the follow-up period showed a higher background brain permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective and quantifiable biomarkers of disease activity in CCMs. This may be applied in natural history studies and may help calibrate clinical trials. The 2 techniques are likely applicable in

  8. Cerebral cavernous malformations arise from endothelial gain of MEKK3-KLF2/4 signalling.

    Science.gov (United States)

    Zhou, Zinan; Tang, Alan T; Wong, Weng-Yew; Bamezai, Sharika; Goddard, Lauren M; Shenkar, Robert; Zhou, Su; Yang, Jisheng; Wright, Alexander C; Foley, Matthew; Arthur, J Simon C; Whitehead, Kevin J; Awad, Issam A; Li, Dean Y; Zheng, Xiangjian; Kahn, Mark L

    2016-04-07

    Cerebral cavernous malformations (CCMs) are common inherited and sporadic vascular malformations that cause strokes and seizures in younger individuals. CCMs arise from endothelial cell loss of KRIT1, CCM2 or PDCD10, non-homologous proteins that form an adaptor complex. How disruption of the CCM complex results in disease remains controversial, with numerous signalling pathways (including Rho, SMAD and Wnt/β-catenin) and processes such as endothelial-mesenchymal transition (EndMT) proposed to have causal roles. CCM2 binds to MEKK3 (refs 7, 8, 9, 10, 11), and we have recently shown that CCM complex regulation of MEKK3 is essential during vertebrate heart development. Here we investigate this mechanism in CCM disease pathogenesis. Using a neonatal mouse model of CCM disease, we show that expression of the MEKK3 target genes Klf2 and Klf4, as well as Rho and ADAMTS protease activity, are increased in the endothelial cells of early CCM lesions. By contrast, we find no evidence of EndMT or increased SMAD or Wnt signalling during early CCM formation. Endothelial-specific loss of Map3k3 (also known as Mekk3), Klf2 or Klf4 markedly prevents lesion formation, reverses the increase in Rho activity, and rescues lethality. Consistent with these findings in mice, we show that endothelial expression of KLF2 and KLF4 is increased in human familial and sporadic CCM lesions, and that a disease-causing human CCM2 mutation abrogates the MEKK3 interaction without affecting CCM complex formation. These studies identify gain of MEKK3 signalling and KLF2/4 function as causal mechanisms for CCM pathogenesis that may be targeted to develop new CCM therapeutics.

  9. Cerebral cavernous malformations arise from endothelial gain of MEKK3-KLF2/4 signaling

    Science.gov (United States)

    Zhou, Zinan; Tang, Alan T.; Wong, Weng-Yew; Bamezai, Sharika; Goddard, Lauren M.; Shenkar, Robert; Zhou, Su; Yang, Jisheng; Wright, Alexander C.; Foley, Matthew; Arthur, J. Simon C.; Whitehead, Kevin J.; Awad, Issam A.; Li, Dean Y.; Zheng, Xiangjian; Kahn, Mark L.

    2016-01-01

    Cerebral cavernous malformations (CCMs) are common inherited and sporadic vascular malformations that cause stroke and seizures in younger individuals1. CCMs arise from endothelial cell loss of KRIT1, CCM2, or PDCD10, non-homologous proteins that form an adaptor complex2. How disruption of the CCM complex results in disease remains controversial, with numerous signaling pathways (including Rho3,4, SMAD5 and Wnt/β-catenin6) and processes such as endothelial-mesenchymal transition (EndMT)5 proposed to play causal roles. CCM2 binds MEKK37–11, and we have recently demonstrated that CCM complex regulation of MEKK3 is essential during vertebrate heart development12. Here, we investigate this mechanism in CCM disease pathogenesis. Using a neonatal mouse model of CCM disease, we find that expression of the MEKK3 target genes KLF2 and KLF4, as well as Rho and ADAMTS protease activity, are increased in the endothelial cells of early CCM lesions. In contrast, we find no evidence of EndMT or increased SMAD or Wnt signaling during early CCM formation. Endothelial-specific loss of Mekk3, Klf2, or Klf4 dramatically prevents lesion formation, reverses the increase in Rho activity, and rescues lethality. Consistent with these findings in mice, we demonstrate that endothelial expression of KLF2 and KLF4 is elevated in human familial and sporadic CCM lesions, and that a disease-causing human CCM2 mutation abrogates MEKK3 interaction without affecting CCM complex formation. These studies identify gain of MEKK3 signaling and KLF2/4 function as causal mechanisms for CCM pathogenesis that may be targeted to develop new CCM therapeutics. PMID:27027284

  10. 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.

  11. 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.

  12. 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.

  13. Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

    DEFF Research Database (Denmark)

    Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A

    2017-01-01

    OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability...... (DCEQP) and quantitative susceptibility mapping (QSM) assessed by MRI. METHODS Forty-six patients with CCMs underwent 2 or more permeability and/or susceptibility studies in conjunction with baseline and follow-up imaging and clinical surveillance during a mean 12.05 months of follow-up (range 2...... permeability at baseline (p = 0.001), as well as higher regional permeability (p = 0.003) in the area that would later develop a new lesion as compared with the homologous contralateral brain region. CONCLUSIONS In vivo assessment of vascular permeability and iron deposition on MRI can serve as objective...

  14. Immune complex formation and in situ B-cell clonal expansion in human cerebral cavernous malformations.

    Science.gov (United States)

    Shi, Changbin; Shenkar, Robert; Kinloch, Andrew; Henderson, Scott G; Shaaya, Mark; Chong, Anita S; Clark, Marcus R; Awad, Issam A

    2014-07-15

    Cerebral cavernous malformations (CCMs) represent clusters of dilated vascular channels, predisposing to hemorrhagic stroke and seizures. They are associated with defective blood brain barrier, hemorrhages of different ages and a robust inflammatory cell infiltrate. We report for the first time evidence of co-localized IgG and complement membrane attack complexes in CCM lesions. CD4(+) and CD8(+) T-cells are aggregated with CD20(+) B-cells. And IgG repertoire analyses demonstrate in situ B-cell clonal expansion and antigen-driven affinity maturation in CCMs. These results suggest an organ-intrinsic adaptive immune response in CCMs that should be further characterized as a potential therapeutic target.

  15. Effective surgical treatment of cerebral cavernous malformations: a multicenter study of 79 pediatric patients.

    Science.gov (United States)

    Hugelshofer, Michael; Acciarri, Nicola; Sure, Ulrich; Georgiadis, Dimitrios; Baumgartner, Ralf W; Bertalanffy, Helmut; Siegel, Adrian M

    2011-11-01

    Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%-20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms. The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures. Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found. Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.

  16. Impairment of tight junctions and glucose transport in endothelial cells of human cerebral cavernous malformations.

    Science.gov (United States)

    Schneider, Hannah; Errede, Mariella; Ulrich, Nils H; Virgintino, Daniela; Frei, Karl; Bertalanffy, Helmut

    2011-06-01

    Cerebral cavernous malformations (CCMs) often cause hemorrhages that can result in severe clinical manifestations, including hemiparesis and seizures. The underlying mechanisms of the aggressive behavior of CCMs are undetermined to date, but alterations of vascular matrix components may be involved. We compared the localization of the tight junction proteins (TJPs) in 12 CCM specimens and the expression of glucose transporter 1 (GLUT-1), which is sensitive to alterations in TJP levels, in 5 CCM specimens with those in 5 control temporal lobectomy specimens without CCM by immunofluorescence microscopy. The TJPs occludin, claudin-5, and zonula occludens ZO-1 were downregulated at intercellular contact sites and partly redistributed within the surrounding tissue in the CCM samples; there was also a marked reduction of GLUT-1 immunoreactivity compared with that in control specimens. Corresponding analysis using quantitative real-time reverse transcription polymerase chain reaction on 8 CCM and 8 control specimens revealed significant downregulation of mRNA expression of occludin, claudin-5, ZO-1, and GLUT-1. The altered expression and localization of the TJPs at interendothelial contact sites accompanied by a reduction of GLUT-1 expression in dilated CCM microvessels likely affect vascular matrix stability and may contribute to hemorrhages of CCMs.

  17. Genetic and cellular basis of cerebral cavernous malformations: implications for clinical management.

    Science.gov (United States)

    Bacigaluppi, S; Retta, S F; Pileggi, S; Fontanella, M; Goitre, L; Tassi, L; La Camera, A; Citterio, A; Patrosso, M C; Tredici, G; Penco, S

    2013-01-01

    Cerebral cavernous malformations (CCMs) are a diffuse cerebrovascular disease affecting approximately 0.5% of the population. A CCM is characterized by abnormally enlarged and leaky capillaries arranged in mulberry-like structures with no clear flow pattern. The lesion might predispose to seizures, focal neurological deficits or fatal intracerebral hemorrhage. However, a CCM can also remain neurologically silent. It might either occur sporadically or as an inherited disorder with incomplete penetrance and variable expressivity. Due to advances in imaging techniques, the incidence of CCM diagnoses are increasing, and the patient must be managed on a multidisciplinary basis: genetic counselling, treatment if needed, and follow-up. Advances have been made using radiological and pathological correlates of CCM lesions adding to the accumulated knowledge of this disease, although management of these patients is very variable among centers. This review is aimed at providing an update in genetic and molecular insights of this condition. Included are implications for genetic counselling, and possible approaches to prevention and treatment that derive from the understanding of pathogenetic mechanisms. © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  18. 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.

  19. 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.

  20. Genome-Wide Sequencing Reveals MicroRNAs Downregulated in Cerebral Cavernous Malformations.

    Science.gov (United States)

    Kar, Souvik; Bali, Kiran Kumar; Baisantry, Arpita; Geffers, Robert; Samii, Amir; Bertalanffy, Helmut

    2017-02-01

    Cerebral cavernous malformations (CCM) are vascular lesions associated with loss-of-function mutations in one of the three genes encoding KRIT1 (CCM1), CCM2, and PDCD10. Recent understanding of the molecular mechanisms that lead to CCM development is limited. The role of microRNAs (miRNAs) has been demonstrated in vascular pathologies resulting in loss of tight junction proteins, increased vascular permeability and endothelial cell dysfunction. Since the relevance of miRNAs in CCM pathophysiology has not been elucidated, the primary aim of the study was to identify the miRNA-mRNA expression network associated with CCM. Using small RNA sequencing, we identified a total of 764 matured miRNAs expressed in CCM patients compared to the healthy brains. The expression of the selected miRNAs was validated by qRT-PCR, and the results were found to be consistent with the sequencing data. Upon application of additional statistical stringency, five miRNAs (let-7b-5p, miR-361-5p, miR-370-3p, miR-181a-2-3p, and miR-95-3p) were prioritized to be top CCM-relevant miRNAs. Further in silico analyses revealed that the prioritized miRNAs have a direct functional relation with mRNAs, such as MIB1, HIF1A, PDCD10, TJP1, OCLN, HES1, MAPK1, VEGFA, EGFL7, NF1, and ENG, which are previously characterized as key regulators of CCM pathology. To date, this is the first study to investigate the role of miRNAs in CCM pathology. By employing cutting edge molecular and in silico analyses on clinical samples, the current study reports global miRNA expression changes in CCM patients and provides a rich source of data set to understand detailed molecular machinery involved in CCM pathophysiology.

  1. B-Cell Depletion Reduces the Maturation of Cerebral Cavernous Malformations in Murine Models.

    Science.gov (United States)

    Shi, Changbin; Shenkar, Robert; Zeineddine, Hussein A; Girard, Romuald; Fam, Maged D; Austin, Cecilia; Moore, Thomas; Lightle, Rhonda; Zhang, Lingjiao; Wu, Meijing; Cao, Ying; Gunel, Murat; Louvi, Angeliki; Rorrer, Autumn; Gallione, Carol; Marchuk, Douglas A; Awad, Issam A

    2016-06-01

    Cerebral cavernous malformations (CCMs) are relatively common vascular malformations, characterized by increased Rho kinase (ROCK) activity, vascular hyper-permeability and the presence of blood degradation products including non-heme iron. Previous studies revealed robust inflammatory cell infiltration, selective synthesis of IgG, in situ antigen driven B-cell clonal expansion, and deposition of immune complexes and complement proteins within CCM lesions. We aimed to evaluate the impact of suppressing the immune response on the formation and maturation of CCM lesions, as well as lesional iron deposition and ROCK activity. Two murine models of heterozygous Ccm3 (Pdcd10), which spontaneously develop CCM lesions with severe and milder phenotypes, were either untreated or received anti-mouse BR3 to deplete B cells. Brains from anti-mouse BR3-treated mice exhibited significantly fewer mature CCM lesions and smaller lesions compared to untreated mice. B cell depletion halted the progression of lesions into mature stage 2 lesions but did not prevent their genesis. Non-heme iron deposition and ROCK activity was decreased in lesions of B cell depleted mice. This represents the first report of the therapeutic benefit of B-cell depletion in the development and progression of CCMs, and provides a proof of principle that B cells play a critical role in CCM lesion genesis and maturation. These findings add biologics to the list of potential therapeutic agents for CCM disease. Future studies would characterize the putative antigenic trigger and further define the mechanism of immune response in the lesions.

  2. Reliable? The Value of Early Postoperative Magnetic Resonance Imaging after Cerebral Cavernous Malformation Surgery.

    Science.gov (United States)

    Chen, Bixia; Göricke, Sophia; Wrede, Karsten; Jabbarli, Ramazan; Wälchli, Thomas; Jägersberg, Max; Sure, Ulrich; Dammann, Philipp

    2017-07-01

    Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits caused by repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy. After surgical resection, follow-up magnetic resonance imaging (MRI) is usually performed to confirm 1) the complete resection of the CCM and, especially in cases of cavernoma-related epilepsy, 2) the complete resection of the hemosiderin deposits. This prospective study evaluates the value of early postoperative MRI (within 72 hours) regarding the detection of CCM or hemosiderin remnants compared with a standard 3-6 months postoperative MRI control in 61 CCM cases. Sensitivity of early postoperative MRI for CCM remnant detection was 66.67% (95% confidence interval [CI], 9.43%-99.16%), specificity was 76.74% (95% CI, 61.37%-88.24%), positive predictive value was 16.67% (95% CI, 2.09%-48.41%), and negative predictive value was 97.06% (95% CI, 84.67%-99.93%). Because of the high number of patients who could not be evaluated because of imaging artifacts, sensitivity and specificity analysis was not performed for early postoperative MRI using T2*/susceptibility-weighted imaging to assess hemosiderin remnants. Sensitivity of early postoperative MRI for hemosiderin remnant detection using T2-weighted sequences was 85.71% (95% CI, 63.66%-96.95%), specificity was 66.67% (95% CI, 44.68%-84.37%), positive predictive value was 69.23% (95% CI, 55.45%-80.27%), and negative predictive value was 84.21% (95% CI, 64.31%-94.04%). Our data suggest that early postoperative MRI after CCM surgery is often hampered by imaging artifacts creating false-positive results and therefore ineligible for a resection control. However, reliability of a negative result on early postoperative T2-weighted MRI is relatively high regarding both CCM and hemosiderin remnants. Copyright © 2017

  3. Management of cerebral cavernous malformations in the pediatric population: a literature review and case illustrations.

    Science.gov (United States)

    Kosnik-Infinger, L; Carroll, C; Greiner, H; Leach, J; Mangano, F T

    2015-09-01

    Cavernous malformations (CM) are vascular malformations of the central nervous system that may occur in the brain and spinal cord. They are one of the four major types of vascular malformations that also includes developmental venous anomalies (DVA)s, arteriovenous malformations (AVMs), and capillary telangiectasias. CMs are a common vascular malformation, and 25% of them occur in the pediatric age group. They can present with acute or chronic symptoms including headache, neurologic deficits secondary to hemorrhage, mass effect, or epilepsy. This review will focus on the neurosurgical management of intracranial cavernous malformations in children. Pediatric CMs have special considerations different from CM that occur in the adult population which are highlighted throughout this review. Characteristics specific to pediatric CM epidemiology, genetics, presentation, pathology, location, size, epilepsy, and management will be discussed. Specific considerations must be entertained with the diagnosis of pediatric CM in that management needs to include consideration of the lifetime risk of hemorrhage, as well as the possibility of development of epilepsy. If in an accessible location, most cavernomas should be surgically removed in a timely fashion to provide lifelong cure for pediatric patients. The review closes with the discussion of two interesting cavernous malformation cases occurring in a 12-year old male and a 12-year old female that exhibit many of the important aspects specific to the management of a pediatric patient with CM, highlighting the importance of a multidisciplinary approach to treatment.

  4. 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)

  5. A novel mouse model of cerebral cavernous malformations based on the two-hit mutation hypothesis recapitulates the human disease.

    Science.gov (United States)

    McDonald, David A; Shenkar, Robert; Shi, Changbin; Stockton, Rebecca A; Akers, Amy L; Kucherlapati, Melanie H; Kucherlapati, Raju; Brainer, James; Ginsberg, Mark H; Awad, Issam A; Marchuk, Douglas A

    2011-01-15

    Cerebral cavernous malformations (CCMs) are vascular lesions of the central nervous system appearing as multicavernous, blood-filled capillaries, leading to headache, seizure and hemorrhagic stroke. CCM occurs either sporadically or as an autosomal dominant disorder caused by germline mutation of one of the three genes: CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10. Surgically resected human CCM lesions have provided molecular and immunohistochemical evidence for a two-hit (germline plus somatic) mutation mechanism. In contrast to the equivalent human genotype, mice heterozygous for a Ccm1- or Ccm2-null allele do not develop CCM lesions. Based on the two-hit hypothesis, we attempted to improve the penetrance of the model by crossing Ccm1 and Ccm2 heterozygotes into a mismatch repair-deficient Msh2(-/-) background. Ccm1(+/-)Msh2(-/-) mice exhibit CCM lesions with high penetrance as shown by magnetic resonance imaging and histology. Significantly, the CCM lesions range in size from early-stage, isolated caverns to large, multicavernous lesions. A subset of endothelial cells within the CCM lesions revealed somatic loss of CCM protein staining, supporting the two-hit mutation mechanism. The late-stage CCM lesions displayed many of the characteristics of human CCM lesions, including hemosiderin deposits, immune cell infiltration, increased endothelial cell proliferation and increased Rho-kinase activity. Some of these characteristics were also seen, but to a lesser extent, in early-stage lesions. Tight junctions were maintained between CCM lesion endothelial cells, but gaps were evident between endothelial cells and basement membrane was defective. In contrast, the Ccm2(+/-)Msh2(-/-) mice lacked cerebrovascular lesions. The CCM1 mouse model provides an in vivo tool to investigate CCM pathogenesis and new therapies.

  6. Dubin-Johnson syndrome with multiple liver cavernous hemangiomas: report of a familial case.

    Science.gov (United States)

    Li, Peifeng; Wang, Yingmei; Zhang, Jinmei; Geng, Ming; Li, Zengshan

    2013-01-01

    Dubin-Johnson syndrome (DJS) is a rare autosomal recessive inheritance disorder of bilirubin metabolism. Herein we reported a complicated but interesting case which is readily resulted in misdiagnosis or an indefinite diagnosis, and this is the first reported familial case of DJS with multiple liver cavernous hemangiomas. A 49-year-old man was referred to our hospital for jaundice and multiple low-density liver masses. Extensive laboratory investigations showed conjugated hyperbilirubinaemia and positive urine bilirubin. Microscopically, lesions were composed of blood-filled vascular channels of various sizes lined by a single layer of flat endothelial cells supported by fibrous tissue. Coarse brown granules presented in the hepatocytes of the liver lobules locating beside the tumor, particularly in the centrilobular hepatocytes, and the granules showed blue-green with Schmorl's reaction lipofuscin staining. Interestingly, one of the patient's six siblings (female) shared the same condition with him. The relationship between DJS and hemangiomas remains unclear, and it might be contributed to some hereditary factors, or probably occurred simultaneously by chance. It was certified that the true reason for the long-term unclear jaundice was DJS, which was presumed clinically to be caused by bile excretion obstacles associated with the hemangiomas. Liver biopsy and histochemical stain may be helpful to identify the reason of jaundice and avoid misdiagnosis or an indefinite diagnosis.

  7. Systemic Expression of Vascular Endothelial Growth Factor in Patients with Cerebral Cavernous Malformation Treated by Stereotactic Radiosurgery.

    Science.gov (United States)

    Park, Sang-Jin; Park, Seong-Hyun

    2016-09-01

    Increased expression of angiogenic factors, such as vascular endothelial growth factor (VEGF), is associated with the pathogenesis of cerebral cavernous malformations (CCMs). The purpose of this study was to investigate plasma levels of VEGF in normal subjects and in patients with CCM and to evaluate change in these levels following stereotactic radiosurgery (SRS). Peripheral venous blood was collected from 6 patients with CCM before SRS using Gamma Knife and at the 1 week, 1 month, 3month, and 6 month follow-up visits. Plasma VEGF levels were measured using commercially available enzyme-linked immunosorbent assay kits. Peripheral blood samples were obtained from 10 healthy volunteers as controls. Mean plasma VEGF level of 41.9 pg/mL (range, 11.7-114.9 pg/mL) in patients with CCM at baseline was higher than that of the healthy controls (29.3 pg/mL, range, 9.2-64.3 pg/mL), without significant differences between CCM patients and controls (p=0.828). Plasma VEGF level following SRS dropped to 24.6 pg/mL after 1 week, and decreased to 18.5 pg/mL after 1 month, then increased to 24.3 pg/mL after 3 months, and 32.6 pg/mL after 6 months. Two patients suffering from rebleeding after SRS showed a higher level of VEGF at 6 months after SRS than their pretreatment level. Plasma VEGF levels in patients with CCM were elevated over controls at baseline, and decreased from baseline to 1 month after SRS and increased further for up to 6 months. Theses results indicated that anti-angiogenic effect of SRS might play a role in the treatment of CCMs.

  8. 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.

  9. Family adaptation to cerebral palsy in adolescents

    DEFF Research Database (Denmark)

    Guyard, Audrey; Michelsen, Susan I; Arnaud, Catherine

    2017-01-01

    modelled with structural equations. RESULTS: 31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best...... of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were...... protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors. CONCLUSIONS: Particular attention must be paid...

  10. Cerebral Cavernous Malformations (CCM)

    Science.gov (United States)

    ... all children with HHT should have the same screening for lung AVMs recommended for adults. Children can be safely treated with embolization. ? What are the symptoms or signs of HHT in the gastrointestinal tract (stomach and intestines)? Unexplained anemia or low blood count, ...

  11. Cerebral Cavernous Malformations (CCM)

    Science.gov (United States)

    ... has someone who helps with referrals, insurance authorization, logistics and scheduling. Since HHT is a rare disorder, ... Disclaimer | Research Members Login | Rare Diseases Clinical Research Network The BVMC (U54NS065705) is a part of the ...

  12. 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.

  13. PTEN/PI3K/Akt/VEGF signaling and the cross talk to KRIT1, CCM2, and PDCD10 proteins in cerebral cavernous malformations.

    Science.gov (United States)

    Kar, Souvik; Samii, Amir; Bertalanffy, Helmut

    2015-04-01

    Cerebral cavernous malformations (CCM) are common vascular malformation of the brain and are associated with abnormal angiogenesis. Although the exact etiology and the underlying molecular mechanism are still under investigation, recent advances in the identification of the mutations in three genes and their interactions with different signaling pathways have shed light on our understanding of CCM pathogenesis. The phosphatidylinositol 3-kinase (PI3K)/Akt pathway is known to play a major role in angiogenesis. Studies have shown that the phosphatase and tensin homologue deleted on chromosome ten (PTEN), a tumor suppressor, is an antagonist regulator of the PI3K/Akt pathway and mediates angiogenesis by activating vascular endothelial growth factor (VEGF) expression. Here, we provide an update literature review on the current knowledge of the PTEN/PI3K/Akt/VEGF signaling in angiogenesis, more importantly in CCM pathogenesis. In addition to reviewing the current literatures, this article will also focus on the structural domain of the three CCM proteins and their interacting partners. Understanding the biology of these proteins with respect to their signaling counterpart will help to guide future research towards new therapeutic targets applicable for CCM treatment.

  14. Parental adaptation in families of young children with cerebral palsy

    NARCIS (Netherlands)

    Rentinck, I.C.M.

    2009-01-01

    Background For most parents, the birth of their child is a unique and touching moment. However, in some families a child is born with a physical disability. Among the large variety of childhood developmental disabilities, cerebral palsy (CP) is considered to be the major physical disability

  15. Family ecology of young children with cerebral palsy.

    Science.gov (United States)

    LaForme Fiss, A; Chiarello, L A; Bartlett, D; Palisano, R J; Jeffries, L; Almasri, N; Chang, H-J

    2014-07-01

    Family ecology in early childhood may influence children's activity and participation in daily life. The aim of this study was to describe family functioning, family expectations of their children, family support to their children, and supports for families of young children with cerebral palsy (CP) based on children's gross motor function level. Participants were 398 children with CP (mean age = 44.9 months) and their parents residing in the USA and Canada. Parents completed four measures of family ecology, the Family Environment Scale (FES), Family Expectations of Child (FEC), Family Support to Child (FSC) and Family Support Scale (FSS). The median scores on the FES indicated average to high family functioning and the median score on the FSS indicated that families had helpful family supports. On average, parents reported high expectations of their children on the FEC and strong support to their children on the FSC. On the FES, higher levels of achievement orientation were reported by parents of children in Gross Motor Function Classification System (GMFCS) level II than parents of children in level I, and higher levels of control were reported by parents of children in level I than parents of children in level IV. On the FEC, parents of children with limited gross motor function (level V) reported lower expectations than parents of children at all other levels. Family ecology, including family strengths, expectations, interests, supports and resources, should be discussed when providing interventions and supports for young children with CP and their families. © 2013 John Wiley & Sons Ltd.

  16. Longitudinal changes in seizure outcomes after resection of cerebral cavernous malformations in patients presenting with seizures: a long-term follow-up of 46 patients.

    Science.gov (United States)

    Kim, Jiha; Kim, Chi Heon; Chung, Chun Kee

    2014-08-01

    Seizure is the most common presentation in patients with cerebral cavernous malformations (CCMs). Although many articles have documented seizure outcomes after resection of CCM, few have conducted long-term follow-ups; thus, the fluctuating seizure outcomes have been neglected. The purpose of this study is to describe long-term postoperative seizure outcomes in patients with CCM and to compare seizure outcomes between patients with sporadic seizures and those with chronic seizures. Forty-six patients with CCM presenting with seizures underwent surgery. The male-to-female ratio was 1:1, and the average age at initial seizure onset was 27.6 years. The mean preoperative seizure duration was 42.7 months. Patients were divided into two groups: a chronic group (N = 20) and a sporadic group (N = 26) according to seizure frequency and duration. The mean postoperative follow-up duration was 96.3 months, and the postoperative seizure outcomes were checked annually based upon Engel's classification. After the first year of follow-up, 80.8 % of the sporadic group and 75.0 % of the chronic group were evaluated as Engel class I. These rates increased to 100.0 % and 90.0 %, respectively, at the eighth year of follow-up. Overall, 29 (63.0 %) of the 46 patients experienced changes in seizure outcomes over the follow-up period. Despite their delayed improvements, the chronic group showed less favorable outcomes throughout follow-up (p = 0.025). Long-term follow-up is indispensable for accurately assessing postoperative seizure outcomes because these outcomes change continuously. We recommend earlier surgery to achieve seizure-free status in patients with CCM. However, even in the chronic group, surgery is recommended, considering the overall delayed improvement.

  17. Lesions from patients with sporadic cerebral cavernous malformations harbor somatic mutations in the CCM genes: evidence for a common biochemical pathway for CCM pathogenesis.

    Science.gov (United States)

    McDonald, David A; Shi, Changbin; Shenkar, Robert; Gallione, Carol J; Akers, Amy L; Li, Stephanie; De Castro, Nicholas; Berg, Michel J; Corcoran, David L; Awad, Issam A; Marchuk, Douglas A

    2014-08-15

    Cerebral cavernous malformations (CCMs) are vascular lesions affecting the central nervous system. CCM occurs either sporadically or in an inherited, autosomal dominant manner. Constitutional (germline) mutations in any of three genes, KRIT1, CCM2 and PDCD10, can cause the inherited form. Analysis of CCM lesions from inherited cases revealed biallelic somatic mutations, indicating that CCM follows a Knudsonian two-hit mutation mechanism. It is still unknown, however, if the sporadic cases of CCM also follow this genetic mechanism. We extracted DNA from 11 surgically excised lesions from sporadic CCM patients, and sequenced the three CCM genes in each specimen using a next-generation sequencing approach. Four sporadic CCM lesion samples (36%) were found to contain novel somatic mutations. Three of the lesions contained a single somatic mutation, and one lesion contained two biallelic somatic mutations. Herein, we also describe evidence of somatic mosaicism in a patient presenting with over 130 CCM lesions localized to one hemisphere of the brain. Finally, in a lesion regrowth sample, we found that the regrown CCM lesion contained the same somatic mutation as the original lesion. Together, these data bolster the idea that all forms of CCM have a genetic underpinning of the two-hit mutation mechanism in the known CCM genes. Recent studies have found aberrant Rho kinase activation in inherited CCM pathogenesis, and we present evidence that this pathway is activated in sporadic CCM patients. These results suggest that all CCM patients, including those with the more common sporadic form, are potentially amenable to the same therapy.

  18. Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel.

    Science.gov (United States)

    Akers, Amy; Al-Shahi Salman, Rustam; A Awad, Issam; Dahlem, Kristen; Flemming, Kelly; Hart, Blaine; Kim, Helen; Jusue-Torres, Ignacio; Kondziolka, Douglas; Lee, Cornelia; Morrison, Leslie; Rigamonti, Daniele; Rebeiz, Tania; Tournier-Lasserve, Elisabeth; Waggoner, Darrel; Whitehead, Kevin

    2017-05-01

    Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies. To develop guidelines for CCM management. The Angioma Alliance ( www.angioma.org ), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol. Of 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%). Current evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was

  19. Cerebral autoregulation and symptoms of orthostatic hypotension in familial dysautonomia.

    Science.gov (United States)

    Fuente Mora, Cristina; Palma, Jose-Alberto; Kaufmann, Horacio; Norcliffe-Kaufmann, Lucy

    2017-07-01

    Familial dysautonomia is an inherited autonomic disorder with afferent baroreflex failure. We questioned why despite low blood pressure standing, surprisingly few familial dysautonomia patients complain of symptomatic hypotension or have syncope. Using transcranial Doppler ultrasonography of the middle cerebral artery, we measured flow velocity (mean, peak systolic, and diastolic), area under the curve, pulsatility index, and height of the dictrotic notch in 25 patients with familial dysautonomia and 15 controls. In patients, changing from sitting to a standing position, decreased BP from 124 ± 4/64 ± 3 to 82 ± 3/37 ± 2 mmHg (p < 0.0001, for both). Despite low BP, all patients denied orthostatic symptoms. Middle cerebral artery velocity fell minimally, and the magnitude of the reductions were similar to those observed in healthy controls, in whom BP upright did not fall. While standing, patients had a greater fall in cerebrovascular resistance (p < 0.0001), an increase in pulsatility (p < 0.0001), and a deepening of the dicrotic notch (p = 0.0010), findings all consistent with low cerebrovascular resistance. No significant changes occurred in controls. Patients born with baroreflex deafferentation retain the ability to buffer wide fluctuations in BP and auto-regulate cerebral blood flow. This explains how they can tolerate extremely low BPs standing that would otherwise induce syncope.

  20. ATLAS Cavern baseplate

    CERN Multimedia

    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.

  1. Psychological impact of cerebral palsy on families: The African perspective

    Directory of Open Access Journals (Sweden)

    Olajide A Olawale

    2013-01-01

    Full Text Available Background: Psychological stress associated with cerebral palsy (CP is known to be one of the most depressing conditions of families. In the traditional African society, some peculiar factors may contribute to the stress. Aims: The aims of this study were to identify and describe, from the African perspective, the psychological impact of CP on families and determine the strategies adopted by families in coping with it. Settings and Design: The study was a cross-sectional descriptive survey conducted in the Physiotherapy Department of a tertiary hospital. Materials and Methods: Participants were 52 parents of children with CP. They completed a questionnaire designed to determine the degree of psychological stress on the families and strategies adopted to cope with the stress. Statistical Analysis: Descriptive statistics were used to show responses in graphical formats. Results: Respondents agreed that having adequate knowledge of CP would help them cope well with the demands of taking care of children with CP. 38.5% of respondents said that people in the society accused them of some wrongdoing that has made their children to have CP. Personal problems experienced include loss of job, lack of concentration at work, loss of family joy, and derangement of financial affairs of the family. 26 (50% of them resort to religious/spiritual intervention as an alternative or complementary mode of treatment for their children while 28% resort to dependence on the extended family system for support. Conclusion: Families caring for children with CP generally have a positive attitude towards their children. However, there is need to educate the public on the causes of CP and treatment options available to families.

  2. 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

  3. [Cavernous haemangiomas: hearing and vestibular inaugural symptoms].

    Science.gov (United States)

    Dumas, G; Schmerber, S

    2004-11-01

    Cavernous haemangiomas (cavernomas)(CH) are relatively rare (2% of cranial tumoral pathology) vascular malformations mostly observed in the central nervous system. Their most common topographical site in brain stem is midline in the pons, for which clinical course may mimic symptoms of peripheral origin (sudden deafness, fluctuating hearing loss, Meniere-like vertigo). To establish the correlation between the clinical manifestations of hearing and balance disturbance and the anatomical site within the pons of cavernous haemangiomas, and to describe their clinical features, and the findings on auditory brainstem response (ABR) and magnetic resonance imaging (MRI). To propose a literature review about CH and its implications. We made a retrospective review of the histories of three patients aged 24, 44 and 45 years, diagnosed as having cavernomas of the brainstem in which audiometric evaluation, videonystagmography (VNG), ABR and imaging techniques lead to the diagnosis of intracranial cavernoma. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all 3 patients, especially in relation to our understanding of the auditory and vestibular pathways within the brainstem. The literature regarding cavernomas of the pons is reviewed and the clinical, neuroimage, pathological, natural course and management aspects of the disease are discussed. We recommend the use of cerebral MRI for initial diagnosis which shows a typical rosette-like appearance with a heterogeneous signal on T2-weighted images, along with follow-up and investigation into similar profiles among family members. At present there is no consensus about the treatment to follow when cavernomas are located in the brain stem. There is no specific medical treatment for this condition, and surgery is indicated only exceptionally. Anticoagulant therapy, platelet-dispersing medication and violent sports activities are contraindicated.

  4. Abducens Nerve Palsy and Ipsilateral Horner Syndrome in a Patient With Carotid-Cavernous Fistula.

    Science.gov (United States)

    Kal, Ali; Ercan, Zeynep E; Duman, Enes; Arpaci, Enver

    2015-10-01

    The combination of abducens nerve palsy and ipsilateral Horner syndrome was first described by Parkinson and considered as a localizing sign of posterior cavernous sinus lesions. The authors present a case with right abducens nerve palsy with ipsilateral Horner syndrome in a patient with carotid-cavernous fistula because of head trauma. The patient was referred to the ophthalmology clinic with diplopia complaint after suffering a head trauma during a motorcycle accident. Cerebral angiography showed low-flow carotid-cavernous fistula.

  5. Brainstem Cavernous Angioma

    Science.gov (United States)

    ... Elmaci I, Lee RR, Breiter SN, Rigamonti D. Dynamic nature of cavernous malformations: a prospective magnetic resonance ... intended for medical diagnostic use of any kind. | Website by Teramark MENU

  6. CMS cavern inspection robot

    CERN Document Server

    Ibrahim, Ibrahim

    2017-01-01

    Robots which are immune to the CMS cavern environment, wirelessly controlled: -One actuated by smart materials (Ionic Polymer-Metal Composites and Macro Fiber Composites) -One regular brushed DC rover -One servo-driven rover -Stair-climbing robot

  7. Bilateral orbital cavernous haemangiomas.

    OpenAIRE

    Fries, P D; Char, D. H.

    1988-01-01

    Simultaneous bilateral orbital lesions are rare. The differential diagnosis includes orbital pseudotumour, metastasis, leukaemia, lymphoma, Wegener's granulomatosis, and neurofibromatosis. We report what we believe to be the first case of bilateral orbital cavernous haemangiomas.

  8. Unusual cerebral white matter change in a Chinese family with Spinocerebellar ataxia type 12.

    Science.gov (United States)

    Hu, Tao; Zhao, Bi; Wei, Qian-qian; Shang, Huifang

    2015-02-15

    In a Chinese family with Spinocerebellar ataxia type 12 (SCA12), presenting with action tremor, mild cerebellar dysfunction, and hyperreflexia, genetic testing revealed abnormal CAG repeat length in the brain-specific protein phosphatase 2, regulatory subunit B, beta isoform (PPP2R2B) gene. To our knowledge, this is the first report on patients with SCA12 presenting with prominent cerebral white matter change besides cerebral and/or cerebellar atrophy.

  9. 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.

  10. 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

  11. Endovascular treatment of traumatic carotid cavernous fistula with trapping technique

    Directory of Open Access Journals (Sweden)

    Benny Young

    2013-08-01

    Full Text Available Conventional endovascular treatment for carotid cavernous fistula (CCF involves a direct delivery of either coils, detachable balloon or both to the fistula with end point of CCF resolution and carotid artery preservation. But in few cases with severe laceration of carotid artery, the feasible endovascular technique applicable is by blocking the filling of fistula from cerebral circulation. This method known as trapping technique which implicates carotid artery occlusion, was performed in our present case with good result. (Med J Indones. 2013;22:178-82. doi: 10.13181/mji.v22i3.588Keywords: Carotid cavernous fistula (CCF, carotid occlusion, trapping technique

  12. Variable manifestations of familial hemiplegic migraine associated with reversible cerebral edema in children.

    Science.gov (United States)

    Asghar, Sheila J; Milesi-Hallé, Alessandra; Kaushik, Chavvi; Glasier, Charles; Sharp, Gregory B

    2012-09-01

    Three children with familial hemiplegic migraine presented with right-sided weakness, speech difficulty, altered mental status, and gait abnormalities. These persistent aura signs were accompanied by left-sided slowing and cerebral dysfunction, documented by electroencephalograms. Cranial magnetic resonance imaging revealed cortical edema restricted to the left cerebral hemisphere. Follow-up electroencephalogram and imaging studies produced normal results 1-4 months afterward. However, cognitive changes persisted. Genetic testing demonstrated variable results: one child manifested a CACNA1A mutation compatible with familial hemiplegic migraine type 1, whereas another demonstrated an ATP1A2 sequence alteration. No known mutations were evident in the third child, with minor head trauma thought to precipitate the familial hemiplegic migraine. These findings demonstrate the variable clinical and genetic heterogeneity of childhood familial hemiplegic migraine. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Delivering healthcare services to children with cerebral palsy and their families: a narrative review.

    Science.gov (United States)

    Hayles, Emily; Jones, Anne; Harvey, Desley; Plummer, David; Ruston, Sally

    2015-05-01

    Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are supported in the literature and how these should be applied in clinical practice. This narrative review aims to identify and review the evidence for current approaches to healthcare service delivery for children with cerebral palsy. Databases were searched using key terms to identify relevant research articles and grey literature from December 2011 to September 2013. Search results were screened and sorted according to inclusion and exclusion criteria. Thirty-two documents were included for evaluation and their content was analysed thematically. Three current approaches to healthcare service delivery for children with cerebral palsy identified in this narrative review were family-centred care, the World Health Organisation's International Classification of Functioning, Disability and Health, and collaborative community-based primary care. However, healthcare services for children with cerebral palsy and their families are inconsistently delivered according to these approaches and the identified guidelines or standards of care for children with cerebral palsy have limited incorporation of these approaches. Future research is required to investigate how these approaches to healthcare service delivery can be integrated into clinical practices to enable clinicians to improve services for this population.

  14. Excavating the CMS experimental cavern

    CERN Document Server

    Laurent Guiraud

    2000-01-01

    Diggers work 100 m underground to remove rock from the huge cavern that will soon be the site for the CMS experiment at CERN. Workers travel down the shaft into the cavern in an elevator maneuvered by a crane, equipment must also be lowered in this way. When the cavern is completed, the 12 500 tonne CMS experiment will then be lowered piece by piece, as no crane on Earth will be able to carry the experiment's full weight.

  15. Family life of caregivers: A descriptive study of disruption of family activities, leisures and interaction of caregivers of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Ramita Sardana

    2016-07-01

    Full Text Available Context: The purpose of this research was to study family life of caregivers who provide primary care to children with Cerebral Palsy. Aim: To study the family activities, leisure and interaction of caregivers of children with Cerebral Palsy. Settings and Design: Study was conducted in Dept. of Physical Medicine and Rehabilitation, AIIMS, New Delhi. Methods and Material: Study sample consisted of 65 primary caregivers of children with Cerebral Palsy. Questionnaires about family activities, leisure and interaction from Family burden interview schedule were used. Descriptive statistics and multiple regressions were used for data analysis. Results: All three domains i.e. disruption of routine family activities, family leisure and family interaction were found to be disrupted in caregivers of children with Cerebral Palsy. Various factors like education of caregiver, total children, family income, duration of caregiving, speech disturbance in child, seizures and mental retardation were found to effect scores of disruption of family activities, leisure and interaction. Conclusions: Caregivers of children with Cerebral palsy experience disruption of family activities, leisure and interaction. For proper care of children caregiver’s family life should be taken care of. Healthcare providers should enhance support networks to encourage and promote normal family activities, leisure and interactions of caregivers.

  16. 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.

  17. 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.

  18. Cerebral gigantism associated with jaw cyst basal cell naevoid syndrome in two families.

    Science.gov (United States)

    Cramer, H; Niederdellmann, H

    1983-01-01

    We report 9 subjects from 2 families with the syndrome of cerebral gigantism, seven of the patients also had jaw cyst basal cell naevoid syndrome. Neurological, radiological, somatic and biochemical features of this hitherto unreported association are described. Neurological symptoms included mild hydrocephalus, ventricular malformation, cerebellar syndrome, intracranial calcification, oculomotor disturbances, EEG abnormalities and rarely, mild peripheral nervous disorders. A disturbance of calcium metabolism appears to be a prominent feature of the genetically determined nonprogressive syndrome.

  19. 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

  20. A novel CCM2 variant in a family with non-progressive cognitive complaints and cerebral microbleeds.

    OpenAIRE

    Cohn-Hokke, P. E.; Holstege, H.; Weiss, M.M.; Van Der Flier, W. M.; Barkhof, F.; Sistermans, E.A.; Pijnenburg, Y.A.; van Swieten, J. C.; Meijers-Heijboer, H; Scheltens, P

    2016-01-01

    Lobar cerebral microbleeds are most often sporadic and associated with Alzheimer's disease. The aim of our study was to identify the underlying genetic defect in a family with cognitive complaints and multiple lobar microbleeds and a positive family history for early onset Alzheimer's disease. We performed exome sequencing followed by Sanger sequencing for validation purposes on genomic DNA of three siblings with cognitive complaints, reduced amyloid-beta-42 in CSF and multiple cerebral lobar...

  1. Genetics Home Reference: cerebral cavernous malformation

    Science.gov (United States)

    ... from these genes are found in the junctions connecting neighboring blood vessel cells. The proteins interact with ... Criteria for Links Data Files & API Site Map Customer Support USA.gov Copyright Privacy Accessibility FOIA Viewers & ...

  2. MTHFR homozygous mutation and additional risk factors for cerebral infarction in a large Italian family.

    Science.gov (United States)

    Del Balzo, Francesca; Spalice, Alberto; Perla, Massimo; Properzi, Enrico; Iannetti, Paola

    2009-01-01

    Several cases with cerebral infarctions associated with the C677T mutation in the methylenetetrahydrofolate reductase gene (MTHFR) have been reported. Given the large number of asymptomatic individuals with the MTHFR mutation, additional risk factors for cerebral infarction should be considered. This study describes a large family with the MTHFR mutation and a combination of heterozygous factor V Leiden mutations and different additional exogenous and endogenous thrombogenic risk factors. Psychomotor retardation and a left fronto-insular infarct associated with the MTHFR mutation together with diminished factor VII and low level of protein C was documented in the first patient. In the second patient, generalized epilepsy and a malacic area in the right nucleus lenticularis was associated with the MTHFR mutation and a low level of protein C. In the third patient, right hemiparesis and a left fronto-temporal porencephalic cyst were documented, together with the MTHFR mutation and hyperhomocysteinemia. An extensive search of additional circumstantial and genetic thrombogenic risk factors should be useful for prophylaxis and prognosis of infants with cerebral infarctions associated with the MTHFR mutation and of their related family members.

  3. Direct carotid cavernous fistula after submucous resection of the nasal septum.

    Science.gov (United States)

    Bizri, A R; al-Ajam, M; Zaytoun, G; al-Kutoubi, A

    2000-01-01

    A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.

  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. Experiences from families of children with cerebral paralysis in context of social vulnerability

    Directory of Open Access Journals (Sweden)

    Marja Rany Rigotti Baltor

    2013-07-01

    Full Text Available OBJECTIVE: to describe and to analyze the experience from families of children with cerebral paralysis living under circumstances of social vulnerability. METHOD: six resident families in area with this characteristic were interviewed. It was opted to use the Symbolic Interactionism as theoretic reference and the Thematic Content Analysis of Bardin as analysis method for the data. RESULT: the experience of such families is represented in the subjects: Reorganizing the Life, with the categories "Discovering the way" and "Accommodating the routine", and Stopping a Constant Fight with the categories: "Primary Carer being overcharged", "Coexisting with the preconception", "Having locomotion difficulty" and "Living with financial difficulties". CONCLUSION: the social vulnerability influences how the family bears the chronic condition. Professionals and strategies of public health are a power to minimize impacts including those related to the family budget, but they have not been effective. They need to be sensitized to become supporting resources, to offer and to guide the access to the support networks and to spur the social service in action when necessary. This study adds knowledge to the already existing by pointing out peculiarities of the family experience in situations regarding two variables of difficult handling: chronicity and social vulnerability, evidencing the role of the professional in search of the solution for the confrontation of demands and sufferings together with the family.

  6. Changes in Cerebral Blood Flow in Patients with Familial Mediterranean Fever.

    Science.gov (United States)

    Çetin, Gözde; Utku, Uygar; Atilla, Nurhan; Gişi, Kadir; Sayarlioğlu, Mehmet

    2017-06-01

    It is known that there is a relationship between systemic inflammation and atherosclerosis. Atherosclerosis is one of the best-known causes of cerebrovascular diseases. The aim of this study was to assess cerebral blood flow velocity using transcranial Doppler (TCD) ultrasonography in patients with familial Mediterranean fever (FMF). A total of 30 patients aged from 20 to 50 years with FMF were enrolled in the FMF group consecutively. The control group (non-FMF group) consisted of 30 age- and sex-matched randomly selected patients without FMF who had other diagnoses such as fibromyalgia and did not have risk factors for atherosclerosis. Bilateral peak-systolic, end-diastolic, and mean blood flow velocities in the middle cerebral artery (MCA), values of Gosling's pulsatility index, and values of Pourcelot's resistance index were recorded using TCD ultrasonography by a neurosonologist blinded to the FMF and control groups. There were 30 participants in the FMF group in remission (male/female: 4/26, mean age: 34.7±5.9 years) and 30 participants in the control group (male/female: 4/26, mean age: 32.3±4.7 years). C-reactive protein levels and bilateral blood flow velocities in the MCA were significantly higher in the FMF group than in the control group. This study suggests that persistent clinical and subclinical inflammation in patients with FMF causes an increase in cerebral blood flow velocities. Our findings provide an insight into this association between FMF and cerebrovascular diseases.

  7. Growing up with cerebral palsy: perceptions of the influence of family.

    Science.gov (United States)

    Freeborn, D; Knafl, K

    2014-09-01

    Cerebral palsy (CP) is a non-progressive condition present from birth or infancy that includes various neurological patterns of dysfunction. It is characterized by abnormal motor control and/or posture and can involve communication difficulties. Children and youth with CP face multiple social and developmental challenges during their formative years including mild to severe physical limitations, poor socialization, limited recreational activities, and stigmatization. Families play a key role in supporting adaptation to CP. The purpose of this paper was to explore women's perceptions of the ways their families contributed to their overall quality of life with CP. Drawing on data from a qualitative study of eight women with CP, the purpose of this analysis was to examine perceptions of the ways in which their families and individual family members contributed to participants' overall quality of life and adaptation to CP. Respondents ranged in age from 22 years to 55 years and had varied forms of CP. The study was based on a feminist biographical approach, which combines biographical methods with feminist principles. Participants provided considerable, rich contextual data on their family life and the pivotal role family played. The analysis identified four themes related to supportive family roles: (1) being an advocate, and teaching advocacy; (2) promoting inclusion and acceptance; (3) integrating therapy into daily life; and (4) the importance of siblings as friends and mentors. Health-care providers can contribute to the family's ability to facilitate quality of life by providing guidance on how to be advocates and teach advocacy, including the child with CP in family activities, accessing therapy and incorporating beneficial therapies at home, and promoting healthy sibling relationships. © 2013 John Wiley & Sons Ltd.

  8. 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.

  9. The huge ATLAS cavern now fully excavated

    CERN Document Server

    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!

  10. Carotid cavernous fistula: Ophthalmological implications

    Directory of Open Access Journals (Sweden)

    Chaudhry Imtiaz

    2009-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient′s signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

  11. Cavernous sinus cavernous hemangioma largely extending into the sella turcica and mimicking pituitary adenoma: case report.

    Science.gov (United States)

    Hori, Satoshi; Hayashi, Nakamasa; Nomoto, Kazuhiro; Sato, Hikari; Hayashi, Tomohide; Nagai, Shoichi; Nishikata, Manabu; Endo, Shunro

    2010-01-01

    A 77-year-old female presented with a rare cavernous sinus cavernous hemangioma with extension to the sella turcica, neuroradiologically mimicking nonfunctioning pituitary macroadenoma. The lesion was partially removed via transsphenoidal surgery, and the histological diagnosis was cavernous hemangioma. After stereotactic radiosurgery using a cyber knife, the lesion decreased in size. Stereotactic radiosurgery may be a good option for cavernous sinus cavernous hemangioma with high risk of surgical bleeding.

  12. Comparison of Family and Therapist Perceptions of Physical and Occupational Therapy Services Provided to Young Children with Cerebral Palsy

    Science.gov (United States)

    LaForme Fiss, Alyssa C.; McCoy, Sarah Westcott; Chiarello, Lisa A.

    2012-01-01

    The purpose of this study was to determine whether parents and therapists have similar perceptions of therapy services provided to young children with cerebral palsy (CP), reflecting collaboration and provision of family-centered care. Forty-six parents of young children with CP and 40 therapists providing services for those children participated.…

  13. Digging the CMS experimental cavern

    CERN Multimedia

    Laurent Guiraud

    2001-01-01

    The huge CMS experimental cavern is located 100 m underground and has two access shafts through which the experiment's components will be lowered. Initially assembled on the surface, each part of the 12 500 tonne machine must be lowered individually with very little clearance.

  14. 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.

  15. 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.

  16. Multiple Cavernous Angiomas Associated With Psychotic Symptoms: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Sayadnasiri

    2016-09-01

    Full Text Available Introduction Multiple cerebral cavernous angiomas (CCA have genetic origin. They are uncommon entity and rarely occurring with psychiatric manifestations. Case Presentation A 28- year-old man presented with delusional disorder some months after diagnosis of CCA for which a neurosurgical intervention had been performed. According to clinical and neuroimaging findings, we discuss the possible correlation of CCA with psychotic symptoms of this patient. Conclusions Possibly, abnormal brain development secondary to a genetic abnormality or peri-natal insult predisposed patient to two different neuropsychiatric conditions.

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

    Directory of Open Access Journals (Sweden)

    Siti Hajar Mat Abu

    2013-01-01

    Full Text Available 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. Numerical estimation of structural integrity of salt cavern wells.

    NARCIS (Netherlands)

    Orlic, B.; Thienen-Visser, K. van; Schreppers, G.J.

    2016-01-01

    Finite element analyses were performed to estimate axial deformation of cavern wells due to gas storage operations in solution-mined salt caverns. Caverns shrink over time due to salt creep and the cavern roof subsides potentially threatening well integrity. Cavern deformation, deformation of salt

  19. Seismic response and stability of underground rock caverns: a case study of Baihetan underground cavern complex

    National Research Council Canada - National Science Library

    Cui, Zhen; Sheng, Qian; Leng, Xianlun; Chen, Jian

    2016-01-01

    The seismic stability of the underground cavern complex, which houses the Baihetan hydropower plant in Yunnan Province, China, currently the world's 2nd largest underground rock cavern group, is studied in this article...

  20. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

    Science.gov (United States)

    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  1. 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.

  2. Selection of the methods used in MR angiography with arteriovenous malformation, carotid cavernous fistula, moyamoya disease, and cerebral aneurysms; A comparison of 3-D phase-contrast MRA with 3-D time-of-flight MRA

    Energy Technology Data Exchange (ETDEWEB)

    Ikawa, Fusao; Uozumi, Tohru; Kuwabara, Satoshi (Hiroshima Univ. (Japan). School of Medicine) (and others)

    1993-02-01

    The methods used in MR angiography (MRA) can be roughly divided into two groups: time-of-flight methods (TOF methods) which make use of the influx effect of the flow, and the phase-contrast method of Dumoulin, Souza, and their collaborators (PC method), which utilizes phase differences induced by the flow. In this study, the selection of the MRA method was determined by a comparison of the three-dimensional (3-D) PC and the 3-D TOF method in normal and clinical cases. The tool used was SIGNA Advantage (1.5T) made by GE. The 3-D PC method was applied under a pulse sequence generated by gradient-recalled acquisition in the steady state (GRASS); the pulse sequence used for the 3-D TOF method was spoiled GRASS (SPGR) in a total of 28 cases. The following conclusions were reached: the TOF method should be used when aneurysms, arteriovenous malformations (AVM), and moyamoya disease have been diagnosed, and the PC method should be used when AVM and carotid cavernous fistulae (CCF) are to be evaluated in the flow and when CCFs have been diagnosed. (author).

  3. 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.

  4. Predictors of needs for community and financial resources for families of pre-school children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Bertule D.

    2016-01-01

    Full Text Available An understanding of predictors of family needs for the families of preschool children with cerebral palsy (CP is important for provision of efficient and cost-effective services. The aim of this study was to identify the characteristics of children, families and services that are risk factors to meeting family needs for community and financial resources. 234 parents of pre-school children with CP completed a modified version of the Family Needs Survey (FNS, the Measure of Processes of Care (MPOC-20, and a demographic questionnaire. The gross motor function level and communication function level of children were classified on the basis of the Gross Motor Function Classification System (GMFCS and the Communication Function Classification System (CFCS respectively. Two hierarchical multiple regression models were generated to determine the predictors of unmet family needs. The socialisation and communication skills of children, as well as caregiver employment and family income levels were significant predictors of family needs for community resources (adjusted R2=0.44. Significant risk factors in terms of family needs for financial resources included the child's gross motor limitations, caregiver employment, low levels of family income and no ability to receive services on the basis of enabling and partnership principles (adjusted R2=0.51. A child's limitations in terms of communication, gross motor functions and socialisation, as well as the socioeconomic status of the child's family, must be taken into account when planning services for families with preschool children with CP.

  5. 颅内发育性静脉异常伴海绵状血管畸形三例患者的临床及影像学特点%Clinical and imaging feature of 3 patients with combined developmental venous anomalies and cerebral cavernous malformations

    Institute of Scientific and Technical Information of China (English)

    刘建军; 熊葶; 李尊波; 李盛彧; 贾颐

    2012-01-01

    Objective To investigate the clinical,neuroradiologic characteristics and possible causes in 3 patients with combined developmental venous anomalies (DVAs) and cerebral cavernous malformations (CCM).Methods The clinical examination,magnetic resonance imaging (MRI) T1-weighted (T1 WI),T2-weighted (T2WI),susceptibility-weighted imaging (SWI) or T2 fast field echo (T2 FFE),contrast-enhanced MRI at 1.5 T field strength and digital substrate angiography were performed in 3 patients.Results Three patients presented with the seizure,vertigo,and dizziness respectively.MRI findings of reticulated “popcorn like” lesion with complete hemosiden rim showed typical sign of CCM.DSA,contrast-enhanced MRI and MRI-SWI revealed the caput medusae of the medullary veins and collected veins which was drained into subcortical and deep venous system,which indicated DVAs in 3 patients.The angulated medullary veins and collected veins in approaching distal zone of CCM were observed.Conclusion DVAs can be combined with CCM.The angulated medullary veins and collected veins combined with CCM in same territory reveals that the angioarchitectural factors is a key factor in pathogenesis of cavernous malformation.%目的 探索颅内发育性静脉异常(DVAs)并发海绵状血管畸形(CCM)的临床及影像学特点.方法 对分别以癫痫、头昏、头晕发病的3例患者行头颅MRI磁敏感成像(MRI-SWI)或T2快速梯度回波(T2FFE)、钆喷酸葡胺增强、MRA及全脑血管造影检查.结果 MRI-SWI或T2FFE可见边缘低信号、中心为不同强度混杂信号的爆米花样或网格状的病灶,分布于额叶皮质及皮质下,提示CCM;在MRI增强及全脑血管造影中可见水母头样表现,提示有DVAs.在分析DVAs和CCM的关系中发现CCM病灶均发生在DVAs区域,可见引流静脉与CCM病灶呈成角弯曲.结论 DVAs可并发CCM,影像学可提供有特征性的改变,DVAs血管因素可能是CCM形成的原因之一.

  6. Structure-guided identification of a family of dual receptor-binding PfEMP1 that is associated with cerebral malaria

    DEFF Research Database (Denmark)

    Lennartz, Frank; Adams, Yvonne; Bengtsson, Anja

    2017-01-01

    Cerebral malaria is a deadly outcome of infection by Plasmodium falciparum, occurring when parasite-infected erythrocytes accumulate in the brain. These erythrocytes display parasite proteins of the PfEMP1 family that bind various endothelial receptors. Despite the importance of cerebral malaria,...

  7. Arachnoid cyst in cavernous sinus: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyoung Gun; Yoo, Won Jong; Jung, So Lyung; Lee, Hae Giu; Lim, Hyun Wook; Im, Soo Ah [The Catholic University of Kore College of Medicine, Puchun (Korea, Republic of)

    2002-12-01

    Arachnoid cyst of the cavernous sinus is very rare. When present, its anatomic location frequently gives rise to cranial nerve palsy. We report a case of arachnoid cyst of the cavernous sinus in a 38-year-old man with impeder eyeball movement and diplopia.

  8. Spontaneous Resolution of Direct Carotid Cavernous Fistula

    NARCIS (Netherlands)

    Ishaq, Mazhar; Arain, Muhammad Aamir; Ahmed, Saadullah; Niazi, Muhammad Khizar; Khan, Muhammad Dawood; Iqbal, Zamir

    2010-01-01

    Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the ca

  9. 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.

  10. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    Science.gov (United States)

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  11. EVOKED CAVERNOUS ACTIVITY: NEUROANATOMIC IMPLICATIONS

    Science.gov (United States)

    Yilmaz, Ugur; Vicars, Brenda; Yang, Claire C.

    2013-01-01

    We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited 7 males with thoracic spinal cord injury (SCI) and sexual dysfunction and 6 males who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS subjects, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one subject had reproducible hand SSRs. None of these subjects had ECA or foot SSRs. All the PS subjects had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared to the preoperative period (p>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men following radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers. PMID:19609298

  12. Rock cavern storage of spent fuel

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Won Jin; Kim, Kyung Soo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kwon, Sang Ki [Inha University, Incheon (Korea, Republic of)

    2015-12-15

    The rock cavern storage for spent fuel has been assessed to apply in Korea with reviewing the state of the art of the technologies for surface storage and rock cavern storage of spent fuel. The technical feasibility and economic aspects of the rock cavern storage of spent fuel were also analyzed. A considerable area of flat land isolated from the exterior are needed to meet the requirement for the site of the surface storage facilities. It may, however, not be easy to secure such areas in the mountainous region of Korea. Instead, the spent fuel storage facilities constructed in the rock cavern moderate their demands for the suitable site. As a result, the rock cavern storage is a promising alternative for the storage of spent fuel in the aspect of natural and social environments. The rock cavern storage of spent fuel has several advantages compared with the surface storage, and there is no significant difference on the viewpoint of economy between the two alternatives. In addition, no great technical difficulties are present to apply the rock cavern storage technologies to the storage of domestic spent fuel.

  13. Operative management of tumors involving the cavernous sinus.

    Science.gov (United States)

    Sekhar, L N; Møller, A R

    1986-06-01

    In the past, neurosurgeons have been reluctant to operate on tumors involving the cavernous sinus because of the possibility of bleeding from the venous plexus or injury to the internal carotid artery (ICA) or the third, fourth, or sixth cranial nerves. The authors describe techniques for a more aggressive surgical approach to neoplasms in this area that are either benign or locally confined malignant lesions. During the last 2 years, seven tumors involving the cavernous sinus have been resected: six totally and one subtotally. The preoperative evaluation included axial and coronal computerized tomography, cerebral angiography, and a balloon-occlusion test of the ICA. Intraoperative monitoring of the third, fourth, sixth, and seventh cranial nerves was used to assist in locating the nerves and in avoiding injury to them. The first major step in the operative procedure was to obtain proximal control of the ICA at the petrous apex and distal control in the supraclinoid segment. The cavernous sinus was then opened by a lateral, superior, or inferior approach for tumor resection. Temporary clipping and suture of the ICA was necessary in one patient. None of the patients died or suffered a stroke postoperatively. Permanent trigeminal nerve injury occurred in three patients; in two, this was the result of tumor invasion. One patient suffered temporary paralysis of the third, fourth, and sixth cranial nerves, and in another the sixth cranial nerve was temporarily paralyzed. Preoperative cranial nerve deficits were improved postoperatively in three patients. Radiation therapy was administered postoperatively to four patients. These seven patients have been followed for 6 to 18 months to date and none has shown evidence of recurrence of the intracavernous tumor.

  14. Impact of Non-medical Out-of-pocket Expenses on Families of Children With Cerebral Palsy Following Orthopaedic Surgery.

    Science.gov (United States)

    Vessey, Judith A; DiFazio, Rachel L; Strout, Tania D; Snyder, Brian D

    2017-07-24

    Limited research has been conducted on the non-medical out-of-pocket expenses (NOOPEs) incurred by families of children with chronic health conditions. The study objectives were to: 1) calculate the estimated NOOPEs incurred by families during hospitalization of their child, 2) identify predictors of high NOOPEs, and 3) assess the impact of the child's chronic health condition on the family's finances. Prospective observational study. Parents were included if their child was 3-20years old, had severe, non-ambulatory cerebral palsy (CP), and scheduled for hip or spine surgery. Parents reported all NOOPEs incurred during their child's hospitalization using the Family Expense Diary. Families completed the subscales of the Impact on Family Scale and the Assessment of Caregivers Experience with Neuromuscular Disease. Descriptive and univariate and multiple hierarchical regression models were used in the analysis. Fifty two parents participated. The total NOOPEs ranged from $193.00 to $7192.71 (M=$2001.92) per hospitalization representing an average of 4% of the family's annual earned income. Caregiver age (F=8.393, phospital (F=4.497, p=0.039) were significant predictors of high NOOPEs. The subscale scores indicated that a child's chronic health condition had a significant impact on family finances. Hospitalization is associated with numerous NOOPEs that create additional financial demands for families caring for a child with severe CP. NOOPEs should be addressed when preparing families for their children's planned hospital admissions, especially those families of CSHCN who experience significant financial impacts secondary to their children's care. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. 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.

  16. Pulmonary cavernous hemangioma:a case report

    Institute of Scientific and Technical Information of China (English)

    Chunyi Jia; Shaolin Sun; Xiaokai Zhang; Lixin Zhang

    2014-01-01

    We report a rare case of pulmonary cavernous hemangioma in a 51-year-old female. A computed tomographic scan of the chest showed an il-defined mass measuring 2.3 cm × 2.2 cm in the right lower lobe. Surgical resection was per-formed and postoperative histological examination revealed cavernous hemangioma. We reviewed the clinical features and therapeutic methods of hemangioma.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. Environmental settings and families' socioeconomic status influence mobility and the use of mobility devices by children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Valéria C. R. Cury

    Full Text Available Functional mobility of children with cerebral palsy (CP is influenced by personal and environmental factors, serving as barriers and/or facilitators and impacting on children's strategies and functional outcome. OBJECTIVES: To describe typical mobility methods used by children with CP at home, school and community and to compare them across family's socioeconomic levels (SES. METHODS: The Functional Mobility Scale was used to assess mobility of 113 children with CP of high and low SES at home, school, and community. RESULTS: Differences in mobility methods of participants classified as Gross Motor Function Classification System levels II, III and IV were found between home and community. For levels III and IV, differences were also found between home and school. At home, participants from higher SES used wheelchairs more frequently while those from lower SES used floor mobility (crawling. CONCLUSIONS: Environmental settings and families' socioeconomic status influence mobility and use of mobility devices by children with CP.

  2. AbetaPP/APLP2 family of Kunitz serine proteinase inhibitors regulate cerebral thrombosis.

    Science.gov (United States)

    Xu, Feng; Previti, Mary Lou; Nieman, Marvin T; Davis, Judianne; Schmaier, Alvin H; Van Nostrand, William E

    2009-04-29

    The amyloid beta-protein precursor (AbetaPP) is best recognized as the precursor to the Abeta peptide that accumulates in the brains of patients with Alzheimer's disease, but less is known about its physiological functions. Isoforms of AbetaPP that contain a Kunitz-type serine proteinase inhibitor (KPI) domain are expressed in brain and, outside the CNS, in circulating blood platelets. Recently, we showed that KPI-containing forms of AbetaPP regulates cerebral thrombosis in vivo (Xu et al., 2005, 2007). Amyloid precursor like protein-2 (APLP2), a closely related homolog to AbetaPP, also possesses a highly conserved KPI domain. Virtually nothing is known of its function. Here, we show that APLP2 also regulates cerebral thrombosis risk. Recombinant purified KPI domains of AbetaPP and APLP2 both inhibit the plasma clotting in vitro. In a carotid artery thrombosis model, both AbetaPP(-/-) and APLP2(-/-) mice exhibit similar significantly shorter times to vessel occlusion compared with wild-type mice indicating a prothrombotic phenotype. Similarly, in an experimental model of intracerebral hemorrhage, both AbetaPP(-/-) and APLP2(-/-) mice produce significantly smaller hematomas with reduced brain hemoglobin content compared with wild-type mice. Together, these results indicate that AbetaPP and APLP2 share overlapping anticoagulant functions with regard to regulating thrombosis after cerebral vascular injury.

  3. [Neuro-ophthalmology and interventional neuro-radiology--co-treatment for carotid cavernous sinus fistula].

    Science.gov (United States)

    Platner, Eva; Bakon, Mati; Huna-Baron, Ruth

    2013-02-01

    Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous communications in the cavernous sinus. In many cases of CCF's the primary signs are ocular manifestations, which include: pulsatile proptosis, orbital bruit, chemosis and conjunctival injection, elevated intraocular pressure, venous stasis retinopathy, and cranial nerve pareses. Patients in whom the fistula causes arterial drainage into the cerebral veins and sinuses are at risk for intracranial hemorrhage. The most common treatment for CCF's is endovascular occlusion of the lesion. The goal of this procedure is to occlude the fistula but preserve the patency of the internal carotid artery. The CCF itself, as well as its treatment, can be sight- and even life-threatening. We describe 3 case reports of patients with CCF, in order to demonstrate the cooperation between the neuro-opthalmologist and the invasive neuro-radiologist, in the follow-up of the patient and in the treatment timing decision.

  4. Analysis of cavern stability at the West Hackberry SPR site.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    2009-05-01

    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 repressuization 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 ft 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 is

  5. Dorsal spinal epidural cavernous hemangioma

    Directory of Open Access Journals (Sweden)

    Darshana Sanghvi

    2010-01-01

    Full Text Available A 61-year-old female patient presented with diffuse pain in the dorsal region of the back of 3 months duration. The magnetic resonance imaging showed an extramedullary, extradural space occupative lesion on the right side of the spinal canal from D5 to D7 vertebral levels. The mass was well marginated and there was no bone involvement. Compression of the adjacent thecal sac was observed, with displacement to the left side. Radiological differential diagnosis included nerve sheath tumor and meningioma. The patient underwent D6 hemilaminectomy under general anesthesia. Intraoperatively, the tumor was purely extradural in location with mild extension into the right foramina. No attachment to the nerves or dura was found. Total excision of the extradural compressing mass was possible as there were preserved planes all around. Histopathology revealed cavernous hemangioma. As illustrated in our case, purely epidural hemangiomas, although uncommon, ought to be considered in the differential diagnosis of spinal epidural soft tissue masses. Findings that may help to differentiate this lesion from the ubiquitous disk prolapse, more common meningiomas and nerve sheath tumors are its ovoid shape, uniform T2 hyperintense signal and lack of anatomic connection with the neighboring intervertebral disk or the exiting nerve root. Entirely extradural lesions with no bone involvement are rare and represent about 12% of all intraspinal hemangiomas.

  6. Dorsal spinal epidural cavernous hemangioma.

    Science.gov (United States)

    Sanghvi, Darshana; Munshi, Mihir; Kulkarni, Bijal; Kumar, Abhaya

    2010-07-01

    A 61-year-old female patient presented with diffuse pain in the dorsal region of the back of 3 months duration. The magnetic resonance imaging showed an extramedullary, extradural space occupative lesion on the right side of the spinal canal from D5 to D7 vertebral levels. The mass was well marginated and there was no bone involvement. Compression of the adjacent thecal sac was observed, with displacement to the left side. Radiological differential diagnosis included nerve sheath tumor and meningioma. The patient underwent D6 hemilaminectomy under general anesthesia. Intraoperatively, the tumor was purely extradural in location with mild extension into the right foramina. No attachment to the nerves or dura was found. Total excision of the extradural compressing mass was possible as there were preserved planes all around. Histopathology revealed cavernous hemangioma. As illustrated in our case, purely epidural hemangiomas, although uncommon, ought to be considered in the differential diagnosis of spinal epidural soft tissue masses. Findings that may help to differentiate this lesion from the ubiquitous disk prolapse, more common meningiomas and nerve sheath tumors are its ovoid shape, uniform T2 hyperintense signal and lack of anatomic connection with the neighboring intervertebral disk or the exiting nerve root. Entirely extradural lesions with no bone involvement are rare and represent about 12% of all intraspinal hemangiomas.

  7. Analysis of cavern stability at the Bryan Mound SPR site.

    Energy Technology Data Exchange (ETDEWEB)

    Ehgartner, Brian L.; Sobolik, Steven Ronald

    2009-04-01

    This report presents computational analyses that simulate the structural response of caverns at the Strategic Petroleum Reserve Bryan Mound site. The cavern field comprises 20 caverns. Five caverns (1, 2, 4, and 5; 3 was later plugged and abandoned) were acquired from industry and have unusual shapes and a history dating back to 1946. The other 16 caverns (101-116) 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 3-D geomechanics model of the site that predicts deformations, strains, and stresses. Future leaching scenarios due 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 result in this report is relevant to caverns 1, 2, and 5. The caverns have non-cylindrical shapes and have potential regions where the surrounding salt may be damaged during workover procedures. During a workover the normal cavern operating pressure is lowered to service a well. At this point the wellhead pressures are atmospheric. When the workover is complete, the cavern is repressurized. The resulting elastic stresses are sufficient to cause tension and large deviatoric stresses at several locations. With time, these stresses relax to a compressive state due to salt creep. However, the potential for salt damage and fracturing exists. The analyses predict tensile stresses at locations with sharp-edges in the wall geometry, or in the case of cavern 5, in the neck region between the upper and lower lobes of the cavern. The effects do not appear to be large-scale, however, so the only major impact is the potential for stress-induced salt falls in cavern 5, potentially leading to

  8. AβPP/APLP2 Family of Kunitz Serine Proteinase Inhibitors Regulate Cerebral Thrombosis

    Science.gov (United States)

    Xu, Feng; Previti, Mary Lou; Nieman, Marvin T.; Davis, Judianne; Schmaier, Alvin H.; Van Nostrand, William E.

    2009-01-01

    The amyloid β-protein precursor (AβPP) is best recognized as the precursor to the Aβ peptide that accumulates in the brains of patients with Alzheimer’s disease, but less is known about its physiological functions. Isoforms of AβPP that contain a Kunitz-type serine proteinase inhibitor (KPI) domain are expressed in brain and, outside the CNS, in circulating blood platelets. Recently, we showed that KPI-containing forms of AβPP regulates cerebral thrombosis in vivo (Xu et al., 2005 Proc. Natl. Acad. Sci. USA 102:18135–18140; Xu et al. 2007 Stroke 38:2598–2601). Amyloid precursor like protein-2 (APLP2), a closely related homolog to AβPP, also possesses a highly conserved KPI domain. Virtually nothing is known of its function. Here we show that APLP2 also regulates cerebral thrombosis risk. Recombinant purified KPI domains of AβPP and APLP2 both inhibit the plasma clotting in vitro. In a carotid artery thrombosis model both AβPP−/− and APLP2−/− mice exhibit similar significantly shorter times to vessel occlusion compared with wild-type mice indicating a pro-thrombotic phenotype. Similarly, in an experimental model of intracerebral hemorrhage both AβPP−/− and APLP2−/− mice produce significantly smaller hematomas with reduced brain hemoglobin content compared with wild-type mice. Together, these results indicate that AβPP and APLP2 share overlapping anticoagulant functions with regard to regulating thrombosis after cerebral vascular injury. PMID:19403832

  9. Changes in Cerebral Blood Flow in Presymptomatic Mutation Carriers of Familial Frontotemporal Dementia (FTD-3), Measured with MRI

    DEFF Research Database (Denmark)

    Lunau, Line Andersen; Mouridsen, Kim; Rodell, Anders

    , temporal, parietal, and occipital lobes, hippocampus, basal ganglia and cerebellum. Data were normalized to white matter in order to smooth inter-individual differences. Results: We included 8 carriers and 7 first-degree related family non-carriers. Comparing carriers with non-carriers, the former showed...... decreased mean CBF values at the capillary level in all ROIs, with significant changes in capillary CBF in the parietal (mean change 14 %; p = 0.03) and occipital (mean change 9 %; p = 0.02) lobes. Conclusions: Decreased cerebral blood flow can be measured in presymptomatic CHMP2B mutation carriers...... with statistically significant differences in the occipital- and parietal lobes. Alterations in CBF possibly affect the whole brain. Data indicate that FTD-3 pathology might involve brain capillaries. This may impact the understanding of the pathogenesis involving endosomal dysfunction and implicates involvement...

  10. Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study

    OpenAIRE

    Surender, S.; Gowda, Vykuntaraju K; Sanjay, K. S.; G V Basavaraja; Naveen Benakappa; Asha Benakappa

    2016-01-01

    Introduction: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children's HRQOL and their families, and its relationship with gross motor dysfunction. Subjects and Methods: CP children aged 3–10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed usin...

  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. Dural cavernous haemangioma of posterior cranial fossa.

    Directory of Open Access Journals (Sweden)

    Goel A

    1993-10-01

    Full Text Available A rare case of extracerebral dural cavernous angioma sited near the sigmoid sinus is reported. This 60 yr old male patient gave history of episodic ataxia of left sided limbs experienced twice on same day and occasional giddiness. Examination did not reveal any findings. A mass was diagnosed on CT Scan following which angiography was carried out. The features matched with those of a meningioma. Retro-sigmoid craniectomy was performed. Occipital artery was coagulated. Tumor was dissected out. Post-operative course of the patient was uneventful. Histopathology revealed that the mass was a cavernous haemangioma.

  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. 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".

  16. 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...

  17. Cavernous hemangioma of Meckel's cave. Case report.

    Science.gov (United States)

    Fehlings, M G; Tucker, W S

    1988-04-01

    A case of a cavernous hemangioma located within Meckel's cave and involving the gasserian ganglion is described in a patient presenting with facial pain and a trigeminal nerve deficit. Although these lesions have been reported to occur in the middle fossa, this is believed to be the first case of such a vascular malformation arising solely from within Meckel's cave.

  18. 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.

  19. Congenital pial arteriovenous fistula in the temporal region draining into cavernous sinus: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ziyin; Wang, Chaohua; Zhang, Changwei; Xie, Xiaodong [Dept. of Neurosurgery, West China Hospital of Sichuan University, Chengdu (China); Wang, Kun; Tang, Jianjian [Dept. of Neurosurgery, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2013-06-15

    This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.

  20. Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer

    Science.gov (United States)

    Kamio, Yoshinobu; Hiramatsu, Hisaya; Kamiya, Mika; Yamashita, Shuhei; Namba, Hiroki

    2017-01-01

    Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus. PMID:28061497

  1. Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma: A case report

    Directory of Open Access Journals (Sweden)

    Toyama Yoshiaki

    2011-03-01

    Full Text Available Abstract Cavernous hemangioma consists mainly of congenital vascular malformations present before birth and gradually increasing in size with skeletal growth. A small number of patients with cavernous hemangioma develop scoliosis, and surgical treatment for the scoliosis in such cases has not been reported to date. Here we report a 12-year-old male patient with severe progressive scoliosis due to a huge subcutaneous cavernous hemangioma, who underwent posterior correction and fusion surgery. Upon referral to our department, radiographs revealed a scoliosis of 85° at T6-L1 and a kyphosis of 58° at T4-T10. CT and MR images revealed a huge hemangioma extending from the subcutaneous region to the paraspinal muscles and the retroperitoneal space and invading the spinal canal. Posterior correction and fusion surgery using pedicle screws between T2 and L3 were performed. Massive hemorrhage from the hemangioma occurred during the surgery, with intraoperative blood loss reaching 2800 ml. The scoliosis was corrected to 59°, and the kyphosis to 45° after surgery. Seven hours after surgery, the patient suffered from hypovolemic shock and disseminated intravascular coagulation due to postoperative hemorrhage from the hemangioma. The patient developed sensory and conduction aphasia caused by cerebral hypoxia during the shock on the day of the surgery. At present, two years after the surgery, although the patient has completely recovered from the aphasia. This case illustrates that, in correction surgery for scoliosis due to huge subcutaneous cavernous hemangioma, intraoperative and postoperative intensive care for hemodynamics should be performed, since massive hemorrhage can occur during the postoperative period as well as the intraoperative period.

  2. The association of carotid cavernous fistula with Graves′ ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Ozlem Celik

    2013-01-01

    Full Text Available Graves′ ophthalmopathy (GO is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.

  3. Method of drilling a borehole through cavernous underground formations

    Energy Technology Data Exchange (ETDEWEB)

    Huizinga, R.J.; Stewart, R.B.

    1981-07-15

    To pass a cavern in an underground formation through which a borehole is being drilled, a cementing tube is lowered through the hole and into the cavern. A lightweight cement slurry (such as a foam cement slurry) is introduced into the cavern to build up a cement column extending between the floor and the ceiling of the cavity at a location where the borehole should pass the cavity. 6 claims.

  4. Neuraxis Cavernous Malformations: a Four Cases Report

    Directory of Open Access Journals (Sweden)

    Yandy Prieto Leyras

    2013-04-01

    Full Text Available Cavernous malformations are benign vascular tumors, with a raspberry-like morphology, commonly described as part of the group of the so called cryptic vascular malformations, which are rare neurological presentations. They are considered to be a controversial chapter in neuroscience due to the clinical-topographic variability of their presentation. Their management remains controversial. We present the cases of four patients with neuraxis cavernomas who are characterization from clinical and imaging standpoint, up to their final outcome. Early detection, understanding, and better management of the neuraxis cavernous malformations are the result of contemporary technological advances. The historical review on the subject shows the difference between the few cases that could be clinically diagnosed through conventional radiology and the largest number of lesions detected at autopsy or during surgery.

  5. Nasopharyngeal carcinoma presented as cavernous sinus tumour.

    Science.gov (United States)

    Moona, Mohammad Shafi; Mehdi, Itrat

    2011-12-01

    A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed with a cavernous sinus meningioma on the basis of MRI findings but no initial biopsy was taken. Depending on the radiologic diagnosis the patient was treated with gamma knife surgery twice, abroad. During follow up he developed left ear deafness and left cervical lymph adenopathy. An ENT evaluation with biopsy from the nasopharynx and cervical lymph node was taken. The histopathologic diagnosis of the resected tumour showed a nasopharyngeal carcinoma with cervical lymph node metastasis (poorly differentiated lympho-epithelial carcinoma). The cavernous sinus tumour which was initially treated as a meningioma was in fact metastasis from the nasopharyngeal carcinoma, making this an interesting and rare occurrence.

  6. Cavernous hemangioma of the right atrium.

    Science.gov (United States)

    Contrafouris, Constantinos; Kanakis, Meletios; Milonakis, Michael; Azariadis, Prodromos; Chatzis, Andrew

    2016-11-01

    A 42-year-old woman was diagnosed during the 3rd month of pregnancy with a large right atrial tumor. Three weeks after successful completion of a full-term pregnancy, she was admitted and underwent surgical removal of the tumor. Postoperative course was uneventful and pathology showed cavernous hemangioma. These neoplasms should be removed in order to prevent severe arrhythmias as also potential malignant transformation.

  7. Thoracic Cavernous Lymphangioma Provoking Massive Chyloptysis

    Directory of Open Access Journals (Sweden)

    Robert Ferguson MD

    2013-09-01

    Full Text Available Chyloptysis is a relatively rare embodiment of disease that encompasses a lengthy differential and provides many diagnostic and therapeutic challenges. Presented here is the case of a young woman with massive chyloptysis due to a thoracic cavernous lymphangioma arising in the peripartum period. The severity of her condition mandated the use of cardiopulmonary bypass to resect her lymphangioma. We believe that the extent of her symptoms, etiology of disease, and surgical management represent a unique scenario in the literature.

  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. 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.

  10. 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.

  11. Transvenous injection of Onyx for casting of the cavernous sinus for the treatment of a carotid-cavernous fistula.

    Science.gov (United States)

    Arat, Anil; Cekirge, Saruhan; Saatci, Isil; Ozgen, Burce

    2004-12-01

    A complex case of carotid-cavernous fistula was treated transvenously by injection of ethyl vinyl alcohol co-polymer into the cavernous sinus after an unsuccessful embolization attempt with detachable coils and liquid adhesive agents. There were no complications. At 3 months the patient's symptoms had resolved completely, and a control angiogram revealed persistent occlusion. The physical properties of ethyl vinyl alcohol polymer justify further investigation of this agent for the treatment of carotid-cavernous fistula.

  12. Differential cerebral deposition of IDE and NEP in sporadic and familial Alzheimer’s disease

    Science.gov (United States)

    Dorfman, Verónica Berta; Pasquini, Laura; Riudavets, Miguel; López-Costa, Juan José; Villegas, Andrés; Troncoso, Juan Carlos; Lopera, Francisco; Castaño, Eduardo Miguel; Morelli, Laura

    2011-01-01

    Alzheimer’s disease (AD) is characterized by amyloid β (Aβ) accumulation in the brain and is classified as familial early-onset (FAD) or sporadic late-onset (SAD). Evidences suggest that deficits in the brain expression of insulin degrading enzyme (IDE) and neprilysin (NEP), both proteases involved in amyloid degradation, may promote Aβ deposition in SAD. We studied by immunohistochemistry IDE and NEP cortical expression in SAD and FAD samples carrying the E280A presenilin-1 missense mutation. We showed that IDE, a soluble peptidase, is linked with aggregated Aβ40 isoform while NEP, a membrane-bound protease, negatively correlates with amyloid angiopathy and its expression in the senile plaques is independent of aggregated amyloid and restricted to SAD cases. NEP, but not IDE, is over-expressed in dystrophic neurites, both proteases are immunoreactive in activated astrocytes but not in microglia and IDE was the only one detected in astrocytes of white matter from FAD cases. Collectively, our results support the notion that gross conformational changes involved in the modification from “natively folded-active” to “aggregated-inactive” IDE and NEP may be a relevant pathogenic mechanism in SAD. PMID:19019493

  13. Estresse parental em famílias de crianças com paralisia cerebral: revisão integrativa Parental stress in families of children with cerebral palsy: an integrative review

    Directory of Open Access Journals (Sweden)

    Celmo Celeno Porto

    2013-06-01

    levels of stress. Satisfaction with social support, satisfaction with the parental role, a good family rapport, an emotional bond between father/mother and child, spousal support and the sense of being an active participation in social life help reduce stress levels. Parents of children with cerebral palsy are likely to have their health affected by higher levels of stress. Thus, health professionals should give them special attention.

  14. 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

  15. 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....

  16. 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.

  17. 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.

  18. Rhino-orbito-cerebral mucormycosis: Magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Parveen A Lone

    2015-01-01

    Full Text Available Rhino-orbito-cerebral mucormycosis (ROCM is a potentially fatal fungal infection that commonly affects diabetic and other immunocompromised patients. Necrotizing and angioinvasive features of this class of pathogenic fungi facilitate spread from sinuses into orbit and brain with devastating consequences like cavernous sinus thrombosis. We describe magnetic resonance, including diffusion weighted imaging findings in a case of micobiologically documented ROCM in a 50-year-old diabetic man. Restricted diffusion was demonstrated in the distribution of infiltrating lesion right from soft issue facial component through left orbit and in the cavernous sinus. Favorable outcome was achieved with surgical debridement and prolonged amphotericin therapy.

  19. 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.

  20. Family empowerment model in cerebral infarction patients%家属赋能模式在脑梗塞病人中的应用

    Institute of Scientific and Technical Information of China (English)

    李芳

    2013-01-01

    Objective: To investigate the family empowerment model in cerebral infarction patients and their families in the application. Methods: 80 cases of cerebral infarction were randomly divided into the observation group and the control group with 40 cases in each group, the control group used the traditional methods of health education; used in the observed group family empowerment mode to carry out health education. Comparison of two groups of patients and their families to the disease knowledge and skils to master degree, degree of satisfaction to the nursing work and the postoperative complications. Results: the patients in the observation group and family health education knowledge and the degree of the satisfaction to the nursing work is higher than that of control group; nursing complication than that of control group (P<0.05). Conclusion: the application of family empowerment on cerebral infarction patients for health education, can significantly improve the patient's self awareness of rehabilitation and family members of patients with the patient's cognitive nursing care; nursing work satisfaction, reduce the occurrence of complications.%  目的:探讨家属赋能模式在脑梗塞患者及其家属中的应用效果.方法:将80例脑梗塞患者随机分为观察组和对照组各40例,对照组采用传统方法进行健康教育;观察组应用家属赋能模式实施健康教育.比较两组患者及家属对疾病认知及技能掌握度、对护理工作的满意度及并发症发生情况.结果:观察组患者及家属对健康教育知识的掌握度和对护理工作的满意度高于对照组;护理并发症少于对照组(P<0.05).结论:应用家属赋能模式对脑梗塞患者进行健康教育,可显著提高患者的自我康复意识及患者家属对病人的认知照护能力;提高护理工作的满意度,减少并发症发生.

  1. Giant cavernous hemangioma of the adrenal gland

    Science.gov (United States)

    Quildrian, Sergio Damián; Silberman, Ezequiel Aníbal; Vigovich, Felix Alberto; Porto, Eduardo Agustín

    2012-01-01

    INTRODUCTION Cavernous hemangioma of the adrenal gland is a rare non-functioning benign neoplasm. PRESENTATION OF CASE A 62-year-old woman with chronic obstructive pulmonary disease was diagnosed as having an incidental non-functioning adrenal tumor. Because of the impossibility of ruling out the presence of malignancy, conventional surgical resection was carried out. The histopathology revealed a 12.5 cm × 11.5 cm × 8 cm adrenal mass with large and lacunae vascular spaces lined with mature endothelial cells. These findings were compatible with cavernous hemangioma. DISCUSSION The majority of patients in the literature underwent surgical resection due to the impossibility of excluding malignancy, because of related symptoms in patients with large masses, or because of the risk of spontaneous tumoral rupture. CONCLUSION These tumors are quite infrequent. Due to the low frequency and the lack of specific symptoms, most adrenal hemangiomas are diagnosed postoperatively. PMID:23287064

  2. Endovascular management of carotid-cavernous fistulas

    Institute of Scientific and Technical Information of China (English)

    GAO Bu-lang; LI Ming-hua; LI Yong-dong; FANG Chun; WANG Jue; DU Zhuo-ying

    2007-01-01

    Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas (CCF) and their complications such as pseudoaneurysms. Methods: Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coil embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stent management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% (4/22). A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% (8/22). Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.

  3. Beta adrenergic receptors in human cavernous tissue

    Energy Technology Data Exchange (ETDEWEB)

    Dhabuwala, C.B.; Ramakrishna, C.V.; Anderson, G.F.

    1985-04-01

    Beta adrenergic receptor binding was performed with /sup 125/I iodocyanopindolol on human cavernous tissue membrane fractions from normal tissue and transsexual procedures obtained postoperatively, as well as from postmortem sources. Isotherm binding studies on normal fresh tissues indicated that the receptor density was 9.1 fmoles/mg. with a KD of 23 pM. Tissue stored at room temperature for 4 to 6 hours, then at 4C in saline solution for 19 to 20 hours before freezing showed no significant changes in receptor density or affinity, and provided evidence for the stability of postmortem tissue obtained within the same time period. Beta receptor density of 2 cavernous preparations from transsexual procedures was not significantly different from normal control tissues, and showed that high concentrations of estrogen received by these patients had no effect on beta adrenergic receptor density. Displacement of /sup 125/iodocyanopindolol by 5 beta adrenergic agents demonstrated that 1-propranolol had the greatest affinity followed by ICI 118,551, zinterol, metoprolol and practolol. When the results of these displacement studies were subjected to Scatfit, non- linear regression line analysis, a single binding site was described. Based on the relative potency of the selective beta adrenergic agents it appears that these receptors were of the beta 2 subtype.

  4. CaveMan Version 3.0: A Software System for SPR Cavern Pressure Analysis

    Energy Technology Data Exchange (ETDEWEB)

    BALLARD,SANFORD; EHGARTNER,BRIAN L.

    2000-07-01

    The U. S. Department of Energy Strategic Petroleum Reserve currently has approximately 500 million barrels of crude oil stored in 62 caverns solution-mined in salt domes along the Gulf Coast of Louisiana and Texas. One of the challenges of operating these caverns is ensuring that none of the fluids in the caverns are leaking into the environment. The current approach is to test the mechanical integrity of all the wells entering each cavern approximately once every five years. An alternative approach to detecting cavern leaks is to monitor the cavern pressure, since leaking fluid would act to reduce cavern pressure. Leak detection by pressure monitoring is complicated by other factors that influence cavern pressure, the most important of which are thermal expansion and contraction of the fluids in the cavern as they come into thermal equilibrium with the host salt, and cavern volume reduction due to salt creep. Cavern pressure is also influenced by cavern enlargement resulting from salt dissolution following introduction of raw water or unsaturated brine into the cavern. However, this effect only lasts for a month or two following a fluid injection. In order to implement a cavern pressure monitoring program, a software program called CaveMan has been developed. It includes thermal, creep and salt dissolution models and is able to predict the cavern pressurization rate based on the operational history of the cavern. Many of the numerous thermal and mechanical parameters in the model have been optimized to produce the best match between the historical data and the model predictions. Future measurements of cavern pressure are compared to the model predictions, and significant differences in cavern pressure set program flags that notify cavern operators of a potential problem. Measured cavern pressures that are significantly less than those predicted by the model may indicate the existence of a leak.

  5. Carotid and cranial nerve reconstruction after removal of cavernous sinus lesions.

    Science.gov (United States)

    Sekhar, L N; Sen, C N; Lanzino, G; Pomonis, S

    1991-12-01

    During the last 7 years, approximately 170 neoplasms, and 35 vascular lesions involving the cavernous sinus were treated by the first two authors. During the treatment of such lesions, the direct vein graft reconstruction of the internal carotid artery from the petrous to the supraclinoid or infraclinoid ICA was performed in 23 patients. Graft occlusion occurred in 3 patients and in one of these, it was successfully salvaged by placing a long venous graft from the extracranial ICA to the M3 segment of the middle cerebral artery. The latter 3 patients were neurologically normal. One patient with significant atherosclerotic disease suffered the dissection of the distal internal carotid artery with the graft being patent. The suturing technique. This patient eventually died. Two patients with severely compromised collateral circulation suffered minor strokes due to the temporary occlusion of the ICA. This has been avoided in the more recent patients by the adoption of brain protection techniques such as moderate hypothermia, induced hypertension, and barbiturate coma. Low dose heparin therapy during grafting and high dose intravenous steroids prior to the grafting also appear to be beneficial. Direct vein graft reconstruction of the intracavernous carotid artery is a valuable tool during the management of cavernous sinus lesions. The advantages and disadvantages of this technique as well as the pros and cons of other revascularization techniques will be discussed. During microsurgical removal of cavernous sinus lesions, the cranial nerves III-VI were reconstructed by direct resuture or by nerve grafting in 16 patients. In the majority of these patients, recovery of cranial nerve function was observed, which was very encouraging.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. 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.

  7. Treatment and Outcome of Epileptogenic Temporal Cavernous Malformations

    Institute of Scientific and Technical Information of China (English)

    Yong-Zhi Shan; Xiao-Tong Fan; Liang Meng; Yang An; Jian-Kun Xu; Guo-Guang Zhao

    2015-01-01

    Background:The aim of this study is to explore the treatment and outcome ofepileptogenic temporal lobe cavernous malformations (CMs).Methods:We analyzed retrospectively the profiles of 52 patients diagnosed as temporal lobe CMs associated with epilepsy.Among the 52 cases,11 underwent a direct resection of CM along with the adjacent zone of hemosiderin rim without electrocorticogram (ECoG) monitoring while the other 41 cases had operations under the guidance of ECoG.Forty-six patients were treated by lesionectomy + hemosiderin rim while the other six were treated by lesionectomy + hemosiderin rim along with extended epileptogenic zone resection.The locations of lesions,the duration of illness,the manifestation,the excision ranges and the outcomes of postoperative follow-up were analyzed,respectively.Results:All of the 52 patients were treated by microsurgery.There was no neurological deficit through the long-term follow-up.Outcomes of seizure control are as follows:42 patients (80.8%) belong to Engel Class Ⅰ,5 patients (9.6%) belong to Engel Class Ⅱ,3 patients (5.8%) belong to Engel Class Ⅲ and 2 patients (3.8%) belong to Engel Class Ⅳ.Conclusion:Patients with epilepsy caused by temporal CMs should be treated as early as possible.Resection of the lesion and the surrounding hemosiderin zone is necessary.Moreover,an extended excision of epileptogenic cortex or cerebral lobes is needed to achieve a better prognosis if the ECoG indicates the existence of an extra epilepsy onset origin outside the lesion itself.

  8. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study.

    Science.gov (United States)

    al-Mefty, O; Khalil, N; Elwany, M N; Smith, R R

    1990-11-01

    During direct surgery of neoplastic and vascular lesions of the cavernous sinus, the intracavernous carotid artery may be injured beyond repair, or its total isolation may be necessary for surgical management of these lesions. The newly developed procedure of a saphenous vein graft bypass of the cavernous carotid artery allows re-establishment of carotid circulation. Patients with poor collateral circulation are at high risk for ischemic complications induced by the prolonged temporary occlusion required to perform the bypass graft. Optimal management of these patients is to perform the venous bypass graft for permanent vascularization while maintaining carotid cerebral circulation through an intraoperative shunt. We studied this procedure in cadavers, and three shunt types were evaluated: the external intrapetrous-supraclinoid shunt (Type A), the internal intrapetrous-supraclinoid shunt (Type B), and the neck internal carotid-supraclinoid shunt (Type C). Anatomical landmarks, techniques, distances, caliber, and materials used are presented. The rationale and candidates for such a procedure are discussed. The specifications of an optimal balloon shunt are presented, and the three procedures are compared.

  9. [Giant cavernous hemangioma of the orbit (case report)].

    Science.gov (United States)

    Grusha, Ia O; Ismailova, D S; Eksarenko, O V; Fedorov, A A; Kharlap, S I

    2014-01-01

    The following case demonstrates a successful en bloc removal of a massive cavernous hemangioma of the orbit via vertical transpalpebral approach with postoperative improvement of optic nerve condition and optimal cosmetic result.

  10. Therapeutic surprise! Photodynamic therapy for cavernous haemangioma of the disc

    Directory of Open Access Journals (Sweden)

    Mahesh P Shanmugam

    2017-01-01

    Full Text Available Purpose: To report the response of cavernous haemangioma of the disc to PDT. Methods and Patients: A 32 years old lady presented to us with complaints of sudden onset of blurry vision in her right eye. What seemed initially as polypoidal choroidal vasculopathy turned out as cavernous haemangioma of the disc after pneumatic displacement of the sub-retinal haeme. She was treated with PDT as she was prone to recurrent haemorrhage from the lesion due to her low platelet count. Results: Complete regression of the cavernous haemangioma was noted as early as the second week itself and remained regressed for 4 months. Conclusion: PDT can be safe option for patients presenting with symptomatic cavernous haemangioma of the disc or retina.

  11. Cavernous hemangioma of the dura mater mimicking meningioma

    Directory of Open Access Journals (Sweden)

    Hambra Di Vitantonio

    2015-01-01

    Conclusions: Dural-based cavernous hemangiomas of the convexity are uncommon lesions. Up to now, only 13 cases have been described in the literature. The authors have discussed clinical aspects, radiological features, surgical treatment, and operative findings.

  12. 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.

  13. Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome.

    Science.gov (United States)

    Kim, Jeong Gyun; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

    2014-02-01

    Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.

  14. Oil field waste disposal in salt caverns: An information website

    Energy Technology Data Exchange (ETDEWEB)

    Tomasko, D.; Veil, J. A.

    1999-12-10

    Argonne National Laboratory has completed the construction of a Website for the US Department of Energy (DOE) that provides detailed information on salt caverns and their use for disposing of nonhazardous oil field wastes (NOW) and naturally occurring radioactive materials (NORM). Specific topics in the Website include the following: descriptions of salt deposits and salt caverns within the US, salt cavern construction methods, potential types of wastes, waste emplacement, regulatory issues, costs, carcinogenic and noncarcinogenic human health risks associated with postulated cavern release scenarios, new information on cavern disposal (e.g., upcoming meetings, regulatory issues, etc.), other studies supported by the National Petroleum Technology Office (NPTO) (e.g., considerations of site location, cavern stability, development issues, and bedded salt characterization in the Midland Basin), and links to other associated Web sites. In addition, the Website allows downloadable access to reports prepared on the topic that were funded by DOE. Because of the large quantities of NOW and NORM wastes generated annually by the oil industry, information presented on this Website is particularly interesting and valuable to project managers, regulators, and concerned citizens.

  15. The role of the family in intervention of infants at high risk of cerebral palsy : a systematic analysis

    NARCIS (Netherlands)

    Dirks, Tineke; Hadders-Algra, Mijna

    2011-01-01

    During the past two decades, awareness of the role of the family in the child's life has increased and the term 'family-centred services' (FCS) has been introduced to facilitate care for children with special needs and their families. It is, however, unclear how various early intervention programmes

  16. The role of the family in intervention of infants at high risk of cerebral palsy : a systematic analysis

    NARCIS (Netherlands)

    Dirks, Tineke; Hadders-Algra, Mijna

    2011-01-01

    During the past two decades, awareness of the role of the family in the child's life has increased and the term 'family-centred services' (FCS) has been introduced to facilitate care for children with special needs and their families. It is, however, unclear how various early intervention programmes

  17. 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

  18. 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.

  19. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  20. 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.

  1. 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).

  2. Facilidades e dificuldades da família no cuidado à criança com paralisia cerebral Dificultades y facilidades de la familia en el cuidado a los niños con parálisis cerebral Family's abilities and difficulties in caring for children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Meryeli Santos de Araújo Dantas

    2012-09-01

    , promueven el bienestar de la familia/niño con parálisis cerebral.This is a qualitative research and exploratory-descriptive study aimed at finding out the family's abilities and difficulties in caring for children with cerebral palsy. Data was collected from seven families, between March and April 2009, through semi-structured interviews. The analysis followed the principles of thematic interpretation. The difficulties are more evident than the abilities and bring repercussions to daily life activities. Dealing with difficulties to control seizures, spasticity, changes in postural tone, occurrence of primitive reflexes, result in the complexity to perform simple tasks like feeding, bathing, locomotion, because children become increasingly dependent on caregivers. Over time, the difficulties give way to the routine and adaptation to the child's daily life. Strengthening relationships with families by improving their bonds and developing quality and comprehensive actions, promotes the welfare of the family / child with cerebral palsy.

  3. 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.

  4. Gallium scintigraphy in a case of septic cavernous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J.; Malat, J.; Gladstone, A.G.; Richman, A.H.

    1986-09-01

    Septic cavernous sinus thrombosis, a relatively uncommon disease entity, frequently can be fatal. Early diagnosis is imperative in order that appropriate treatment be instituted. A 59-year-old woman who was admitted to our institution with complaints of diplopia, blurred vision and fevers that developed following a tooth extraction is presented. Initial CT and lumbar puncture on the day of admission were totally normal. A repeat CT performed 48 hours after admission, on the same day as gallium imaging, demonstrated findings consistent with cavernous sinus thrombosis. Gallium imaging demonstrated intense uptake in the left cavernous sinus and left orbit as well as moderately increased activity in the right cavernous sinus and orbit, confirming infection. The patient was treated with antibiotics, and repeat CT and gallium imaging were performed ten days later, both of which demonstrated near total resolution of the disease process. Conceivably, if gallium imaging had been initiated on the day of admission it may have been the first study to demonstrate an infectious process in the cavernous sinus. Gallium imaging should be considered as a diagnostic tool in the noninvasive workup of this entity.

  5. 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.

  6. CAVERN ROOF STABILITY FOR NATURAL GAS STORAGE IN BEDDED SALT

    Energy Technology Data Exchange (ETDEWEB)

    DeVries, Kerry L; Mellegard, Kirby D; Callahan, Gary D; Goodman, William M

    2005-06-01

    This report documents research performed to develop a new stress-based criterion for predicting the onset of damage in salt formations surrounding natural gas storage caverns. Laboratory tests were conducted to investigate the effects of shear stress, mean stress, pore pressure, temperature, and Lode angle on the strength and creep characteristics of salt. The laboratory test data were used in the development of the new criterion. The laboratory results indicate that the strength of salt strongly depends on the mean stress and Lode angle. The strength of the salt does not appear to be sensitive to temperature. Pore pressure effects were not readily apparent until a significant level of damage was induced and the permeability was increased to allow penetration of the liquid permeant. Utilizing the new criterion, numerical simulations were used to estimate the minimum allowable gas pressure for hypothetical storage caverns located in a bedded salt formation. The simulations performed illustrate the influence that cavern roof span, depth, roof salt thickness, shale thickness, and shale stiffness have on the allowable operating pressure range. Interestingly, comparison of predictions using the new criterion with that of a commonly used criterion indicate that lower minimum gas pressures may be allowed for caverns at shallow depths. However, as cavern depth is increased, less conservative estimates for minimum gas pressure were determined by the new criterion.

  7. Logging Geology Study of the Caverned Paleokarst Reservoir Distribution

    Institute of Scientific and Technical Information of China (English)

    WuXinsong; YangLei; PanWenqing; GuQiaoyuan

    2005-01-01

    In recent years, many carbonate rock oilfields such as Lunnan and Tahe have been found in the Tarim Basin, and the main reservoir space of the stable high yield wells in these oilfields consists mainly of the caverns formed by the paleo-karstification and the dissolution pores and fractures connected with them. Nevertheless, it is difficult to predict effectively the distribution of the cavern reservoir because of its extremely serious heterogeneity. In this paper, a case study of the Lunxi Oilfield in the north uplift of the Tarim Basin is conducted to introduce the logging geology method for predicting the distribution of the caverned paleokarst, reservoir. By means of building up the logging recognition style of different caverns and differentiating and correlating the karst zones with logging curves, and through an analysis of the paleokarst topography background, the favorable karst zones and distribution areas of the high quality cavern reservoir have been located, which lays a new basis for further exploration in this area.

  8. Malaria cerebral Cerebral malaria

    OpenAIRE

    Carlos Hugo Zapata Zapata; Silvia Blair Trujillo

    2003-01-01

    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 citoqu...

  9. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  10. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  11. 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.

  12. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Tishler, R.B.; Loeffler, J.S.; Alexander, E. III; Kooy, H.M. (Harvard Medical School, Boston, MA (United States)); Lunsford, L.D.; Duma, C.; Flickinger, J.C. (Univ. of Pittsburgh Medical Center, PA (United States))

    1993-09-20

    Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (University of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs.

  13. Seizure risk from cavernous or arteriovenous malformations

    Science.gov (United States)

    Josephson, C.B.; Leach, J.-P.; Duncan, R.; Roberts, R.C.; Counsell, C.E.

    2011-01-01

    Objectives: To determine the risk of epileptic seizures due to a brain arteriovenous malformation (AVM) or cavernous malformation (CM). Methods: In a prospective population-based study of new diagnoses of AVMs (n = 229) or CMs (n = 139) in adults in Scotland in 1999–2003, we used annual medical records surveillance, general practitioner follow-up, and patient questionnaires to quantify the risk of seizures between clinical presentation and AVM/CM treatment, last follow-up, or death. Results: The 5-year risk of first-ever seizure after presentation was higher for AVMs presenting with intracranial hemorrhage or focal neurologic deficit (ICH/FND: n = 119; 23%, 95% confidence interval [CI] 9%–37%) than for incidental AVMs (n = 40; 8%, 95% CI 0%–20%), CMs presenting with ICH/FND (n = 38; 6%, 95% CI 0%–14%), or incidental CMs (n = 57; 4%, 95% CI 0%–10%). For adults who had never experienced ICH/FND, the 5-year risk of epilepsy after first-ever seizure was higher for CMs (n = 23; 94%, 95% CI 84%–100%) than AVMs (n = 37; 58%, 95% CI 40%–76%; p = 0.02). Among adults who never experienced ICH/FND and presented with or developed epilepsy, there was no difference in the proportions achieving 2-year seizure freedom over 5 years between AVMs (n = 43; 45%, 95% CI 20%–70%) and CMs (n = 35; 47%, 95% CI 27%–67%). Conclusions: AVM-related ICH confers a significantly higher risk of a first-ever seizure compared to CMs or incidental AVMs. Adults with a CM have a high risk of epilepsy after a first-ever seizure but achieve seizure freedom as frequently as those with epilepsy due to an AVM. PMID:21536634

  14. 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.)

  15. 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.

  16. 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”

  17. Cavernous Hemangioma as A Palpable Breast Mass: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Tae Seok; Kim, Eun Kyung; Kwak, Jin Young; Moon, Hee Jung; Cha, Yoon Jin [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Cavernous hemangioma of the breast is rare, and if manifested as a focal palpable mass of the breast, it should be differentiated from angiosarcoma and other breast malignancies. We described a case of a 54-year-old woman with apalpable breast mass confirmed as a cavernous hemangioma. This lesion presented as a hyperdense mass on mammography and a hypoechoicmass with internal calcifications on ultrasonography. The calcifications exhibited a round shape and central lucency, making themphleboliths. Phlebolithsisare characteristic findings in soft tissue hemangiomas, and finding them during a mammography helps to identify hemangiomas

  18. 脑性瘫痪患儿及其家属生存质量研究%Study on the quality of life of children with cerebral palsy and their family members

    Institute of Scientific and Technical Information of China (English)

    黄小玲; 张双好; 李家妮; 丁建英; 廖金生

    2012-01-01

    Objective: To explore the effect of cerebral palsy on the quality of life (QOL) of the children and their family members. Methods: The pediatric quality of life inventory measurement models ( PedsQL) (4.0 version) was used to detect the QOL of the children with cerebral palsy and the normal children; the Mos 36 - item short form health survey was used to detect the QOL of the family members of the children with cerebral palsy and the normal children. The differences of QOL between the children with cerebral palsy and the normal children and between their family members were compared. Results: The scores of physical function, emotional function, social function, school function, and the total score of the children with cerebral palsy were significantly lower than those of normal children (P<0.01) . Except physical function and role physical, the scores of body pain, general health, activity, social function, role model function , mental health, and the total score of the family members of the children with cerebral palsy were significantly lower than those of the family members of normal children ( P <0. 05) . Conclusion: QOL of the children with cerebral palsy and their family members were higher than the normal children and their family members, thus, in the course of actual rehabilitation therapy, comprehensive methods should be a-dopted to improve the QOL of children with cerebral palsy and their family members, at the same time, the society should pay more attention to the families with children with cerebral palsy.%目的:探讨脑性瘫痪对患儿及其家属生存质量的影响.方法:采用儿童生存质量测定量表体系(the pediatric quality of life inventory measurement models,PedsQL)4.0作为测定工具,分别对脑性瘫痪儿童及正常儿童进行生存质量测定;采用SF-36健康调查量表(the Mos 36-item short form health survey)作为测定工具,分别对脑性瘫痪儿童家属及正常儿童家属进行生存质量测定,比较

  19. 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.

  20. Transvenous treatment of a complex cavernous sinus dural arteriovenous fistula secondary to balloon embolization of a traumatic carotid-cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    HAI Jian; CHEN Zuo-quan; DENG Dong-feng; PAN Qing-gang; LING Feng

    2006-01-01

    @@ AIthough recurrent traumatic carotid-cavernous fistula (CCF) and its treatment have been reported sporadically,1 a complex cavernous sinus dural arteriovenous fistula (DAVF) secondary to balloon embolization of a direct traumatic CCF is rare. In 2005, we treated such a case via transvenous approach using coils and N-buty-2-cyanoacrylate (NBCA). The causes of recurrent cavernous sinus DAVF and its endovascular approach are discussed.

  1. 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 ...

  2. Stakeholders' views of the introduction of assistive technology in the classroom: How family-centred is Australian practice for students with cerebral palsy?

    Science.gov (United States)

    Karlsson, P; Johnston, C; Barker, K

    2017-07-01

    With family-centred care widely recognized as a cornerstone for effective assistive technology service provision, the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom. In this cross-sectional study, we compare survey results from parents (n = 76), school staff (n = 33) and allied health professionals (n = 65) with experience in the use of high-tech assistive technology. Demographic characteristics and the stakeholders' perceived helpfulness and frequency attending assessment and set-up sessions were captured. To evaluate how family-centred the assistive technology services were perceived to be, the parents filled out the Measure of Processes of Care for Caregivers, and the professionals completed the Measure of Processes of Care for Service Providers. Descriptive statistics and one-way analysis of variance were used to conduct the data analysis. Findings show that parents are more involved during the assessment stage than during the implementation and that classroom teachers are often not involved in the initial stage. Speech pathologists in particular are seen to be to a great extent helpful when implementing assistive technology in the classroom. This study found that family-centred service is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. No statistically significant differences were found with respect to school staff and allied health professionals' roles, their years of experience working with students with cerebral palsy and the scales in the Measure of Processes of Care for Service Providers. To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. The findings also point to the significance of parents' involvement, with the support of

  3. Cerebral malaria Malaria cerebral

    OpenAIRE

    Silvia Blair Trujillo; Carlos Hugo Zapata Zapata

    2003-01-01

    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...

  4. 社区与家庭疗育对脑瘫婴儿及脑瘫高危儿康复的影响%Community and Family Influence on Cerebral Palsy Infants and High-risk Infants with Cerebral Palsy Rehabilitation

    Institute of Scientific and Technical Information of China (English)

    杜娇娇; 高岩

    2014-01-01

    Objective To investigate the cerebral palsy infants and high-risk infants with cerebral palsy in community and family intervention combined with rehabilitation ef ect. Methods Cerebral palsy infants and high-risk infants with cerebral palsy in 60 cases, were randomly divided into the treatment group and the parent group. The conventional group received conventional rehabilitation therapy, the parent group give parents system rehabilitation training on the basis of conventional group. Results After 2 course of treatment, curative ef ect is bet er than the conventional group parent group, there was significant dif erence ( <0.05). Conclusion The cerebral palsy infants and high-risk infants with cerebral palsy to community and family intervention combined with rehabilitation, can improve the treatment ef ect.%目的探讨脑瘫婴儿及脑瘫高危儿社区与家庭疗育结合康复的效果。方法选取脑瘫婴儿儿及脑瘫高危儿60例,随机分为常规组和家长组。常规组采用常规康复治疗方案,家长组在常规组的基础上给予家长系统康复培训。结果治疗2个疗程后,家长组疗效好于常规组,差异有显著性(<0.05)。结论对脑瘫婴儿及脑瘫高危儿采取社区与家庭疗育相结合的康复,可提高治疗效果。

  5. Cerebral oedema in episodic ataxia.

    Science.gov (United States)

    Crevits, L; Cambron, M; Anseeuw, S

    2009-03-01

    We report a patient with episodic ataxia (presumably of type 2) who developed cerebral oedema secondary to a common infection (presumably viral). Cerebral oedema may be a part of the clinical spectrum of familial episodic ataxia and argues for an overlap with hemiplegic migraine. It is suggested to consider a diagnosis of episodic ataxia or familial hemiplegic migraine in catastrophic reactions to apparent trivial trauma or infection.

  6. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available 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. 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.

  7. 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)

  8. 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.

  9. NA62 cavern and sub-detectors 2017

    CERN Multimedia

    Graham, Connor

    2017-01-01

    The NA62 cavern, with the completed detector, during breaks in data taking in July 2017. Pictures from 05-07-17 by Dan Protopopescu and pictures from 08-07-17 by Connor Graham (Both Glasgow-affiliated). Includes pictures of the whole experiment, safety systems and sub-detector elements.

  10. Cavernous hemangioma of the dura mater mimicking meningioma

    Science.gov (United States)

    Di Vitantonio, Hambra; De Paulis, Danilo; Ricci, Alessandro; Marzi, Sara; Dehcordi, Soheila Raysi; Galzio, Renato Juan

    2015-01-01

    Background: Cavernomas are benign lesions that most commonly occur intra-parenchymally, but occasionally they have been described as arising from the dura mater. Extra-axial cavernous angiomas (or hemangiomas) account for 0.4–2% of all intracranial vascular malformations, and they usually occur in the middle cranial fossa, associated with the cavernous sinus. Other possible localizations (e.g. tentorium, convexity, anterior cranial fossa, cerebellopontine angle, Meckel's cave, sella turcica and internal auditory meatus) are rare, and they account only for 0.2–0.5%. Case Description: We report a case of a 30-year-old female presenting with a 2 years history of headache unresponsive to drug therapy. The magnetic resonance imaging showed a dural-based lesion in the left frontal region; the lesion size was: 1.5 cm × 3.5 cm. The appearance suggested a convexity meningioma. A left frontal craniotomy was performed, and the histopathological diagnosis deposed for a cavernous hemangioma of the dura mater. The follow-up at 1-year was good without any neurologic deficit. Conclusions: Dural-based cavernous hemangiomas of the convexity are uncommon lesions. Up to now, only 13 cases have been described in the literature. The authors have discussed clinical aspects, radiological features, surgical treatment, and operative findings. PMID:26421218

  11. Carotid-cavernous fistula after functional endoscopic sinus surgery.

    Science.gov (United States)

    Karaman, Emin; Isildak, Huseyin; Haciyev, Yusuf; Kaytaz, Asim; Enver, Ozgun

    2009-03-01

    Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

  12. A Case of Brainstem Cavernous Angioma Presenting with Persistent Hiccups

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Arami

    2010-07-01

    Full Text Available "nIntractable hiccup most be considered as a symptom of underlying serious pathologies. We report a case of medulla oblongata cavernous angima presented with persistant hiccup and without any improvement during routine nonpharmacologic and pharmacologic treatment regimns. The patient is under our follow up visits and surgery is very high risk for this young girl.

  13. 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.

  14. 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.

  15. 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.

  16. Traumatic basilar pseudoaneurysm with a basilar-cavernous arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J.; Deasy, N.P.; Jeffree, M.A. [Dept. of Neuroradiology, King' s Coll. Hospital, London (United Kingdom); Martin, A.J.; Strong, A.J. [Dept. of Neurosurgery, King' s Coll. Hospital, London (United Kingdom)

    2001-03-01

    A traumatic pseudoaneurysm of the basilar artery with a basilar-cavernous sinus arteriovenous fistula was diagnosed in a 12-year-old girl using CT, MRI and angiography. It was successfully treated by coil embolisation. We speculate on the mode of formation of this rare traumatic lesion. (orig.)

  17. 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

  18. Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações Family caregiver of stroke sequel patients: meanings and implications

    Directory of Open Access Journals (Sweden)

    Fernanda de Freitas Mendonça

    2008-01-01

    Full Text Available O acidente vascular cerebral (AVC está entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicações de se tornar cuidador de um indivíduo seqüelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no período de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos à análise de discurso proposta por Martins e Bicudo. Da análise das entrevistas emergiram sete categorias: voltando-se para o Ser cuidado, descrevendo os cuidados, apresentando as mudanças, o apoio da espiritualidade, compreendendo o significado do cuidado, expressando as necessidades para cuidar e perspectivas para o futuro. Os resultados revelaram que ser cuidador familiar é um fenômeno complexo, que gera nos sujeitos sentimentos de alegria e felicidade concomitantes aos sentimentos de medo, ansiedade e revolta.The brain vascular accident (BVA is one of the main death causes worldwide. Due to the impairments imposed by the BVA, there is the family caregiver. This work aims to analyze the meaning and implications of being a caregiver of a stroke sequel person. It is a qualitative research, carried out with five caregivers in Londrina-PR, from August to December 2005. Data were collected in semi-structured interviews and were subjected to discourse analysis proposed by Martins and Bicudo. From the analysis of interviews seven categories arouse: turning to the being cared, describing care, presenting changes, spirituality support, understanding the meaning of care, expressing the needs to take care and future perspectives. Results revealed that being a family caregiver is a complex phenomenon, that creates in the subjects feelings of happiness and along with feelings of fear, anxiety and revolt.

  19. 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.

  20. Changes in Cerebral Blood Flow in Presymptomatic Mutation Carriers of Familial Frontotemporal Dementia (FTD-3), Measured with MRI

    DEFF Research Database (Denmark)

    Lunau, Line Andersen; Mouridsen, Kim; Rodell, Anders;

    CHMP2B is a part of the ESCRTIII complex necessary for endosomal trafficking and protein degradation (1,3). Studies in presymptomatic CHMP2B-mutation carriers have shown both localized cortical (4) and more generalized brain atrophy (5). The purpose of this study is to assess functional change...... (6). Perfusion data were extracted from 9 regions-of-interest (ROIs), normalized to white matter, and statistically compared between carriers and non-carriers. The Montreal Brain Template defined the 9 ROIs, which were preselected based on the previous studies of structural changes: including frontal......, temporal, parietal, and occipital lobes, hippocampus, basal ganglia and cerebellum. Data were normalized to white matter in order to smooth inter-individual differences. Results: We included 8 carriers and 7 first-degree related family non-carriers. Comparing carriers with non-carriers, the former showed...

  1. A measurement of creep and permeability of a salt cavern; Une mesure de la permeabilite et du fluage d`une caverne dans le sel

    Energy Technology Data Exchange (ETDEWEB)

    Berest, P.; Bergues, J.; Brouard, B. [Ecole Polytechnique, (LMS), 91 - Palaiseau (France); Durup, G.; Guerber, B. [Gaz de France (GDF), 93 - La-Plaine-Saint-Denis (France)

    1999-07-01

    Rock mass properties differ significantly from those measured on samples in the laboratory. A test has been performed on a deep brine-filled cavern, with the objective of measuring the equilibrium pressure reached when the cavern was closed. Such an equilibrium is reached when salt mass creep, which leads to cavern shrinkage, balances brine permeation through the cavern wall. A K = 2.10{sup -19} m{sup 2} value of the average in situ intrinsic permeability has been deduced from the test; it is significantly higher than the intrinsic permeability measured in a well or in the laboratory. This result supports cavern abandonment scenarios in which the risk of natural fracturing due to high brine pressures is alleviated. (authors) 14 refs.

  2. 家庭亲密度适应性与脑梗死患者自尊的关系%Correlation between family coherence and adaptation and self-esteem among patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    颜雅伟

    2013-01-01

    Objective To evaluate the correlation between family coherence and adaptation and selfesteem among patients with cerebral infarction.Methods A total of 253 patients were included in the study,they were investigated by Rosenberg Self-Esteem Scale and Family Coherence and Adaptation Scale.Results Self-esteem was significantly positively correlated with real family coherence and real family adaptation,while significantly negatively correlated with dissatisfaction of family coherence and dissatisfaction of family adaptation.Age,family income and the course of disease were the influencing factors of family coherence and adaptation and self-esteem.Conclusions The self-esteem was conrelated with family coherence and adaptation among patients with cerebral infarction.%目的 探讨家庭亲密度适应性与脑梗死患者自尊的关系.方法 采用家庭亲密度适应性量表和Rosenberg自尊量表对253例脑梗死患者进行横断面调查,并进行相关性分析.结果 自尊与实际亲密度实际适应性均显著正相关;自尊与亲密度不满意程度、适应性不满意程度均显著负相关;自尊与理想亲密度和理想适应性的相关性无意义.年龄、家庭收入和病程为家庭亲密度适应性和自尊的影响因素.结论 脑梗死患者自尊与家庭亲密度和适应性有关,受年龄、家庭收入及病程影响.

  3. Parenting acceptance and commitment therapy: a randomised controlled trial of an innovative online course for families of children with cerebral palsy.

    Science.gov (United States)

    Whittingham, Koa; Sheffield, Jeanie; Boyd, Roslyn N

    2016-10-19

    Cerebral palsy (CP) impacts on the entire family in a manner that is long-term, complex and multifactorial. In addition, the quality of the parent-child relationship impacts on many and varied child outcomes, making the provision of easily accessible and evidence-based support to parents of children with CP a priority. This paper reports the protocol of a randomised controlled trial of an innovative and translatable online intervention, parenting acceptance and commitment therapy (PACT), for families of children with CP. We predict that participating in the PACT programme will be associated with improvements in the parent-child relationship, in child functioning and in adjustment and quality of life for both parent and child. We aim to recruit 66 parents of children (2-10 years old) diagnosed with CP to this study. Families will be randomly assigned to two groups: wait-list control and PACT. PACT is a parenting intervention grounded in acceptance and commitment therapy (ACT) and developed into an online course 'PARENT101 Parenting with Purpose' using the edX platform. All participants will be offered PACT before completion of the study. Assessments will take place at baseline, following completion of PACT and at 6-month follow-up (retention) and will focus on the parent-child relationship, parent and child adjustment and parent and child quality of life. Analysis will follow standard methods for randomised controlled trials using general linear models, specifically analysis of variance or analysis of covariance. Ethics approvals have been obtained through the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/15/QRCH/115) and The University of Queensland (2015001743). If efficacy is demonstrated, then the PARENT101 course has the potential to be disseminated widely in an accessible manner and at minimal cost. Further, the PACT framework may provide a blueprint for similar online courses with parents in a full range of

  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. Orthostatic hypotension associated with dorsal medullary cavernous angioma.

    Science.gov (United States)

    Idiaquez, J; Araya, P; Benarroch, E

    2009-01-01

    Orthostatic hypotension (OH) is a rare manifestation of medulla oblongata lesions that may be because of interruption of descending sympathoexcitatory axons. To illustrate the location of a medullary lesion that produced OH following resection in relationship to the location of putative sympathoexcitatory pathways. A case with dorsal medullary cavernous angioma presenting with OH is described. The possible localization of lesion was compared with distribution of tyrosine hydroxylase (TH)-immunoreactive axons in a comparable section of the medulla of a control brain. The patient had marked OH after partial removal of the cavernous angioma. Biopsy confirmed the diagnosis. The magnetic resonance imaging location of the lesion overlapped that of TH-immunoreactive axons of the medullary transtegmental tract. A restricted lesion of medullary lesion interrupting the catecholaminergic transtegmental tract arising from the sympathoexcitatory C1 neurons of the rostral ventrolateral medulla could result in severe OH.

  6. 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.

  7. 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

  8. 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.

  9. MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Jie; Xu, Yi-Kai; Yang, Rui-Meng; Yu, Tian; Lin, Bing-Quan [Nanfang Hospital, Southern Medical University, Department of Diagnostic Imaging Center, Guangzhou, Guangdong (China); Li, Long [Guangdong Provincial Corps Hospital, Chinese People' s Armed Police Forces, Department of Radiology, Guangzhou, Guangdong (China); Ye, Xiang-Hua [Nanfang Hospital, Southern Medical University, Department of Radiotherapy, Guangzhou, Guangdong (China); Zhang, Nan [Nanfang Hospital, Southern Medical University, Department of Pathology, Guangzhou, Guangdong (China)

    2009-11-15

    The aims of the study were to summarize the characteristics of the spinal epidural cavernous hemangioma, especially for the MRI, and to improve the accurate rate of the preoperative diagnosis. The clinical and medical imaging data of six patients with pure spinal epidural cavernous hemangioma proved by operation and pathology were analyzed retrospectively. The level was thoracic (n = 2), thoracolumbar (n = 1), lumbar (n = 1), and sacral (n = 2). The tumor showed lobulated contour, and the areas the tumors appeared were dorsal side of spinal cord (n = 2), ventral side (n = 1), and lateral side (n = 3). In all six patients, the lesions were isointense to the spinal cord on T{sub 1}-weighted images and hyperintense on T{sub 2}-weighted images and showed homogeneously strong enhancement on contrast-enhanced T{sub 1}-weighted images. The characteristic MRI features were named as the ''wafting-silk'' sign. Widening of the intervertebral neural foramen (n = 4) and erosion of the adjacent bones (n = 3) can be observed. MRI of the epidural cavernous hemangioma showed the characteristic lobulated contour, which encircled the spinal cord. T{sub 1}WI on the MRI presented as isointense and T{sub 2}WI presented as hyperintense and a homogeneously strong enhancement, so we first proposed the sign of wafting silk. The widening of the intervertebral neural foramen and erosion of the adjacent bones can easily be observed. MR imaging has an important role in the detection and diagnosis of pure spinal epidural cavernous hemangioma. (orig.)

  10. [Condition of cavernous tissue of the penis after unilateral incomplete proximal intracavernous falloprosthesis].

    Science.gov (United States)

    Taurashvili, G I; Medvedev, V L; Chilov, S A; Kochov, V N; Taruashvili, I G

    2011-01-01

    Unilateral incomplete proximal intracavernous falloprosthesis (UIPIF) was followed by US-dopplerography of the intact penis and penis in medical erection induced by E1 prostoglandin introduction into the intact cavernous body. UIPIF preserves 89-90% of functionally active cavernous tissue with effective blood flow. Investigation 2 months and more after operation demonstrated that systolic blood flow rate in the cavernous artery of the cavernous tissue around the endoprosthersis can reach values registered in normal erection. The conclusion is made that after UIPIF quality of sexual life of the patient improves due to creation of additional density and axial stability of the trunk of the penis.

  11. Geotechnical issues and guidelines for storage of compressed air in excavated hard rock caverns

    Energy Technology Data Exchange (ETDEWEB)

    Allen, R.D.; Doherty, T.J.; Fossum, A.F.

    1982-04-01

    The results of a literature survey on the stability of excavated hard rock caverns are presented. The objective of the study was to develop geotechnical criteria for the design of compressed air energy storage (CAES) caverns in hard rock formations. These criteria involve geologic, hydrological, geochemical, geothermal, and in situ stress state characteristics of generic rock masses. Their relevance to CAES caverns, and the identification of required research areas, are identified throughout the text. This literature survey and analysis strongly suggests that the chief geotechnical issues for the development and operation of CAES caverns in hard rock are impermeability for containment, stability for sound openings, and hydrostatic balance.

  12. Isolated oculomotor nerve palsy caused by cavernous sinus dural arteriovenous fistula: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [The Catholic Univ. of Korea, Suwon (Korea, Republic of); Kim, Bum Soo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-10-15

    Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.

  13. Update on cavern disposal of NORM-contaminated oil field wastes.

    Energy Technology Data Exchange (ETDEWEB)

    Veil, J. A.

    1998-09-22

    Some types of oil and gas production and processing wastes contain naturally occurring radioactive material (NORM). If NORM is present at concentrations above regulatory levels in oil field waste, the waste requires special disposal practices. The existing disposal options for wastes containing NORM are limited and costly. Argonne National Laboratory has previously evaluated the feasibility, legality, risk and economics of disposing of nonhazardous oil field wastes, other than NORM waste, in salt caverns. Cavern disposal of nonhazardous oil field waste, other than NORM waste, is occurring at four Texas facilities, in several Canadian facilities, and reportedly in Europe. This paper evaluates the legality, technical feasibility, economics, and human health risk of disposing of NORM-contaminated oil field wastes in salt caverns as well. Cavern disposal of NORM waste is technically feasible and poses a very low human health risk. From a legal perspective, a review of federal regulations and regulations from several states indicated that there are no outright prohibitions against NORM disposal in salt caverns or other Class II wells, except for Louisiana which prohibits disposal of radioactive wastes or other radioactive materials in salt domes. Currently, however, only Texas and New Mexico are working on disposal cavern regulations, and no states have issued permits to allow cavern disposal of NORM waste. On the basis of the costs currently charged for cavern disposal of nonhazardous oil field waste (NOW), NORM waste disposal in caverns is likely to be cost competitive with existing NORM waste disposal methods when regulatory agencies approve the practice.

  14. The Status Quo Analysis and Guidance about Family Rehabilitation of Mental Retardation Children with Cerebral Palsy%智力低下脑瘫患儿家庭康复现状分析及指导

    Institute of Scientific and Technical Information of China (English)

    张扣琴; 高晶; 王丽娜

    2013-01-01

    家庭是儿童最自然的生活环境,因此在脑性瘫痪(脑瘫)患儿的康复中,家庭也受到越来越多的关注.本文总结了智力低下脑瘫患儿家庭康复存在的误区,分析存在此误区原因的现状,并给予家庭康复的指导建议,以使家长树立积极的康复态度,指导其使用正确的方式来促进智力低下脑瘫患儿的全面康复.%Family, as the most natural living environment of children, is being paid more and more attention in the rehabilitation of children with cerebral palsy. This paper summarizes the misunderstanding in the family rehabilitation of mental retardation children with cerebral palsy, analyzes the present situation and reason of this error and gives guidance and suggestions on the home rehabilitation. The purpose of this paper is to make parents set up a positive attitude to rehabilitation, and guide them to use right way to promote an all - round rehabilitation of mental retardation children with cerebral palsy.

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

    Energy Technology Data Exchange (ETDEWEB)

    Rudeen, David Keith; 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.

  16. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report

    Science.gov (United States)

    Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct. PMID:28149481

  17. Post-traumatic carotid cavernous fistula of late manifestation report

    Directory of Open Access Journals (Sweden)

    Joanna Roskal-Wałek

    2015-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal connection between the carotid artery and the cavernous sinus. Carotid cavernous fistula of traumatic aetiology occurs more commonly. The characteristic triad of symptoms covers the following: pulsating exophthalmos, a humming sound within the skull, and dilation and tortuosity of conjunctival and episcleral veins. The diagnosis of CCF may constitute a diagnostic problem in the situation when the symptoms occur several weeks after injury, it may overlap with other post-traumatic changes, and the dominant symptom may be cranial nerve palsy. The lack of a correct diagnosis and adequate causative therapy creates the risk of not only loss of vision, but also of life. We present a case of a patient who developed fistula symptoms a few weeks after an injury. The diagnosis of post-traumatic CCF was confirmed by imaging examinations. The application of transluminal embolisation led to the resolution of the majority of symptoms.

  18. Intraosseous Cavernous Hemangioma in the Mandible: A Case Report.

    Science.gov (United States)

    Elif, Bilgir; Derya, Yildirim; Gulperi, Kocer; Sevgi, Bozova

    2017-01-01

    Intraosseous vascular lesions are rare conditions. They are most commonly seen in the vertebral column and skull; nevertheless, the mandible is a quite rare location. In this report, we present a case of intraosseous cavernous hemangioma in the mandible and discuss the clinical and radiological features. A 28-year-old male patient attended to our clinic with a complaint of painless swelling of mandible. Clinical evaluation revealed a bone-hard, smooth-surfaced, immobile mass in the left mandibular lingual area. The patient was evaluated with panoramic and occlusal radiography and computed tomography. The lesion surgically excised and pathological examination revealed an intraosseous cavernous hemangioma. Follow-up imaging 1 year later with cone beam computed tomography revealed recurrence of the lesion. The conclusion of this paper; when a bone hard, well-shaped mass was seen in the mandible, the possibility of intraosseous hemangioma must be remembered and before surgical procedure detailed radiographic evaluation should be performed. Key words:Hemangioma, intraosseous, mandible, cavernous, cbct.

  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. 家庭亲密度和适应性与脑梗死后抑郁的相关性分析%Correlation between family cohesion and adaptability with depression in patients after cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    吴爱芬; 杨飞

    2013-01-01

    Objective To explore the correlation between family cohesion and adaptability with depress in patients after cerebral infarction.Methods Totally,108 patients after cerebral infarction were investigated by Hamilton Depression Scale and Family Adaptability and Cohesion Evaluation Scale,and were divided into depression group (n =63) and non-depression group (n =45).Family cohesion and adaptability in two groups was compared,and analyzing the correlation between family cohesion and adaptability with depression was analyzed.Results The scores of family cohesion and adaptability in depression group were lower (P < 0.01),and the dissatisfactory degree of family cohesion and adaptability were higher than those in non-depression group (P < 0.01).Depression was negatively correlated with family cohesion and adaptability (P < 0.05),and positively correlated with dissatisfactory degree of family cohesion and adaptability (P < 0.05).Conclusion Poor Family cohesion and adaptability are the important causes of depression in patients after cerebral infarction.%目的 探讨家庭亲密度和适应性与脑梗死后抑郁的关系.方法 采用汉密尔顿抑郁量表、家庭亲密度和适应性量表对108例首次发病脑梗死患者进行调查,根据是否存在抑郁,分为抑郁组(63例)和非抑郁组(45例).比较两组患者家庭亲密度和适应性的差别,并进行家庭亲密度和适应性评分与抑郁的相关性分析.结果 抑郁组实际亲密度和实际适应性评分均低于非抑郁组患者(P<0.01),亲密度不满意程度和适应性不满意程度评分均高于非抑郁组患者(P<0.01).抑郁与实际亲密度和实际适应性均呈负相关(P<0.05),与亲密度不满意程度和适应性不满意程度均呈正相关(P<0.05).结论 家庭亲密度和适应性差是脑梗死后抑郁的重要原因.

  1. 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

  2. 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.

  3. 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

  4. 家庭早期综合康复护理对脑瘫患儿的影响%Family Early Comprehensive Rehabilitation Nursing for Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    丁宇; 周兵; 陆波

    2015-01-01

    目的:研究家庭早期综合康复护理对脑瘫患儿的治疗影响;方法:选取我国在2013年1月到12月所接收的240例脑瘫患儿,将他们作为研究对象,并对患儿的家属进行康复护理的相关指导,内容主要包含对头部的自主控制训练,日常行动的相关训练,营养饮食的训练,并通过对比接受家庭早期综合康复护理对脑瘫患儿的影响情况;结果:患者在接受家庭早期综合康复护理的效果都比护理之前好,而且效率高达85%以上;结论:家庭早期综合康复护理能够在脑瘫患儿的治疗过程中扮演十分重要的角色,并且取得较高的效果,可以在临床医学之中进行广泛推广。%Objective:Study of family early comprehensive rehabilitation nursing in the treatment of children with cerebral palsy; Methods:240 cases children with cerebral palsy are selected as the research objects received in January to December 2013, and give advice of related guidance to the families of the children of rehabilitation nursing, and the contents mainly includes the independent control training of the head, related training of daily operation, training of nutrition diet, and comparing to children with cerebral palsy who had no family early comprehensive rehabilitation nursing; Result:Patients who had took family early comprehensive rehabilitation nursing have better effect of care than before, and the efficiency is as high as 85%above;Conclusion:Family early comprehensive rehabilitation nursing plays a very important role in the process of the treatment of children with cerebral palsy, and obtain a better effect, and can be widely used in clinical medicine.

  5. 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

  6. 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

  7. Factors of Families Related to Outcome of Rehabilitation for Cerebral Palsy Children%脑性瘫痪患儿家属对康复效果的影响因素

    Institute of Scientific and Technical Information of China (English)

    王春蕾; 谢家兴; 李文娟; 顾秀娟; 李志军; 屈伟利; 郑奕晗

    2014-01-01

    Objective To investigate the factors of families related to the outcome of rehabilitation for cerebral palsy children. Methods Families of 153 cerebral palsy children were investigated with questionnaires of family condition, knowledge of cerebral palsy, compliance, and the Eysenck Personality Questionnaire, Marital Quality Questionnaire, Social Support Scale, Symptom Check List, Happiness Index. The children were assessed with Comprehensive Assessment for Disable Children before and after rehabilitation. Results There were signifi-cant differences of compliance, knowledge of cerebral palsy, being of other healthy children, personality of extraversion/introversion and ly-ing, and mental symptom between the families of the cerebral palsy children improved or not after rehabilitation (P<0.05). Multivariate Lo-gistic regression analysis showed that, being of other healthy children, personality of extraversion/introversion and mental symptom were the independent factors. Conclusion It may relate to the outcome of rehabilitation for cerebral palsy children of family condition, personali-ty and mental health of the families, which need further intervention.%目的:研究影响脑瘫患儿康复效果的家属因素。方法对153例脑瘫患儿的153名家属,采用家庭基本情况、对患儿疾病了解程度、依从性3项自制调查问卷和艾森克人格量表、婚姻质量问卷、社会支持量表、症状自评量表、幸福感指数5项标准调查问卷进行调查;康复前后采用残疾儿童综合功能评定法对患儿进行评定。结果康复有效、无效的患儿间,家属的依从性、对患儿疾病了解程度、家中有无健康子女、艾森克人格内外向和掩饰性、症状自评6项因素有显著性差异(P<0.05)。多因素Logis-tic回归分析显示,家中有无健康子女、内外向人格、症状自评是影响患儿康复效果的独立因素。结论脑瘫患儿的家庭状况、家长的人格特征和心

  8. Endovascular management of dural fistulas into the cavernous sinus. A systematic review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2014-06-01

    Full Text Available Background: Dural fistula to the cavernous sinus (DFCS is an infrequent pathology that consists in the anomalous communication between the meningeal branches of the internal carotid artery (ICA and/or the external carotid artery (ECA and the cavernous sinus. Aim: To perform a systematic review to evaluate clinical and imaging findings in DFCS, and current indications for treatment.

  9. Tuberculoma of the Cavernous Sinus and Meckel's Cave in a Child.

    Science.gov (United States)

    Kumar, V R Roopesh; Madhugiri, Venkatesh S; Verma, Surendra Kumar; Barathi, S Deepak; Yadav, Awdhesh Kumar; Bidkar, Prasanna

    2013-01-01

    Tuberculous infection of the cavernous sinus and Meckel's cave is extremely rare. In this report, we describe a patient with tuberculoma of the cavernous sinus and Meckel's cave, extending to the petrous apex. The patient underwent microsurgical excision of the lesion and antitubercular chemotherapy resulting in a good outcome. We describe the diagnostic difficulties and review the relevant literature.

  10. Endovascular treatment with transvenous approach for embolization of carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Benny Young

    2014-10-01

    Full Text Available The aim of endovascular treatment in carotid cavernous fistula is to close the tear side at cavernous sinus part. It can be dealt either by transvenous or transarterial approach. The option is influenced by type of fistula and angioarchitectural findings. We described two different transvenous routes emphasizing on anatomical consideration and its technical aspect.

  11. Vascular plug for ICA occlusion in cavernous carotid aneurysms: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Scott, David A.; Keston, Peter; White, Philip; Sellar, Robin [Western General Hospital, Division of Clinical Neurosciences, Edinburgh (United Kingdom)

    2008-09-15

    Large, symptomatic aneurysms of the cavernous internal carotid artery (ICA) can be successfully treated by a combination of aneurysm coiling and occlusion of the parent vessel. We describe the use of an Amplatzer (AGA medical corporation, Plymouth, MA, USA) detachable nitinol vascular plug to occlude the ICA in four patients with symptomatic cavernous ICA aneurysms. (orig.)

  12. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  13. 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

  14. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment.

    Science.gov (United States)

    Khalsa, Siri Sahib; Hollon, Todd C; Shastri, Ravi; Trobe, Jonathan D; Gemmete, Joseph J; Pandey, Aditya S

    2016-06-08

    Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus.

  15. Direct orbital puncture of the cavernous sinus for the treatment of a carotid-cavernous dural AV fistula with a concomitant venous/lymphatic malformation.

    Science.gov (United States)

    Coumou, Adriaan D; van den Berg, René; Bot, Joost C; Beetsma, Daan B; Saeed, Peerooz

    2014-02-01

    A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

  16. 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.

  17. 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.

  18. 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.

  19. [Pontine cavernous angioma (cavernoma) with initial ENT manifestations].

    Science.gov (United States)

    Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Marqués Rebollo, L; Blasco Huelva, A

    2006-01-01

    We report the case of a 22 years old female who consulted us for facial parestesias, hearing loss in right ear and sudden tinnitus. Her audiometry showed an unilateral discreet sensorineural hipoacusia and the cranial IRM, a mass of 20 mm diameter in right pontine region and bulbus informed as cavernous angioma with signs of recent bleeding. The patient was sent to Neurosurgery but she refused the intervention. The risk of hemorrhage in the cavernomas is estimated at 0.25% to 1.6% per year and represents the main reason to advise a surgical treatment.

  20. Studies on activation in the ATLAS cavern with MPX detectors

    Energy Technology Data Exchange (ETDEWEB)

    Bergmann, Benedikt; Sopczak, Andre; Biskup, Bartolomej; Jakubek, Jan; Pospisil, Stanislav; Solc, Jaroslav; Sopko, Vit; Suk, Michal; Turecek, Daniel; Vykydal, Zdenek; Benes, Petr [IEAP CTU Prague (Czech Republic); Asbah, Nedaa; Leroy, Claude; Soueid, Paul [Universite de Montreal (Canada)

    2013-07-01

    The ATLAS-MPX detectors are based on Medipix2 silicon devices designed by CERN for the detection of different types of radiation. These detectors are successfully operating in the ATLAS detector at 16 positions and collect data independent of the ATLAS data-recording chain. Their data was used to study the activation of the surrounding material and the ATLAS-MPX detectors itself during and after collisions. As the detectors also offer the possibility to distinguish between different types of radiation, an attempt was made to estimate the corresponding dose rates at different locations in the ATLAS detector and in the cavern. First results are presented.

  1. Cavernous Hemangioma of the Skull and Meningioma: Association or Coincidence?

    Directory of Open Access Journals (Sweden)

    M. Kilani

    2015-01-01

    Full Text Available Intraosseous cavernous hemangiomas of the skull are rare. Meningiomas are quite frequently encountered in a neurosurgical practice. The association between these two entities is nevertheless very uncommon. The authors present a case of a 72-year-old woman suffering from headache. The MRI showed a parietal meningioma with adjacent thick bone. The meningioma and the bone were removed. The histological examination confirmed the diagnosis of meningioma and revealed a cavernoma of the skull. The relationship between the lesions suggests more than a coincidental association. Several hypotheses are proposed to explain common causal connections.

  2. Site investigations on cavernous limestone for the Remouchamps Viaduct, Belgium

    OpenAIRE

    Waltham, Antony; Vandenven, Georges; Ek, Camille

    1986-01-01

    POOR GROUND CONDITIONS on cavernous limestone created severe difficulties at the sites of four piers of the Remouchamps Viaduct. The discovery, during excavations for foundations, of large open cavities prompted a major re-appraisal of site investigation procedure, and also some redesign of the viaduct structure. La situation défavorable des fondations de quatre des piliers du viaduc autoroutier de Remouchamps posa des problèmes de construction. La présence de cavités karstiques largement ...

  3. An interesting case of angiogenesis in cavernous hemangioma

    Directory of Open Access Journals (Sweden)

    Dipankar Das

    2016-01-01

    Full Text Available Cavernous hemangioma is the most common orbital tumor in adult. There is lot of literatures for clinicopathological features of this tumor. These tumors had been studied for the model of angiogenesis in many of the experimental setups. We present a case of 34-year-old male with this tumor in the left eye with computerized tomography evidence. Postsurgical laboratory findings gave interesting evidence of tumor angiogenesis with tumor endothelial cells and sprouting of the small vessels endothelial cells. Podosome rosette could be conceptualized from the characteristic patterns seen in the tumor.

  4. Neodymium YAG laser for treatment of oral cavernous hemangiomas

    Science.gov (United States)

    Bradley, Paul F.

    1999-02-01

    Oral cavernous haemangiomas are common lesions which may require treatment due to episodes of bleeding when bitten or deformity particularly when involving the lips and/or cheeks. Surgery can be hazardous due to haemorrhage while cryosurgery tends to be tedious for large lesions and be accompanied by major oedema. Sclerosants produce hard bulky masses. Embolization is seldom helpful due to lack of arterial feeders. The Nd:YAG laser is proving a useful modality in the oro-facial region and appeared worth investigating for these lesions in a laboratory animal model, by thermography and in the clinical situation.

  5. Uncommon cavernous malformation of the optic chiasm: a case report

    Directory of Open Access Journals (Sweden)

    Ning Xianbin

    2012-08-01

    Full Text Available Abstract Cavernous malformation (CM is a vascular malformation disorder characterized by a berry-like mass of expanded blood vessels. CM, originating from the optic chiasm. usually leads to chiasma syndrome presenting with bitemporal hemianopsia. We report a 28-year-old male presenting with left homonymous hemianopsia. Magnetic resonance imaging (MRI revealed an occupied lesion located in the right side of the optic chiasm, and a clinical diagnosis of chiasmal CM was made. Microsurgical excision was performed via anterolateral pterional craniotomy. The patient showed good recovery with slight improvement of the visual field deficits after the operation. No CM recurrence was discovered during the follow-up MRI scans.

  6. Acute fulminant invasive fungal sinusitis with cavernous sinus syndrome.

    Science.gov (United States)

    Chi, Tzu-Hang; Chen, Hsien-Shen; Yuan, Chien-Han; Su, Feng-Ming

    2014-11-01

    Acute fulminant invasive fungal sinusitis is most commonly found in immunocompromised patients with conditions such as diabetes mellitus, malignancies and acquired immune deficiency syndrome. The most common pathogens are Aspergillus and Mucoraceae and the sinus most frequently involved is the maxillary sinus. Fever, rhinorrhea, facial pain, headache, and diplopia are common presenting symptoms. Complications of this infection include intracranial and / or intraorbital spread of the infection; the prognosis is poor. Here, a rare case of acute fulminant invasive fungal sinusitis with cavernous sinus syndrome is reported.

  7. [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.

  8. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Cerebral Palsy KidsHealth > For Teens > Cerebral Palsy Print A A ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  9. Is portal vein cavernous transformation a component of congenital hepatic fibrosis?

    Institute of Scientific and Technical Information of China (English)

    Ozlem Yonem; Yusuf Bayraktar

    2007-01-01

    Congenital hepatic fibrosis (CHF) is an autosomal recessive disorder that belongs to the family of fibropolycystic liver diseases. This family includes a spectrum of disorders which are usually found in combination with each other and are usually inherited.Clinically fibropolycystic diseases have three effects being present in different proportions, those of a space occupying lesion, of portal hypertension and of cholangitis. In most patients, the first manifestations of CHF are signs and symptoms related to portal hypertension such as splenomegaly and varices. Portal hypertension in these patients has been attributed to the hypoplasia or compression of the portal vein radicles in the fibrous bands. Cavernous transformation of the portal vein (CTPV) is a relatively rare condition resulting from extrahepatic portal vein obstruction with recanalization or collateral vein formation to bypass the obstruction. It has been found that patients with CHF having an accompanying CTPV have relatively large splenomegaly and suffers more frequent episodes of bleeding from esophageal varices. We believe that CTPV is a congenital component of CHF and also one of the important causative factors of portal hypertension in these patients.

  10. Factors Affecting the Rehabilitation of Children with Cerebral Palsy Continue Families Compliance Analysis%影响脑瘫儿童延续家庭康复依从性的因素分析∗1

    Institute of Scientific and Technical Information of China (English)

    梁秋叶; 覃花桃

    2015-01-01

    Objective:Survey of cerebral palsy (Cerebral Palsy,CP)children continue family rehabilitation adherence factors,to provide a scientific basis for rehabilitation of children with CP and effective.Methods:Select January 2012 to January 2014 outpatient rehabilitation for children with cerebral palsy diagnosis in 120 cases of children,all patients were given comprehensive outpatient rehabilitation therapy combined with family rehabilitation training,6 months after the reference GMFM 88 term gross motor function assessment table succession of children and parents to assess the questionnaire,understanding the factors influencing children’s rehabilitation and continuing CP family rehabilitation ad-herence.Results:120 cases of children with CP,there are 42 cases of children with parents insist on family rehabilita-tion training,compliance rate of 35%.Rehabilitation of the 20 cases,effective 90 cases,10 cases of treatment failure. The total effective rate was 92% (1 7% effective rate).The parents of awareness of CP knowledge,questioning family rehabilitation training,poor family mental health,lack of confidence in long-term training for patience,totally dependent on doctors in rehabilitation hospitals and other factors directly affect the continuation of the family rehabilitation com-pliance.Conclusion:CP guiding strengthen parent education and early intervention rehabilitation knowledge,CP can im-prove the level of knowledge and adherence to the continuation of the family rehabilitation training,to promote rehabili-tation of children with CP and improve the quality of child survival have an important role.%目的::调查对脑瘫(Cerebral palsy,CP)儿童延续家庭康复依从性的影响因素,为 CP 儿童有效的康复提供科学依据。方法:选择2012年1月—2014年1月在门诊儿童康复科诊断为脑瘫的儿童120例,全部病例均给予门诊综合康复治疗结合家庭康复训练,6个月后参照 GMFM 88项粗大运动功能评定表陆续

  11. Nitrogen Monitoring of West Hackberry 117 Cavern Wells

    Energy Technology Data Exchange (ETDEWEB)

    Bettin, Giorgia [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lord, David L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    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).

  12. 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.

  13. 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).

  14. Cavernous sinus hemangioma: a fourteen year single institution experience.

    Science.gov (United States)

    Bansal, Sumit; Suri, Ashish; Singh, Manmohan; Kale, Shashank Sharad; Agarwal, Deepak; Sharma, Manish Singh; Mahapatra, Ashok Kumar; Sharma, Bhawani Shankar

    2014-06-01

    Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable.

  15. First underground storage cavern to boost Singapore growth

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2007-03-15

    This article discussed the planning and development of the Jurong Rock Cavern (JRC), Singapore's first underground rock cavern for the storage of hydrocarbons. The JRC will be constructed beneath the seabed, and will be used to store up to 3 million cubic metres of liquid hydrocarbons such as crude oil, condensates, and diesel oil. The facility will enhance the safety and security of Jurong Island, and will allow lands to be used for higher-value manufacturing operations. Jurong Island is currently home to 3 major oil and gas companies. The JTC Corporation was formed to deliver infrastructure and services to the island. Two logisparks were created to provide integrated logistics and supply chain support for companies located on the island. It is expected that the JRC will bring significant benefits to Jurong Island companies. Space currently used to store hydrocarbons will be used to develop up to 10 specialty chemical manufacturing plants. Phase 1 of the JRC will include the development of a storage capacity of 1.47 million cubic metres, while phase 2 is expected to conclude with the addition of a further 1.3 million cubic metres. Singapore is currently the world's third largest refining centre. It was concluded that there are now approximately 80 companies operating on Jurong Island, and profits from chemical refining activities in 2006 exceeded $74 billion. 3 figs.

  16. 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.

  17. 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

  18. 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 .

  19. Genetics Home Reference: hereditary cerebral amyloid angiopathy

    Science.gov (United States)

    ... Neubert TA, Lu Y, Rebeck GW, Frangione B, Greenberg SM, Ghiso J. Iowa variant of familial Alzheimer's ... ML, van Duinen SG, Roos RA, Frosch MP, Greenberg SM. The cerebral beta-amyloid angiopathies: hereditary and ...

  20. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  1. Predictors of seizure freedom in the surgical treatment of supratentorial cavernous malformations.

    Science.gov (United States)

    Englot, Dario J; Han, Seunggu J; Lawton, Michael T; Chang, Edward F

    2011-12-01

    Seizures are the most common presenting symptom of supratentorial cerebral cavernous malformations (CCMs) and progress to medically refractory epilepsy in 40% of patients. Predictors of seizure freedom in the resection of CCMs are incompletely understood. The authors systematically reviewed the published literature on seizure freedom following the resection of supratentorial CCMs in patients presenting with seizures. Seizure outcomes were stratified across 12 potential prognostic variables. A total of 1226 patients with supratentorial CCMs causing seizures were identified across 31 predominantly retrospective studies; 361 patients had medically refractory epilepsy. Seventy-five percent of the patients were seizure free after microsurgical lesion removal, whereas 25% continued to have seizures. All patients had had preoperative seizures and > 6 months of postoperative follow-up. Modifiable predictors of postoperative seizure freedom included gross-total resection (OR 36.6, 95% CI 8.5-157.5) and surgery within 1 year of symptom onset (OR 1.83, 95% CI 1.30-2.58). Additional prognostic indicators of a favorable outcome were a CCM size seizures (OR 2.38, 95% CI 1.29-4.39), and the lack of secondarily generalized seizures (OR 3.33, 95% CI 2.09-5.30). Other factors, including extended resection of the hemosiderin ring, were not significantly predictive. In the surgical treatment of supratentorial CCMs, gross-total resection and early operative intervention may improve seizure outcome. While surgery should not be considered the first-line treatment for CCM-related epilepsy, it is important to understand the variables associated with seizure freedom in CCM resection given the considerable morbidity and diminished quality of life associated with epilepsy.

  2. Treatment of traumatic carotid-cavernous fistula at the Udon Thani Center Hospital.

    Science.gov (United States)

    Thanapura, Chatchawan

    2004-06-01

    There are many options available in management of traumatic carotid-cavernous fistulae (CCF). The carotid occlusion or the carotid preservation techniques are two basic approaches available. This study evaluated the carotid occlusion technique performed at The Udon Thani Center Hospital. We retrospectively studied 12 consecutive cases of traumatic CCF. The patients varied in terms of their ages, gender, side of lesion and symptoms. The occlusion was performed with muscle occlusion and trapping of the carotid artery. The diagnosis was made clinically and on CT brain. The Matas test was performed clinically with external compression of the contralateral carotid artery. No patient underwent cerebral angiography. From August 1997 to June 2002 the 12 patients were treated by muscle embolization only; muscle embolization with internal carotid ligation (Brooks technique); muscle embolization with trapping (Jaeger-Hamby procedure); or muscle embolization with trapping and external carotid ligation. The patients ranged from 15 to 62 years. Eleven were male. All had unilateral fistulae though only 3 involved the left eye. Eleven patients were cured and there was only one major complication of a patient who developed a second and third nerve palsy. The carotid occlusion technique is less popular in view of the great advances with detachable balloons and success with carotid preservation techniques. Despite this, under extenuating circumstances such as the lack of angiography, poor socio-economic status, or patients wanting to be treated close to home, this procedure is still an appropriate therapeutic option, as reflected by the success at our hospital. The more affluent patients had wider options and thus were sent to other centers for carotid preservation techniques like detachable balloon embolization.

  3. Microsurgical thromboendarterectomy of the cavernous carotid artery--case report and surgical technique.

    Science.gov (United States)

    Fujitsu, K; Fujii, S; Tanaka, N; Kuwabara, T

    1990-10-01

    A 53-year-old male suffered a transient right hemiparesis and left monocular blindness. Angiography revealed 80% stenosis of the cavernous carotid artery. Microsurgical thromboendarterectomy was performed by a direct approach through Parkinson's triangle. During surgery, the carotid circulation was transiently trapped between the cervical and the supraclinoid segment and the trapped arterial lumen was irrigated with heparinized saline. Soft elastic lesion was easily removed. Cavernous carotid thromboendarterectomy through a direct approach is considered as a suitable operation for the solitary and localized stenotic lesions of the cavernous carotid artery, although this operation has not yet been reported to date.

  4. The Family Rehabilitation Care in Children with Spastic Cerebral Palsy Fine motor Application%家庭康复护理在痉挛型脑瘫患儿精细运动中应用

    Institute of Scientific and Technical Information of China (English)

    张荣洁

    2013-01-01

    Objective:To investigate the home rehabilitation care with massage Acupuncture facilitation techniques and occupational therapy in children with spastic cerebral palsy fine motor. Methods:67 cases of children with spastic cerebral palsy were randomly divided into intervention group and the control group, the control group received conventional treatment, the intervention group with the home rehabilitation care. Results:Fine motor ability intervention group than the control group, the difference was statistically significant.Conclusions:Family rehabilitative care with massage acupuncture, facilitation techniques and occupational therapy, and significantly improve fine motor function in children with spastic cerebral palsy. The standardized rehabilitation and family rehabilitation care, fine motor function and daily living skills of children with cerebral palsy improve, has a very important role.%  目的:探讨家庭康复护理配合按摩针灸、促通技术及作业疗法在痉挛型脑瘫患儿精细运动中的应用效果。方法:67例痉挛型脑瘫患儿随机分为干预组、对照组,对照组给予常规治疗,干预组配合家庭康复护理。结果:干预组精细运动能力提高优于对照组,2组比较差异有统计学意义。结论:家庭康复护理配合按摩针灸、促通技术及作业疗法,明显提高痉挛型脑瘫患儿精细运动功能。因此规范的康复治疗与正确的家庭康复护理,对脑瘫患儿的精细运动功能及日常生活能力提高,具有非常重要的作用。

  5. Endovascular treatment of carotid-cavernous vascular lesions.

    Science.gov (United States)

    Aguiar, Guilherme Brasileiro DE; Silva, João Miguel; Paiva, Aline Lariessy; Jory, Maurício; Conti, Mario Luiz; Veiga, José Carlos

    2017-01-01

    to evaluate the endovascular treatment of vascular lesions of the cavernous segment of the internal carotidartery (ICA) performed at our institution. we conducted a descriptive, retrospective and prospective study of patients with aneurysms of the cavernous portion of the ICA or with direct carotid-cavernous fistulas (dCCF) undergoing endovascular treatment. we included 26 patients with intracavernous aneurysms and ten with dCCF. All aneurysms were treated with ICA occlusion. Those with dCCF were treated with occlusion in seven cases and with selective fistula occlusion in the remaining three. There was improvement of pain and ocular proptosis in all patients with dCCF. In patients with intracavernous aneurysms, the incidence of retro-orbital pain fell from 84.6% to 30.8% after treatment. The endovascular treatment decreased the dysfunction of affected cranial nerves in both groups, especially the oculomotor one. the endovascular treatment significantly improved the symptoms in the patients studied, especially those related to pain and oculomotor nerve dysfunction. avaliar o tratamento endovascular de lesões vasculares da artéria carótida interna (ACI), segmento cavernoso, realizado na Santa Casa de São Paulo. estudo descritivo, retrospectivo e prospectivo, de pacientes com aneurisma da porção cavernosa da ACI ou com fístulas carótido-cavernosas diretas (FCCd) submetidos a tratamento endovascular. foram incluídos 26 pacientes com aneurismas intracavernosos e dez com FCCd. Todos os aneurismas foram tratados com oclusão da ACI. Os com FCCd foram tratados com oclusão, em sete casos, e com oclusão seletiva da fístula nos outros três. Houve melhora da dor e proptose ocular em todos os pacientes com FCCd. Nos pacientes com aneurisma intracavernoso, a incidência de dor retro-orbitária caiu de 84,6% para 30,8% após o tratamento. Após o tratamento endovascular houve uma melhora importante da disfunção de nervos cranianos afetados em ambos os grupos

  6. A Patient With PHACE Syndrome With Marked Ipsilateral Cerebral Atrophy

    Directory of Open Access Journals (Sweden)

    Nan-Koong Wang

    2010-04-01

    Full Text Available The association of posterior fossa malformation, facial cavernous hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects and eye abnormalities (PHACE syndrome represents a rare congenital anomaly with a broad spectrum of clinical manifestations and female predominance. We herein report on a girl who manifested the typical clinical features of PHACE syndrome, unusually associated with severe ipsilateral cerebral atrophy and hemiplegia. She received surgical aortoplasty, local steroid injection and laser therapy for the hemangioma, and intense physical therapy soon after diagnosis. The etiology of PHACE syndrome remains unclear, and its clinical spectrum is broad. The current case suggests that the spectrum of PHACE syndrome should be further expanded to include other forms of cerebral disorder.

  7. 老年脑梗死患者健康行为与家庭功能水平的关系%Relationship between Health Behavior and Family Function in Elderly Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    张凤珠; 翁艺真

    2016-01-01

    目的:调查分析老年脑梗死患者健康行为与家庭功能水平的相关性。方法选取200例老年脑梗死患者为研究对象,在患者出院后2个月进行问卷调查,收集患者一般资料,采用健康促进生活方式量表II(HPLP Ⅱ)调查健康行为情况,采用家庭功能评定量表(FAD)调查患者家庭功能情况,并分析二者相关性。结果 HPLP Ⅱ总分为(116.9±17.9),条目均分为(2.4±0.4),其中运动锻炼得分最低。FAD总分为(131.6±15.3)条目均分为(2.2±0.3),其中总功能得分最低。整体功能处于中等水平。FAD与 HPLP Ⅱ呈负相关性,其中 FAD总分与 HPLP Ⅱ各维度评分均呈显著负相关性,而HPLP Ⅱ总分与FAD量表中除情感介入外,各维度呈显著负相关性(P<0.05)。结论老年脑梗死患者健康行为与家庭功能有着密切的相关性,且目前二者水平均有待提高,对于老年脑梗死患者的院外护理重点为加强家庭功能中各维度水平,促进健康行为的提高。%Objective To investigate and analyze the health behavior and family function of elderly patients with cerebral infarction and its correlation .Methods Select 200 cases of cerebral infarction in the elderly first-episode patients as the re‐search object ,in discharged patients after 2 months of questionnaire survey ,general information of patients were collected , adopting a healthy Promoting Lifestyle Scale II (HPLP II) survey of health behavior situation ,using the family function e‐valuation table (FAD) to investigate the patients family function ,and analyze the two review and evaluate the correlation of dimensions .Results the total score of the HPLP II was(116 .9 ± 17 .9) ,and the score was(2 .4 ± 0 .4) ,and the lowest score was exercise .The total score was (131 .6 ± 15 .3) ,and the average score was (2 .2 ± 0 .3) ,and the whole function was in the medium level ,and the lowest

  8. 全程家属参与式健康教育在脑梗死二级预防中的应用%Application of carrying out health education for family members in second prevention of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    石莹

    2015-01-01

    Objective To investigate the effects of carrying out health education for family members on second prevention of cerebral infarction. Methods 144 cases with cerebral infarction were randomly divided into study group (72 cases) and con‐trol group (72 cases). The traditional health education method was used in the control group ,and only for the patients ;The study group required at least one family member as companion to participate in health education. The knowledge level about disease ,compliance behavior and nursing satisfaction were compared between the two groups after 6 months. Results All of the knowledge level about disease ,compliance behavior and nursing satisfaction of the study group were superior to that of the control group(P< 0.05) ,and the nursing satisfaction raised 98% . Conclusion Methods Results Conclusion Carrying out health education can improve the level of family nursing and cooperative degree ,increase the therapy compliance and decrease recurrence rate for cerebral infarction patients.%目的:探讨全程家属参与式健康教育在脑梗死患者二级预防中的应用效果。方法将144例脑梗死患者随机分为试验组和对照组各72例。对照组采用传统健康教育方法,仅对患者本人进行健康宣教;试验组要求至少1位家属陪同参与健康教育。教育6个月后比较2组疾病知识掌握情况、遵医行为及护理满意度。结果试验组患者及家属对疾病知识的掌握度、遵医行为均优于对照组(P<0.05),护理满意度提高12%。结论全程家属参与式健康教育可提高脑梗死患者家属的照护水平及配合程度,并以此提高脑梗死患者的治疗依从性,降低脑梗死复发率。

  9. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

    Directory of Open Access Journals (Sweden)

    Güner Koyuncu Çelik

    2016-01-01

    Full Text Available A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI and digital subtraction angiography (DSA imaging revealed a carotid cavernous fistula (CCF. Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report.

  10. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

    Science.gov (United States)

    Yildirim, Erkan

    2016-01-01

    A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report. PMID:28077946

  11. 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.

  12. 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.

  13. 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.

  14. 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.)

  15. [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.

  16. Dural cavernous sinus fistulas. Diagnostic and endovascular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, Goetz [Baylor College of Medicine, Houston, TX (United States). Dept. of Radiology; Ben Taub General Hospital, Houston, TX (United States). Interventional Neuroradiology

    2010-07-01

    Dural cavernous sinus fistulas (DCSFs) represent a benign vascular disease, consisting in an arteriovenous shunt at the cavernous sinus. In the absence of spontaneous resolution, the fistula may lead to eye redness, swelling, proptosis, chemosis, ophthalmoplegia and visual loss. Although modern imaging techniques have improved the diagnostic, patients with low-flow DCSFs are still misdiagnosed. These patients can get erroneously treated for infections and inflammation for months or years and are at risk of visual loss. Early and proper diagnosis helps to avoid deleterious clinical course of the disease. This volume provides a complete guide to clinical and radiological diagnosis as well as to therapeutic management of DCSF with emphasis on modern minimal invasive treatment options. It commences with an informative description of relevant anatomy. After sections on the classification, etiology and pathogenesis of DCSF, the clinical symptomatology of the disease is described in detail. The role of modern non-invasive imaging tools is then addressed with the use of computed tomography, magnetic resonance imaging and ultrasound. Intra-arterial digital subtraction angiography (DSA), although invasive, remains the gold standard and is mandatory for clinical decision-making and strategy in endovascular treatment. Hence, a throughout consideration is given to both, 2D-DSA and 3D rotational angiography, including recent technological advancements such as Dual Volume (DV) imaging and angiographic computed tomography (ACT). After a short section on arteriovenous hemodynamics, the therapeutic management of DCSFs is described in detail. In particular, various transvenous techniques, required for successful endovascular occlusion of DCSF, are discussed in depth. This well-illustrated volume will be invaluable to all who may encounter DCSF in their clinical practice. (orig.)

  17. 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

  18. Endoscopic endonasal transclival resection of a ventral pontine cavernous malformation: technical case report.

    Science.gov (United States)

    Gómez-Amador, Juan Luis; Ortega-Porcayo, Luis Alberto; Palacios-Ortíz, Isaac Jair; Perdomo-Pantoja, Alexander; Nares-López, Felipe Eduardo; Vega-Alarcón, Alfredo

    2016-10-21

    Brainstem cavernous malformations are challenging due to the critical anatomy and potential surgical risks. Anterolateral, lateral, and dorsal surgical approaches provide limited ventral exposure of the brainstem. The authors present a case of a midline ventral pontine cavernous malformation resected through an endoscopic endonasal transclival approach based on minimal brainstem transection, negligible cranial nerve manipulation, and a straightforward trajectory. Technical and reconstruction technique advances in endoscopic endonasal skull base surgery provide a direct, safe, and effective corridor to the brainstem.

  19. Dural arteriovenous fistulas of the cavernous sinus - clinical case and treatment

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2014-06-01

    Full Text Available The purpose of our article is to present the results of our treatment of dural arteriovenous fistula of the cavernous sinus by glue embolization of the external carotid artery feeders. By this case presentation we try to clarify the clinical course, with the dural carotid cavernous fistula (CCF, characterizing a pallet of symptoms, paying special attention to radiological finding and endovascular treatment.

  20. Color Doppler Imaging in the Diagnosis and Follow-up of Carotid Cavernous Sinus Fistulas

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    This report describes color doppler imaging (CDI) in theevaluation and follow-up of nine patients with carotid cavernous sinusfistulas.The orbits and carotid arteries were examined with CDI.In allcases,the diagnosis was confirmed by angiography.CDI clearlydemonstrated the dilated superior ophthalmic veins (SOVs) with retrogradeflow and low resistance arterial doppler waveform in all nine patients (10eyes).After the study of quantitative hemodynamics,we found that directcarotid cavernous sinus fistulas s...

  1. Mixed capillary-cavernous extramedullary intradural hemangioma of the spinal cord mimicking meningioma: Case report.

    Science.gov (United States)

    Alobaid, Abdullah; Bennardo, Michael Ross; Cenic, Aleksa; Lach, Boleslaw

    2015-06-01

    Hemangiomas are customarily described as low-grade vascular tumors most often located in the head and neck, but on rare occasions occurring in the intradural space of the spine. The different subtypes of hemangiomas can be distinguished histologically as capillary, cavernous, or mixed types. We describe a rare case of a mixed capillary-cavernous extramedullary intradural hemangioma of the thoracic spinal cord, mimicking meningioma radiologically.

  2. Image–guided resection of small lesions in the cavernous sinus and Meckel's cave

    OpenAIRE

    Nakamura, M.; Krauss, J K

    2010-01-01

    Abstract Objective The microsurgical resection of tumors or vascular lesions in the cavernous sinus and the neighbouring Meckel's cave has been considered as hazardous because of often associated cranial nerve morbidity. Despite increasing consent that many of such tumors should not undergo surgical therapy, the cavernous sinus and Meckel's cave may harbour small lesions of various origin, which are amenable for surgical resection. Surgery in this anatomical area needs a...

  3. The CMS cavern at Point 5 (SX5) in February 2005

    CERN Multimedia

    Tejinder S. Virdee

    2005-01-01

    The CMS cavern at Point 5 (also called SX5) in Cessy, neighbouring France. The 4th and 5th pictures, taken in March 2003, shows the cavern during its construction, while the first three photos are taken once ready in February 2005. Fig. 6 shows the structure assembly in June 2005 and Fig. 7 the civil engineering works on the SX5 surface in April 2004.

  4. [Embolization as a treatment method in traumatic bilateral direct carotid cavernous fistula].

    Science.gov (United States)

    Sprezak, Kamila; Brzegowy, Paweł; Urbanik, Andrzej

    2012-01-01

    A case of 42-year-old man with rare posttraumatic bilateral direct carotid. cavernous fistulas, who was three times treated by endovascular management via trans-arterial route with stent-assisted microcoil placement, is reported. Presented technique might be method of choice for the intervention in cases of bilateral traumatic ca. rotid-cavernous fistulas. Stent-as sisted microcoil placement may in crease ability to successfully treat fistulas with preservation of the parent artery.

  5. The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: our first experience

    Directory of Open Access Journals (Sweden)

    Chiriac A.

    2016-06-01

    Full Text Available Complex cavernous sinus fistulae (CCF are still a technical challenge to neurovascular team. The most commonly performed treatment consists in endovascular embolization of the lesion through an arterial or venous approach. Not always these conventional routes are feasible, requiring alternative routes. We report a case of a 44-year-old woman with a complex indirect (Barrow D carotid cavernous sinus fistula treated by two interventional sessions that imposing a retrograde direct transvenous approach via the superior ophthalmic vein.

  6. The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: our first experience

    OpenAIRE

    Chiriac A.; Dobrin N.; Ion Georgiana; Costan V.; Poeata I.

    2016-01-01

    Complex cavernous sinus fistulae (CCF) are still a technical challenge to neurovascular team. The most commonly performed treatment consists in endovascular embolization of the lesion through an arterial or venous approach. Not always these conventional routes are feasible, requiring alternative routes. We report a case of a 44-year-old woman with a complex indirect (Barrow D) carotid cavernous sinus fistula treated by two interventional sessions that imposing a retrograde direct transvenous ...

  7. Preoperative diagnosis of cavernous hemangioma presenting with melena using wireless capsule endoscopy of the small intestine

    Science.gov (United States)

    Akazawa, Yu; Hiramatsu, Katsushi; Nosaka, Takuto; Saito, Yasushi; Ozaki, Yoshihiko; Takahashi, Kazuto; Naito, Tatsushi; Ofuji, Kazuya; Matsuda, Hidetaka; Ohtani, Masahiro; Nemoto, Tomoyuki; Suto, Hiroyuki; Yamaguchi, Akio; Imamura, Yoshiaki; Nakamoto, Yasunari

    2016-01-01

    Background and study aims: Primary neoplasms of the small intestine are relatively rare in all age groups, accounting for about 5 % of all gastrointestinal tumors 1. Cavernous hemangiomas of the small intestine are also rare, can cause gastrointestinal bleeding, and are extremely difficult to diagnose preoperatively 2. We present a patient who presented with melena and iron deficiency anemia, for whom wireless capsule endoscopy and single-balloon enteroscopy facilitated the diagnosis of cavernous hemangioma. PMID:27004239

  8. Disposal of NORM-Contaminated Oil Field Wastes in Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Blunt, D.L.; Elcock, D.; Smith, K.P.; Tomasko, D.; Viel, J.A.; and Williams, G.P.

    1999-01-21

    In 1995, the U.S. Department of Energy (DOE), Office of Fossil Energy, asked Argonne National Laboratory (Argonne) to conduct a preliminary technical and legal evaluation of disposing of nonhazardous oil field waste (NOW) into salt caverns. That study concluded that disposal of NOW into salt caverns is feasible and legal. If caverns are sited and designed well, operated carefully, closed properly, and monitored routinely, they can be a suitable means of disposing of NOW (Veil et al. 1996). Considering these findings and the increased U.S. interest in using salt caverns for NOW disposal, the Office of Fossil Energy asked Argonne to conduct further research on the cost of cavern disposal compared with the cost of more traditional NOW disposal methods and on preliminary identification and investigation of the risks associated with such disposal. The cost study (Veil 1997) found that disposal costs at the four permitted disposal caverns in the United States were comparable to or lower than the costs of other disposal facilities in the same geographic area. The risk study (Tomasko et al. 1997) estimated that both cancer and noncancer human health risks from drinking water that had been contaminated by releases of cavern contents were significantly lower than the accepted risk thresholds. Since 1992, DOE has funded Argonne to conduct a series of studies evaluating issues related to management and disposal of oil field wastes contaminated with naturally occurring radioactive material (NORM). Included among these studies were radiological dose assessments of several different NORM disposal options (Smith et al. 1996). In 1997, DOE asked Argonne to conduct additional analyses on waste disposal in salt caverns, except that this time the wastes to be evaluated would be those types of oil field wastes that are contaminated by NORM. This report describes these analyses. Throughout the remainder of this report, the term ''NORM waste'' is used to mean &apos

  9. 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.

  10. 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.

  11. Probabilistic Analysis of a Rock Salt Cavern with Application to Energy Storage Systems

    Science.gov (United States)

    Mahmoudi, Elham; Khaledi, Kavan; Miro, Shorash; König, Diethard; Schanz, Tom

    2017-01-01

    This study focuses on the failure probability of storing renewable energy in the form of hydrogen or compressed air in rock salt caverns. The validation of the short- and long-term integrity and stability of rock salt cavern is a prerequisite in their design process. The present paper provides a reliability-based analysis of a typical renewable energy storage cavern in rock salt. An elasto-viscoplastic creep constitutive model is implemented into a numerical model of rock salt cavern to assess its behavior under different operation conditions. Sensitivity measures of different variables involved in the mechanical response of cavern are computed by elementary effect global sensitivity method. Subset simulation methodology is conducted to measure the failure probability of the system with a low computational cost. This methodology is further validated by a comparison with a Monte Carlo-based probabilistic analysis. The propagation of parameter uncertainties and the failure probability against different failure criteria are evaluated by utilizing a Monte Carlo-based analysis. In this stage, the original finite element model is substituted by a surrogate model to further reduce the computational effort. Finally, a reliability analysis approach is employed to obtain the minimum admissible internal pressure in a cavern.

  12. A new endoscopic surgical classification and invasion criteria for pituitary adenomas involving the cavernous sinus.

    Science.gov (United States)

    Ceylan, Savas; Anik, Ihsan; Koc, Kenan

    2011-01-01

    There are two major problems for the pituitary adenomas invading the Cavernous Sinus (CS); differentiation of extension and invasion and inability to demonstrate the medial wall via preoperative imaging methods. Two important corridors are defined in endoscopic cavernous sinus approaches; the lateral and medial corridor. A retrospective analysis was performed in 400 endoscopic transphenoidal approaches and 360 pituitary adenomas underwent endoscopic transphenoidal surgery in our department between September 1997 and December 2010. 48 patients affected by the tumours involving the cavernous sinus were included in this study. We performed an intraoperative evaluation of cavernous sinus invasion considering visualization of the medial wall defect, intracavernous ICA segments, minor tumour extensions through small focal pit holes of the medial wall of CS or confirming carotid segments of CS by micro-doppler. Cavernous sinus involvement was classified into three types according to the medial and lateral corridor extension of the tumor as 25 isolated medial corridor involvement (Type I), 5 isolated lateral corridor involvement (Type II) and 18 total involvement (Type III). Our classification depends on fully surgical endoscopic approach supported by neuroimaging techniques and anatomical studies and shows a good predictive value for all cavernous sinus involvement.

  13. 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.

  14. Intelligent Stability Design of Large Underground Hydraulic Caverns: Chinese Method and Practice

    Directory of Open Access Journals (Sweden)

    Xiating Feng

    2011-10-01

    Full Text Available The global energy shortage has revived the interest in hydroelectric power, but extreme geological condition always pose challenges to the construction of hydroelectric power stations with large underground caverns. To solve the problem of safe design of large underground caverns, a Chinese-style intelligent stability design, representing recent developments in Chinese techniques for the construction of underground hydropower systems is presented. The basic aim of this method is to help designers improve the stability and design efficiency of large underground hydropower cavern groups. Its flowchart consists of two parts, one is initial design with an ordinal structure, and the other is dynamic design with a closed loop structure. In each part of the flowchart, analysis techniques, analysis content and design parameters for caverns’ stability are defined, respectively. Thus, the method provides designers with a bridge from the basic information of objective engineering to reasonable design parameters for managing the stability of hydraulic cavern groups. Application to two large underground caverns shows that it is a scientific and economical method for safely constructing underground hydraulic caverns.

  15. Fractal Prediction of Grouting Volume for Treating Karst Caverns along a Shield Tunneling Alignment

    Directory of Open Access Journals (Sweden)

    Wen-Chieh Cheng

    2017-06-01

    Full Text Available Karst geology is common in China, and buried karst formations are widely distributed in Guangdong province. In the process of shield tunneling, the abundant water resources present in karst caverns could lead to the potential for high water ingress, and a subsequent in situ stress change-induced stratum collapse. The development and distribution of karst caverns should therefore be identified and investigated prior to shield tunnel construction. Grouting is an efficient measure to stabilize karst caverns. The total volume of karst caverns along the shield tunneling alignment, and its relationship with the required volume of grouts, should be evaluated in the preliminary design phase. Conventionally, the total volume of karst caverns is empirically estimated based on limited geological drilling hole data; however, accurate results are rarely obtained. This study investigates the hydrogeology and engineering geology of Guangzhou, the capital of Guangdong province, and determines the fractal characteristics of the karst caverns along the tunnel section of Guangzhou metro line no. 9. The karst grouting coefficients (VR were found to vary from 0.11 in the case of inadequate drilling holes to 1.1 in the case where adequate drilling holes are provided. A grouting design guideline was furthermore developed in this study for future projects in karst areas.

  16. Acute abducens nerve palsy as a presenting feature in carotid-cavernous fistula in a 6-year-old girl [

    Directory of Open Access Journals (Sweden)

    Pawar, Neelam

    2013-04-01

    Full Text Available [english] Carotid-cavernous fistulas (CCF are abnormal communications between the internal carotid artery and the cavernous sinus. Traumatic carotid-cavernous fistulae are rare potential complications of craniofacial trauma. Typical findings of CCF are proptosis, chemosis, headache, oculomotor or abducens nerve palsy, trigeminal pain and pulsating bruit over the temporal skull and the bulb.CCF are reported very rarely in childhood. This report describes the clinical and radiological findings of a pediatric patient presented with CCF.

  17. 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 ...

  18. 脑梗死恢复期患者家属需求及相关因素分析%Requirements of recovery cerebral infarction panients' family and the related factors

    Institute of Scientific and Technical Information of China (English)

    张春燕; 林可可; 王攀峰

    2011-01-01

    目的 了解脑梗死患者及家属在恢复期的需求,并分析其相关因素。方法 采用自行设计的需求调查表,对81名住院患者家属进行调查。结果 81名患者家属需求得分85 ~ 230分,平均(150.84±32.40)分,在7个维度中用药护理的需求最高,需求前10项中有6项是用药护理的需求,需求后10项中日常生活护理有6项,其中管道护理需求最低只占14.8%。男性家属和女性家属在日常生活护理方面的需求差异有统计学意义[(21.70±6.11)分比(17.63±5.50)分;t=3.13,P<0.01];有、无照护经历的家属需求总分差异有统计学意义[(164.90±30.28)分比(142.12±30.81)分;t=-3.26,P<0.01];患者家属需求的其他相关因素有护工协助照护、家属与患者的关系、家属的文化程度(P<0.05)。结论 恢复期脑梗死患者家属对用药护理、患者心理护理、家属自身需求、家庭安全环境、康复护理及预防并发症护理存在不同程度的需,护士应针对性地对家属进行宣教。%Objective To explore the requirements of patients with recovery cerebral infarction and their family and the related factors. Methods 81 patients in hospital were investigated by a self-designed questionnaire. Results Needs score of 81 patients was 85 -230, and the average was (150.84 ±32.40).Medication care was the most needs of all the seven dimensions. 6 medication cares were in the top 10 needs,and 6 ordinary nursing in the last 10 items and pipeline nursing was the lowest and accounted for 14.8%. Male family members were different from the female in the nursing requirements [(21.70 ± 6. 11 ) vs ( 17.63 ±5.50) ; t =3.13, P <0. 01] ; Family members with and without care vigorous were also different [( 164.90 ±30.28) vs ( 142. 12 ± 30.81 ) ; t =- 3. 26, P < 0. 01]. Other related needs of family members were care workers, relationship between the patients and the family members, and education status of

  19. 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

  20. The effect of comprehensive intervention on the negative emotion of the families of patients with acute cerebral stroke%综合干预减轻急性脑卒中患者家属负性情绪

    Institute of Scientific and Technical Information of China (English)

    兰洁; 廖光荣; 方向红; 张秀芳; 杨雨竹

    2013-01-01

    Objective To explore the effect of omprehensive intervention on the negative emotion of the families of patients with acute cerebral strokeMethods Ninety the families of patients with acute cerebral stroke were divided into the intervention group and the control group with 45 cases in each.The intervention group was given comprehensive intervention including supportive psychology intervention,cognitive psychology intervention,group psychology intervention and behavior intervention.The control group was given the routine health care education.The anxiety and depression self-rating scale and self-made questionnaire and scoring were used to evaluate the negative emotion of patients'families.Results Compared with the control group,the scores of the anxiety and depression self-rating scale and self-made questionnaire in the intervention group were lower (P < 0.05 or P < 0.01).Conclusions The comprehensive intervention can improve negative emotion of the patients'families.So they can cooperate with the medical workers to treat and care the patients.%目的 探讨专家门诊综合干预对急性脑卒中患者家属负性情绪的改善效果.方法 将90例急性脑卒中患者家属随机分为干预组和对照组,每组45例,干预组予以综合干预措施,包括支持心理干预、认知心理干预、集体心理干预及行为干预等,对照组则按常规健康教育,应用焦虑和抑郁自评量表和自行设计的问卷评估患者家属的负性情绪.结果 两组患者家属焦虑和抑郁自评量表和问卷评分,干预后干预组均比对照组明显低(P<0.05或P<0.01).结论 专家门诊心理干预能改善患者家属的负性情绪,使之有效配合医护人员治疗护理患者.

  1. 4D flow preliminary investigation of a direct carotid cavernous fistula due to a ruptured intracavernous aneurysm.

    Science.gov (United States)

    Nakagawa, Shunsuke; Murai, Yasuo; Wada, Takeshi; Tateyama, Kojiro

    2015-01-22

    Inadequate information is available about the cerebral blood flow and surgical strategies of a direct aneurysmal carotid cavernous fistula (daCCF). We report a quantitative analysis of flow velocity and volume using preoperative time-resolved phase-contrast MRI (four-dimensional (4D) flow MRI) in a daCCF. This is the first report of 4D flow findings with a daCCF. A 55-year-old woman developed a sudden headache and bruit of the right orbit, and MRI suggested the presence of a daCCF. Quantitative analysis using preoperative 4D flow MRI revealed the flow volume of the right internal carotid artery. The daCCF was successfully treated by high-flow bypass using a radial artery graft and internal carotid artery trapping. Postoperative angiography showed a complete obliteration of the daCCF. Studies to collect data from additional cases are required so that 4D flow findings can be further used in the management of daCCFs. 2015 BMJ Publishing Group Ltd.

  2. Association of protein Z and factor VII gene polymorphisms with risk of cerebral hemorrhage: a case–control and a family-based association study in a Chinese Han pulation

    Indian Academy of Sciences (India)

    YI ZENG; LE ZHANG; ZHIPING HU; QIDONG YANG; MINGMING MA; BAOQIONG LIU; JIAN XIA; HONGWEI XU; YUNHA I LIU; XIAOPING DU

    2016-06-01

    Protein Z (PZ) and factor (F) VII are two important factors in the clotting pathway which have similar structure, linkedfunction and nearby gene sites. The aims of this study were to investigate whether the common variants of PZ and FVII genesare associated with the risk of cerebral hemorrhage (CH) and to explore the combined effects of PZ and FVII polymorphismsfor CH risk. We performed genotyping analysis for two single-nucleotide polymorphisms (SNPs) of FVII (rs510317 andrs6046) and three SNPs of PZ (rs2273971, rs3024718 and rs3024731) both in a population-based case–control study andin a family-based association study. Case–control analysis found no evidence of significant association. But family-basedassociation study revealed that the G allele of PZ rs2273971, and three haplotypes carrying the ‘G’ allele of PZ rs2273971:haplotype GA, CG and CGA of PZ and FVII genes, all had a significant effect on CH susceptibility (Z =1.882,P =0.049;Z =1.922,P =0.044; Z =1.826,P =0.047; Z =1.977,P =0.048, respectively). While, the A allele of PZ rs2273971, andfour haplotypes carrying or crossing the ‘A’ allele of PZ rs2273971: haplotypes CA, ACAA, ACAT and ACAAT of PZ andFVII genes, may confer protection against CH (Z =−1.882,P =0.049; Z =−2.000,P =0.045; Z =−2.319,P =0.020;Z =−2.002,P =0.045; Z =−2.015,P =0.043, respectively). This is a first family-based association study providing geneticevidences that PZ and FVII genes, especially PZ rs2273971 are involved in the development of CH in Han-Chinese families.

  3. Association of protein Z and factor VII gene polymorphisms with risk of cerebral hemorrhage: a case-control and a family-based association study in a Chinese Han population.

    Science.gov (United States)

    Zeng, Yi; Zhang, Le; Hu, Zhiping; Yang, Qidong; Ma, Mingming; Liu, Baoqiong; Xia, Jian; Xu, Hongwei; Liu, Yunhai; Du, Xiaoping

    2016-06-01

    Protein Z (PZ) and factor (F) VII are two important factors in the clotting pathway which have similar structure, linked function and nearby gene sites. The aims of this study were to investigate whether the common variants of PZ and FVII genes are associated with the risk of cerebral hemorrhage (CH) and to explore the combined effects of PZ and FVII polymorphisms for CH risk. We performed genotyping analysis for two single-nucleotide polymorphisms (SNPs) of FVII (rs510317 and rs6046) and three SNPs of PZ (rs2273971, rs3024718 and rs3024731) both in a population-based case-control study and in a family-based association study. Case-control analysis found no evidence of significant association. But family-based association study revealed that the G allele of PZ rs2273971, and three haplotypes carrying the 'G' allele of PZ rs2273971: haplotype GA, CG and CGA of PZ and FVII genes, all had a significant effect on CH susceptibility (Z = 1.882, P = 0.049; Z = 1.922, P = 0.044; Z = 1.826, P = 0.047; Z = 1.977, P = 0.048, respectively). While, the A allele of PZ rs2273971, and four haplotypes carrying or crossing the 'A' allele of PZ rs2273971: haplotypes CA, ACAA, ACAT and ACAAT of PZ and FVII genes, may confer protection against CH (Z= -1.882, P = 0.049; Z= -2.000, P = 0.045; Z= -2.319, P = 0.020; Z= -2.002, P = 0.045; Z= -2.015, P = 0.043, respectively). This is a first family-based association study providing genetic evidences that PZ and FVII genes, especially PZ rs2273971 are involved in the development of CH in Han-Chinese families.

  4. Diagnosis and treatment of traumatic carotid cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    杨东虹; 何奇元; 邹咏文; 许民辉

    2002-01-01

    Objective: To discuss the diagnosis and managementof traumatic carotid cavernous fistula (TCCF).Methods: In all 15 patients with TCCF confirmed byangiography, 8 patients got early diagnosis and cure. WithSeldinger technique adpoted in the puncture of femoralartery, Magic 3 F-1.8 F BD catheters combining withballoon were used to embolize the fistula or the internalcarotid artery.Results: Early diagnosis and cure were achieved in 8patients within one week and no sequelae occurred. Sevenpatients with delayed diagnosis who were cured beyond oneweek had some sequelae such as hypopsia in 5 cases,incomplete oculomotor paralyses in 3 and incompleteabducent paralyses in 2. Among all the 15 cases, theinternal carotid artery was preserved in 12 cases acountingfor 80%. Occluding the fistula with sacrifice of the internalcarotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.Conclusions: The preferred therapy for TCCF is toocclude the fistula using detachable balloon. The diagnosisand treatment for TCCF can significantly reduce occurrencerate of the complications and sequelae.

  5. 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.

  6. 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...

  7. 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.

  8. Management of supratentorial cavernous malformations: craniotomy versus gammaknife radiosurgery.

    Science.gov (United States)

    Shih, Yang-Hsin; Pan, David Hung-Chi

    2005-02-01

    Although craniotomy is the preferred treatment for symptomatic solitary supratentorial cavernous malformation (CM), radiosurgery is also an option. Our aim was to see which of these strategies was the most effective and under what circumstances. Of the 46 patients with solitary supratentorial CM that we retrospectively studied, 24 presented with seizures, 16 with focal neurological deficits due to intracerebral hemorrhage, and 6 with both seizures and bleeding. Sixteen were treated with craniotomy and 30 with gammaknife radiosurgery (GKRS). The main outcome measures for comparing craniotomy with GKRS were the proportion of postoperative seizure-free patients and the proportion of patients in whom no rebleeding occurred. Of patients presenting with seizures with/without bleeding, a significantly higher proportion of the craniotomy group than the GKRS group became and remained seizure-free (11/14 [79%] versus 4/16 [25%]; P < 0.002), and of those presenting with bleeding with/without seizures, a somewhat (though nonsignificantly) higher proportion did not rebleed (4/4 [100%] versus 12/18 [67%]) after surgery. The remaining 2 of the 16 craniotomy patients did not rebleed and had no residual tumor at follow up. Twelve of the 30 GKRS patients had evidence of tumor regression at follow up. In the clinical management of solitary supratentorial CM, craniotomy for lesionectomy resulted in better seizure control and rebleeding avoidance than GKRS.

  9. Cavernous sinus invasion by pituitary macroadenomas: neuroradiological, clinical and surgical correlation

    Directory of Open Access Journals (Sweden)

    CUKIERT ARTHUR

    1998-01-01

    Full Text Available The classical imaging gold-standard for this diagnosis is the presence of tumor lateral to the carotid artery. Seventeen patients with pituitary macroadenomas with intraoperative confirmation of cavernous sinus invasion were studied with MRI. Only 8 patients had tumor lateral to the carotid artery; 13 had tumor within the carotid syphon and all lacked the ring enhancement of the medial wall of the cavernous sinus. In 10 patients, widening of the posterior double leaflets of the cavernous sinus could be. All patients were operated by the transesphenoidal route. Only one patient was cured by surgery alone. Only 3 patients disclosing the above mentioned MRI features were identified in a series of 250 patients and did not have cavernous sinus invasion. The present criteria proved to be useful in the pre-operative diagnosis of cavenous sinus invasion and patients' counselling. Pre-operative diagnosis of cavernous sinus invasion of pituitary tumors has a great impact in the management of such patients.

  10. A noisy zygoma fracture--complication of carotid-cavernous sinus fistula: total recovery of monocular blindness and frozen-eye after endoarterial coil embolization.

    NARCIS (Netherlands)

    Bierenbroodspot, F.; Damme, P.A. van; Cruysberg, J.R.M.

    2005-01-01

    A case of a patient with a zygoma fracture in combination with a carotid-cavernous sinus fistula--an arterio-venous fistula between the internal carotid artery and the cavernous sinus--is presented. The most frequent cause is trauma, but the carotid-cavernous sinus fistula itself may have been the c

  11. 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

  12. Disposal of NORM-contaminated oil field wastes in salt caverns -- Legality, technical feasibility, economics, and risk

    Energy Technology Data Exchange (ETDEWEB)

    Veil, J.A.; Smith, K.P.; Tomasko, D.; Elcock, D.; Blunt, D.; Williams, G.P.

    1998-07-01

    Some types of oil and gas production and processing wastes contain naturally occurring radioactive materials (NORM). If NORM is present at concentrations above regulatory levels in oil field waste, the waste requires special disposal practices. The existing disposal options for wastes containing NORM are limited and costly. This paper evaluates the legality, technical feasibility, economics, and human health risk of disposing of NORM-contaminated oil field wastes in salt caverns. Cavern disposal of NORM waste is technically feasible and poses a very low human health risk. From a legal perspective, there are no fatal flaws that would prevent a state regulatory agency from approaching cavern disposal of NORM. On the basis of the costs charged by caverns currently used for disposal of nonhazardous oil field waste (NOW), NORM waste disposal caverns could be cost competitive with existing NORM waste disposal methods when regulatory agencies approve the practice.

  13. 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.

  14. Transient electromagnetic detection method in water-sealed underground storage caverns

    Directory of Open Access Journals (Sweden)

    Fang Lin

    2016-09-01

    Full Text Available Taking advantage of the water sensitivity of the transient electromagnetic method (TEM, this study assesses the effectiveness of the water curtain system for underground LPG storage caverns during the excavation period. It also detects fracture water flow during the excavation process in light of the practice of two pilot large underground LPG storage caverns in China. Comparative maps of apparent resistivity derived from TEM measurements before and after water-filling during the excavation process have been discussed to improve the quality of the water curtain system. This is the first case to apply TEM to detect the quality of the water curtain system during the construction of underground LPG storage cavern projects, and it is found to be practical, more visualized and worth popularizing.

  15. Underground physics without underground labs: large detectors in solution-mined salt caverns

    CERN Document Server

    Monreal, Benjamin

    2014-01-01

    A number of current physics topics, including long-baseline neutrino physics, proton decay searches, and supernova neutrino searches, hope to someday construct huge (50 kiloton to megaton) particle detectors in shielded, underground sites. With today's practices, this requires the costly excavation and stabilization of large rooms in mines. In this paper, we propose utilizing the caverns created by the solution mining of salt. The challenge is that such caverns must be filled with pressurized fluid and do not admit human access. We sketch some possible methods of installing familiar detector technologies in a salt cavern under these constraints. Some of the detectors discussed are also suitable for deep-sea experiments, discussed briefly. These sketches appear challenging but feasible, and appear to force few major compromises on detector capabilities. This scheme offers avenues for enormous cost savings on future detector megaprojects.

  16. Treatment of carotid-cavernous sinus fistulas retrograde via the superior ophthalmic vein (SOV).

    Science.gov (United States)

    Derang, J; Ying, H; Long, Y; Reifa, S; Qiming, W; Yimu, F; Guoxiang, S; Shimin, C; Lihua, X; Shi, W; Zunhua, C

    1999-09-01

    Carotid-cavernous sinus fistula is an old difficulty in neurosurgery. At present, the main way to deal with it is by embolizing the fistula via an arterial route. But if the fistula is small or supplied by several branches, it is difficult to embolize via an arterial approach. In this report, 21 patients with carotid-cavernous sinus fistulae were successfully cured by embolizing the fistula via the SOV approach. All patients were cured, and there were no serious postoperative complications. Follow-up has been carried out in 19 cases for 8 months to more than 4 years; no recurrence manifested. For carotid-cavernous sinus fistulae that cannot be embolized arterially, the superior ophthalmic vein route is an easy, safe, effective and promising approach.

  17. Cavernous hemangioma-like kaposi sarcoma: histomorphologic features and differential diagnosis.

    Science.gov (United States)

    Onak Kandemir, Nilüfer; Barut, Figen; Doğan Gün, Banu; Solak Tekin, Nilgün; Hallaç Keser, Sevinç; Oğuz Özdamar, Sükrü

    2013-01-01

    Aim. Cavernous hemangioma-like Kaposi sarcoma is a rare morphologic type of Kaposi sarcoma. So far there are no cases in the literature defining the histological features of this morphologic spectrum in detail. In this study we presented two classical-type cutaneous Kaposi sarcoma cases with histologic findings resembling cavernous hemangioma in company with clinical and histopathological data. Cases. One hundred and eighty-five classical-type cutaneous Kaposi sarcoma lesions in 79 patients were assessed retrospectively in terms of histopathological features. Findings of two cases showing features of cavernous hemangioma-like Kaposi sarcoma whose clinical data could be accessed were presented in accompany with the literature data. Both cases were detected to have bluish-purple, protruded, irregularly bordered cutaneous lesions. Histopathological examination revealed a lesion formed by cavernous hemangioma-like vascular structures organized in a lobular pattern that became dilated and filled with blood. Typical histological findings of early-stage KS, consisting of mononuclear inflammation, extravasated erythrocytes, and a few immature vascular structures in superficial dermis, were observed. All cases were serologically HIV-1 negative. A positive reaction with HHV-8, CD31, CD34, and D2-40 monoclonal antibodies was identified at both cavernous hemangioma-like areas and in immature vascular structures. Results. Cavernous hemangioma-like Kaposi sarcoma is a rare Kaposi sarcoma variant presenting with diagnostic challenges, that may be confused with hemangioma. As characteristic morphological features may not be observed in every case, it is important for diagnostic purposes to show immunohistochemical HHV-8 positivity in this variant.

  18. The cavernous sinus in cluster headache - a quantitative structural magnetic resonance imaging study.

    Science.gov (United States)

    Arkink, Enrico B; Schoonman, Guus G; van Vliet, Jorine A; Bakels, Hannah S; Sneeboer, Marjolein Am; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-03-01

    Background It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods In this case-control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.

  19. Logistic regression analysis on risk factors for vascular dementia following cerebral infarction in 403 patients from Chongqing City Hospital and family follow-up studies

    Institute of Scientific and Technical Information of China (English)

    Hong Yang; Jingcheng Li; Huadong Zhou

    2007-01-01

    BACKGROUND: Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects.OBJECTIVE: To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN: Case analysis.SETTING: Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS: Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects.METHODS: ①Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission. Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups: dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder>24 hours and CT or MRI imageology.③Neurophysiological examination was conducted in all the patients at 7 to 10 days after stroke (score was two SD less than or equaled to normal level was considered as abnormal).④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-IV (published by American Psychiatric Association) on admission and 3 months after admission. Neurologic

  20. 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.

  1. Gamma Knife radiosurgery for hemangioma of the cavernous sinus.

    Science.gov (United States)

    Lee, Cheng-Chia; Sheehan, Jason P; Kano, Hideyuki; Akpinar, Berkcan; Martinez-Alvarez, Roberto; Martinez-Moreno, Nuria; Guo, Wan-Yuo; Lunsford, L Dade; Liu, Kang-Du

    2017-05-01

    OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare vascular tumors. A direct microsurgical approach usually results in massive hemorrhage and incomplete tumor resection. Although stereotactic radiosurgery (SRS) has emerged as a therapeutic alternative to microsurgery, outcome studies are few. Authors of the present study evaluated the role of SRS for CSH. METHODS An international multicenter study was conducted to review outcome data in 31 patients with CSH. Eleven patients had initial microsurgery before SRS, and the other 20 patients (64.5%) underwent Gamma Knife SRS as the primary management for their CSH. Median age at the time of radiosurgery was 47 years, and 77.4% of patients had cranial nerve dysfunction before SRS. Patients received a median tumor margin dose of 12.6 Gy (range 12-19 Gy) at a median isodose of 55%. RESULTS Tumor regression was confirmed by imaging in all 31 patients, and all patients had greater than 50% reduction in tumor volume at 6 months post-SRS. No patient had delayed tumor growth, new cranial neuropathy, visual function deterioration, adverse radiation effects, or hypopituitarism after SRS. Twenty-four patients had presented with cranial nerve disorders before SRS, and 6 (25%) of them had gradual improvement. Four (66.7%) of the 6 patients with orbital symptoms had symptomatic relief at the last follow-up. CONCLUSIONS Stereotactic radiosurgery was effective in reducing the volume of CSH and attaining long-term tumor control in all patients at a median of 40 months. The authors' experience suggests that SRS is a reasonable primary and adjuvant treatment modality for patients in whom a CSH is diagnosed.

  2. 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.)

  3. Cavernous hemangioma concurrently involving the anterior and middle mediastinum and the lung parenchyma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Hyun; Lee, Soo Jung; Kim, Sung Jin; Cho, Bum Sang [Dept. of Radiology, Chungbuk National University Hospital, Cheongju (Korea, Republic of)

    2017-04-15

    Hemangioma is rarely found in the mediastinum or lung. In the mediastinum, this tumor is usually located in the anterior mediastinum and manifests as a nonspecific soft tissue mass. In the lung, it usually presents as a well-defined nodule. To the best of our knowledge, there is no case of cavernous hemangioma concurrently involving the mediastinum and lung parenchyma, except for one case of concurrent cardiac and pulmonary hemangiomas. Here, we present an interesting case of cystic anterior and middle mediastinal masses together with multiple pulmonary nodules and ground glass opacities, which were diagnosed as cavernous hemangiomas. When similar findings are encountered, clinicians should consider hemangioma in the differential diagnosis.

  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. 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.

  6. Cavernous Hemangioma of the External Canal, Tympanic Membrane, and Middle Ear Cleft: A Case Report.

    Science.gov (United States)

    Odat, Haitham; Al-Qudah, Mohannad; Al-Qudah, Mohammad A

    2016-06-01

    Cavernous hemangioma involving the external canal, tympanic membrane, and middle ear cavity is extremely rare. We present a case of a 45-year-old woman who had progressive right sided decreased hearing, pulsatile tinnitus, and aural fullness of 7 months duration. Microscopic examination, imaging studies, surgical treatment, and histological evaluation are reported. To the best of our knowledge, this is the first case of cavernous hemangioma with simultaneous involvement of the external ear, tympanic membrane, middle ear, and attic reported in English literature.

  7. 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.

  8. Sirt1 in cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Kevin B Koronowski

    2015-01-01

    Full Text Available Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD +-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer′s Disease, Parkinson′s Disease, and Huntington′s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance.

  9. Sirt1 in cerebral ischemia

    Science.gov (United States)

    Koronowski, Kevin B.; Perez-Pinzon, Miguel A.

    2015-01-01

    Cerebral ischemia is among the leading causes of death worldwide. It is characterized by a lack of blood flow to the brain that results in cell death and damage, ultimately causing motor, sensory, and cognitive impairments. Today, clinical treatment of cerebral ischemia, mostly stroke and cardiac arrest, is limited and new neuroprotective therapies are desperately needed. The Sirtuin family of oxidized nicotinamide adenine dinucleotide (NAD+)-dependent deacylases has been shown to govern several processes within the central nervous system as well as to possess neuroprotective properties in a variety of pathological conditions such as Alzheimer’s Disease, Parkinson’s Disease, and Huntington’s Disease, among others. Recently, Sirt1 in particular has been identified as a mediator of cerebral ischemia, with potential as a possible therapeutic target. To gather studies relevant to this topic, we used PubMed and previous reviews to locate, select, and resynthesize the lines of evidence presented here. In this review, we will first describe some functions of Sirt1 in the brain, mainly neurodevelopment, learning and memory, and metabolic regulation. Second, we will discuss the experimental evidence that has implicated Sirt1 as a key protein in the regulation of cerebral ischemia as well as a potential target for the induction of ischemic tolerance. PMID:26819971

  10. Cerebral Palsy Checklist: Teens & Young Adult (13 to 21)

    Science.gov (United States)

    ... Affects Your Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting Involved Teaching Kids to Be Smart About Social Media Cerebral Palsy Checklist: Teens & Young Adults KidsHealth > For Parents > Cerebral Palsy Checklist: ...

  11. 家庭中心式护理对脑瘫患儿家长生存质量的影响%Effects of family-centered care on quality of life in the parents of children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    马明

    2014-01-01

    目的:了解家庭中心式护理对脑瘫患儿家长生存质量的影响。方法选择脑瘫患儿家长104名,将2011年2-5月抽取的52名脑瘫患儿家长作为干预组,2010年10月-2011年1月抽取的52例脑瘫患儿家长作为对照组。对干预组家庭实施家庭中心式护理模式,对照组采用普通护理模式。干预前后用世界卫生组织生存质量测定量表简表( WHOQOL-BREF )和纽卡斯尔护理服务满意度量表( NSNS)进行评估。结果干预前两组患者的 WHOQOL-BREF 各领域得分差异无统计学意义( P >0.05)。干预后,干预组WHOQOL-BREF各领域得分为生理领域(62.64±13.63)分,心理领域(59.46±14.15)分,社会关系领域(63.41±13.40)分,环境领域(48.52±15.20)分,NSNS得分(57.15±6.38)分,均要高于对照组的(54.40±13.22),(47.12±16.16),(53.98±13.52),(42.43±13.35),(51.42±7.90)分,差异有统计学意义(Z分别为-3.139,-4.136,-3.792,-2.232,-4.725;P<0.05);干预组自身对照,干预后WHOQOL-BREF各领域得分均高于干预前,差异有统计学意义( Z分别为-4.213,-4.068,-3.299,-4.160;P<0.05)。结论家庭中心式护理模式可以提高脑瘫患儿住院康复治疗期间患儿家长的生存质量,并提高他们对护理服务的满意度。%Objective To explore the effects of family-centered care on quality of life in parents of children with cerebral palsy .Methods One hundred and four parents of children with cerebral palsy from February to May, 2011, were distributed into intervention group , and 52 parents of children with cerebral palsy from October to January , 2011 , were distributed into control group .The family-centered care was used among intervention group , while the control group was treated with traditional nursing care . The World Health Organization Quality of

  12. Use of Actuator-Driven Pulsed Water Jet in Brain and Spinal Cord Cavernous Malformations Resection.

    Science.gov (United States)

    Endo, Toshiki; Takahashi, Yoko; Nakagawa, Atsuhiro; Niizuma, Kuniyasu; Fujimura, Miki; Tominaga, Teiji

    2015-09-01

    A piezo actuator-driven pulsed water jet (ADPJ) system is a novel surgical instrument that enables dissection of tissue without thermal damage. It can potentially resect intra-axial lesions while preserving neurological function. To report our first experience of applying an ADPJ system to brain and spinal cord cavernous malformations. Four patients (2 women and 2 men, mean age 44.5 years) with brain (n = 3) and spinal cord (n = 1) cavernous malformations were enrolled in the study. All surgeries were performed with the aid of the ADPJ system. Postoperative neurological function and radiological findings were evaluated. The ADPJ system was useful in dissecting boundaries between the lesion and surrounding brain/spinal cord tissues. The pulsed water jet provided a clear surgical view and helped surgeons follow the margins. Water jet dissection peeled off the brain and spinal cord tissues from the lesion wall. Surrounding gliotic tissue was preserved. As a consequence, the cavernous malformations were successfully removed. Postoperative magnetic resonance imaging confirmed total removal of lesions in all cases. Preoperative neurological symptoms completely resolved in 2 patients. The others experienced partial recovery. No patients developed new postoperative neurological deficits; facial palsy temporarily worsened in 1 patient who underwent a suprafacial colliculus approach for the brainstem lesion. The ADPJ provided a clear surgical field and enabled surgeons to dissect boundaries between lesions and surrounding brain and spinal cord gliotic tissue. The ADPJ system is a feasible option for cavernous malformation surgery, enabling successful tumor removal and preservation of neurological function.

  13. Transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes

    Institute of Scientific and Technical Information of China (English)

    CHEN Huai-rui; BAI Ru-lin; HUANG Cheng-guang; LI Bin; LU Yi-cheng

    2007-01-01

    Objective: To evaluate the safety and efficiency of transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes. Methods: Twenty seven patients with dural arteriovenous fistula uf cavernous region were treated by transvenous embolization with micro-coils. The transvenous routes included inferior petrosal sinus, superior ophthalmic vein and facial vein. Results: Clinical cure was achieved in 23 cases and significant improvement of symptoms in 4 cases. Complete angiographic obliteration was documented in 22 patients (82%). Residual shunting were left in 2 patients via pterygoid drainage and 1 case via inter-cavernous sinus, 2 cases via inferior petrosal sinus, disappeared one month later by manual compression carotid artery. Headache and vomiting were the most common symptoms after embolization. Three patients had diplopia and relieved within two months after embolization.There was no permanent procedure-related morbidity. The clinic follow up ranged from 5 months to 6 years, and there was not recurrence case. Conclusion: Transvenous embolization via different venous routes is a safe and efficient method for dural arteriovenous fistula of cavernous region treatment.

  14. CT diagnosis of cavernous hemangioma of the orbit. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Takaki, Yoshikazu; Takahashi, Mutsumasa; Fukui, Kohtaroh; Bussaka, Hiromasa; Takahama, Yuriko; Yano, Tatsushi (Kumamoto Univ. (Japan). School of Medicine)

    1982-11-01

    A case of cavernous hemangioma studied by dynamic CT was reported. Dynamic CT revealed that contrast enhancement progressed from the periphery toward the center and started early to persist over a long period. These findings seemed characteristic of hemangioma of the orbit and other sties including the liver.

  15. Developments in Researches on the Disasters during Cavern Construction in Salt Beds with Multi-Interlayer

    Directory of Open Access Journals (Sweden)

    Huafu Qiu

    2013-08-01

    Full Text Available This study analyses the developments in researches on the disasters during cavern construction in salt beds with multi-interlayer. Relative to the foreign large salt dome landscape, there are many layers of mudstone in salt beds which has a thin single layer. And such special geological conditions increase the difficulty of solution mining in the control of cavity shape and stability of the cavity, which easily leads to disasters. To statistical analysis the disasters in process of cavern building with multi-interlayer in china, it show that: taking Chinese geological conditions for example, the disasters during cavern construction in salt beds with multi-interlayer caused the failure of cavity can be divided into three categories: geological conditions in beds; the damage of cavity wall in the process of cavity building; the distortion of cavity shape expansion. To analyze predisposing factors lead to salt cavern storage failure in detail, the mechanism of the corresponding factors lead to disaster has been summarized. Finally , some suggestions has been proposed to avoid the disaster maybe happened.

  16. Antioxidative mechanism of Lycium barbarum polysaccharides promotes repair and regeneration following cavernous nerve injury

    Institute of Scientific and Technical Information of China (English)

    Zhan-kui Zhao; Hong-lian Yu; Bo Liu; Hui Wang; Qiong Luo; Xie-gang Ding

    2016-01-01

    Polysaccharides extracted from Lycium barbarum exhibit antioxidant properties. We hypothesized that these polysaccharides resist oxida-tive stress-induced neuronal damage following cavernous nerve injury. In this study, rat models were intragastrically administered Lycium barbarum polysaccharides for 2 weeks at 1, 7, and 14 days after cavernous nerve injury. Serum superoxide dismutase and glutathione peroxidase activities signiifcantly increased at 1 and 2 weeks post-injury. Serum malondialdehyde levels decreased at 2 and 4 weeks. At 12 weeks, peak intracavernous pressure, the number of myelinated axons and nicotinamide adenine dinucleotide phosphate-diaphorase-pos-itive nerve ifbers, levels of phospho-endothelial nitric oxide synthase protein and 3-nitrotyrosine were higher in rats administered at 1 day post-injury compared with rats administered at 7 and 14 days post-injury. These ifndings suggest that application of Lycium barbarum polysaccharides following cavernous nerve crush injury effectively promotes nerve regeneration and erectile functional recovery. This neu-roregenerative effect was most effective in rats orally administered Lycium barbarum polysaccharides at 1 day after cavernous nerve crush injury.

  17. Preliminary Technical and Legal Evaluation of Disposing of Nonhazardous Oil Field Waste into Salt Caverns

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, Robert C.; Caudle, Dan; Elcock, Deborah; Raivel, Mary; Veil, John; and Grunewald, Ben

    1999-01-21

    This report presents an initial evaluation of the suitability, feasibility, and legality of using salt caverns for disposal of nonhazardous oil field wastes. Given the preliminary and general nature of this report, we recognize that some of our findings and conclusions maybe speculative and subject to change upon further research on this topic.

  18. Assembly of the gantry crane for lowering CMS into the cavern

    CERN Multimedia

    2006-01-01

    The gantry crane (dark red in the image) that will be used for lowering the enormous pieces of CMS into its cavern, 100m underground, is being assembled. Recently the horizontal cross-beam was delivered and installed, and can be seen on top of the SX5 construction hall at Cessy, France.

  19. Endoscopic approaches to brainstem cavernous malformations: Case series and review of the literature

    Directory of Open Access Journals (Sweden)

    Nikhil R Nayak

    2015-01-01

    Conclusion: The endoscope is a promising adjunct to the neurosurgeon′s ability to approach difficult to access brainstem cavernous malformations. It allows the surgeon to achieve well-illuminated, panoramic views, and by combining approaches, can provide minimally invasive access to most regions of the brainstem.

  20. Pontine glioma extending to the ipsilateral cavernous sinus and Meckel's cave: MR appearance.

    Science.gov (United States)

    Yuh, W T; Nguyen, H D; Mayr, N A; Follett, K A

    1992-01-01

    The authors describe an exophytic glioma of the pons that grew into the Meckel's cave and cavernous sinus in a 75-year-old man. Pontine gliomas should be included in the differential diagnosis of a hyperintense, complex cystic mass seen along the distribution of cranial nerve V.

  1. Large cavernous hemangioma of the adrenal gland: Laparoscopic treatment. Report of a case

    Directory of Open Access Journals (Sweden)

    A. Agrusa

    2015-01-01

    Conclusion: Laparoscopic adrenalectomy is considered the standard treatment in case of diagnosis of benign lesions. In this case report we discussed a large adrenal cavernous hemangioma treated with laparoscopic approach. Fundamental is the study of preoperative endocrine disorders and radiologic findings to exclude signs of malignancy.

  2. Spall formation in solution mined storage caverns based on a creep and fracture analysis

    Energy Technology Data Exchange (ETDEWEB)

    MUNSON,DARRELL E.

    2000-02-02

    Because of limited direct observation, understanding of the interior conditions of the massive storage caverns constructed in Gulf Coast salt domes is realizable only through predictions of salt response. Determination of the potential for formation of salt spans, leading to eventual salt falls, is based on salt creep and fracture using the Multimechanism-Deformation Coupled Fracture (MCDF) model. This is a continuum model for creep, coupled to continuum damage evolution. The model has been successfully tested against underground results of damage around several test rooms at the Waste Isolation Pilot Plant (WIPP). Model simulations, here, evaluate observations made in the Strategic Petroleum Reserve (SPR) storage caverns, namely, the accumulation of material on cavern floors and evidence of salt falls. A simulation of a smooth cavern wall indicates damage is maximum at the surface but diminishes monotonically into the salt, which suggests the source of salt accumulation is surface sluffing. If a protuberance occurs on the wall, fracture damage can form beneath the protuberance, which will eventually cause fracture, and lead to a salt fall.

  3. Wegener's granulomatosis with unusual cavernous sinus and sella turcica extension

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, M.; Bobek-Billewicz, B. [Dept. of Radiology, Medical University of Gdansk (Poland); Bullo, B.; Hermann, A.; Rutkowski, B. [Dept. of Nephrology, Medical University of Gdansk (Poland)

    1999-07-01

    Intracerebral extension of Wegener's granulomatosis (WG) is rare. We present a patient with oculomotor and trochlear nerve palsy with histologically proved WG. An MR examination revealed granulomatous tissue in nasal cavity, paranasal sinuses with meningeal infiltration, and uncommon penetration into cavernous sinus and sella turcica. The MR images before and during pharmacological therapy are presented. (orig.)

  4. Progress on CMS detector lowering: the YE+2 section arriving in the cavern

    CERN Multimedia

    2006-01-01

    On 12 December, a further section of the detector (YE+2) containing the cathode strip chamber made the 10-hour journey underground. This piece is 16 m high and weighs 880 tonnes. There are now four sections of the detector in the experimental cavern, with a further 11 to follow.

  5. 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 ...

  6. Employees with Cerebral Palsy

    Science.gov (United States)

    ... problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture (United Cerebral Palsy, 2010). "Cerebral" refers to the ...

  7. 11 June 2013- Autrian Federal President Dr Heinz Fischer and Federal Minister Prof. Dr Karlheinz Töchterle visit CMS cavern and LHC tunnel at Point 5 and the ASACUSA and AEGIS experiments on the AD. Signature of the guest book in the Globe of Science and Innovation after a round table with 10 young austrian scientists. Family photograph in front of an LHC magnet.

    CERN Multimedia

    TEAM VMO

    2013-01-01

    Welcome line: on French territory by the Representative of the French Republic S. Donnot, Sous-Préfet de Gex; CERN Director-General R. Heuer; Director for Research and Scientific Computing S. Bertolucci; Director for Accelerators and Technology S. Myers; Director for Administration and general Infrastructure S. Lettow; Head of Technology Department F. Bordry; CERN Austrian Circle Spokesperson F. Eder and CERN Protocol S. Molinari. First Lady and Federal Minister Töchterle follow. CERN-HI-1306154 19-32: in CMS conference room, building 3562: general presentation of the Laboratory by the DG; CERN-HI-1306154 33-43: visiting the LHC tunnel at Point 5 with Head of Technology Department F. Bordry CERN-HI-1306154 44-64: in the CMS cavern with Collaboration Spokesperson J. Incandela and CMS and Austrian Academy of Sciences C. Wulz; CERN-HI-1306154 65-90: ASACUSA with E. Widmann and AEGIS with M. Doser. CERN-HI-1306154 91-115: round table, signatures and exchange of gifts in the Globe of Science and Innovation; fa...

  8. Mutation in the α2 isoform of Na,K-ATPase associated Familial Hemiplegic Migraine type 2 (FHM2) leads to elevated contractility and vasodilatation of cerebral arteries in mice

    DEFF Research Database (Denmark)

    Hangaard, Lise; Lykke-Hartmann, Karin; Xie, Zijian;

    is associated with few point mutations in the α2 isoform Na,K-ATPase. Mice bearing a mutation corresponding to the inherited mutation in FHM2 patients (G301R) were used in functional studies of middle cerebral arteries. Middle cerebral arteries from heterozygote G301R mice were not different in total α2 Na...

  9. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up

    Science.gov (United States)

    Briganti, F.; Tortora, F.; Marseglia, M.; Napoli, M.; Cirillo, L.

    2009-01-01

    Summary Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years. PMID:20465897

  10. Cerebral Palsy (For Kids)

    Science.gov (United States)

    ... CPR: A Real Lifesaver Kids Talk About: Coaches Cerebral Palsy KidsHealth > For Kids > Cerebral Palsy Print A A A What's in this article? ... the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step ...

  11. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  12. Neurturin enhances the recovery of erectile function following bilateral cavernous nerve crush injury in the rat

    Directory of Open Access Journals (Sweden)

    Klein Robert D

    2007-03-01

    Full Text Available Abstract Background The molecular mechanisms responsible for the survival and preservation of function for adult parasympathetic ganglion neurons following injury remain incompletely understood. However, advances in the neurobiology of growth factors, neural development, and prevention of cell death have led to a surge of clinical interest for protective and regenerative neuromodulatory strategies, as surgical therapies for prostate, bladder, and colorectal cancers often result in neuronal axotomy and debilitating loss of sexual function or continence. In vitro studies have identified neurturin, a glial cell line-derived neurotrophic factor, as a neuromodulator for pelvic cholinergic neurons. We present the first in vivo report of the effects of neurturin upon the recovery of erectile function following bilateral cavernous nerve crush injury in the rat. Methods In these experiments, groups (n = 8 each consisted of uninjured controls and animals treated with injection of albumin (blinded crush control group, extended release neurotrophin-4 or neurturin to the site of cavernous nerve crush injury (100 μg per animal. After 5 weeks, recovery of erectile function (treatment effect was assessed by cavernous nerve electrostimulation and peak aortic pressures were measured. Investigators were unblinded to specific treatments after statistical analyses were completed. Results Erectile dysfunction was not observed in the sham group (mean maximal intracavernous pressure [ICP] increase of 117.5 ± 7.3 cmH2O, whereas nerve injury and albumin treatment (control produced a significant reduction in ICP elevation of 40.0 ± 6.3 cmH2O. Neurturin facilitated the preservation of erectile function, with an ICP increase of 55% at 62.0 ± 9.2 cmH2O (p Conclusion Treatment with neurturin at the site of cavernous nerve crush injury facilitates recovery of erectile function. Results support further investigation of neurturin as a neuroprotective and/or neuroregenerative

  13. Adrenal Cavernous Hemangioma: A Case Report with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Joseph J. Noh

    2014-05-01

    Full Text Available Context Adrenal cavernous hemangioma is a rare type of tumor that is usually diagnosed post-operatively. There have only been approximately 63 cases reported in the literature to date. Case report We report a case of adrenal cavernous hemangioma in a 27-year-old pregnant woman. The mass was discovered on ultrasonography when she visited a gastroenterologist for vague epigastric discomfort and vomiting. The laboratory tests were within normal limits and did not show any features suggestive of adrenal endocrinologic dysfunction. Computed Tomography (CT revealed a well-defined 7.8 × 7.8 oval mass in the right adrenal gland with speckled calcifications. The mass was removed by transabdominal laparoscopic surgery. Strong positive immunostaining for CD31 and CD34 with weakly positive staining for podoplanin/D2-40 confirmed the diagnosis of cavernous hemangioma. Conclusions We reviewed 52 case reports of adrenal cavernous hemangioma in an attempt to identify tumor characteristics. More than half of the patients reviewed showed a heterogeneous internal structure of the mass with peripheral patchy enhancement on CT. They also showed focal or speckled calcifications either on X-ray or CT. Nevertheless, many of these characteristics overlap with the imaging phenotypes of other common diseases of the adrenal gland and therefore do not seem to provide definite evidence for differential diagnosis. Laparoscopic approach is a feasible and safe modality to remove adrenal cavernous hemangiomas because they seem to form a rigid fibrotic capsule; hence the risk of bleeding due to surgical manipulation is relatively low.

  14. Cerebrovascular accident in the aged: changes in family relations El anciano tras accidente cerebrovascular: alteraciones en el relacionamento familiar O idoso após acidente vascular cerebral: alterações no relacionamento familiar

    Directory of Open Access Journals (Sweden)

    Sueli Marques

    2006-06-01

    Full Text Available The aims of this study were: to identify aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirão Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, totaling 34 participants. The analysis of the consequences displayed the changes in family relations, which made up 13 subcategories, 5 of which were positive and 8 negative, totaling 58 alterations, 30 of which were positive and 28 negative. The study revealed the need to work with the family in order to identify changes and develop an action plan to favor the family's relations and adaptation to the demands, with a view to improving the living conditions of its members, including the aged person.Las finalidades de este estudio fueron las de identificar a los ancianos con diagnóstico médico de Accidente Cerebrovascular, atendidos en la Unidad de Emergencia de un Hospital Gubernamental de Ribeirão Preto-SP, Brasil, y a sus respectivas familias y también identificar las alteraciones en el relacionamiento familiar, que ocurrieron tras el evento. Fue utilizada la Técnica de Incidentes Críticos adaptada para identificar las alteraciones en el relacionamiento familiar ocurridas tras la enfermedad. Para el análisis, fue adoptada la reflexión del Camino del Pensamiento. La muestra fue compuesta por 11 familias, totalizando 34 participantes. El análisis de las consecuencias reveló las alteraciones en el relacionamiento familiar, que constituyeron 13 subcategorías, 5 positivas y 8 negativas, con un total de 58 alteraciones, siendo 30 positivas y 28 negativas. El estudio reveló la necesidad de trabajar con la familia para identificar las alteraciones y

  15. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ghanem

    2014-01-01

    Conclusions: Milrinone improved significantly the global cerebral oxygenation and reduced the incidence of cerebral vasospasm during the dangerous period of cerebral spasm after cerebral aneurysm clipping.

  16. 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.)

  17. Western Portion IKONOS and Landsat ETM Merge Satellite Imagery for Carlsbad Caverns National Park Vegetation Mapping Project

    Data.gov (United States)

    National Park Service, Department of the Interior — IKONOS and Landsat ETM+ image merge for Carlsbad Caverns National Park, New Mexico. The image has a spatial resolution of 12 meters and is comprised of 11 layers....

  18. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

    Directory of Open Access Journals (Sweden)

    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

  19. Small bowel autotransplantation combined with pancreato-duodenectomy for enormous cavernous hemangioma of the small intestine mesentery

    Institute of Scientific and Technical Information of China (English)

    ZENG Yong; WU Hong; YANG Jia-yin

    2008-01-01

    @@ Recent advances in transplantation techniques have allowed pancreatoduodenectomy, distal gastrectomy, hemicolectomy and small bowel autotransplantation to be the therapy of choice for enormous cavernous hemangioma of the small intestine mesentery. There have been a few case reports about small bowel autotransplantation combined with pancreatoduodenectomy for enormous mesenteric cavernous hemangioma of small intestine.1-4 The present surgical methods for enormous cavernous hemangioma of the small intestine mesentery mainly included tumor excision and/or small bowel resection. However, these therapies are not effective for those patients in whom the angiocavernoma has infiltrated the mesenteric artery or pancreas, and these patients often give up therapy. It is recognized that enormous cavernous hemangioma of the small intestine mesentery is a benign lesion, and patients may have an excellent prognosis after complete resection of the lesion.

  20. Failure Analysis of Overhanging Blocks in the Walls of a Gas Storage Salt Cavern: A Case Study

    Science.gov (United States)

    Wang, Tongtao; Yang, Chunhe; Li, Jianjun; Li, Jinlong; Shi, Xilin; Ma, Hongling

    2017-01-01

    Most of the rock salt of China is bedded, in which non-salt layers and rock salt layers alternate. Due to the poor solubility of the non-salt layers, many blocks overhang on the walls of the caverns used for gas storage, constructed by water leaching. These overhanging blocks may collapse at any time, which may damage the tubing and casing string, and even cause instability of the cavern. They are one of the main factors threatening the safety of caverns excavated in bedded rock salt formations. In this paper, a geomechanical model of the JJKK-D salt cavern, located in Jintan salt district, Jintan city, Jiangsu province, China, is established to evaluate the stability of the overhanging blocks on its walls. The characters of the target formation, property parameters of the rock mass, and actual working conditions are considered in the geomechanical model. An index system composed of stress, displacement, plastic zone, safety factor, and equivalent strain is used to predict the collapse length of the overhanging blocks, the moment the collapse will take place, and the main factors causing the collapse. The sonar survey data of the JJKK-D salt cavern are used to verify the reliability and accuracy of the proposed geomechanical model. The results show that the proposed geomechanical model has a good reliability and accuracy, and can be used for the collapse prediction of the overhanging blocks on the wall of the JJKK-D salt cavern. The collapse length of the overhanging block is about 8 m. We conclude that the collapse takes place during the debrining. The reason behind the collapse is the sudden decrease of the fluid density, leading to the increase of the self-weight of the overhanging blocks. This study provides a basis for the collapse prediction method of the overhanging blocks of Jintan salt cavern gas storage, and can also serve as a reference for salt cavern gas storage with similar conditions to deal with overhanging blocks.

  1. Commercial potential of natural gas storage in lined rock caverns (LRC)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-11-01

    The geologic conditions in many regions of the United States will not permit the development of economical high-deliverability gas storage in salt caverns. These regions include the entire Eastern Seaboard; several northern states, notably Minnesota and Wisconsin; many of the Rocky Mountain States; and most of the Pacific Northwest. In late 1997, the United States Department of Energy (USDOE) Federal Energy Technology Center engaged Sofregaz US to investigate the commercialization potential of natural gas storage in Lined Rock Caverns (LRC). Sofregaz US teamed with Gaz de France and Sydkraft, who had formed a consortium, called LRC, to perform the study for the USDOE. Underground storage of natural gas is generally achieved in depleted oil and gas fields, aquifers, and solution-mined salt caverns. These storage technologies require specific geologic conditions. Unlined rock caverns have been used for decades to store hydrocarbons - mostly liquids such as crude oil, butane, and propane. The maximum operating pressure in unlined rock caverns is limited, since the host rock is never entirely impervious. The LRC technology allows a significant increase in the maximum operating pressure over the unlined storage cavern concept, since the gas in storage is completely contained with an impervious liner. The LRC technology has been under development in Sweden by Sydkraft since 1987. The development process has included extensive technical studies, laboratory testing, field tests, and most recently includes a storage facility being constructed in southern Sweden (Skallen). The LRC development effort has shown that the concept is technically and economically viable. The Skallen storage facility will have a rock cover of 115 meters (375 feet), a storage volume of 40,000 cubic meters (250,000 petroleum barrels), and a maximum operating pressure of 20 MPa (2,900 psi). There is a potential for commercialization of the LRC technology in the United States. Two regions were studied

  2. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 2, Big Hill Site, Texas.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-08-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 2 focuses on the Big Hill SPR site, located in southeastern Texas. Volumes 1, 3, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  3. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 3, Bryan Mound Site, Texas.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-09-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 3 focuses on the Bryan Mound SPR site, located in southeastern Texas. Volumes 1, 2, and 4, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  4. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 4, West Hackberry site, Louisiana.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-09-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 4 focuses on the West Hackberry SPR site, located in southwestern Louisiana. Volumes 1, 2, and 3, respectively, present images for the Bayou Choctaw SPR site, Louisiana, the Big Hill SPR site, Texas, and the Bryan Mound SPR site, Texas. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  5. Sonar atlas of caverns comprising the U.S. Strategic Petroleum Reserve. Volume 1, Bayou Choctaw site, Louisiana.

    Energy Technology Data Exchange (ETDEWEB)

    Rautman, Christopher Arthur; Lord, Anna Snider

    2007-10-01

    Downhole sonar surveys from the four active U.S. Strategic Petroleum Reserve sites have been modeled and used to generate a four-volume sonar atlas, showing the three-dimensional geometry of each cavern. This volume 1 focuses on the Bayou Choctaw SPR site, located in southern Louisiana. Volumes 2, 3, and 4, respectively, present images for the Big Hill SPR site, Texas, the Bryan Mound SPR site, Texas, and the West Hackberry SPR site, Louisiana. The atlas uses a consistent presentation format throughout. The basic geometric measurements provided by the down-cavern surveys have also been used to generate a number of geometric attributes, the values of which have been mapped onto the geometric form of each cavern using a color-shading scheme. The intent of the various geometrical attributes is to highlight deviations of the cavern shape from the idealized cylindrical form of a carefully leached underground storage cavern in salt. The atlas format does not allow interpretation of such geometric deviations and anomalies. However, significant geometric anomalies, not directly related to the leaching history of the cavern, may provide insight into the internal structure of the relevant salt dome.

  6. Radiation-induced intracerebral cavernous angiomas in children with malignant brain tumors. A report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Sugiyama, Tatsuya; Matsutani, Masao; Ogura, Hiroaki; Yoshizawa, Hidehiko; Nishikawa, Ryo [Saitama Medical School, Moroyama (Japan)

    2002-06-01

    Cavernous angiomas forming in the brain after radiation therapy for pediatric brain tumors have recently attracted special interest as a late complication of radiation therapy. We report here on two children with malignant brain tumors who developed intracerebral cavernous angiomas 4 to 5 years after radiation therapy. A 14-year-old girl with a primitive neuroectodermal tumor developed a cavernous angioma in the hypothalamus after being irradiated with 55 Gy 4 years ago. The second case, 13-year-old boy with a pineal mixed germ cell tumor showed a cavernous angioma at the thalamus 5 years after receiving radiation therapy with a dose of 60 Gy. Both patients did not show any abnormal symptoms and the cavernous angiomas diagnoses were made with MRI findings. A review of 20 reported cases of radiation-induced cavernous angiomas in the brain revealed some characteristic findings. Eighteen of the 20 cases were children, fourteen cases developed hemorrhage, the radiation dose administered was distributed between 18-60 Gy (median dose of 43.5 Gy), and the median latent period was 7.5 years (range: 2-21 years). As a differential diagnosis for the recurrent tumor is guite difficult in most cases, it is necessary to observe patients who developed angioma-like lesions in the irradiated area carefully. (author)

  7. Phase II Study to Assess the Efficacy of Hypofractionated Stereotactic Radiotherapy in Patients With Large Cavernous Sinus Hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Wang Xin; Liu Xiaoxia; Mei Guanghai; Dai Jiazhong; Pan Li [Departments of Neurosurgery and CyberKnife, Huashan Hospital, Fudan University, Shanghai (China); Wang Enmin, E-mail: wangem@fudan.edu.cn [Departments of Neurosurgery and CyberKnife, Huashan Hospital, Fudan University, Shanghai (China)

    2012-06-01

    Purpose: Cavernous sinus hemangioma is a rare vascular tumor. The direct microsurgical approach usually results in massive hemorrhage. Although radiosurgery plays an important role in managing cavernous sinus hemangiomas as a treatment alternative to microsurgery, the potential for increased toxicity with single-session treatment of large tumors is a concern. The purpose of this study was to assess the efficacy of hypofractionated stereotactic radiotherapy in patients with large cavernous sinus hemangiomas. Methods: Fourteen patients with large (volume >20 cm{sup 3}) cavernous sinus hemangiomas were enrolled in a prospective Phase II study between December 2007 and December 2010. The hypofractionated stereotactic radiotherapy dose was 21 Gy delivered in 3 fractions. Results: After a mean follow-up of 15 months (range, 6-36 months), the magnetic resonance images showed a mean of 77% tumor volume reduction (range, 44-99%). Among the 6 patients with cranial nerve impairments before hypofractionated stereotactic radiotherapy, 1 achieved symptomatic complete resolution and 5 had improvement. No radiotherapy-related complications were observed during follow-up. Conclusion: Our current experience, though preliminary, substantiates the role of hypofractionated stereotactic radiotherapy for large cavernous sinus hemangiomas. Although a longer and more extensive follow-up is needed, hypofractionated stereotactic radiotherapy of 21 Gy delivered in 3 fractions is effective in reducing the tumor volume without causing any new deficits and can be considered as a treatment modality for large cavernous sinus hemangiomas.

  8. 27 Febuary 2012 - US DoE Associate Director of Science for High Energy Physics J. Siegrist visiting the LHC superconducting magnet test hall with adviser J.-P. Koutchouk and engineer M. Bajko; in CMS experimental cavern with Spokesperson J. Incadela;in ATLAS experimental cavern with Deputy Spokesperson A. Lankford; in ALICE experimental cavern with Spokesperson P. Giubellino; signing the guest book with Director for Accelerators and Technology S. Myers.

    CERN Multimedia

    Laurent Egli

    2012-01-01

    27 Febuary 2012 - US DoE Associate Director of Science for High Energy Physics J. Siegrist visiting the LHC superconducting magnet test hall with adviser J.-P. Koutchouk and engineer M. Bajko; in CMS experimental cavern with Spokesperson J. Incadela;in ATLAS experimental cavern with Deputy Spokesperson A. Lankford; in ALICE experimental cavern with Spokesperson P. Giubellino; signing the guest book with Director for Accelerators and Technology S. Myers.

  9. Strategic Petroleum Reserve (SPR) oil storage cavern sulphur mines 2-4-5 certification tests and analysis. Part I: 1981 testing. Part II: 1982 testing

    Energy Technology Data Exchange (ETDEWEB)

    Beasley, R.R.

    1982-12-01

    Well leak tests and a cavern pressure were conducted in June through December 1981, and are described in Part I. The tests did not indicate conclusively that there was no leakage from the cavern, but the data indicate that cavern structural failure during oil storage is unlikely. The test results indicated that retesting and well workover were desirable prior to making a decision on the cavern use. Well leak tests were conducted in March through May 1982, and are described in Part II. The tests indicated that there was no significant leakage from wells 2 and 4 but that the leakage from wells 2A and 5 exceeded the DOE criterion. Because of the proximity of cavern 2-4-5 to the edge of the salt, this cavern should be considered for only one fill/withdrawal cycle prior to extensive reevaluation. 57 figures, 17 tables.

  10. A problemática do cuidador familiar do portador de acidente vascular cerebral La problemática del cuidador familiar con el portador de accidente cerebral vascular The problematic aspects of the family caregiver of people who suffered strokes

    Directory of Open Access Journals (Sweden)

    Luciene Miranda de Andrade

    2009-03-01

    Full Text Available Objetivou-se identificar a problemática da família de pessoas acometidas de acidente vascular cerebral hospitalizadas e discutir as dificuldades do cuidador familiar para o cuidado no âmbito domiciliar. A amostra constou de 154 famílias de pacientes internados em um hospital da rede pública de saúde, Fortaleza-CE. Conforme os resultados denotam, a maioria dos cuidadores são mulheres, 104 (67,5%; 122 casos (79,2% apresentam comprometimento familiar e alterações na vida diária em 115 dos acompanhantes (74,7%; 150 (97,4% não receberam orientações acerca dos cuidados, mas 143 (92,9% sentem-se seguros para acompanhá-los. O sentimento predominante foi a tristeza, 125 (81,2%, e as dúvidas principais foram: alimentação, 64 (41,6%, administração de medicamentos, 49 (29,9%, e possíveis complicações clínicas após a alta, 49 (29,9%. Estes resultados alertam para o papel do enfermeiro como educador, não somente na prevenção das doenças crônico-degenerativas, mas, também, na orientação aos cuidadores familiares sobre os cuidados dispensados após a alta hospitalar.El objetivo fue identificar la problemática de la familia de personas acometidas de accidente vascular cerebral hospitalizadas y discutir las dificultades del cuidador familiar en el ámbito domiciliar. La muestra fue constituida por 154 familias de pacientes internados en un hospital de la red pública de salud, en Fortaleza, CE. Conforme los resultados denotan, la mayoría de los cuidadores son mujeres, 104 (67,5%, 122 casos (79,2% presentan comprometimiento familiar y alteraciones en la vida diaria en 115 de los acompañantes (74,7%; 150 (97,4% no recibieron orientaciones acerca de los cuidados; sin embargo 143 (92,9% se sienten seguros para acompañarlos. El sentimiento predominante fue la tristeza, 125 (81,2%, y las dudas principales fueron: alimentación, 64 (41,6%, administración de medicamentos, 49 (29,9%, y posibles complicaciones clínicas después del

  11. Feeding difficulties in children with cerebral palsy.

    Science.gov (United States)

    Andrew, Morag J; Parr, Jeremy R; Sullivan, Peter B

    2012-12-01

    Feeding difficulties are common in children with cerebral palsy and have an effect on growth, nutritional state, general health, social interaction and behaviour and developmental outcomes. Many factors have an effect on feeding ability. Identification of these factors and amelioration of their impact on feeding difficulties is essential to promote adequate growth and nutrition. Appropriate assessment and management is best achieved by a multiprofessional team skilled in the care of children with cerebral palsy and feeding impairments. Feeding difficulties must be considered within the wider context of family and social circumstance.

  12. Design and construction of the tensioned ties for UX15 cavern vault

    CERN Document Server

    Parkin, R J H

    2002-01-01

    Due to the programme constraints for the UX15 cavern set by CERN, it has been necessary to complete the concrete lining of the vault prior to the excavation of the bench. The vault lining is therefore being temporarily suspended from a number of pre-tensioned high capacity multi-strand tensioned ties. During excavation of the bench, additional loads will be imposed onto the vault lining due to ground displacements. In order to minimise the number of ties, the previously completed linings of the PX14 and PX16 access shafts will be used to support some of the load. Three-dimensional modelling has been undertaken to design the structures and determine the expected behaviour of this complex support system. Geotechnical instrumentation has been installed in the concrete linings and the ground to monitor loads and displacements during construction. After the cavern walls have been completed, the ties will be released.

  13. Conus medullaris hematomyelia associated with an intradural-extramedullary cavernous angioma.

    Science.gov (United States)

    Mastronardi, L; Frondizi, D; Guiducci, A; Nardi, M; Maira, G

    1999-01-01

    A unique case of a 50-year-old woman with a conus medullaris hematomyelia associated with a low thoracic intradural-extramedullary cavernous angioma localized 2 cm above is reported. The patient had a 2-month history of progressive paraparesis, hypoesthesia of legs, and bowel and bladder disturbances. The symptoms worsened acutely during the last days before admission. A thoraco-lumbar MRI showed a space-occupying lesion at T10-T11 (vertebral interspace associated with a hematomyelia localized about 2 cm below. A T10-L1 laminectomy was performed and complete removal of both lesions was obtained with microsurgical technique. A non-traumatic hematomyelia should always prompt the suspicion of a spinal AVM or, more rarely, of a cavernous angioma. The possible anatomical and clinical correlations of this unusual association are discussed.

  14. Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-hai; YANG Xin-jian; WU Zhong-xue; LI You-xiang; JIANG Peng

    2012-01-01

    This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus,which appeared following closed head trauma.A 39-year-old man suffered from a blunt head trauma in an automobile accident.Two weeks after the trauma,progressive chemosis of left eye was presented.Four months after the trauma,digital subtraction angiography showed an internal carotid artery bifurcation aneurysm,with drainage into the cavernous sinus.The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx.Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery.Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.

  15. Cavernous hemangioma of adult pancreas: A case report and literature review

    Science.gov (United States)

    Mondal, Utpal; Henkes, Nichole; Henkes, David; Rosenkranz, Laura

    2015-01-01

    Pancreatic hemangioma is a rare type of benign vascular tumor. Low clinical suspicion and inability of current cross sectional imaging techniques to differentiate it from other pancreatic lesions, contribute to the difficulty in making the correct diagnosis. Without a definitive diagnosis, and due to concern for malignancy, in many instances, surgery is performed. We report a case of pancreas cavernous hemangioma in an 18-year-old female. The patient presented with three-month history of epigastric pain. Physical examination and routine blood tests were normal. Abdominal Computed Tomography scan revealed a 5 cm × 6 cm complex non-enhancing cystic mass in the head of pancreas. Magnetic resonance imaging, endoscopic ultrasonography (EUS) and EUS guided fine needle aspiration cytology were non-diagnostic. Because of uncontrolled symptoms, the patient underwent surgical resection. Histopathology and Immunohistochemical staining confirmed the diagnosis of cavernous hemangioma of pancreas. PMID:26361427

  16. Successful resection of the recurrence of a cavernous malformation of the optic chiasm

    Directory of Open Access Journals (Sweden)

    Martin Scholz

    2008-11-01

    Full Text Available Martin Scholz, Albrecht Harders, Sebastian Lücke, Ioannis Pechlivanis, Martin Engelhardt, Kirsten SchmiederDepartment of Neurosurgery, Ruhr-University Bochum, Knappschaftskrankenhaus, GermanyAbstract: The case of a 33-year-old female who suffered from a recurrence of an intrachiasmatic cavernous malformation is presented. She had already undergone surgery in 1991 and 2001 and was admitted to our hospital with reduced vision in the right eye. After MRI, and diagnosis of recurrence of the cavernoma, a neurosurgical operation was performed using the pterional approach. The intraoperative situation was documented with micro photographs. The postoperative course was uneventful. The female described a minimal improvement of her vision. No postoperative complications were observed. To our knowledge, microsurgically complete extirpation of a recurrence of an intrachiasmatic cavernoma has not yet been reported in the literature.Keywords: optic chiasm, pterional approach, cavernous malformation

  17. Magnetic resonance imaging of spinal intramedullary cavernous angioma and its surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Isu, Toyohiko; Fujimoto, Makoto; Asaoka, Katsuyuki; Mabuchi, Shoji; Okumura, Hitoshi; Tsusaka, Tomofumi; Honma, Sanae; Ogata, Akihiko; Nanbu, Toshikazu (Kushiro Rousai Hospital, Hokkaido (Japan))

    1993-12-01

    Findings of magnetic resonance (MR) imaging were examined in 5 patients (2 men and 3 women) with spinal intramedullary cavernous angioma. They ranged in age from 30 to 59 years. The area surrounding isointense area was hypointense on both T1- and T2-weighted images, showing an old hematoma. The isointense area was enhanced by Gd-DTPA, which was surgically proven to be an angioma itself. Surgical outcome was favorable in 4 patients, in whom preoperative neurologic symptoms were mild and an angioma was extirpated, and unfavorable in the other one, who was diagnosed 15 years after the onset and was serious before operation. Identifying s hematoma associated with angioma from an angioma itself is important in MRI diagnosis of spinal intramedullary cavernous angioma. Early diagnosis and treatment may contribute to favorable surgical outcome. (N.K.).

  18. Cavernous angioma in the cisterna magna; Angioma cavernoso na cisterna magna

    Energy Technology Data Exchange (ETDEWEB)

    Settani, Flavio A.P. [Sao Paulo Univ., SP (Brazil); Fontoura, Emilio A.F.; Hweringer, Lindolfo Carlos; Cardoso, Arquimedes Cavalcanti [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil)

    2000-08-01

    We report a rare case of cavernous angioma in the cisterna magna. The diagnosis of this uncommon condition appears to be difficult to establish only upon clinical and radiological findings. In spite of the recent advances in neuroimaging, this type of angiomas is still diagnosed through surgery and histopathological examination. This 21-year-old patient was submitted to a suboccipital craniotomy which disclosed a vascular lesion which was totally removed. (author)

  19. First DT+RPC chambers installation round in the UX5 cavern

    CERN Multimedia

    Jesus Puerta-Pelayo

    2007-01-01

    DT+RPC packages corresponding to sectors 1 and 7 of the barrel region cannot be installed on surface, since the lowering gantry from SX5 to UX5 uses their gaps to hold the wheels. Therefore this installation has to be carried out in the cavern. These pictures illustrate the first installation round on YB+2 right after the lowering. A total of 8 chambers were successfully installed in 2 days.

  20. A cavernous haemangioma of breast in male: radiological-pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Carreira, C.; Romero, C.; Urbasos, M.; Pinto, J. [Servicio de Radiologia, Hospital ' ' Virgen de la Salud' ' , Toledo (Spain); Rodriguez, R.; Francisco, J.M. de [Servicio de Anatomia Patologica, Hospital ' ' Virgen de la Salud' ' , Toledo (Spain)

    2001-02-01

    Vascular tumours of the breast are especially rare in men, and a majority of them are angiosarcomas. In fact, we found only four cases of haemangioma in males in the literature. We present a case of cavernous haemangioma in a male aged 48 years, and which commenced as a palpable mass. We performed differential diagnosis and radiological-pathological correlation. We established the correct classification of this case histologically, and decided on the definitive therapeutic approach. (orig.)

  1. When nearing the ATLAS cavern UX15 through RB16: the TX1S shielding

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    Photo 01: 52 tons of ATLAS TX1S shielding with bare hands. Photos 02,03,04: Installation of the second TX1S shielding tube at Point Photos 05,06: Positioning of TX1S shielding, the first ATLAS/LHC interface component to be installed underground. Photo 07: Final adjustment of the TX1S shielding tube at the interface between the LHC tunnel and the ATLAS cavern (UX15).

  2. Cavernous hemangioma arising from the gastro-splenic ligament: A case report

    Institute of Scientific and Technical Information of China (English)

    Kin-Fah Chin; Ghaith Khair; Palani Sathish Babu; David Russell Morgan

    2009-01-01

    We present a rare case of a 45-year-old woman who presented with epigastric pain associated with early satiety and weight loss. Imaging revealed a large intraabdominal mass in the epigastrium. Despite intensive investigations, including ultrasound scanning, computed tomography, upper gastrointestinal endoscopy, and percutaneous biopsy, a diagnosis could not be obtained.A histological diagnosis of cavernous hemangioma arising from the gastro-splenic ligament was confirmed after laparoscopic excision and histological examination of the intra-abdominal epigastric mass.

  3. Imaging findings of cavernous hemangioma arising from the transverse colon: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ki Hwan; Kim, Ho Kyun; Lee, Hye Kyung; Shim, Jae Chan; Lee, Ghi Jai; Lee, Kyoung Eun; Suh, Jung Ho [Seoul Paik Hospital, Inje University College of Medicine, Seoul, (Korea, Republic of)

    2013-12-15

    Diffuse cavernous hemangioma (DCH) of the large bowel is a rare disease and usually involves the rectosigmoid colon. There have been only a few reports on the CT and MR imaging findings of DCH of the large bowel which are helpful in its correct diagnosis. We report herein an asymptomatic patient with DCH of the transverse colon and describe the CT and MRI features of the colon.

  4. Diffuse Cavernous Hemangioma of the Penis, Scrotum, Perineum, and Rectum - A rare tumor

    Directory of Open Access Journals (Sweden)

    Rastogi Rajul

    2008-01-01

    Full Text Available Hemangiomas are benign lesions that occur in any part of the body. Genital hemangioma involving the entire penis and scrotum are extremely rare. More rarely they can extend in to the pelvis making preoperative imaging imperative and decisive in treatment. Very few cases have been reported in the medical literature. Hereby, a rare cavernous hemangioma that involves the entire penis, scrotum and extends into perineum and rectum in an 18-year-old male is presented with review of literature.

  5. Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Seong Su Hwang; Hyun Joo Choi; Soo Youn Park

    2009-01-01

    Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangioma is extremely rare in adults. Typically, lymphangioma appears on computed tomography (CT) as a lower attenuation of a cystic mass, however, some cases appear to be a solid mass. We describe the CT and 18FFDG positron emission tomography/CT appearance in a case of jejunal and mesenteric cavernous lymphangiomatosis mimicking metastasis in an adult patient with rectal cancer.

  6. Relationship between cerebral sodium-glucose transporter and hyperglycemia in cerebral ischemia.

    Science.gov (United States)

    Yamazaki, Yui; Harada, Shinichi; Tokuyama, Shogo

    2015-09-14

    Post-ischemic hyperglycemia exacerbates the development of cerebral ischemia. To elucidate this exacerbation mechanism, we focused on sodium-glucose transporter (SGLT) as a mediator that lead hyperglycemia to cerebral ischemia. SGLT transport glucose into the cell, together with sodium ion, using the sodium concentration gradient. We have previously reported that suppression of cerebral SGLT ameliorates cerebral ischemic neuronal damage. However, detail relationship cerebral between SGLT and post-ischemic hyperglycemia remain incompletely defined. Therefore, we examined the involvement of cerebral SGLT on cerebral ischemic neuronal damage with or without hyperglycemic condition. Cell survival rate of primary cultured neurons was assessed by biochemical assay. A mouse model of focal ischemia was generated using a middle cerebral artery occlusion (MCAO). Neuronal damage was assessed with histological and behavioral analyses. Concomitant hydrogen peroxide/glucose treatment exacerbated hydrogen peroxide alone-induced cell death. Although a SGLT family-specific inhibitor, phlorizin had no effect on developed hydrogen peroxide alone-induced cell death, it suppressed cell death induced by concomitant hydrogen peroxide/glucose treatment. α-MG induced a concentration-dependent and significant decrease in neuronal survival. PHZ administered on immediately after reperfusion had no effect, but PHZ given at 6h after reperfusion had an effect. Our in vitro study indicates that SGLT is not involved in neuronal cell death in non-hyperglycemic condition. We have already reported that post-ischemic hyperglycemia begins to develop at 6h after MCAO. Therefore, current our in vivo study show post-ischemic hyperglycemic condition may be necessary for the SGLT-mediated exacerbation of cerebral ischemic neuronal damage.

  7. Traumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid-cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils. Case report.

    Science.gov (United States)

    Lee, Chang-Young; Yim, Man-Bin; Kim, Il-Man; Son, Eun-Ik; Kim, Dong-Won

    2004-01-01

    This report documents the treatment of a traumatic aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a carotid-cavernous fistula (CCF), which appeared following closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid hematoma after he had suffered a severe closed head injury in a motor vehicle accident. Cerebral angiography performed 11 days after the injury demonstrated a traumatic aneurysm and severe narrowing of the right supraclinoid ICA, which was consistent with a dissection-induced stenosis associated with a direct CCF. Both lesions were successfully obliterated with preservation of the parent artery by using stents in conjunction with coils. Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.

  8. Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Bink, Andrea; Berkefeld, Joachim; Zanella, Friedhelm; Mesnil de Rochemont, Richard du [Goethe University, Department of Neuroradiology, Frankfurt am Main (Germany); Luechtenberg, Marc [Goethe University, Department of Ophthalmology, Frankfurt/Main (Germany); Gerlach, Ruediger [Goethe University, Department of Neurosurgery, Frankfurt/Main (Germany); Neumann-Haefelin, Tobias [Goethe University, Department of Neurology, Frankfurt/Main (Germany)

    2009-06-15

    To determine technical success and acute complication rates after endovascular coil packing of the cavernous sinus. Nineteen patients presented with either direct (13) or dural (6) arteriovenous fistula (AVF) and were treated by means of coil embolization of the cavernous sinus. The aim of treatment was complete obliteration of the fistula. In a retrospective study, the degree of obliteration, regression of symptoms as well as complication rates were evaluated. Initial complete obliteration was achieved in 12 patients, subtotal occlusion of the sinus in 6 and incomplete packing with major residual fistula in 1 of the patients. Retreatment was successfully performed in two patients with early recurrence of AVF. Follow-up showed complete occlusion rates in 16 and subtotal obliteration in 3 patients. Chemosis and exophthalmus regressed rapidly in all affected patients. Persistence of cranial nerve deficits was observed in 11 cases. Postinterventional thrombosis of the ophthalmic vein was the only major acute complication (n = 2). Coil embolization of the cavernous sinus in cases with AVF is a complex procedure that is technically feasible and safe in the majority of cases. Adequate anticoagulation is recommended to avoid thrombembolic complications. Long-term outcome has to be determined by further studies. (orig.)

  9. [Management of orbital cavernous hemangioma - evaluation of surgical approaches: report of 43 cases].

    Science.gov (United States)

    Aymard, P-A; Langlois, B; Putterman, M; Jacomet, P-V; Morax, S; Galatoire, O

    2013-12-01

    Cavernous hemangioma is the most frequent benign orbital tumor in adults. The purpose of this study was to examine its clinical features, to define surgical indications, and to determine the roles of the various surgical approaches praticed in ophthalmology: transconjunctival (increasingly utilized), anterior transcutaneous, and lateral orbitotomy. The records of all patients treated for orbital cavernous hemangioma (OCH) since 2004 at the Fondation Rothschild (Paris, France) were retrospectively reviewed. Forty-three patients were treated for orbital cavernous hemangioma. Fifty-eight percent were women, mean age 50.2; 79 % of the tumors were intraconal. Among those patients, 36 underwent surgical removal, 5 were followed periodically, and 2 were lost to follow-up. The main surgical indications were: optic nerve compression (26 patients), proptosis (24 patients) and diplopia (3 patients). Transconjunctival, anterior transcutaneous and Kronlein approaches were used in 16, 12 and 4 patients respectively. Four patients had intrapalpebral hemangiomas easily reached transcutaneously. Two patients demonstrated transient partial 3rd nerve palsy (one with the lateral orbitotomy approach and one with the transconjunctival approach), one patient with the lateral orbitotomy approach developed a palsy of the superior branch of the 3rd nerve, and one patient with the transcutaneous anterior approach developed mydriasis. Surgical excision of OCH's is required in the presence of clinical complications. The transconjunctival approach is a safe technique which can lead to complete resection of the tumor in most cases.

  10. Saline Cavern Adiabatic Compressed Air Energy Storage Using Sand as Heat Storage Material

    Directory of Open Access Journals (Sweden)

    Martin Haemmerle

    2017-03-01

    Full Text Available Adiabatic compressed air energy storage systems offer large energy storage capacities and power outputs beyond 100MWel. Salt production in Austria produces large caverns which are able to hold pressure up to 100 bar, thus providing low cost pressurized air storage reservoirs for adiabatic compressed air energy storage plants. In this paper the results of a feasibility study is presented, which was financed by the Austrian Research Promotion Agency, with the objective to determine the adiabatic compressed air energy storage potential of Austria’s salt caverns. The study contains designs of realisable plants with capacities between 10 and 50 MWel, applying a high temperature energy storage system currently developed at the Institute for Energy Systems and Thermodynamics in Vienna. It could be shown that the overall storage potential of Austria’s salt caverns exceeds a total of 4GWhel in the year 2030 and, assuming an adequate performance of the heat exchanger, that a 10MWel adiabatic compressed air energy storage plant in Upper Austria is currently feasible using state of the art thermal turbomachinery which is able to provide a compressor discharge temperature of 400 °C.

  11. RESISTANCE OF KARST CAVERNS NITROGEN-FIXING BACTERIA TO EXTREME FACTORS

    Directory of Open Access Journals (Sweden)

    Tashyrev O. B.

    2014-10-01

    Full Text Available To determine the studied bacteria resistance quantitative parameters of extreme factors such as toxic metals (Cu2+, organic xenobiotics (p-nitrochlorobenzene and UV-irradiation were the aim of the research. Six strains of nitrogen-fixing bacteria isolated from clays of two caverns Mushkarova Yama (Podolia, Ukraine and Kuybyshevskaya (Western Caucasus, Abkhazia and Azotobacter vinelandii УКМ В-6017 as a reference strain have been tested. For this purpose the maximum permissible concentration of Cu2+ and p-nitrochlorobenzene in the concentration gradient and lethal doses of UV by the survival caverns have been determined. Maximum permissible concentrations for strains were as 10 ppm Cu2+, 70–120 ppm of p-nitrochlorobenzene. The maximum doses of UV-irradiation varied in the range of 55–85 J/m2 (LD99.99. It is shown that three classes of extreme factors resistance parameters of karst caverns strains are similar to the strain of terrestrial soil ecosystems. The most active studied strains reduce the concentration of p-nitrochlorobenzene in the medium in 13 times. The ability of nitrogen-fixing bacteria to degrade p-nitrochlorobenzene could be used in creation new environmental biotechnology for industrial wastewater treatment from nitrochloroaromatic xenobiotics. Isolated strains could be used as destructors for soils bioremediation in agrobiotechnologies and to optimize plants nitrogen nutrition in terrestrial ecosystems.

  12. Increased expression of nestin in the major pelvic ganglion following cavernous nerve injury

    Science.gov (United States)

    Kutlu, O; Ross, AE; Schaeffer, EM; Gratzke, C; Stief, CG; Strong, TD; Burnett, AL; Hedlund, P; Bivalacqua, TJ

    2017-01-01

    In an effort to identify neuronal repair mechanisms of the major pelvic ganglion (MPG), we evaluated changes in the expression of nestin, an intermediate filament protein and neural stem cell marker following cavernous nerve crush injury (CNI). We utilized two groups of Sprague Dawley rats: (i) sham and (ii) bilateral CNI. Erectile responses to cavernous nerve stimulation (CNS) were determined at 48 h in a subset of rats. The MPG was isolated and removed at 48 h after CNI, and nestin immunolocalization, protein levels and RNA expression were evaluated. At 48 h, erectile responses to CNS in CNI rats were substantially reduced (P<0.05; ~70% decrease in intracavernous pressure/mean arterial pressure) compared with sham surgery controls. This coincided with a dramatic 10-fold increase (P<0.05) in nestin messenger RNA expression and protein levels in the MPG of rats with CNI. Immunoflourescence microscopy demonstrated that nestin upregulation after CNI occurred within the ganglion cell bodies and nerve fibers of the MPG. In conclusion, CNI induces nestin in the MPG. These data suggest that nestin may be involved in the regenerative process of the cavernous nerve following crush injury. PMID:21993267

  13. Hepatocellular carcinoma with concomitant hepatic angiomyolipoma and cavernous hemangioma in one patient.

    Science.gov (United States)

    Ge, Xiao-Wen; Zeng, Hai-Ying; Su-Jie, Akesu; Du, Min; Ji, Yuan; Tan, Yun-Shan; Hou, Ying-Yong; Xu, Jian-Fang

    2015-03-21

    The risk of developing hepatocellular carcinoma (HCC) is strongly associated with hepatitis B virus infection. Hepatic angiomyolipoma (AML), a rare benign tumor, is composed of a heterogeneous mixture of adipose cells, smooth muscle cells and blood vessels. Here, we report the case of a 44-year-old man who developed HCC with a concomitant hepatic AML and a cavernous hemangioma, in the absence of cirrhosis. To our knowledge, based on an extensive literature search using the www.pubmed.gov website, this is the first report of an HCC case with both concomitant AML and cavernous hemangioma at the same position in the liver. The presence of the hepatitis B surface antigen was detected, but the liver function was normal. Clinical and pathological data were collected before and during the treatment. Hepatic AML was diagnosed based on the typical histological characteristics and immunohistochemical staining, which revealed, a positive staining with a melanocytic cell-specific monoclonal antibody. There was no evidence of tuberous sclerosis complex in this patient. Although the HCC was poor- to moderately-differentiated, the characteristics of the AML and the cavernous hemangioma in this patient did not match any criteria for malignancy. Hepatectomy followed by transarterial chemoembolization treatment were effective therapeutic methods for the adjacent lesions in this patient. This case is an interesting coincidence.

  14. Resection of Giant Hepatic Cavernous Hemangiomas after Dissection of the Third Porta Hepatis

    Institute of Scientific and Technical Information of China (English)

    YAOXiaoping; ZHOUWeiping; WANGYi; WUMengchao; JINGLiang

    2002-01-01

    Objective:To estabhsh a novel and safe operation technique for the resection of giant hepatic cavernous hemangiomas involving the retro-hepatic vena cava.Methods:After ligating the hepatic artery of affected lobe, the short hepatic veins at the third porta hepatis were dissected and ligated individually to separate the tumor from the retrohepatic vena cava, followed by the resection of the tumor under intermittent interruption of the porta hepatis.Results:A total of 62 giant hepatic cavernous hemangiomas were successfully resected without hepatic vascular exclusion. Right and caudate lobectomies were done in 27 cases, right hemihepatectornies in 5 cases, right upper segnentectomies in 7 cases, right posterior lobectomies in 7 cases, extended left and caudate lobectomies in 10 cases, and caudate lobectomies in 6 cases. The blood transfusion requirement during operation was 1 400 ml on average. All did well postoperatively during a follow up of 4 - 84 months.Conclusion:It is safe and feasible to resect giant hepatic cavernous hemangioma following dissection of the third porta hepatis. Duringoperation the key step is dissection of the short hepatic veins.

  15. Evaluation of Computational Method of High Reynolds Number Slurry Flow for Caverns Backfilling

    Energy Technology Data Exchange (ETDEWEB)

    Bettin, Giorgia [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-05-01

    The abandonment of salt caverns used for brining or product storage poses a significant environmental and economic risk. Risk mitigation can in part be address ed by the process of backfilling which can improve the cavern geomechanical stability and reduce the risk o f fluid loss to the environment. This study evaluate s a currently available computational tool , Barracuda, to simulate such process es as slurry flow at high Reynolds number with high particle loading . Using Barracuda software, a parametric sequence of simu lations evaluated slurry flow at Re ynolds number up to 15000 and loading up to 25%. Li mitations come into the long time required to run these simulation s due in particular to the mesh size requirement at the jet nozzle. This study has found that slurry - jet width and centerline velocities are functions of Re ynold s number and volume fractio n The solid phase was found to spread less than the water - phase with a spreading rate smaller than 1 , dependent on the volume fraction. Particle size distribution does seem to have a large influence on the jet flow development. This study constitutes a first step to understand the behavior of highly loaded slurries and their ultimate application to cavern backfilling.

  16. Micro-Macro Analysis and Phenomenological Modelling of Salt Viscous Damage and Application to Salt Caverns

    Science.gov (United States)

    Zhu, Cheng; Pouya, Ahmad; Arson, Chloé

    2015-11-01

    This paper aims to gain fundamental understanding of the microscopic mechanisms that control the transition between secondary and tertiary creep around salt caverns in typical geological storage conditions. We use a self-consistent inclusion-matrix model to homogenize the viscoplastic deformation of halite polycrystals and predict the number of broken grains in a Representative Elementary Volume of salt. We use this micro-macro modeling framework to simulate creep tests under various axial stresses, which gives us the critical viscoplastic strain at which grain breakage (i.e., tertiary creep) is expected to occur. The comparison of simulation results for short-term and long-term creep indicates that the initiation of tertiary creep depends on the stress and the viscoplastic strain. We use the critical viscoplastic deformation as a yield criterion to control the transition between secondary and tertiary creep in a phenomenological viscoplastic model, which we implement into the Finite Element Method program POROFIS. We model a 850-m-deep salt cavern of irregular shape, in axis-symmetric conditions. Simulations of cavern depressurization indicate that a strain-dependent damage evolution law is more suitable than a stress-dependent damage evolution law, because it avoids high damage concentrations and allows capturing the formation of a damaged zone around the cavity. The modeling framework explained in this paper is expected to provide new insights to link grain breakage to phenomenological damage variables used in Continuum Damage Mechanics.

  17. Homozygosity for a missense mutation in the 67 kDa isoform of glutamate decarboxylase in a family with autosomal recessive spastic cerebral palsy: parallels with Stiff-Person Syndrome and other movement disorders

    Directory of Open Access Journals (Sweden)

    Woods C Geoffrey

    2004-11-01

    Full Text Available Abstract Background Cerebral palsy (CP is an heterogeneous group of neurological disorders of movement and/or posture, with an estimated incidence of 1 in 1000 live births. Non-progressive forms of symmetrical, spastic CP have been identified, which show a Mendelian autosomal recessive pattern of inheritance. We recently described the mapping of a recessive spastic CP locus to a 5 cM chromosomal region located at 2q24-31.1, in rare consanguineous families. Methods Here we present data that refine this locus to a 0.5 cM region, flanked by the microsatellite markers D2S2345 and D2S326. The minimal region contains the candidate gene GAD1, which encodes a glutamate decarboxylase isoform (GAD67, involved in conversion of the amino acid and excitatory neurotransmitter glutamate to the inhibitory neurotransmitter γ-aminobutyric acid (GABA. Results A novel amino acid mis-sense mutation in GAD67 was detected, which segregated with CP in affected individuals. Conclusions This result is interesting because auto-antibodies to GAD67 and the more widely studied GAD65 homologue encoded by the GAD2 gene, are described in patients with Stiff-Person Syndrome (SPS, epilepsy, cerebellar ataxia and Batten disease. Further investigation seems merited of the possibility that variation in the GAD1 sequence, potentially affecting glutamate/GABA ratios, may underlie this form of spastic CP, given the presence of anti-GAD antibodies in SPS and the recognised excitotoxicity of glutamate in various contexts. Table 4 GAD1 single nucleotide substitutions detected on mutation analysis and occurring in sequences submitted to NCBI SNP database and in the literature. This is not a definitive list, but includes those described at the time of the mutational analysis. *Nucleotide positions were not provided by Maestrini et al. [47]. Source SNP position in mRNA, from the translational start site (bp Gene position of SNP(bp Amino acid change (ALappalainen et al. (2002 A(-478Del Exon

  18. Role of EPI in diagnosing cavernous hemangioma and small HCC : comparison with fast T2-weighted MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Suk; Lee, Jun Woo; Kim, Chang Won; Jung, Hyun Woo; Choi, Sang Yoel; Lee, Suck Hong; Kim, Byung Soo [Pusan National Univeraty Hospital, Pusan (Korea, Republic of)

    1998-05-01

    The purpose of this study is to compare single-shot echo-planar MR imaging (EPI) with breath-hold fast T2-weighted imaging (HASTE or Turbo spin-echo T2WI) for evaluation of the role of EPI in distinguishing small hepatocellular carcinoma from cavernous hemangioma. We retrospectively evaluated MR images of 35 patients (21 cases of small HCC and 14 cases of cavernous hemangioma). EPI and breath-hold fast T2WI images were obtained and compared on the basis of lesion detection sensitivity, lesion-to-liver signal intensity ratio (SIR), contrast ratio (CR), and lesion-to-liver contrast to noise ratio (CNR). For the detection of small HCC, the sensitivity of EPI and breath-hold fast T2WI were equal in 14 of 21 cases (71.4%). The detection sensitivity of cavernous hemangioma with EPI and breath-hold fast T2WI was 100 % (14/14). Mean SIR on breath-hold fast T2WI was 2.02 {+-} 0.45 for small HCC and 3.65 {+-} 0.97 for cavernous hemangioma; on EPI, the corresponding figures were 2.91 {+-} 0.57 for cavernous hemangioma; On EPI, the figures obtained were 2.27 {+-} 0.52 and 6.26 {+-} 2.19, respectively. Mean CNR on breath-hold fast T2WI was 14.24 {+-} 4.098 for small HCC and 50.28 {+-} 10.96 for cavernous hemangioma, while on EPI, the corresponding figures were 13.84 {+-} 3.02 and 45.44 {+-} 11.21. In detecting focal hepatic mass, the sensitivity of EPI and breath-hold fast T2WI are comparable for the diagnosis of small HCC and cavernous hemangioma, EPI can provided additional information. (author). 20 refs., 2 tabs., 4 figs.

  19. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... SSI file Error processing SSI file Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  20. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...

  1. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  2. Cuidar de pessoa incapacitada por acidente vascular cerebral no domicílio: o fazer do cuidador familiar El cuidado de la persona incapacitada por accidente cerebro vascular en el domicilio: el hacer del cuidador familiar Taking care of persons handicapped by cerebral vascular accident at home: the familial caregiver activity

    Directory of Open Access Journals (Sweden)

    Nara Marilene Oliveira Girardon Perlini

    2005-06-01

    incapacitated by cerebral vascular accident. The sample was comprised of 35 family caregivers, most of them women, wives or daughters. The care given is directly related to the degree of incapacity of the person who is being cared for. The orientation received indicated no commitment of professionals for the continuity of the care. The caregivers learn in daily practice how to care, based on observation and assistance to nursing during the internment period. The difficulties are related to physical effort, to lack of information and fear, to the embarassment and the shame of handling someone else's body. The study focuses on the need for preparation for hospital discharge, emphasizes the family as a concrete space for care; and observed an increase in life expectancy.

  3. Matrix Metalloproteinases in Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Vivek Mehta

    2013-01-01

    Full Text Available Delayed cerebral vasospasm is a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH. While the cellular mechanisms underlying vasospasm remain unclear, it is believed that inflammation may play a critical role in vasospasm. Matrix metalloproteinasees (MMPs are a family of extracellular and membrane-bound proteases capable of degrading the blood-rain barrier (BBB. As such, MMP upregulation following SAH may result in a proinflammatory extravascular environment capable of inciting delayed cerebral vasospasm. This paper presents an overview of MMPs and describes existing data pertinent to delayed cerebral vasospasm.

  4. ICF 理论框架为基础的农村脑瘫患儿实用家庭康复模式探讨%Exploration on the ICF-based practical family rehabilitation model for rural children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    张明武; 黄艳植; 蒙爱珍; 陈国治; 谭玮玮; 黄亮量; 蒋锦生; 罗寀宾; 林盈盈

    2013-01-01

    目的:探讨适合于居住在农村的脑瘫患儿的实用家庭康复模式。方法以国际功能、残疾和健康分类( ICF)理论框架为基础,通过家长集中培训、专业技术人员入户指导和电话回访三种形式,指导家长在家庭对50例农村脑瘫患儿进行为期1年的家庭康复。结果50例患儿的运动能力有明显改善,生活自理能力与社会适应能力也得到了提高,康复总有效率达88%。结论以ICF理论框架为基础的农村脑瘫患儿家庭康复模式,能让家长日常工作与患儿康复训练两不误,家长依从性高,患儿的康复训练能得到长期坚持,并取得了良好的效果,值得推广。%Objective To investigate the practical family rehabilitation model suitable for rural children with cerebral palsy .Methods Based on the theoretical framework of International Classification of Functioning , Disability and Health( ICF) , parents were guided to conduct one-year family rehabilitation for 50 rural children with cerebral palsy at home through concentrated training for parents , guidance by professional and technical personnel entering their homes as well as telephone interview .Results The sports ability self-care ability of daily living and social a-daptability of the 50 children with cerebral palsy were improved with a total rehabilitation efficiency rate of 88%. Conclusion The ICF-based family rehabilitation model for rural children with cerebral palsy allows parents to do their daily work with children rehabilitation training , parents′compliance is high and the rehabilitation of children can get long-term adherence with good results , thus it is worthy of promotion .

  5. Mutation in the α2 isoform of Na,K-ATPase associated Familial Hemiplegic Migraine type 2 (FHM2) leads to elevated contractility and vasodilatation of cerebral arteries in mice

    DEFF Research Database (Denmark)

    Hangaard, Lise; Lykke-Hartmann, Karin; Xie, Zijian

    ,K-ATPase mRNA in comparison with WT, but 51±11% of their mRNA contained G301R mutation. G301R mice had elevated blood pressure and unchanged heart rate. Inner diameter of cerebral arteries from G301R mice was significantly larger than in WT. G301R arteries were more sensitive and had higher maximal...

  6. 家属赋能模式在青年脑梗死患者药物治疗依从性中应用的效果评价%Effect of family empowerment model on medication adherence in youth patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    刘延锦; 吕培华; 王爱霞; 王金鑫; 雷金花

    2014-01-01

    目的 探讨家属赋能模式在青年脑梗死患者药物治疗依从性中的应用效果.方法 采用便利抽样的方法,抽取郑州市某三级甲等医院神经内科84例患者及家属进行调查,采用随机数字表法分为干预组和对照组,各42例患者及家属,对照组给予常规健康教育,干预组采用家属赋能模式进行分阶段健康教育.比较2组患者健康教育前后的药物治疗依从性.结果 2组患者健康教育后药物治疗依从性均高于自身健康教育前,干预组患者健康教育后药物治疗依从性与对照组同期比较差异有统计学意义.结论 应用家属赋能模式进行健康教育,可显著提高青年脑梗死患者的药物治疗依从性.%Objective To explore the effects of family empowerment model on medication adherence in youth patient with cerebral infarction.Methods By convenience sampling,a questionnaire survey was conducted among 84 patients and families of neurology department in a third-grade and a-level general hospital in Zhengzhou.The patients and families were randomly divided into the control group and the intervention group,each group consisted of 42 patients and families.Patients and families in the control group got routine health education,but patients and families in the intervention group were intervened under family empowerment.The medication adherence of the patients were compared between the two groups before and after health education.Results The medication adherence in both groups were higher after health education than that before health education,the diffidence in the comparison of medication adherence was statistically significant between the two groups after health education.Conclusions The family empowerment model can improve the medication adherence in youth patient with cerebral infarction.

  7. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  8. Anestesia e paralisia cerebral

    OpenAIRE

    Március Vinícius M Maranhão

    2005-01-01

    JUSTIFICATIVA E OBJETIVOS: A paralisia cerebral (PC) é uma doença não progressiva decorrente de lesão no sistema nervoso central, levando a um comprometimento motor do paciente. O portador de PC freqüentemente é submetido a procedimentos cirúrgicos devido a doenças usuais e situações particulares decorrentes da paralisia cerebral. Foi objetivo deste artigo revisar aspectos da paralisia cerebral de interesse para o anestesiologista, permitindo um adequado manuseio pré, intra e pós-operatório n...

  9. The Cerebral Palsy Research Registry: Development and Progress Toward National Collaboration in the United States

    Science.gov (United States)

    Hurley, Donna S.; Sukal-Moulton, Theresa; Msall, Michael E.; Gaebler-Spira, Deborah; Krosschell, Kristin J.; Dewald, Julius P.

    2011-01-01

    Cerebral palsy is the most common neurodevelopmental motor disability in children. The condition requires medical, educational, social, and rehabilitative resources throughout the life span. Several countries have developed population-based registries that serve the purpose of prospective longitudinal collection of etiologic, demographic, and functional severity. The United States has not created a comprehensive program to develop such a registry. Barriers have been large population size, poor interinstitution collaboration, and decentralized medical and social systems. The Cerebral Palsy Research Registry was created to fill the gap between population and clinical-based cerebral palsy registries and promote research in the field. This is accomplished by connecting persons with cerebral palsy, as well as their families, to a network of regional researchers. This article describes the development of an expandable cerebral palsy research registry, its current status, and the potential it has to affect families and persons with cerebral palsy in the United States and abroad. PMID:21677201

  10. Pancreatic portal cavernoma in patients with cavernous transformation of the portal vein: MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Vilgrain, Valerie [Universite Paris 7 Denis Diderot, Paris (France); AP-HP, Hopital Beaujon, Department of Radiology, Clichy (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); Hopital Beaujon, Department of Radiology, Paris (France); Condat, Bertrand; Plessier, Aurelie [AP-HP, Hopital Beaujon, Department of Gastroenterology, Clichy (France); O' Toole, Dermot [Centre de reference des maladies vasculaires du foie, AP-HP, Hopital Beaujon, Department of Hepatology, PMAD, Clichy (France); Ruszniewski, Philippe [Universite Paris 7 Denis Diderot, Paris (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); Centre de reference des maladies vasculaires du foie, AP-HP, Hopital Beaujon, Department of Hepatology, PMAD, Clichy (France); Valla, Dominique C. [Universite Paris 7 Denis Diderot, Paris (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); AP-HP, Hopital Beaujon, Department of Gastroenterology, Clichy (France)

    2009-11-15

    The purpose of the article was to prospectively evaluate the MR findings of pancreatic portal cavernoma in a consecutive series of patients with cavernous transformation of the portal vein. This study was approved by the review board of our institution, and informed consent was obtained. The clinical and biological data and the MR imaging for 20 patients (11 female, 9 male; median age, 49 years) with cavernous transformation of the portal vein and no evidence of previous pancreatic disease were reviewed. The presence of pancreatic portal cavernoma (defined as intra- and/or peripancreatic portal cavernoma), morphological changes in the pancreas, biliary and ductal pancreatic abnormalities, and extension of the portal venous thrombosis were qualitatively assessed. Fifteen patients (75%) had pancreatic portal cavernoma with collateral formation in the pancreas and/or collaterals around the pancreas seen on dynamic contrast-enhanced MR sequences: three patients had both intra- and peripancreatic portal cavernoma, six had intrapancreatic portal cavernoma alone and six had peripancreatic portal cavernoma only. The presence of intra- or peripancreatic portal cavernoma was significantly associated with extension of the thrombosis to the splenic and superior mesenteric veins (p = 0.05). Morphological changes in the pancreas, heterogeneity on T2-weighted sequences and main ductal pancreatic abnormalities were seen in two, four and two patients, respectively. All these patients had intrapancreatic portal cavernoma. Bile duct dilatation was observed in 13 (65%) patients: among them three had extrahepatic dilatation only and these three patients had associated intrapancreatic portal cavernoma. In patients with cavernous transformation of the portal vein, intra- or peripancreatic portal cavernoma is common. In conclusion, intra- or peripancreatic portal cavernoma was only observed in patients with extension of the thrombosis to the splenic vein and/or the superior mesenteric

  11. Effect of sildenafil in cavernous arteries of patients with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Claro Joaquim A

    2003-01-01

    Full Text Available INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHODS: 29 male patients, with mean age of 53.8 years (32 to 75 years, were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months. Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS® system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners. RESULTS: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Zcalculated = - 0.695 NS (Wilcoxon test. Twenty one of the 29 patients (72.4% showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity. CONCLUSION: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in

  12. Bilateral cavernous sinus thrombosis as first manifestation of primary Burkitt lymphoma of the thyroid gland

    Directory of Open Access Journals (Sweden)

    Mehdi Moghaddasi

    2017-06-01

    Full Text Available Cavernous sinus thrombosis (CST is a rare condition that is usually associated with infections, pregnancy, vasculitis and some types of medication, such as the contraceptive pill and paraneoplastic. Primary Burkitt lymphoma (PBL of the thyroid gland is very uncommon and the clinical description of such cases has been largely limited to case reports. In this paper, we present a case of CST as the first manifestation of PBL of the thyroid gland. To the best of our knowledge, our patient is the first case report of PBL of the thyroid gland that presents with bilateral CST.

  13. Gradenigo’s syndrome and thrombosis of the cavernous sinus secundary to acute otitis media

    Directory of Open Access Journals (Sweden)

    Hellín-Meseguer D

    2012-05-01

    Full Text Available Gradenigo’s syndrome is characterized by facial pain in the area supplied by the trigeminal nerve and a unilateral external ophthalmoplegia (paralysis of VI cranial nerve secondary to acute apical petrositis for evolutionary complication of otitis media. This is a serious complication that requires immediate treatment to prevent permanent damage and may be associated with other intracranial complications such as thrombosis of the cavernous sinus. We report a 4 year old male who complains of fever, headache and external ocular paralysis in the course of acute otitis media.

  14. Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction.

    Science.gov (United States)

    Sekhar, L N; Burgess, J; Akin, O

    1987-12-01

    The efficacy of three operative approaches to the cavernous sinus (CS) and the possibilities of vascular and cranial nerve reconstruction in and around the CS were studied in 50 cadaver specimens (25 heads). The lateral operative approach was through the lateral wall, between Cranial Nerves V1 and IV, or between Cranial Nerves V1 and V2. The superior approach was through the superior wall of the CS after removing the anterior clinoid process and unroofing the optic canal. The inferior approach followed the petrous internal carotid artery (ICA) into the CS after an extradural subtemporal exposure or after a combined subtemporal and infratemporal fossa exposure. The different exposures of the spaces of the CS and of the intracavernous structures provided by the superior and the lateral approaches were complementary. The exposure provided by the inferior approach was minimal; however, the junction of the petrous and cavernous ICA was best exposed by this route. The combined subtemporal and infratemporal fossa approach exposed the petrous ICA (for proximal control or for reconstruction) with the greatest ease and with the least temporal lobe retraction. The combination of the superior and lateral approaches and the complete mobilization of the intracavernous ICA facilitated its repair after experimental lacerations. Lacerations of either the inferior and the inferomedial aspects of any portion of the cavernous ICA or of the anterior surface of the posterior vertical segment of the artery were the most difficult to repair. End-to-end anastomosis was more difficult with the posterior third of the artery than with the anterior two-thirds. A vein graft with an average length of 3.5 cm could be sutured from the petrous to the supraclinoid ICA to bypass the cavernous ICA, with an average occlusion time of 45 minutes. End-to-end technique was judged better for the proximal anastomosis, but end (graft)-to-side anastomosis was easier to perform at the distal end because of the

  15. Development of cavernous haemangioma following radical chemo-radiotherapy for nasopharyngeal carcinoma.

    Science.gov (United States)

    Ellenbogen, J R; Joshi, S M; Kitchen, N

    2009-08-01

    We report an adult case of nasopharyngeal carcinoma treated with radical chemo-radiotherapy, with subsequent development of a histologically proved temporal cavernous haemangioma within the radiation field. Case report and review of the current literature concerning radiation-induced, secondary, space-occupying lesions. The increasing role of radiotherapy in nasopharyngeal carcinoma treatment, together with improved patient survival, is likely to lead to radiation-induced, secondary, space-occupying lesions being encountered more frequently. We emphasise the need to be vigilant for this important but relatively rare complication, which has significant associated morbidity.

  16. Burkitt's lymphoma with bilateral cavernous sinus and mediastinal involvement in a child

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, Thierry A.G.M.; Tschirch, Frank; Schneider, Jacques F.L.; Martin-Fiori, Ernst; Willi, Ulrich V. [Department of Radiology and Magnetic Resonance Imaging, University Children' s Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich (Switzerland); Niggli, Felix [Department of Paediatrics, University Children' s Hospital Zurich, Zurich (Switzerland)

    2003-10-01

    We report a 12-year-old boy who presented with incomplete right ophthalmoplegia, exophthalmos and headache. Initial CT and MRI revealed a mass in the right cavernous sinus. During tumour work-up, CT identified additional tumour within the mediastinum. Biopsy of the mediastinal lesion identified Burkitt's lymphoma. We report on this case because radiologists and clinicians should be alerted to identify sites of primary Burkitt's lymphoma outside of the central nervous system if clinical symptoms indicate, or imaging shows, CNS lesions. Primary CNS involvement in Burkitt's lymphoma is rare. (orig.)

  17. Treatment of recurrent traumatic carotid cavernous fistula via endovascular embo lism technique

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Endovascular embolism technique has been demonstrated to be the best initial option for treatment of carotid cavernous fistula (CCF). Several large series re ports have shown that most CCFs can be successfully occluded via transarterial or transvenous endovascular approach.1-6 This paper reports a case of C CF recurred after endovascular occlusion of internal carotid artery (ICA) proxim al to the fistula. A new technique has been described for transarterial emboliza tion with tungsten microcoils via surgical exposure to ICA, which has not been r eported previously in the literatures.

  18. A cavernous hemangioma of the thyroid gland: First documentation by ultrasound of a rare pathology.

    Science.gov (United States)

    Gutzeit, Andreas; Stuckmann, Gerd; Tosoni, Ivo; Erdin, Dieter; Binkert, Christoph A

    2011-01-01

    Hemangioma of the thyroid gland is an extremely rare condition. We report a case of a primary cavernous hemangioma in the left lobe of the thyroid gland in an 84-year-old woman. Ultrasound examination of the lesion showed an inhomogeneous and hypoechoic nodule that was well demarcated from the rest of the left lobe and hypovascular on color Doppler ultrasound. Ultrasound-guided fine-needle aspiration was performed. The cytologic differential diagnosis included an anaplastic carcinoma of the thyroid gland. After hemithyroidectomy, the final diagnosis was a benign hemangioma of the thyroid gland.

  19. One-step endovascular treatment of bilateral traumatic carotid-cavernous fistulae with atypical clinical course.

    Science.gov (United States)

    Chiriac, Alexandru; Iliescu, Bogdan F; Dobrin, Nicolae; Poeata, Ion

    2014-01-01

    Traumatic carotid-cavernous fistula (TCCF) is a rare neurovascular pathologic entity. The bilateral form occurs even rarer and given the potential risk for both optic tracts presents an urgent indication for quick and effective treatment. We present a patient with a bilateral Barrow type A TCCF with a fulminant development of symptoms, who was successfully treated with bilateral detachable balloons in a single session endovascular procedure. The patient experienced complete relief of symptoms, however the complete neurological deficit in the left optic nerve was persistent.

  20. The first section of the CMS detector (centre of photo) arriving from the vertical shaft, viewed from the cavern floor.

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    In the early morning of 2 November, the first section of the CMS detector began its eagerly awaited descent into the underground cavern. You may imagine the CMS detector as a loaf of sliced bread, cut into 15 slices of different sizes. The two HF sections are the end pieces; the slices in between will be lowered sequentially according to their positions in the ‘loaf', starting from the HF+ section at the far end of the cavern, towards the access shaft at the opposite end.

  1. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  2. [Traumatic arteriovenous pial fistula masquerading as a carotid-cavernous fistula: an uncommon disorder with an unusual presentation].

    Science.gov (United States)

    Santos-Franco, Jorge Arturo; Lee, Angel; Nava-Salgado, Giovanna; Zenteno, Marco; Gómez-Villegas, Thamar; Dávila-Romero, Julio César

    2012-01-01

    Traumatic intracranial pial arteriovenous fistulae are infrequent lesions. Their cardinal signs have been related to mass effect and hemorrhage, but their clinical manifestations due to venous retrograde flow into ophthalmic veins has never been described. This phenomenon is usually seen in dural arteriovenous fistula draining to the cavernous sinus or carotid-cavernous sinus fistula.A traumatic intracranial pial arteriovenous fistula arising from the supraclinoid internal carotid artery in a young patient was revealed by aggressive behavior and ophthalmologic manifestations. The endovascular management included the use of coils, stent, and ethylene-vinyl alcohol with transient balloon occlusion of the parent vessel.

  3. [A case of primary intraosseous cavernous hemangioma extending from the orbital rim to the sphenoid wing: a case report].

    Science.gov (United States)

    Inaka, Yasufumi; Otani, Naoki; Nishida, Sho; Kumagai, Kohsuke; Fujii, Kazuya; Ueno, Hideaki; Tomiyama, Arata; Tomura, Satoshi; Osada, Hideo; Wada, Kojiro; Mori, Kentaro

    2014-11-01

    A primary intraosseous cavernous hemangioma located at the sphenoid bone with extensive involvement of the orbital roof and the lateral wall of the orbit is very rare. A 48-year-old woman presented with progressive right exophthalmos and diplopia. CT showed a bony mass lesion in the right sphenoid bone extending to the orbital bone. MRI showed an abnormal lesion in the sphenoid bone, which was heterogeneously enhanced with gadolinium. All of the abnormal bone was surgically removed, and histological examination confirmed a cavernous angioma. We also present a brief clinical and radiological review of seven previously reported cases.

  4. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    Energy Technology Data Exchange (ETDEWEB)

    Asari S.; Satch, T.; Sakurai, M.; Yamamoto, Y. (Matsuyama Shimin Hospital, Matsuyama (Japan)); Sadamoto, K.

    1981-06-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography (combination of axial, modified coronal, half axial (Towne), and semisagittal planes). The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography.

  5. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  6. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  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. Current proceedings of cerebral palsy.

    Science.gov (United States)

    Fan, Hueng-Chuen; Ho, Li-Ing; Chi, Ching-Shiang; Cheng, Shin-Nan; Juan, Chun-Jung; Chiang, Kuo-Liang; Lin, Shinn-Zong; Harn, Horng-Jyh

    2015-01-01

    Cerebral palsy (CP) is a complicated disease with varying causes and outcomes. It has created significant burden to both affected families and societies, not to mention the quality of life of the patients themselves. There is no cure for the disease; therefore, development of effective therapeutic strategies is in great demand. Recent advances in regenerative medicine suggest that the transplantation of stem cells, including embryonic stem cells, neural stem cells, bone marrow mesenchymal stem cells, induced pluripotent stem cells, umbilical cord blood cells, and human embryonic germ cells, focusing on the root of the problem, may provide the possibility of developing a complete cure in treating CP. However, safety is the first factor to be considered because some stem cells may cause tumorigenesis. Additionally, more preclinical and clinical studies are needed to determine the type of cells, route of delivery, cell dose, timing of transplantation, and combinatorial strategies to achieve an optimal outcome.

  9. Subcutaneous Cavernous Hemangioma in the Nasal Dorsum: Report of Case Treated with Endoscopic Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Socher, Jan Alessandro

    2014-01-01

    Full Text Available Introduction Hemangiomas are vascular malformations, with slow blood flow, that can occur in any part on the body. They are more common in women and, predominantly, are isolated lesions. The malformation does not spontaneously regress. Subcutaneous hemangioma is a rare variant with an aggressive growth pattern that sometimes recurs after excision. Objective Case report of a subcutaneous cavernous hemangioma in the nasal dorsum treated with endoscopic rhinoplasty. Case Report A 27-year-old woman had a fibroelastic tumor mass in the midline of the nasal dorsum, which was pulsatile; she had obstruction and nasal congestion with associated rhinorrhea, with evolution and worsening over the previous 2 years. Computed tomography showed a tumor demarcated in the nasal dorsum without evidence of intracranial communication. Endoscopic rhinoplasty with septoplasty and associated paranasal sinus sinusectomy was performed without arteriography embolization, sclerotherapy, or laser. Pathologic diagnosis showed cavernous hemangioma. Postoperative follow-up shows no recurrence at 3 years. Discussion This case presented with atypical features, thus making the diagnosis a challenge. Imaging studies were required to confirm the vascular nature of the tumor. Excisional biopsy is the procedure of choice for pathologic examination. Subcutaneous hemangiomas never involute and always need treatment. The surgical approach is exceptional because there was no preoperative diagnosis. In addition, the closed technique provided best aesthetic results in this case. Conclusion Endoscopic rhinoplasty is suitable for nasal dorsum tumor resection and has superior aesthetic result to open techniques.

  10. TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion: Targeted Approach

    Directory of Open Access Journals (Sweden)

    Natanel Jourabchi

    2013-01-01

    Full Text Available 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 hematemesis. The patient was severely anemic, hemodynamically unstable, and required emergent portal decompression. Attempts to recanalize the main portal vein using traditional transjugular access were unsuccessful. After percutaneous transhepatic right portal vein access and navigation of a wire through the occluded main portal vein, an angioplasty balloon was inflated at the desired site of shunt takeoff. The balloon was targeted and punctured from the transjugular approach, and a wire was passed into the portal system. TIPS placement then proceeded routinely. Conclusion. Although occlusion of the portal vein increases difficulty of performing TIPS, it should not be considered an absolute contraindication. We have described a method for recanalizing an occluded portal vein using a combined transhepatic and transjugular approach for TIPS. This approach may be useful to relieve portal hypertension in patients who fail endoscopic and/or surgical therapies.

  11. A retrospective review of cases preoperatively diagnosed by radiologic imaging as cavernous venous malformations.

    Science.gov (United States)

    Jayaram, Anupam; Cohen, Liza M; Lissner, Gary S; Karagianis, Achilles G

    2017-04-03

    The purpose of this study is to examine orbital lesions identified on preoperative radiologic imaging as cavernous venous malformations (CVMs), identify their imaging characteristics, and determine if these may help differentiate CVMs from other intraorbital masses. An IRB-approved retrospective chart review over 30 years was undertaken identifying lesions "consistent with cavernous hemangioma" on radiologic studies, which were subsequently surgically resected with a tissue diagnosis. All radiologic images (CT and MRI) obtained preoperatively were re-reviewed by a single masked neuroradiologist. The pattern of contrast enhancement on sequential MRI views was used to determine whether the enhancing characteristics helped identify CVMs compared to other intraorbital masses. Fifty-seven orbital lesions consistent with a CVM were identified on imaging. Fourteen (25%) of them were resected, of which nine (64%) were found to be CVMs on pathologic examination. Five (36%) were found to be a different lesion, most commonly schwannoma (21%). On imaging, CVMs tended to display heterogeneous progressive enhancement, whereas other tumors, in particular schwannomas, enhanced at their maximum level immediately. Based on these characteristics, on re-review, the masked neuroradiologist was able to differentiate a CVM versus other tumors for all 14 imaging cases. This study suggests that examining the pattern of contrast enhancement may help to correctly differentiate a CVM from other isolated, encapsulated orbital lesions on CT/MR imaging.

  12. Cavernous angioma of the cauda equina: case report Angioma cavernoso de cauda equina: relato de caso

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2004-06-01

    Full Text Available We present a rare case of cavernous angioma of the cauda equina and review the eleven cases available in the literature. A 44-year-old woman presented with low back pain and sciatica associated with bowel and bladder dysfunction and motor weakness of the lower extremity. The MRI revealed an enhancing, heterogeneous and hyperintense intradural lesion compressing the cauda equina roots at the L4 level. Laminectomy at L3-L4 and total removal of the tumor were performed without additional neurological deficit. Pathology revealed a cavernous angioma. The literature, clinical presentation, technical examinations, and treatment are reviewed.Relatamos um caso de angioma cavernoso de cauda equina em mulher de 44 anos de idade com sintomas de lombociatalgia associada a fraqueza de membros inferiores e disfunção esfincteriana vesical e anal. Exame de ressonância magnética evidenciou lesão expansiva intradural heterogênea e hiperintensa na cauda eqüina. Indicado tratamento cirúrgico com remoção completa através de laminectomia L3 e L4. O exame anatomopatológico foi compatível com angioma cavernoso. Os onze casos encontrados na literatura são revisados correlacionando a apresentação clínica, tratamento proposto e prognóstico.

  13. Visits to the ATLAS cavern - A record of 20000 visitors in 2006!

    CERN Multimedia

    Alessandra Ciocio

    The year 2006 closed with the impressive record of just under 20000 visitors to the ATLAS cavern. These visitors come from all walks of life - people within ATLAS, groups from other CERN divisions, retired CERN staff, school groups both from the local area and from far away, companies looking for something different as a special outing, celebrities (Cirque du Soleil, Black Eyed Peas hip-hop group) passing through Geneva who had read Angels and Demons, a stream of VIP visitors and now, more and more, Press visitors. There have been public visits in the ATLAS cavern since the middle of 2003. At that time a lot of the visitors were guided by Bernard Lebegue and Francois Butin. The total number of visits in 2003 was 2220 people. Not bad for just two guides! Over the following three years demand for visits increased to such an extent that the ATLAS Visits Service was created and is now run very successfully under the supervision of Connie Potter in the ATLAS Secretariat in close collaboration with the ever-helpfu...

  14. Compressed air energy storage monitoring to support refrigerated mined rock cavern technology.

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Moo Yul; Bauer, Stephen J.

    2004-06-01

    This document is the final report for the Compressed Air Energy Storage Monitoring to Support Refrigerated-Mined Rock Cavern Technology (CAES Monitoring to Support RMRCT) (DE-FC26-01NT40868) project to have been conducted by CAES Development Co., along with Sandia National Laboratories. This document provides a final report covering tasks 1.0 and subtasks 2.1, 2.2, and 2.5 of task 2.0 of the Statement of Project Objectives and constitutes the final project deliverable. The proposed work was to have provided physical measurements and analyses of large-scale rock mass response to pressure cycling. The goal was to develop proof-of-concept data for a previously developed and DOE sponsored technology (RMRCT or Refrigerated-Mined Rock Cavern Technology). In the RMRCT concept, a room and pillar mine developed in rock serves as a pressure vessel. That vessel will need to contain pressure of about 1370 psi (and cycle down to 300 psi). The measurements gathered in this study would have provided a means to determine directly rock mass response during cyclic loading on the same scale, under similar pressure conditions. The CAES project has been delayed due to national economic unrest in the energy sector.

  15. Blunt abdominal injury with rupture of giant hepatic cavernous hemangioma and laceration of the spleen.

    Science.gov (United States)

    Kang, Lung-Yun; Huang, Fong-Dee; Liu, Yuan-Yuarn

    2015-02-01

    A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration (5 cm) of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of >1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.

  16. Sixty-four-slice computed tomography in surgical strategy of portal vein cavernous transformation

    Institute of Scientific and Technical Information of China (English)

    Ming-Man Zhang; Cong-Lun Pu; Ying-Cun Li; Chun-Bao Guo

    2011-01-01

    AIM:To investigate the role of 64-slice computed tomography (CT) in portal vein cavernous transformation to determine surgical strategy.METHODS:The site of lesions and extent of collateral circulation in 12 pediatric cases of cavernous transformation of the portal vein with surgical treatment were analyzed.RESULTS:Eleven of 12 children had esophageal vari-ces and were treated with lower esophageal and gastric devascularization and splenectomy,and the other case was only treated with splenectomy.There were eight cases with spontaneous spleen/stomach-renal shunt,four with Retzius vein opening,which was reserved during surgery.Three cases of lesions involving the intrahepatic portal vein (PV) were treated with livingdonor liver transplantation.One patient died from PV thrombosis after liver transplantation,and the rest had no significant complications.CONCLUSION:The PV,its branches and collateral circulation were clearly seen by 64-slice spiral CT angi-ography,which helped with preoperative surgical planning.

  17. Study on Mechanical Characteristics of Fully Grouted Rock Bolts for Underground Caverns under Seismic Loads

    Directory of Open Access Journals (Sweden)

    Guoqing Liu

    2017-01-01

    Full Text Available This study establishes an analytical model for the interaction between the bolt and surrounding rock based on the bearing mechanism of fully grouted rock bolts. The corresponding controlled differential equation for load transfer is deduced. The stress distributions of the anchorage body are obtained by solving the equations. A dynamic algorithm for the bolt considering shear damage on the anchoring interface is proposed based on the dynamic finite element method. The rationality of the algorithm is verified by a pull-out test and excavation simulation of a rounded tunnel. Then, a case study on the mechanical characteristics of the bolts in underground caverns under seismic loads is conducted. The results indicate that the seismic load may lead to stress originating from the bolts and damage on the anchoring interface. The key positions of the antiseismic support can be determined using the numerical simulation. The calculated results can serve as a reference for the antiseismic optimal design of bolts in underground caverns.

  18. Acute Cavernous Sinus Syndrome from Metastasis of Lung Cancer to Sphenoid Bone

    Directory of Open Access Journals (Sweden)

    Marianna Zelenak

    2012-01-01

    Full Text Available Cavernous sinus syndrome is a rare entity in oncology reported only in occasional case reports. Optimal therapy is thus poorly defined with rapidly progressive disease dominating the picture. Management includes prompt diagnosis, attempts at stabilization of cranial nerve function, and aggressive control of central pain syndrome. Here, we report cavernous sinus syndrome secondary to the original squamous cell carcinoma of the lung. With common presenting causes of this syndrome being infection, thrombosis or tumor, it might seem that metastatic tumor would be expected in a patient with a cancer diagnosis. What was not so expected was the extremely rapid progression from mild headache and mild trigeminal neuralgia with negative-contrast head CT to a massive, destructive lesion involving several skull bones and skull base, only 3 weeks later. In addition, the patient was severely immunosuppressed at the completion of induction chemotherapy. Infectious processes, although unlikely, were considered, as aggressive cancer therapy (including high-dose steroids and radiation therapy had no impact on this disease. Despite accurate localization, the aggressive nature of this disease with massive bone destruction and dural thickening limited any chance of a durable control. We discuss the process of evaluation, diagnosis and treatment of symptoms and the importance of a team approach to best palliate these unfortunate patients.

  19. Apparent glacially induced structural controls on limestone conduit development in Ohio Caverns, United States

    Directory of Open Access Journals (Sweden)

    Adrienne M. Watts

    2016-01-01

    Full Text Available Rock discontinuities such as bedding planes and joints are important controls on the form that caves take. We examined structural controls on the development of Ohio Caverns. The cave formed in Devonian limestone underlying a small bedrock knob (Mt. Tabor within the Interior Lowland province, United States. The area has been overridden by continental glaciation multiple times. The bedrock is pervasively fractured, with many curved and wavy near-vertical fractures showing many different orientations. In the case of Ohio Caverns, it appears that the controlling fractures in map view may not be joints sensu stricto, but rather some combination of tensile and shear (mode-1 and mode-2 fractures, probably forming in the regime transition between tensile and shear fracturing. This is easy to envision in a situation with ice advancing over this topographic high, and would result in the curved fractures that are observed in many places in the cave. It can also explain the numerous fracture directions. However, not all fractures are conduit-significant. The cave initiated on or near a single bedding plane, and the cave passages exhibit strong keyhole or plus-sign cross sections. Passage and fracture orientations are inconsistent with regionally expected directions. It is likely that mechanical, hydraulic, and thermal stresses related to glaciation caused the fracturing in Mt. Tabor. The cave then developed on this template according to local hydrologic conditions. This presents a newly documented structural template sub-type for cave development.

  20. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral...

  1. Psychological Problems in Children with Cerebral Palsy: A Cross-Sectional European Study

    Science.gov (United States)

    Parkes, Jackie; White-Koning, Melanie; Dickinson, Heather O.; Thyen, Ute; Arnaud, Catherine; Beckung, Eva; Fauconnier, Jerome; Marcelli, Marco; McManus, Vicki; Michelsen, Susan I.; Parkinson, Kathryn; Colver, Allan

    2008-01-01

    Objectives: To describe psychological symptoms in 8-12-year-old children with cerebral palsy; to investigate predictors of these symptoms and their impact on the child and family. Design: A cross-sectional multi-centre survey. Participants: Eight hundred and eighteen children with cerebral palsy, aged 8-12 years, identified from population-based…

  2. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  3. Cerebral microvascular amyloid beta protein deposition induces vascular degeneration and neuroinflammation in transgenic mice expressing human vasculotropic mutant amyloid beta precursor protein.

    NARCIS (Netherlands)

    Miao, J.; Xu, F.; Davis, J.; Otte-Holler, I.; Verbeek, M.M.; Nostrand, W.E. van

    2005-01-01

    Cerebral vascular amyloid beta-protein (Abeta) deposition, also known as cerebral amyloid angiopathy, is a common pathological feature of Alzheimer's disease. Additionally, several familial forms of cerebral amyloid angiopathy exist including the Dutch (E22Q) and Iowa (D23N) mutations of Abeta. Incr

  4. PTOSIS DUE TO CAVERNOUS SINUS SYNDROME AS A RARE PRESENTATION OF ADVANCED BREAST METASTASIS IN A PATIENT WITH DELAYED DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    KW Khaw

    2012-08-01

    Full Text Available Complications of breast cancer metastasis may be the first manifestation of the disease. We report a rare case of left eyeptosis secondary to cavernous sinus syndrome in a 34-year-old lady due to refusal of proper medical treatment for metastaticbreast cancer. The delay in seeking medical treatment was attributed to her use of Traditional Chinese Medicine (TCM.

  5. The Effect of Audio Tours on Learning and Social Interaction: An Evaluation at Carlsbad Caverns National Park

    Science.gov (United States)

    Novey, Levi T.; Hall, Troy E.

    2007-01-01

    Auditory forms of nonpersonal communication have rarely been evaluated in informal settings like parks and museums. This study evaluated the effect of an interpretive audio tour on visitor knowledge and social behavior at Carlsbad Caverns National Park. A cross-sectional pretest/posttest quasi-experimental design compared the responses of audio…

  6. 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.

  7. Stability analysis and determination of rock pillar between two adjacent caverns in different regions of Asmari formation in Iran

    Institute of Scientific and Technical Information of China (English)

    Abdollahipour Abolfazl a; ⇑; Ghannadshirazi Hossein b

    2014-01-01

    Large underground caverns are commonly used in variety of applications. In many cases, because of the geomechanical limitations of dimensions and requirement of high volume, several parallel caverns are used. Plastic zone integration requires a larger rock pillar distance of theses adjacent caverns while eco-nomic and access reasons require smaller distance. In Iran many underground projects are located in West and South West. Asmari formation covers a large part of these regions. The stability of underground spaces that are constructed or will be constructed in this formation has been investigated. A proper cross section based on plastic analysis and a stability criterion has been proposed for each region. Finally, in each case, allowable rock pillar between adjacent caverns with similar dimension was determined with two methods (numerical analysis and fire service law). Results show that Fire Service Law uses a very con-servative safety factor and it was proposed to use a correction factor for allowable distance based on application of underground space.

  8. Vascular lesions of the lumbar epidural space: magnetic resonance imaging features of epidural cavernous hemangioma and epidural hematoma

    Directory of Open Access Journals (Sweden)

    Basile Júnior Roberto

    1999-01-01

    Full Text Available The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

  9. Prognostic analysis and complications of traumatic carotid cavernous fistulas after treatment with detachable balloon and/or coil embolization

    Institute of Scientific and Technical Information of China (English)

    杨振九; 李宏伟; 吴良贵; 郑俊宁; 张佳栋; 史锡文; 楚功仁

    2004-01-01

    Objective:To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolization and the prevention of its complications.Methods: From October, 1992 to March, 2002, 17patients with traumatic carotid-cavernous fistulas were treated with detachable balloon and/or coil embolization in our hospital. The clinical data and imaging features of CT, MR and selective angiogram of these patients were analyzed.Results: One week after treatment with embolization, the clinical symptoms of the 17 patients were remitted, and optic cacophony, nystagmus, exophthalmos and dropsy of conjunctiva disappeared. Two patientsmanifested surgical complications, one patient died. Sixteen patients survived. They were all followed up for more than 2 years, which showed one patient had handicap in movement, and in one patient the signs and symptoms of traumatic carotid-cavernous fistulas reoccurred 2 months after treatment.Conclusions: The detachable balloon and/or coil embolization is safe and reliable. It is a good method to treat traumatic carotid-cavernous fistulas.

  10. Relaxation of rabbit cavernous smooth muscle to 17β-estradiol: a non-genomic, NO-independent mechanism

    Institute of Scientific and Technical Information of China (English)

    Sae-ChulKim; Kyung-KunSeo; Soon-ChulMyung; MooYeolLee

    2004-01-01

    Aim: To investigate whether estrogen was involved in relaxation of rabbit cavernous smooth muscle.Methods: Relaxation response of the rabbit cavernous smooth muscles to 17β-estradiol (0.3, 3, 30 and 300 nmol/L) were observed in vitro. The response of the muscle strips to estrogen after incubation with either actinomycin D (10μmol/L) or L-NAME (10μmol/L) were also evaluated. Inside-out mode of patch clamp in a single smooth muscle cell was applied to investigate the Maxi-K channel activities. Results: Estrogen caused a dose-dependent relaxation of the strips precontracted with norepinephrine. The maximal response was noted about 10 minutes after treatment. Theestrogen-induced relaxation was prevented by neither actinomycin D nor L-NAME, suggesting that the response was not mediated by gene transcription or nitric oxide (NO). Application of 17β-estradiol increased the Maxi-K channelactivities. Conclusion: 17β-estradiol may be involved in relaxation of rabbit cavernous smooth muscles via a nongenomic and NO independent mechanism. 17β-estradiol stimulates Maxi-K channel of the rabbit cavernous myocyte.

  11. Two cystic cavernous angiomas after radiotherapy for atypical meningioma in adult woman : case report and literature review.

    Science.gov (United States)

    Ruggeri, Andrea Gennaro; Donnarumma, Pasquale; Pichierri, Angelo; Delfini, Roberto

    2014-01-01

    A correlation between radiation therapy and cavernoma has been suspected since 1994. Since then, only a few cases of radio-induced cavernomas have been reported in the literature (85 patients). Most of them were children, and the most frequent original tumour had been medulloblastoma. The authors report a case of two cystic cavernous angiomas after radiation therapy for atypical meningioma in adult woman. This is the first case of cavernous angioma after radiotherapy for low grade meningioma. A 39-year-old, Latin american woman was operated on for a frontal atypical meningioma with intradiploic component and adjuvant radiotherapy was delivered (6000 cGy local brain irradiation, fractionated over 6 weeks). Follow-up MR imaging showed no recurrences of the tumour and no other lesions. Ten years later, at the age of 49, she consulted for progressive drug-resistant headache. MR imaging revealed two new well defined areas of different signal intensity at the surface of each frontal pole. Both lesions were surgically removed; the histopathological diagnosis was cavernous angioma. This is the first case of cavernous angioma after radiation therapy for atypical meningioma : it confirms the development of these lesions after standard radiation therapy also in patients previously affected by non-malignant tumours.

  12. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  13. Clinical treatment experiences of intracranial cavernous angiomas%颅内海绵状血管瘤的临床治疗经验

    Institute of Scientific and Technical Information of China (English)

    王黎; 傅先明; 牛朝诗; 喻廉; 汪业汉

    2011-01-01

    目的 探讨颅内海绵状血管瘤(ICCA)的治疗策略.方法 回顾性分析55例经病理证实的颅内海绵状血管瘤病人的临床资料.其中采用常规开颅方式手术30例,神经导航手术19例,立体定向手术6例.结果 全切除52例,大部切除3例.术后无死亡,无颅内出血.术后主要并发症为感染、脑水肿和脑梗死,对症治疗后均好转.结论 神经导航手术是切除体积小、位置深颅内海绵状血管瘤病灶的首选方法;以癫(癎)为首发症状的病人,术中辅以皮质脑电图描记加皮质电灼或切除,对术后癫(癎)的控制有良好效果.%Objective To investigate the treatment strategies of intracranial cavernous angiomas (ICCA). Methods Clinical data of 55 patients with ICCA comfirmed by pathology were analyzed retrospectively. The conventional surgery was performed in 30 patients, neuronavigation surgery in 19 and stereotactic surgery in 6. Results Complete removal was achieved in 52 patients and subtotal removal in 3. No death and intracranial hemorrhage occurred after operation. The main postoperative complications included infection, encephaledema and cerebral infarction, and the patients recovered well after symptomatic treatment. Conclusions Neuronavigation surgery is the first choice for the removal of small and deep lesions of ICCA. Electrocorticography and cortex figuration or removal during operation is helpful for the postoperative control of patients with first symptom of epilepsia.

  14. Feasibility report on alternative methods for cooling cavern oils at the U.S. Strategic Petroleum Reserve.

    Energy Technology Data Exchange (ETDEWEB)

    Levin, Bruce L.; Lord, David L.; Hadgu, Teklu

    2005-06-01

    Oil caverns at the U.S. Strategic Petroleum Reserve (SPR) are subjected to geothermal heating from the surrounding domal salt. This process raises the temperature of the crude oil from around 75 F upon delivery to SPR to as high as 130 F after decades of storage. While this temperature regime is adequate for long-term storage, it poses challenges for offsite delivery, with warm oil evolving gases that pose handling and safety problems. SPR installed high-capacity oil coolers in the mid-1990's to mitigate the emissions problem by lowering the oil delivery temperature. These heat exchanger units use incoming raw water as the cooling fluid, and operate only during a drawdown event where incoming water displaces the outgoing oil. The design criteria for the heat exchangers are to deliver oil at 100 F or less under all drawdown conditions. Increasing crude oil vapor pressures due in part to methane intrusion in the caverns is threatening to produce sufficient emissions at or near 100 F to cause the cooled oil to violate delivery requirements. This impending problem has initiated discussion and analysis of alternative cooling methods to bring the oil temperature even lower than the original design basis of 100 F. For the study described in this report, two alternative cooling methods were explored: (1) cooling during a limited drawdown, and (2) cooling during a degas operation. Both methods employ the heat exchangers currently in place, and do not require extra equipment. An analysis was run using two heat transfer models, HEATEX, and CaveMan, both developed at Sandia National Laboratories. For cooling during a limited drawdown, the cooling water flowrate through the coolers was varied from 1:1 water:oil to about 3:1, with an increased cooling capacity of about 3-7 F for the test cavern Bryan Mound 108 depending upon seasonal temperature effects. For cooling in conjunction with a degas operation in the winter, cavern oil temperatures for the test cavern Big Hill 102

  15. Deep Fracturing of the Hard Rock Surrounding a Large Underground Cavern Subjected to High Geostress: In Situ Observation and Mechanism Analysis

    Science.gov (United States)

    Feng, Xia-Ting; Pei, Shu-Feng; Jiang, Quan; Zhou, Yang-Yi; Li, Shao-Jun; Yao, Zhi-Bin

    2017-08-01

    Rocks that are far removed from caverns or tunnels peripheries and subjected to high geostress may undergo `deep fracturing'. Deep fracturing of hard rock can cause serious hazards that cause delays and increase the cost of construction of underground caverns with high sidewalls and large spans (especially when subjected to high geostress). To extensively investigate the mechanism responsible for deep fracturing, and the relationship between fracturing and the excavation & support of caverns, this paper presents a basic procedure for making in situ observations on the deep fracturing process in hard rock. The basic procedure involves predicting the stress concentration zones in the surrounding rocks of caverns induced by excavation using geomechanical techniques. Boreholes are then drilled through these stress concentration zones from pre-existing tunnels (such as auxiliary galleries) toward the caverns before its excavation. Continuous observations of the fracturing of the surrounding rocks are performed during excavation using a borehole camera in the boreholes in order to analyze the evolution of the fracturing process. The deep fracturing observed in a large underground cavern (high sidewalls and large span) in southwest China excavated in basalt under high geostress is also discussed. By continuously observing the hard rock surrounding the arch on the upstream side of the cavern during the excavation of the first three layers, it was observed that the fracturing developed into the surrounding rocks with downward excavation of the cavern. Fracturing was found at distances up to 8-9 m from the cavern periphery during the excavation of Layer III. Also, the cracks propagated along pre-existing joints or at the interfaces between quartz porphyry and the rock matrix. The relationship between deep fracturing of the surrounding rocks and the advance of the cavern working faces was analyzed during excavation of Layer Ib. The results indicate that the extent of the

  16. Cerebral phaeohyphomycosis by Exophiala dermatitidis

    Directory of Open Access Journals (Sweden)

    S Sood

    2014-01-01

    Full Text Available Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  17. Cerebral phaeohyphomycosis by Exophiala dermatitidis.

    Science.gov (United States)

    Sood, S; Vaid, V K; Sharma, M; Bhartiya, H

    2014-01-01

    Cerebral phaeohyphomycosis is a rare and frequently fatal disease. We report a case of cerebral phaeohyphomycosis caused by Exophiala dermatitidis in a young immuno competent male presenting to a tertiary care hospital in Jaipur.

  18. 245例脑外伤所致精神障碍者家属抑郁状况及相关因素分析%Depression Status of the Family Member and Its Influencing Factors in the Patient with Mental Disorder Caused by Cerebral Trauma: 245 Cases Analysis

    Institute of Scientific and Technical Information of China (English)

    杨成龙; 庞艳霞; 谢岩平; 许海峰

    2013-01-01

    目的 了解脑外伤所致精神障碍者家属抑郁状况及其影响因素. 方法 应用自行设计的一般资料调查问卷和抑郁自评量表(self-rating depression scale,SDS),对245名被鉴定人家属进行抑郁状况调查,并依据SDS评分指数分为抑郁组和非抑郁组,进行单因素以及多元逐步回归分析.结果 245名被鉴定人家属中117名家属存在不同程度的抑郁症状,其中轻度68例、中度42例、重度7例.在多元逐步回归分析中,亲缘关系、家属性格特征、付费方式为被鉴定人家属抑郁状况的主要影响因素. 结论 脑外伤所致精神障碍者家属抑郁状况应引起足够重视,给予针对性的心理干预.%Objective To determine the family member's depression status and its influencing factors in the patient with mental disorder caused by cerebral trauma.Methods The self-designed information questionnaire and self-rating depression scale (SDS) were used to investigate 245 family members' depression conditions.On the basis of SDS score index,all cases were divided into depression group and non-depression group.The data were analyzed by the tmivariate analysis and multiple factors regression analysis.Results In the 245 family members,117 family members had different degrees of depressive symptoms including 68 with mild depression,42 with moderate depression,and 7 with severe depression.In the multiple factors regression analysis,genetic relationship,personality characteristics and payment method were the main influencing factors of the depression status.Conclusion Much attention should be paid to the family member's depression condition of the patient with mental disorder caused by cerebral trauma through specific psychological intervention.

  19. Design and operation problems related to water curtain system for underground water-sealed oil storage caverns

    Institute of Scientific and Technical Information of China (English)

    Zhongkui Li; Baoqi Lu; Jing Zou; Bin Xu; Zhizeng Zhang

    2016-01-01

    The underground water-sealed storage technique is critically important and generally accepted for the national energy strategy in China. Although several small underground water-sealed oil storage caverns have been built in China since the 1970s, there is still a lack of experience for large-volume underground storage in complicated geological conditions. The current design concept of water curtain system and the technical instruction for system operation have limitations in maintaining the stability of surrounding rock mass during the construction of the main storage caverns, as well as the long-term stability. Although several large-scale underground oil storage projects are under construction at present in China, the design concepts and construction methods, especially for the water curtain system, are mainly based on the ideal porosity medium flow theory and the experiences gained from the similar projects overseas. The storage projects currently constructed in China have the specific features such as huge scale, large depth, multiple-level arrangement, high seepage pressure, complicated geological conditions, and high in situ stresses, which are the challenging issues for the stability of the storage caverns. Based on years’ experiences obtained from the first large-scale (millions of cubic meters) underground water-sealed oil storage project in China, some design and operation problems related to water curtain system during project construction are discussed. The drawbacks and merits of the water curtain system are also presented. As an example, the conventional concept of“filling joints with water”is widely used in many cases, as a basic concept for the design of the water curtain system, but it is immature. In this paper, the advantages and disadvantages of the conventional concept are pointed out, with respect to the long-term stability as well as the safety of construction of storage caverns. Finally, new concepts and principles for design and

  20. Characterizing Excavation Damaged Zone and Stability of Pressurized Lined Rock Caverns for Underground Compressed Air Energy Storage

    Science.gov (United States)

    Kim, Hyung-Mok; Rutqvist, Jonny; Jeong, Ju-Hwan; Choi, Byung-Hee; Ryu, Dong-Woo; Song, Won-Kyong

    2013-09-01

    In this paper, we investigate the influence of the excavation damaged zone (EDZ) on the geomechanical performance of compressed air energy storage (CAES) in lined rock caverns. We conducted a detailed characterization of the EDZ in rock caverns that have been excavated for a Korean pilot test program on CAES in (concrete) lined rock caverns at shallow depth. The EDZ was characterized by measurements of P- and S-wave velocities and permeability across the EDZ and into undisturbed host rock. Moreover, we constructed an in situ concrete lining model and conducted permeability measurements in boreholes penetrating the concrete, through the EDZ and into the undisturbed host rock. Using the site-specific conditions and the results of the EDZ characterization, we carried out a model simulation to investigate the influence of the EDZ on the CAES performance, in particular related to geomechanical responses and stability. We used a modeling approach including coupled thermodynamic multiphase flow and geomechanics, which was proven to be useful in previous generic CAES studies. Our modeling results showed that the potential for inducing tensile fractures and air leakage through the concrete lining could be substantially reduced if the EDZ around the cavern could be minimized. Moreover, the results showed that the most favorable design for reducing the potential for tensile failure in the lining would be a relatively compliant concrete lining with a tight inner seal, and a relatively stiff (uncompliant) host rock with a minimized EDZ. Because EDZ compliance depends on its compressibility (or modulus) and thickness, care should be taken during drill and blast operations to minimize the damage to the cavern walls.

  1. The efficacy of resection of an intradural extramedullary foramen magnum cavernous malformation presenting with repeated subarachnoid hemorrhage: a case report.

    Science.gov (United States)

    Oishi, Tomoya; Sakai, Naoto; Sameshima, Tetsuro; Kawaji, Hiroshi; Namba, Hiroki

    2017-03-09

    Intradural extramedullary cavernous angiomas of the central nervous system are a rare type of cavernous angioma, but they can cause fatal subarachnoid hemorrhage. The efficacy of resection for this type of cavernous malformations remains uncertain. This is the first report to recommend surgical resection of these types of lesions regardless of the fatal condition. Our patient was a 70-year-old Japanese man who experienced a sudden onset of an occipital headache, followed by bilateral abducens nerve palsy. Magnetic resonance imaging revealed a small amount of hemorrhage in both of the lateral ventricles and an intradural extramedullary mass lesion in the left side of his foramen magnum. Two weeks after the appearance of initial symptoms, he became comatose. A computed tomography scan showed an increase in the subarachnoid intraventricular hemorrhaging and of the acute hydrocephalus. Following ventricular drainage, total tumor resection was performed using the lateral suboccipital transcondylar approach in conjunction with a first cervical hemilaminectomy. We observed a grape-like vascular-rich tumor with calcification that was adhering tightly to the wall of his left vertebral artery. A histopathological examination of the surgery specimen identified it as a cavernous angioma. After placement of a ventriculoperitoneal shunt and 2 months of rehabilitation, he recovered completely. An intradural extramedullary foramen magnum cavernous malformation is quite rare. The fragile surface of our patient's lesion was causing repeated subarachnoid hemorrhage and consequently progressive fatal neurological deterioration. Surgical resection of the lesion to prevent repeated hemorrhage was performed and he recovered fully. Therefore, we recommend surgical resection of the lesion regardless of the potentially fatal condition.

  2. Design and operation problems related to water curtain system for underground water-sealed oil storage caverns

    Directory of Open Access Journals (Sweden)

    Zhongkui Li

    2016-10-01

    Full Text Available The underground water-sealed storage technique is critically important and generally accepted for the national energy strategy in China. Although several small underground water-sealed oil storage caverns have been built in China since the 1970s, there is still a lack of experience for large-volume underground storage in complicated geological conditions. The current design concept of water curtain system and the technical instruction for system operation have limitations in maintaining the stability of surrounding rock mass during the construction of the main storage caverns, as well as the long-term stability. Although several large-scale underground oil storage projects are under construction at present in China, the design concepts and construction methods, especially for the water curtain system, are mainly based on the ideal porosity medium flow theory and the experiences gained from the similar projects overseas. The storage projects currently constructed in China have the specific features such as huge scale, large depth, multiple-level arrangement, high seepage pressure, complicated geological conditions, and high in situ stresses, which are the challenging issues for the stability of the storage caverns. Based on years' experiences obtained from the first large-scale (millions of cubic meters underground water-sealed oil storage project in China, some design and operation problems related to water curtain system during project construction are discussed. The drawbacks and merits of the water curtain system are also presented. As an example, the conventional concept of “filling joints with water” is widely used in many cases, as a basic concept for the design of the water curtain system, but it is immature. In this paper, the advantages and disadvantages of the conventional concept are pointed out, with respect to the long-term stability as well as the safety of construction of storage caverns. Finally, new concepts and principles

  3. [Cerebral ischemia and histamine].

    Science.gov (United States)

    Adachi, Naoto

    2002-10-01

    Cerebral ischemia induces excess release of glutamate and an increase in the intracellular Ca2+ concentration, which provoke catastrophic enzymatic processes leading to irreversible neuronal injury. Histamine plays the role of neurotransmitter in the central nervous system, and histaminergic fibers are widely distributed in the brain. In cerebral ischemia, release of histamine from nerve endings has been shown to be enhanced by facilitation of its activity. An inhibition of the histaminergic activity in ischemia aggravates the histologic outcome. In contrast, intracerebroventricular administration of histamine improves the aggravation, whereas blockade of histamine H2 receptors aggravates ischemic injury. Furthermore, H2 blockade enhances ischemic release of glutamate and dopamine. These findings suggest that central histamine provides beneficial effects against ischemic neuronal damage by suppressing release of excitatory neurotransmitters. However, histaminergic H2 action facilitates the permeability of the blood-brain barrier and shows deleterious effects on cerebral edema.

  4. Clinical practice: swallowing problems in cerebral palsy.

    Science.gov (United States)

    Erasmus, Corrie E; van Hulst, Karen; Rotteveel, Jan J; Willemsen, Michel A A P; Jongerius, Peter H

    2012-03-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.

  5. Subject variables and cerebral organization for language.

    Science.gov (United States)

    Searleman, A

    1980-08-01

    The present study investigated the usefulness of a variety of subject variables that have been proposed as having predictive value for determining cerebral organization for language. To accomplish this, a total of 373 subjects (117 left-handers and 256 right-handers) were given 240 trials of a consonant-vowel dichotic listening task to assess direction and degree of language lateralization. Each subject was also classified on the basis of eight subject variables (handedness, strength of handedness, familial sinistrality, writing hand posture, sex, sighting dominance, preferred footedness, and overall laterality). The results of the study indicated that left hemisphere language processing is very pervasive and that most of the subject variables examined were not very useful predictors of language lateralization. In addition, surprisingly, footedness and not handedness was the single best predictor of cerebral organization for language.

  6. Hemangioma cavernoso intramedular: relato de caso Spinal cord intramedullary cavernous haemangioma: case report

    Directory of Open Access Journals (Sweden)

    Juliano Colonetti

    2003-09-01

    Full Text Available O hemangioma cavernoso intramedular é anomalia vascular de baixo fluxo, curável através de ressecção cirúrgica. Entretanto, se não forem instituídos o diagnóstico precoce e a terapêutica adequada, pode levar à graves sequelas neurológicas. É extremamente raro a ocorrência de um angioma cavernoso intramedular. É relatado o caso de uma paciente de 33 anos, com um angioma cavernoso intramedular no nível de T6 - T7, que apresentava quadro clínico de compressão medular lenta e progressiva, com piora recente importante. A ressonância magnética da coluna torácica demonstrou, entre a sexta e a sétima vértebras dorsais, lesão expansiva intramedular que se apresentava hipointensa em T1 e discretamente hiperintensa em T2, com pequeno halo hipointenso à sua volta nas duas sequências. A paciente foi submetida a tratamento cirúrgico tardio e não apresentou recuperação neurológica. Os achados clínicos, de imagem e a importância de instituir precocemente o tratamento adequado são analisados e discutidos.The intramedullary cavernous haemangioma is a low flow vascular anomaly curable through surgical resection, howewer if the precocious diagnosis and the appropriate therapeutics are not done it can cause serious neurological sequels.It is extremely rare the occurrence of intramedullary cavernous haemangioma. We report the case of a 33 year-old woman patient with an intramedullary cavernous angioma at T6-T7, that presented a clinical picture of slow and progressive spinal cord compression , with an important recent worsening.The magnetic resonance of the thoracic column demonstrated a T6 - T7 a intramedullary expansive lesion wich presented hypointense on T1 and discretely hyperintense on T2 with a small hypointense area in the two sequences.The patient was submitted to late surgical treatment and did not presented neurological recovery. The clinical and imagelogy pictures, and the importance of instituing precociously the

  7. Stability and support issues in the construction of large span caverns for physics

    Energy Technology Data Exchange (ETDEWEB)

    Laughton, C.; /Fermilab

    2008-05-01

    New physics experiments, proposed to study neutrinos and protons, call for the use of large underground particle detectors. In the United States, such detectors would be housed in the US Deep Underground Science and Engineering Laboratory (DUSEL), sited within the footprint of the defunct Homestake Mine, South Dakota. Although the experimental proposals differ in detail, all rely heavily upon the ability of the mined and reinforced rock mass to serve as a stable host for the detector facilities. Experimental proposals, based on the use of Water Cherenkov detector technology, specify rock caverns with excavated volumes in excess of half a million cubic meters, spans of at least 50 m, sited at depths of approximately one to 1.5 kilometers. Although perhaps sited at shallower depth, proposals based on the use of Liquid Argon (LAr) detector technology are no less challenging. LAr proposals not only call for the excavation of large span caverns, but have an additional need for the safe management of large quantities (kilo-tonnes) of cryogenic liquid, including critical provisions for the fail-safe egress of underground personnel and the reliable exhaust of Argon gas in the event of a catastrophic release. These multi-year, high value physics experiments will provide the key experimental data needed to support the research of a new generation of physicists as they probe the behavior of basic particles and the fundamental laws of nature. The rock engineer must deliver caverns that will reliably meet operational requirements and remain stable for periods conservatively estimated to be in excess of twenty years. This paper provides an overview of the DUSEL site conditions and discusses key end-user requirements and design criteria likely to dominate in determining the viability of experimental options. The paper stresses the paramount importance of collecting adequate site-specific data to inform early siting, dimensioning and layout decisions. Given the large-scale of the

  8. FEATURES OF SPECIFIC IMMUNE RESPONSE IN THE PATIENTS WITH FIBROUS/CAVERNOUS TUBERCULOSIS OF LUNGS

    Directory of Open Access Journals (Sweden)

    T. E. Kissina

    2006-01-01

    Full Text Available Abstract. The aim of the present study was to determine the different profiles of the immune responsiveness of the patients with fibro-cavernous pulmonary tuberculosis to PPD from M.tuberculosis in comparison with their response to standart mitogen and IFNγ. A pronounced specific Th1 response was found, evidenced by the enhanced proliferation and IL-2 and IFNγ production after contact of their peripheral blood mononuclear cells (PBMCs with PPD. At the same time a high frequency of PPD-anergy was shown: сonsiderable proportion of TB patients was characterized by low proliferative response to PPD coupled with the low levels of IL-2 and IFNγ. Most of the patients revealed failure of monocyte/macrophage oxidative burst in response to PPD. Additionally a positive correlation was found between the levels of their PBMC’s oxidative burst and IL-4 production.

  9. Speleological study of the cavern of the Ecce homo hill, in the municipality of Chimichagua, Cesar

    Directory of Open Access Journals (Sweden)

    Frank David Lascarro-Navarro

    2015-06-01

    Full Text Available In the municipality of Chimichagua, Cesar, there is a system of natural caves associated with carbonate sedimentary rocks, which have suffered chemical dissolution and mechanical erosion generating exokarstic and endokarstic processes, which explain the geochemical and morphological phenomena that have given rise to these cavities. This study presents the results of a speleological work performed to the cavern of the Eccehomo Hill, located in the municipality of Chimichagua department of Cesar, concluding that the lithostratigraphic units outside and inside of the cavities are micritic and micritic limestones with fossils that according to the classification of Folk (1974, belong to the Formation Aguas Blancas, of the Cogollo Group. The cavities possess throughout their extension, variety of speleothems, endokarstic process products such as stalactites, moonmilk, castings, flags, sawtooth, found in the walls and ceiling.

  10. Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

    Institute of Scientific and Technical Information of China (English)

    Anthony J. Bella; Guiting Lin; Ilias Cagiannos; Tom F. Lue

    2008-01-01

    Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves (CNs), as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction (ED) after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors (GDNF), bone morphogenic proteins, immunophilin ligands,erythropoetin (EPO), and stem cells.

  11. [The impact of endovascular intervention on visual functions in patients with traumatic carotid-cavernous anastomosis].

    Science.gov (United States)

    Ryzhova, I P

    1997-01-01

    In 217 patients with traumatic carotid-cavernous anastomosis (TCCA) the visual functions investigation before and after endovascular intervention conduction for the anastomosis exclusion was done. Cessation of the noise in the head synchronous with a pulse, decrease of disappearance of an exophthalmus of an eye or superior optical vein pulsation, of congestional appearance in the orbit, were the signs of the complete anastomosis exclusion. Rehabilitation or increase of visual acuity, improvement of an eye fundus ophthalmological picture, vascular index normalization were noted during deep ophthalmological investigation. Decrease of the blind spot parameters was an objective index of the visual functions rehabilitation, witnessing the disappearance of optical nerve disc (OND) oedema, contrast frequential characteristics normalization, critical frequency of light flashings radiance (CFLFR) rise, decrease of a papillary cycle time (PCT). Studying of the parameters mentioned have special significance for the estimation of postoperative conservative therapy efficiency.

  12. 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.

  13. [Cranio-orbital zygomatic extradural approach for cavernous sinus or Meckel's cave tumors].

    Science.gov (United States)

    Kinjo, T; Mukawa, J; Mekaru, S; Koga, H

    1996-06-01

    Direct surgery to cavernous sinus (CS) lesions has become one of the optimal treatments based on advancement in microsurgical anatomy and imaging modality, and the progress of microsurgical techniques. We have removed the CS or Meckel's cave tumors extradurally when they do not extend intradurally, using modified Al-Mefty's cranio-orbital zygomatic craniotomy. Three CS tumors; trigeminal neurofibroma, squamous cell carcinoma and chondrosarcoma, and a Meckel's cave meningioma were reported. Total removal was achieved in all but one (case 4). Postoperative complications were permanent ophthalmoplegia in one, transient ophthalmoplegia in one, subcutaneous CSF accumulation in two and trigeminal dysfunction in one. The extradural approach can be the first choice of methods for total removal of tumors when they are confined to the CS or Meckel's cave.

  14. Cavernous Transformation of the Portal Vein Might Increase the Risk of Liver Abscess

    Directory of Open Access Journals (Sweden)

    Xin-Bo Ai

    2010-09-01

    Full Text Available Cavernous transformation of the portal vein (CTPV is not quite common in adults, and cases with CTPV and acute liver abscess are lacking. We report a patient with CTPV inducing extrahepatic and intrahepatic obstruction, finally leading to acute liver abscess due to bile duct infection. We aim to find out the possible relationship between CTPV and acute liver abscess. A 45-year-old female patient was admitted to our hospital for recurrent upper abdominal pain and distension for one year, aggravated with fever for three years. A diagnosis of CTPV and liver abscess was made by 16-slice computed tomography. Effective antibiotics and drainage were used for this patients, and she was eventually cured. When treating patients with CTPV, extrahepatic and intrahepatic obstruction, one should be aware of the presence of acute liver abscess, and empirical antibiotics might be valuable.

  15. Simulations of argon accident scenarios in the ATLAS experimental cavern a safety analysis

    CERN Document Server

    Balda, F

    2002-01-01

    Some characteristic accidents in the ATLAS experimental cavern (UX15) are simulated by means of STAR-CD, a code using the "Finite-Volume" method. These accidents involve different liquid argon leaks from the barrel cryostat of the detector, thus causing the dispersion of the argon into the Muon Chamber region and the evaporation of the liquid. The subsequent temperature gradients and distribution of argon concentrations, as well as their evolution in time are simulated and discussed, with the purpose of analysing the dangers related to asphyxiation and to contact with cryogenic fluids for the working personnel. A summary of the theory that stands behind the code is also given. In order to validate the models, an experimental test on a liquid argon spill performed earlier is simulated, showing that the program is able to output reliable results. At the end, some safety-related recommendations are listed.

  16. Aeromonas cavernicola sp. nov., isolated from fresh water of a brook in a cavern.

    Science.gov (United States)

    Martínez-Murcia, Antonio; Beaz-Hidalgo, Roxana; Svec, Pavel; Saavedra, Ma José; Figueras, Ma José; Sedlacek, Ivo

    2013-02-01

    Aeromonas P2973 was isolated from the water of a brook in a cavern in the Czech Republic. This isolate could not be biochemically identified at the species level, considering all updated species descriptions. Subsequent extensive phenotypic characterisation, DNA-DNA hybridisation, 16S rRNA gene sequencing and a Multi-Locus Phylogenetic Analysis (MLPA) of the concatenated sequence of 7 housekeeping genes (gyrB, rpoD, recA, dnaJ, gyrA, dnaX and atpD; 4705 bp) was employed in an attempt to ascertain the taxonomy of this isolate. Based on this polyphasic approach, we describe a novel species of the genus Aeromonas, for which the name Aeromonas cavernicola sp. nov. is proposed, with strain CCM7641(T) (DSM24474(T), CECT7862(T)) as the type strain.

  17. Characterization of bedded salt for storage caverns -- A case study from the Midland Basin, Texas

    Energy Technology Data Exchange (ETDEWEB)

    Hovorka, Susan D.; Nava, Robin

    2000-06-13

    The geometry of Permian bedding salt in the Midland Basin is a product of interaction between depositional facies and postdepositional modification by salt dissolution. Mapping high-frequency cycle patterns in cross section and map view using wireline logs documents the salt geometry. Geologically based interpretation of depositional and dissolution processes provides a powerful tool for mapping and geometry of salt to assess the suitability of sites for development of solution-mined storage caverns. In addition, this process-based description of salt geometry complements existing data about the evolution of one of the best-known sedimentary basins in the world, and can serve as a genetic model to assist in interpreting other salts.

  18. Therapeutic embolization of cavernous sinus dural arteriovenous fistulas via transvenous approach

    Institute of Scientific and Technical Information of China (English)

    侯凯; 罗祺; 陈强; 王宏磊; 罗毅男; 王长坤

    2003-01-01

    Objective To describe the transvenous catheterization technique for the treatment of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including its indications, complications and efficacy.Methods Eight patients with symptomatic CSdAVFs were treated by endovascular embolization with platinum coils, via the inferior petrosal sinus (IPS) in 6 patients, and via the Sylvian vein after surgical exposure in other 2 patients.Results Complete angiographic resolution of the fistula was obtained in six patients immediately after the procedures, and a complete resolution of symptoms and signs was achieved in all patients. The residual fistulas in two patients disappeared completely in the follow-up angiography.Conclusion Transvenous embolization is a useful and safe approach in the management of CSdAVFs.

  19. Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

    Directory of Open Access Journals (Sweden)

    Ana Ruth Macêdo Monteiro

    2004-04-01

    Full Text Available O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados em 3 categorias: conhecendo as famílias, identificando o conhecimento dos familiares, atendendo às solicitações dos familiares. A cartilha de orientação, elaborada de acordo com o levantamento das principais dúvidas e/ou dificuldades dos familiares, busca favorecer o processo educativo dessas famílias no ambiente hospitalar, promovendo, assim, seu envolvimento nesse processo. A importância de um trabalho nesse sentido está baseada na possibilidade de uma maior compreensão dos problemas vivenciados pelos pacientes acometidos por AVC e por suas famílias, auxiliando, dessa forma, o enfermeiro a desenvolver ações visando minimizá-los e tornar a situação menos traumática para ambos.The present study aims to identify the knowledge of CVA (Cerebral Vascular Accident patients' close relatives on the disease and its specific cares; and also, to elaborate a guide for the home care of those patients. The present research evaluated family members from 50 CVA patients. These relatives were taking care of the patients for at least 3 days. The data obtained from the testimonies analysis are grouped in three categories: acquainting the families; identifying the family’s knowledge; assisting family’s requests. The guide, organized according to the relatives' main doubts and difficulties, intends to help the educational process of those families in the hospital’s atmosphere, promoting their engagement in the process. This work makes possible a

  20. Transvenous embolization with a combination of detachable coils and Onyx for a complicated cavernous dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HE Hong-wei; JIANG Chu-han; WU Zhong-xue; LI You-xiang; LU Xian-li; WANG Zhong-cheng

    2008-01-01

    Background Treatment of cavemous dural arteriovenous fistulas (DAVF) is usually made by a transartedal approach.However,in many complicated patients,treatments via transarterial approaches can not be achieved,and only an operation via a transvenous approach is feasible.We aimed to study the feasibility of transarterial embolJzation of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavemous DAVF via a transvenous approach.Methods From August 2006 to August 2007,six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach.Three cases were male and the other three were female.Their ages ranged from 36 to 69 years old.The fistula was in the right lateral cavernous sinus in one case,in the left lateral cavernous sinus in another,and in the bilateral cavernous sinus in 4 cases.One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk;one was fed by the branches of the left internal carotid artery and left extemal carotid artery;four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery.One case was drained via one lateral inferior petrosal sinus;three were drained via bilateral inferior petrosal sinuses;one was drained via one lateral ophthalmic and facial veins;one was drained via the infedor petrosal sinus and the ophthalmic and facial veins.Four were embolized via the inferior petrosal sinus,and two were embolized via the ophthalmic and facial veins.Results Among six cases of complicated cavernous DAVF,four were fully embolized with Onyx by a single operation,and two cases were fully embolized with Onyx following two operations.Transient headache was found after operation in all patients,but was cured after several days by the symptomatic treatments.In one case,the first operation via the inferior petrosal sinus was a failure;the feeding branches of