Limited endoscopic transsphenoidal approach for cavernous sinus biopsy: illustration of 3 cases and discussion.

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Graillon, T; Fuentes, S; Metellus, P; Adetchessi, T; Gras, R; Dufour, H

2014-01-01

Advances in transsphenoidal surgery and endoscopic techniques have opened new perspectives for cavernous sinus (CS) approaches. The aim of this study was to assess the advantages and disadvantages of limited endoscopic transsphenoidal approach, as performed in pituitary adenoma surgery, for CS tumor biopsy illustrated with three clinical cases. The first case was a 46-year-old woman with a prior medical history of parotid adenocarcinoma successfully treated 10 years previously. The cavernous sinus tumor was revealed by right third and sixth nerve palsy and increased over the past three years. A tumor biopsy using a limited endoscopic transsphenoidal approach revealed an adenocarcinoma metastasis. Complementary radiosurgery was performed. The second case was a 36-year-old woman who consulted for diplopia with right sixth nerve palsy and amenorrhea with hyperprolactinemia. Dopamine agonist treatment was used to restore the patient's menstrual cycle. Cerebral magnetic resonance imaging (MRI) revealed a right sided CS tumor. CS biopsy, via a limited endoscopic transsphenoidal approach, confirmed a meningothelial grade 1 meningioma. Complementary radiosurgery was performed. The third case was a 63-year-old woman with progressive installation of left third nerve palsy and visual acuity loss, revealing a left cavernous sinus tumor invading the optic canal. Surgical biopsy was performed using an enlarged endoscopic transsphenoidal approach to the decompress optic nerve. Biopsy results revealed a meningothelial grade 1 meningioma. Complementary radiotherapy was performed. In these three cases, no complications were observed. Mean hospitalization duration was 4 days. Reported anatomical studies and clinical series have shown the feasibility of reaching the cavernous sinus using an endoscopic endonasal approach. Trans-foramen ovale CS percutaneous biopsy is an interesting procedure but only provides cell analysis results, and not tissue analysis. However, radiotherapy and

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

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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.)

Gd-DTPA in the evaluation of the normal and adnormal cavernous sinus

International Nuclear Information System (INIS)

Marks, M.P.; Thrush, A.; Enzmann, D.

1989-01-01

This paper reports on Gd-DTPA used in the evaluation of normal and abnormal cavernous sinus anatomy. Twenty-five normal subjects and 11 patients with cavernous sinus invasion were studied before Gd-DTPA enhancement. Normal studies were assessed for the conspicuity of the dural margins, the trigeminal cistern, and intracavernous and exiting cranial nerves. Contrast medium enhancement improved deductibility of the medical cavernous sinus margin (68% vs 38% on precontrast images) and intracavernous cranial nerves. Cranial nerves were inconsistently seen even on postcontrast images (cranial nerve III, 88%; v 1 , 36%, V 2 , 38%). On the abnormal images, contrast enhancement was beneficial in defining the relationship of tumor to parasellar structures, egress of tumor through bony foramina, and compression of the trigeminal cistern

Resolution of clinical symptoms after reopening of an occluded inferior petrosal sinus in a patient with a cavernous sinus dural arteriovenous fistula. A case report.

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Kojima, A; Onozuka, S; Kinoshita, Y

2013-03-01

We describe a rare case with a cavernous sinus (CS) dural arteriovenous fistula (DAVF) in which the clinical symptoms disappeared after the patient underwent reopening of an occluded inferior petrosal sinus (IPS). A 66-year-old woman presented with increased intraocular pressure, chemosis, and proptosis on the left side. Angiography demonstrated a left CS DAVF supplied by the dural branches of bilateral internal carotid arteries. The shunt flow was directed to the superior and inferior ophthalmic veins, while the bilateral IPSs were not opacified. Accordingly, a transvenous embolization of the fistula was attempted. Although the microcatheter was navigated to the cavernous sinus through the occluded left IPS, obliteration of the fistula was unsuccessful because of the failure of superselective catheterization at the fistulous point. However, the final image demonstrated the development of an antegrade shunt flow through the left IPS to the internal jugular vein and disappearance of the retrograde reflux to the superior and inferior ophthalmic veins. The patient's clinical symptoms immediately resolved after the operation, and the symptoms have not recurred during a one-year follow-up period. Inappropriate transvenous embolization of CS DAVFs can result in vascular complications arising from the unintentional redistribution of shunt flow. The present case illustrates that the disappearance of retrograde shunt flow to the ophthalmic veins after reopening of the occluded IPS may be sufficient if a superselective approach fails or is anticipated to result only in an incomplete embolization of the fistulous point.

Successful Treatment of Dental Infection-Induced Chronic Cavernous Sinus Thrombophlebitis With Antibiotics and Low-Molecular-Weight Heparin: Two Case Reports.

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Li, Yuan; Zheng, Bo; Chen, Kangning; Gui, Li

2015-08-01

Two patients developed cavernous sinus thrombophlebitis from a tooth infection. A 36-year-old man experienced a severe headache with bilateral third and sixth cranial nerve palsies after extraction of his left upper third molar. Another 53-year-old diabetic man developed fever, headache, and bilateral complete ophthalmoplegia after a tooth infection. The brain magnetic resonance imaging scans of both patients showed bilateral cavernous sinus partial thrombosis. Broad-spectrum antibiotics plus low-molecular-weight heparin successfully resolved all symptoms. Both patients recovered fully without any recurrence at the 3-month follow-up visit. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Roentgenological investigation of cavernous sinus structure with special reference to paracavernous cranial nerves

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Tsuha, M.; Aoki, H.; Okamura, T.

1987-01-01

We have evaluated the anatomical structure of cavernous sinuses in parasellar blocks obtained from adult cadavers to gain clinically useful information. Ten microdissectional studies of parasellar blocks (20 sides of cavernous sinus) were carried out with special emphasis on the course of paracavernous cranial nerves (3rd to 6th). These were also examined on plain radiographs. Secondly, CT investigations of the cavernous sinuses (notably as to paracavernous cranial nerves) were undertaken in twenty clinical cases having presumed parasellar lesions and in three parasellar blocks from cadavers. The results from microdisectional studies and plain radiographs were as follows. It was found that the 3rd cranial nerve entered the lateral wall of the cavernous sinus close to the antero-inferior part of the posterior clinoid on lateral projection. The 4th cranial nerve, on the other hand, entered near the postero-inferior portion of the posterior clinoid on the same view. Variations in Parkinson's triangle were fairly often noted, although marked asymmetry was not seen in individual cases. From CT findings, it was found that a postenhanced, magnified direct coronal study was essential for identifying paracavernous cranial nerves more clearly. The 3rd and 5th cranial nerves were fairly well identified on axial and coronal projections. Careful radiological investigation including plain skull radiographs and CT seems to be of value for those who diagnose or treat parasellar lesions. (orig.)

Cavernous sinus syndrome in dogs and cats: case series (2002-2015

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Aslynn M. Jones

2018-05-01

Full Text Available The cavernous sinus (CS is a paired venous sinus that runs along either side of the pituitary gland on the floor of the calvarium. Cavernous sinus syndrome (CSS refers to deficits in more than one of the cranial nerves III, IV, V, and VI, as they are in close association in this region. The purpose of this study was to identify the presenting complaints, neurologic findings, diagnosis, and outcomes in dogs and cats with confirmed cavernous sinus syndrome (CSS. Medical records between 2002 and 2015 were reviewed. Inclusion criteria were neurologic signs consistent with CSS and advanced imaging and/or post-mortem examination. Thirteen dogs and 2 cats were included. Twelve dogs received advanced imaging. Post-mortem examination was performed on 2 cats and 3 dogs. Dogs were 6 -13 years (mean= 10.8 years of age and comprised of several different breeds. Both cats were male neutered domestic shorthair, ages 3 and 14 years. Presenting complaints included mydriasis (N=4, behavior changes (N=3, hyporexia (N=3, ptosis (N=2, ataxia (N=2, pain (N=2, weakness (N=2, lethargy (N=2, and one each of epiphora, ocular swelling, polydipsia, seizures, facial muscle atrophy, dysphagia, and head tilt. Neurologic signs included ophthalmoparesis/plegia (N=13, reduced/absent pupillary light response (N= 11, mydriasis (N= 10, reduced/absent corneal sensation (N= 7, ptosis (N= 6, reduced facial sensation (N= 2, and enophthalmos (N=1. Thirteen patients had a mass lesion within the cavernous sinus, 6 of which were confirmed neoplastic via histopathology. Median survival time for the 4 patients treated with radiation therapy was 1035 days (range 150-2280. Median survival for the 4 patients that received medical treatment was 360 days (range 7-1260 days, and for the 5 non-treated patients 14 days (range 0-90 days. In conclusion mydriasis and ophthalmoplegia are common signs of CSS. A mass lesion within the CS is the most common cause. Survival time may be improved with

[Clinical picture and complex treatment of septic thromboses of the cavernous sinuses].

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Mozhaev, S V; Zubkov, Iu N; Ponomarev, A M; Shimchenko, P Ia

1980-07-01

Under analysis are etiology, clinical picture and diagnosis of a septic thrombosis of cavernous sinuses in 28 patients. The authors have shown the interrelationship between local manifestations of the disease, injuries of the brain and its sheaths and septic complications (abscessing pneumonia as the most severe of them). A scheme of the complex treatment of patients with thrombosis of the cavernous sinus is proposed. The leading role in this treatment is played by intracarotid infusion of antibiotics in combination with anticoagulant drugs, vasodilatatory agents and novocaine as well as the therapy of septic complications (abscesses of the face and hairy part of the head, meningoencephalitis, pneumonia).

Selective occlusion of a carotid sinus cavernous fistula after transsphenoidal hypophysectomy

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Lins, E.; Dietrich, U.; Wappenschmidt, J.

1987-01-01

A case of carotid cavernous sinus fistula following transsphenoidal hypophysectomy is reported. A selective occlusion of the fistula with patency of the carotid artery was achieved by means of a detachable balloon catheter. (orig.) [de

Virtual Reality Model of the Three-Dimensional Anatomy of the Cavernous Sinus Based on a Cadaveric Image and Dissection.

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Qian, Zeng-Hui; Feng, Xu; Li, Yang; Tang, Ke

2018-01-01

Studying the three-dimensional (3D) anatomy of the cavernous sinus is essential for treating lesions in this region with skull base surgeries. Cadaver dissection is a conventional method that has insurmountable flaws with regard to understanding spatial anatomy. The authors' research aimed to build an image model of the cavernous sinus region in a virtual reality system to precisely, individually and objectively elucidate the complete and local stereo-anatomy. Computed tomography and magnetic resonance imaging scans were performed on 5 adult cadaver heads. Latex mixed with contrast agent was injected into the arterial system and then into the venous system. Computed tomography scans were performed again following the 2 injections. Magnetic resonance imaging scans were performed again after the cranial nerves were exposed. Image data were input into a virtual reality system to establish a model of the cavernous sinus. Observation results of the image models were compared with those of the cadaver heads. Visualization of the cavernous sinus region models built using the virtual reality system was good for all the cadavers. High resolutions were achieved for the images of different tissues. The observed results were consistent with those of the cadaver head. The spatial architecture and modality of the cavernous sinus were clearly displayed in the 3D model by rotating the model and conveniently changing its transparency. A 3D virtual reality model of the cavernous sinus region is helpful for globally and objectively understanding anatomy. The observation procedure was accurate, convenient, noninvasive, and time and specimen saving.

Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas

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Pollock, Bruce E.; Stafford, Scott L.

2005-01-01

Introduction: The purpose of this study was to evaluate the efficacy and safety of stereotactic radiosurgery as primary management for patients with imaging defined cavernous sinus meningiomas. Methods: Between 1992 and 2001, 49 patients had radiosurgery for dural-based masses of the cavernous sinus presumed to be meningiomas. The mean patient age was 55.5 years. The mean tumor volume was 10.2 mL; the mean tumor margin dose was 15.9 Gy. The mean follow-up was 58 months (range, 16-144 months). Results: No tumor enlarged after radiosurgery. Twelve of 38 patients (26%) with preexisting diplopia or facial numbness/pain had improvement in cranial nerve function. Five patients (10%) had new (n = 3) or worsened (n = 2) trigeminal dysfunction; 2 of these patients (4%) underwent surgery at 20 and 25 months after radiosurgery despite no evidence of tumor progression. Neither patient improved after partial tumor resection. One patient (2%) developed an oculomotor nerve injury. One patient (2%) had an ischemic stroke related to occlusion of the cavernous segment of the internal carotid artery. Event-free survival was 98%, 85%, and 80% at 1, 3, and 7 years after radiosurgery, respectively. Univariate analysis of patient and dosimetric factors found no analyzed factor correlated with postradiosurgical morbidity. Conclusions: Radiosurgery was an effective primary management strategy for patients with an imaging defined cavernous sinus meningioma. Except in situations of symptomatic mass effect, unusual clinical presentation, or atypical imaging features, surgery to confirm the histologic diagnosis is unlikely to provide clinical benefit

Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

International Nuclear Information System (INIS)

Park, Sun Min; Yoon, Sang Min; Lee, Su Min; Park, Jin Hong; Song, Si Yeol; Lee, Sang Wook; Ahn, Seung Do; Kim, Jong Hoon; Choi, Eun Kyung

2017-01-01

We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31–65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm"3 (range, 6.8–83.2 cm"3), and fractionated radiation was administered to a total dose of 50–54 Gy with a daily dose of 2 Gy. The median follow-up period was 6.8 years (range, 2.2–8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9–95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus

Role of fractionated radiotherapy in patients with hemangioma of the cavernous sinus

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Park, Sun Min; Yoon, Sang Min; Lee, Su Min; Park, Jin Hong; Song, Si Yeol; Lee, Sang Wook; Ahn, Seung Do; Kim, Jong Hoon; Choi, Eun Kyung [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2017-09-15

We performed this retrospective study to investigate the outcomes of patients with hemangioma of the cavernous sinus after fractionated radiotherapy. We analyzed 10 patients with hemangioma of the cavernous sinus who were treated with conventional radiotherapy between January 2000 and December 2016. The median patient age was 54 years (range, 31–65 years), and 8 patients (80.0%) were female. The mean hemangioma volume was 34.1 cm{sup 3} (range, 6.8–83.2 cm{sup 3}), and fractionated radiation was administered to a total dose of 50–54 Gy with a daily dose of 2 Gy. The median follow-up period was 6.8 years (range, 2.2–8.8 years). At last follow-up, the volume of the tumor had decreased in all patients. The average tumor volume reduction rate from the initial volume was 72.9% (range, 18.9–95.3%). All 10 of the cranial neuropathies observed before radiation therapy had improved, with complete symptomatic remission in 9 cases (90%) and partial remission in 1 case (10%). No new acute neurologic impairments were reported after radiotherapy. One probable compressive optic neuropathy was observed at 1 year after radiotherapy. Fractionated radiotherapy achieves both symptomatic and radiologic improvements. It is a well-tolerated treatment modality for hemangiomas of the cavernous sinus.

Fat deposition in the cavernous sinus in Cushing disease

International Nuclear Information System (INIS)

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

1984-01-01

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

Fat deposition in the cavernous sinus in Cushing disease

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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.

Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature

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A. Giotakis

2015-01-01

Full Text Available We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA. DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised.

Primary extradural leiomyosarcoma involving cavernous sinus in an immunocompetent patient

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Hanni V Gulwani

2014-01-01

Full Text Available Intracranial leiomyosarcoma (LMS are uncommon malignancies and usually encountered after systemic metastases. Limited cases of primary intracranial LMSs have been reported in the literature. It mostly affects immunocompromised individuals in association with Epstein-Barr virus infection. This is the unusual first case being reported of primary LMS in immunocompetent patient with involvement of cavernous sinus.

Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acquisition MR imaging

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Amemiya, Shiori; Aoki, Shigeki; Ohtomo, Kuni [University of Tokyo, Department of Radiology, Graduate School of Medicine, Bunkyo-ku, Tokyo (Japan)

2009-07-15

The purpose of this study is to apply contrast-enhanced 3D fast-imaging employing steady-state acquisition (3D-FIESTA) imaging to the evaluation of cranial nerves (CN) in patients with cavernous sinus tumors. Contrast-enhanced 3D-FIESTA images were acquired from ten patients with cavernous sinus tumors with a 3-T unit. In all cases, the trigeminal nerve with tumor involvement was easily identified in the cavernous portions. Although oculomotor and abducens nerves were clearly visualized against the tumor area with intense contrast enhancement, they were hardly identifiable within the area lacking contrast enhancement. The trochlear nerve was visualized in part, but not delineated as a linear structure outside of the lesion. Contrast-enhanced 3D-FIESTA can be useful in the assessment of cranial nerves in and around the cavernous sinus with tumor involvement. (orig.)

Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acquisition MR imaging

International Nuclear Information System (INIS)

Amemiya, Shiori; Aoki, Shigeki; Ohtomo, Kuni

2009-01-01

The purpose of this study is to apply contrast-enhanced 3D fast-imaging employing steady-state acquisition (3D-FIESTA) imaging to the evaluation of cranial nerves (CN) in patients with cavernous sinus tumors. Contrast-enhanced 3D-FIESTA images were acquired from ten patients with cavernous sinus tumors with a 3-T unit. In all cases, the trigeminal nerve with tumor involvement was easily identified in the cavernous portions. Although oculomotor and abducens nerves were clearly visualized against the tumor area with intense contrast enhancement, they were hardly identifiable within the area lacking contrast enhancement. The trochlear nerve was visualized in part, but not delineated as a linear structure outside of the lesion. Contrast-enhanced 3D-FIESTA can be useful in the assessment of cranial nerves in and around the cavernous sinus with tumor involvement. (orig.)

Diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm

International Nuclear Information System (INIS)

Chen Huairui; Bai Rulin; Huang Chengguang; Hu Guohan; Luo Chun; Yuan Guoliang; Lu Yicheng

2008-01-01

Objective: To explore the diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Methods: Interventional diagnosed and treated 6 eases of traumatid carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Results: 5 patients presented with recurrent massive epistaxis and symptoms of CCF caused by pseudoaneurysms and fistulas were occluded with detachable balloons and internal carotid arteries were reserved in 2 cases; of which, 1 case also had indirect carotid cavernous fistula in contralateral side, embolizated by trans facial vein approach with microcoil. Complete symptoms resolution was achieved in all cases, without procedure related complications. During the follow-up period, all patients returned to their work. Conclusions: Falling from high speed motorcycle without helmet may be one of the main causes of this disease. The site of strike mostly localize at the frontal and lateral aspects of the orbit. MRI scan is very helpful for the diagnosis before receiving angiography. Detachable balloon occlusion for the pseudoaneurysm and fistula is safe and efficient for the treatment. (authors)

Angiographic patterns of carotid-cavernous fistulas

International Nuclear Information System (INIS)

Georgieva, G.; Jekova, M.; Genov, P.; Hadjidekov, V.

2006-01-01

Full text: The aim of the study is to present our experience in angiographic evaluation of carotid-cavernous fistulas. 8 patients with carotid-cavernous fistula (6 men and 2 women, range of age from 15 to 62) are included in the study out of all undergone cerebral angiography for a four year period (1996 - 2000). All patients underwent CT brain examination, two out of 8 - MRI. Visualization of ipsi- and contra lateral cavernous sinus and ophthalmic vein dilatation are assessed. In all cases the communication between the internal carotid artery and the cavernous sinus has been assessed as direct. Near simultaneous visualization of the home internal carotid artery, the dilated ipsilateral cavernous sinus and dilated superior ophthalmic vein is found in 2 patients, simultaneous visualization of both cavernous sinuses - in two. In 1 patient the early visualization of the cavernous sinus through the fistula enabled visualization of ipsilateral main internal carotid artery from the contra lateral circulation through the communicating arteries.In 1 excessive contralateral cavernous sinus and contralateral superior ophthalmic vein dilatation is detected. In other 1 excessive flow to dilated ipsilateral cavernous sinus lead insufficient circulation in distal vessels. Digital subtraction Angiography remains the most suitable imaging method in carotid-cavernous fistula assessment regarding type of communication and level of following vessels morphology changes

Unilateral duplicated abducens nerve coursing through both the sphenopetroclival venous gulf and cavernous sinus: a case report.

Science.gov (United States)

Coquet, Thomas; Lefranc, Michel; Chenin, Louis; Foulon, Pascal; Havet, Éric; Peltier, Johann

2018-03-15

In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.

Lateral sellar compartment O.T. (cavernous sinus): history, anatomy, terminology.

Science.gov (United States)

Parkinson, D

1998-08-01

Claudios Galen (119-199 a.d.) dissected lower animals with parasellar carotid retia bathed in venous blood and transposed his findings to human anatomy. Andreas Vesalius (1514-1564) corrected most of Galen's errors but apparently never looked into this small, extradural compartment, nor, apparently, did Winslow (Exposition Anatomique de la Structure du Corps Humain. London: N. Prevast, 1734), who christened it the "cavernous sinus," (CS) presumably thinking that it would resemble the corpora cavernosa of the penis. Multiple surgical explorations, gross dissections, microscopic views, and vascular casts from early fetuses to an 81 year old have been examined and reviewed. The CS is not a dural sinus nor is it cavernous. The compartment is extradural, and the venous structures contained within consist of a greatly variable plexus of extremely thin-walled veins. The name, CS, is a barrier to the understanding of the structure and function of this extradural anatomical jewel box, which contains fat, myelinated and nonmyelinated nerves, arteries, and a plexus of veins. It is proposed that this name be changed, because it is inaccurate and misleading. The replacement should leave no doubt about its meaning. The lateral sellar compartment is descriptive and accurate. The veins within are a parasellar plexus.

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

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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.

Imaging diagnosis of dural and direct cavernous carotid fistulae

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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)

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. Copyright © 2013. Published by Elsevier Ltd.

Trans-zygomatic middle cranial fossa approach to access lesions around the cavernous sinus and anterior parahippocampus: a minimally invasive skull base approach.

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Melamed, Itay; Tubbs, R Shane; Payner, Troy D; Cohen-Gadol, Aaron A

2009-08-01

Exposure of the cavernous sinus or anterior parahippocampus often involves a wide exposure of the temporal lobe and mobilization of the temporalis muscle associated with temporal lobe retraction. The authors present a cadaveric study to illustrate the feasibility, advantages and landmarks necessary to perform a trans-zygomatic middle fossa approach to lesions around the cavernous sinus and anterior parahippocampus. The authors performed bilateral trans-zygomatic middle fossae exposures to reach the cavernous sinus and parahippocampus in five cadavers (10 sides). We assessed the morbidity associated with this procedure and compared the indications, advantages, and disadvantages of this method versus more extensive skull base approaches. A vertical linear incision along the middle portion of the zygomatic arch was extended one finger breadth inferior to the inferior edge of the zygomatic arch. Careful dissection inferior to the arch allowed preservation of facial nerve branches. A zygomatic osteotomy was followed via a linear incision through the temporalis muscle and exposure of the middle cranial fossa floor. A craniotomy along the inferolateral temporal bone and middle fossa floor allowed extradural dissection along the middle fossa floor and exposure of the cavernous sinus including all three divisions of the trigeminal nerve. Intradural inspection demonstrated adequate exposure of the parahippocampus. Exposure of the latter required minimal or no retraction of the temporal lobe. The trans-zygomatic middle fossa approach is a simplified skull base exposure using a linear incision, which may avoid the invasivity of more extensive skull base approaches while providing an adequate corridor for resection of cavernous sinus and parahippocampus lesions. The advantages of this approach include its efficiency, ease, minimalism, preservation of the temporalis muscle, and minimal retraction of the temporal lobe.

Aggressive cavernous sinus dural arteriovenous fistula: Angioarchitecture analysis and embolization by various approaches

Directory of Open Access Journals (Sweden)

Chao-Bao Luo

2016-03-01

Conclusion: Aggressive CSDAVFs are associated with occlusion/stenosis of the IPS or compartment of IPS–cavernous sinus with leptomeningeal reflux. In this limited case series, aggressive CSDAVFs most presented with brainstem ischemia, followed by nonhemorrhagic/hemorrhagic stroke in the cerebrum. Embolization through various access routes is a feasible method to manage these aggressive CSDAVFs, with an acceptable level of periprocedural risks.

Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis.

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Briceno, Vanessa; Zaidi, Hasan A; Doucette, Joanne A; Onomichi, Kaho B; Alreshidi, Amer; Mekary, Rania A; Smith, Timothy R

2017-05-01

Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion. Embase, PubMed, and Cochrane Library databases were searched for relevant publications. Fourteen studies with 972 patients with biochemically confirmed growth hormone-secreting pituitary adenomas were included in the meta-analysis. The overall remission prevalence under a fixed-effect model was 47.6% (95% CI = 40.8-54.4%) for patients with invasive macroadenomas (I 2  = 74.6%, p < 0.01); 76.4% (95% CI = 72.2-80.1%) for patients with non-invasive macroadenomas (I 2  = 59.6%, p = 0.03); and 74.2% (95% CI = 66.3-80.7%) for patients with non-invasive microadenomas (I 2  = 36.4, p = 0.10). The significant difference among the three groups resulted from the difference between patients with or without cavernous sinus invasion (p = 0.01) and not from the size of adenomas among those without cavernous sinus invasion (p = 0.66). The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.

Multislice CT imaging of ruptured left sinus of Valsalva aneurysm with fistulous track between left sinus and right atrium.

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Pampapati, Praveenkumar; Rao, Hejmadi Tati Gururaj; Radhesh, Srinivasan; Anand, Hejjaji Krishnamurthy; Praveen, Lokkur Srinivasamurthy

2011-01-01

Sinus of valsalva aneurysm is a rare condition arising from any of the three aortic sinuses. Among them, an aneurysm arising from the left coronary sinus is the rarest. Most of these cases were earlier diagnosed using echocardiography and conventional angiography. But with the availability of advanced imaging modalities like 64 slice cardiac CT and MR modalities, this condition can be accurately assessed noninvasively. We report a case of ruptured aneurysm originating from the left coronary sinus with a long windsock type of fistulous track between the aneurysm and right atrium evaluated by 64 slice cardiac CT imaging. This was later confirmed perioperatively.

ORBITAL CELLULITIS COMPLICATING SINUSITIS: A 15-YEAR ...

African Journals Online (AJOL)

Dr. NWaorgu

cavernous sinus thrombosis, and brain abscess. 3, 4 In ... left orbit was involved in 55% and the right in 31% while it was bilateral ... Figure 1: Age and sex of patients with orbital cellulitis. 0. 5 ... However, Kenny et al and Child have suggested ...

Depiction of the cranial nerves around the cavernous sinus by 3D reversed FISP with diffusion weighted imaging (3D PSIF-DWI)

International Nuclear Information System (INIS)

Ishida, Go; Oishi, Makoto; Jinguji, Shinya; Yoneoka, Yuichiro; Fujii, Yukihiko; Sato, Mitsuya

2011-01-01

The purpose of this study was to evaluate the anatomy of cranial nerves running in and around the cavernous sinus, we employed three-dimensional reversed fast imaging with steady-state precession (FISP) with diffusion weighted imaging (3D PSIF-DWI) on 3-T magnetic resonance (MR) system. After determining the proper parameters to obtain sufficient resolution of 3D PSIF-DWI, we collected imaging data of 20-side cavernous regions in 10 normal subjects. 3D PSIF-DWI provided high contrast between the cranial nerves and other soft tissues, fluid, and blood in all subjects. We also created volume-rendered images of 3D PSIF-DWI and anatomically evaluated the reliability of visualizing optic, oculomotor, trochlear, trigeminal, and abducens nerves on 3D PSIF-DWI. All 20 sets of cranial nerves were visualized and 12 trochlear nerves and 6 abducens nerves were partially identified. We also presented preliminary clinical experiences in two cases with pituitary adenomas. The anatomical relationship between the tumor and cranial nerves running in and around the cavernous sinus could be three-dimensionally comprehended by 3D PSIF-DWI and the volume-rendered images. In conclusion, 3D PSIF-DWI has great potential to provide high resolution 'cranial nerve imaging', which visualizes the whole length of the cranial nerves including the parts in the blood flow as in the cavernous sinus region. (author)

[Depiction of the cranial nerves around the cavernous sinus by 3D reversed FISP with diffusion weighted imaging (3D PSIF-DWI)].

Science.gov (United States)

Ishida, Go; Oishi, Makoto; Jinguji, Shinya; Yoneoka, Yuichiro; Sato, Mitsuya; Fujii, Yukihiko

2011-10-01

To evaluate the anatomy of cranial nerves running in and around the cavernous sinus, we employed three-dimensional reversed fast imaging with steady-state precession (FISP) with diffusion weighted imaging (3D PSIF-DWI) on 3-T magnetic resonance (MR) system. After determining the proper parameters to obtain sufficient resolution of 3D PSIF-DWI, we collected imaging data of 20-side cavernous regions in 10 normal subjects. 3D PSIF-DWI provided high contrast between the cranial nerves and other soft tissues, fluid, and blood in all subjects. We also created volume-rendered images of 3D PSIF-DWI and anatomically evaluated the reliability of visualizing optic, oculomotor, trochlear, trigeminal, and abducens nerves on 3D PSIF-DWI. All 20 sets of cranial nerves were visualized and 12 trochlear nerves and 6 abducens nerves were partially identified. We also presented preliminary clinical experiences in two cases with pituitary adenomas. The anatomical relationship between the tumor and cranial nerves running in and around the cavernous sinus could be three-dimensionally comprehended by 3D PSIF-DWI and the volume-rendered images. In conclusion, 3D PSIF-DWI has great potential to provide high resolution "cranial nerve imaging", which visualizes the whole length of the cranial nerves including the parts in the blood flow as in the cavernous sinus region.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

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Aggarwal, Karun; Rastogi, Sanjay; Joshi, Atul; Kumar, Ashish; Chaurasia, Archana; Prakash, Rajat

2017-01-01

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A co...

Cavernous sinus invasion by pituitary adenomas. Relationship between magnetic resonance imaging findings and histologically verified dural invasion

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Daita, Go; Yonemasu, Yukichi; Nakai, Hirofumi; Takei, Hidetoshi; Ogawa, Katsuhiro [Asahikawa Medical Coll., Hokkaido (Japan)

1995-01-01

The relationship between magnetic resonance (MR) imaging findings and histologically verified invasion of the cavernous sinus by tumor cells was studied in 26 patients treated surgically for pituitary adenoma. Dural invasion of the sellar floor by tumor cells was found in 10 cases (38%). All patients were classified according to MR imaging findings into three types. Type I showed a gadolinium-enhanced stripe medial to the carotid artery (5 patients), none of which showed dural invasion. Type II showed no enhanced stripe (17 patients), six of which showed dural invasion. Within this type, tumor size and dural invasion showed no correlation. Type III showed displacement or encasement of the carotid artery by the tumor with or without extracranial extension (4 patients), all of which showed massive infiltration of the tumor cells into the dura mater. This study shows that preoperative MR imaging can provide information for assessment of invasion into the cavernous sinus in patients with pituitary adenoma. (author).

Cavernous sinus lesions biopsy with neuronavigation and tip-cut needle

Science.gov (United States)

Lorenzetti, Martin; Carvalho, Herculano; Cattoni, Maria; Gonçalves-Ferreira, Antonio; Pimentel, José; Antuñes, Joao

2014-01-01

Background: Transoval biopsy of cavernous sinus (CS) lesions is the last non-invasive diagnostic option in those 15% of patients in whom etiology remains unclear in spite of extensive neuroradiological imaging, clinical assessment, and laboratory evaluation. However, there are no guidelines defining indications and the most appropriate technique for this procedure. Case Description: We present four patients in whom we performed X-ray and neuronavigation-assisted transoval CS biopsies using tip-cut needles. Conclusion: The technique described allows the operator to determine the optimal angle for entering the CS, avoiding the complications due to distorted anatomy, and facilitating orientation once inside the CS. It reduces both radiation exposure as well as general anesthesia duration. PMID:25593783

Fulminant superior ophthalimic vein and cavermous sinus thrombophlebitis with intracranial extensions: A case report

International Nuclear Information System (INIS)

Hwang, Ji Sun; Hong, Hyun Sook; Park, Ji Sang; Lee, A Leum; Choo, Eun Ju; Chang, Kee Hyun

2015-01-01

Cavernous sinus thrombophlebitis (CST) is a rare and life-threatening disease without prompt diagnosis and treatment. Two cases of fulminant superior ophthalmic vein (SOV) and CST caused by maxillary periodontitis and sphenoid sinusitis are described. A 65-year-old woman presented with right proptosis, headache, and fever. A 74-year-old woman presented with left periorbital swelling. In both patients, MRI with gadolinium showed expansion of the bilateral cavernous sinus and diffuse dilatation of the SOV with non-enhancement of central thrombus, which indicated CST. The condition was complicated by brain abscess, meningitis, and ischemic stroke. These conditions were improved by antibiotic treatment, but one patient underwent exenteration of the orbit due to orbital rupture during hospitalization

Fulminant superior ophthalimic vein and cavermous sinus thrombophlebitis with intracranial extensions: A case report

Energy Technology Data Exchange (ETDEWEB)

Hwang, Ji Sun; Hong, Hyun Sook; Park, Ji Sang; Lee, A Leum; Choo, Eun Ju; Chang, Kee Hyun [Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

2015-06-15

Cavernous sinus thrombophlebitis (CST) is a rare and life-threatening disease without prompt diagnosis and treatment. Two cases of fulminant superior ophthalmic vein (SOV) and CST caused by maxillary periodontitis and sphenoid sinusitis are described. A 65-year-old woman presented with right proptosis, headache, and fever. A 74-year-old woman presented with left periorbital swelling. In both patients, MRI with gadolinium showed expansion of the bilateral cavernous sinus and diffuse dilatation of the SOV with non-enhancement of central thrombus, which indicated CST. The condition was complicated by brain abscess, meningitis, and ischemic stroke. These conditions were improved by antibiotic treatment, but one patient underwent exenteration of the orbit due to orbital rupture during hospitalization.

Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva.

Science.gov (United States)

Nezafati, Mohammad Hassan; Maleki, Mahmood Hosseinzadeh; Javan, Hadi; Zirak, Nahid

2010-05-01

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.

[Trauma induced left maxillary sinus dislocation of eyeball--a case report].

Science.gov (United States)

Chen, Yu; Liu, Cuiping; Cui, Liping

2013-01-01

Patient male, 27 year old. Left facial and head trauma for 6 hours, due to motor vehicle accident. Patient state of mind was clear at arrival to hospital. Body temperature: 36C; Pulse: 80 Time/Minute; Breath: 20 Time/Minute; Blood pressure: 120/80 mm Hg. An irregular, horizontal laceration at arch of left eyebrow, approximately 8-10 cm. A laceration on left wing of nose skin, approximately 1 cm. A laceration also under lower eyelid skin of right eye, approximately 2 cm. Left blepharedema and enophthalmos. Orbital and nasal sinuses CT indications:contusion and laceration of the left frontal lobe of brain; fracture of the left orbital frontal, ethmoid, sphenoid bone, left nasal, maxillary sinus and zygoma with soft tissue contusion and laceration; the left eyeball and optic nerve sunk into the maxillary sinus (See figure 1). (1) Multiple orbital fractures; (2) Left maxillary sinus dislocation of eyeball; (3) The left frontal lobe contusion and laceration of brain.

Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

Science.gov (United States)

Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

2017-08-01

Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Fate of the three embryonic dural sinuses in infants: the primitive tentorial sinus, occipital sinus, and falcine sinus.

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Mizutani, Katsuhiro; Miwa, Tomoru; Akiyama, Takenori; Sakamoto, Yoshiaki; Fujiwara, Hirokazu; Yoshida, Kazunari

2018-03-01

The primitive tentorial, occipital, and falcine sinuses are thought to attain the adult pattern or regress between the fetal stage and adulthood. The anatomy of these three primitive dural sinuses has seldom been studied in the infant population, and it remains unclear when these dural sinuses reach the adult condition. Using computed tomography digital subtraction venography (CT-DSV), we analyzed the anatomy of these embryonic dural sinuses in infants. We included 13 infants who underwent CT-DSV prior to neurosurgery and 35 cases with unruptured cerebral aneurysms as normal adult controls. Three embryonic dural sinuses, i.e., the primitive tentorial, occipital, and falcine sinuses, were retrospectively analyzed in CT-DSV images of infants and adults. We also analyzed the drainage patterns of the superficial middle cerebral vein (SMCV), determined by the connection between the primitive tentorial sinus and the cavernous sinus. The primitive tentorial, occipital, and falcine sinuses were present in 15.4%, 46.2%, and none of the infants, respectively, and in 10.0, 8.6, and 2.9% of the adults, respectively. The difference in SMCV draining pattern between infants and adults was insignificant. The incidence of the occipital sinus was significantly higher in infants than in adults. The connection between the primitive tentorial sinus and the cavernous sinus appears to be established before birth. The occipital sinus is formed at the embryonic stage and mostly regresses after infancy. The falcine sinus is usually obliterated prenatally. Our findings form the basis for interventions by pediatric interventional neuroradiologists and neurosurgeons.

Successful Transarterial Guglielmi Detachable Coil Embolization of Post-Traumatic Fistula between a Posterior Communicating Artery Aneurysm and the Cavernous Sinus

Science.gov (United States)

Chen, Y.; Jiang, D-Y.; Tan, H-Q.; Wang, L-H.; Chen, X-Y.; Sun, J-H.

2009-01-01

Summary We describe a case of a post-traumatic posterior communicating artery (PCoA) aneurysmcavernous sinus fistula, which is an extremely rare complication of craniocerebral trauma, successfully treated with endosaccular coil embolization via transarterial route. Endosaccular embolization with Guglielmi detachable coils via transarterial route appears to be a feasible, effective and minimally invasive option for the treatment of post-traumatic fistula between the PCoA aneurysm with a small ostia and the cavernous sinus in the subacute phase. PMID:20465883

Preoperative depiction of cavernous sinus invasion by pituitary macroadenomas using three-dimensional anisotropy contrast (3DAC) magnetic resonance axonography on a 3-tesla system

International Nuclear Information System (INIS)

Watanabe, Naoto

2006-01-01

The purpose of this study is to examine whether the cavernous invasion of pituitary macroadenomas can be preoperatively depicted by 3DAC MR images, by comparison of surgical and imaging findings. The depiction is desirable to make the surgical injury of cranial nerves minimal. Subjects are 33 patients (15 males, 18 females; mean age 52.8 y) with macroadenomas who underwent its extraction by endoscopic endonasal transsphenoidal surgery in author's hospital and 25 normal healthy volunteers (12 males, 13 females). Signa-3.0T equipment (General Electric) was used for PROPELLER MR 3DAC and T2 reverse images of coronary cross sections to identify cranial nerves (oculomotor, trochlear, abducent, ophthalmic and maxillary) in the cavernous sinus. Localization of the imaged tumor/nerves in the sinus was statistically analyzed with the endoscopic surgical findings for the invasion. The former obtained here by the high magnetic field imaging was found quite useful for preoperative depiction of the sinus invasion with high sensitivity and specificity. (T.I.)

Non-Hodgkin's lymphoma of the sphenoid sinus presenting as isolated oculomotor nerve palsy

Directory of Open Access Journals (Sweden)

Huh Ji

2007-08-01

Full Text Available Abstract Background Solitary involvement of the sphenoid sinus has rarely been reported in non-Hodgkin's lymphoma. Isolated oculomotor nerve palsy is uncommon as an initial presentation of malignant tumors of the sphenoid sinus. Case presentation A 53-year-old woman presented with a three-month history of headache and diplopia. Neurological examination revealed complete left oculomotor nerve palsy. Magnetic Resonance Imaging (MRI demonstrated a homogenous soft-tissue lesion occupying the left sphenoid sinus and invading the left cavernous sinus. The patient underwent transsphenoidal biopsy and the lesion was histologically diagnosed as non-Hodgkin's lymphoma, diffuse large B-cell type. Tumor cells were positive for CD20 and negative for CD3. Following six cycles of chemotherapy, the left oculomotor nerve palsy that had been previously observed was completely resolved. There was no enhancing lesion noted on follow-up MRI. Conclusion It is important to recognize that non-Hodgkin's lymphoma of the sphenoid sinus can present with isolated oculomotor nerve palsy, although it is extremely rare. The cranial nerve deficits can resolve dramatically after chemotherapy.

May the Inferior Petrosal Sinus Recanalization During Endovascular Treatment for Carotid-Cavernous Fistulas Increase the Risk of Sixth Nerve Palsy?

Science.gov (United States)

Robert, Thomas; Valsecchi, Daniele; Sylvestre, Philippe; Blanc, Raphaël; Ciccio, Gabriele; Smajda, Stanislas; Redjem, Hocine; Piotin, Michel

2018-05-03

Sixth nerve palsy is a common complication of endovascular treatment for carotid-cavernous fistulas (CCF). Two hypotheses are evoked: the spontaneous venous congestion into the cavernous sinus and the direct compression of the nerve by the embolic agent into the cavernous sinus. Nevertheless, the evidence is still uncertain. Knowing the vicinity of the sixth nerve with the inferior petrosal sinus (IPS) in the Dorello canal, we hypothesized that the recanalization of the IPS increased the risk of nerve damage. We analyzed a prospective database of patients treated for CCFs from March 2009 to April 2016. We excluded patients who did not need treatment, cases of high-flow CCF, and patients lost to follow-up, obtaining a homogeneous population of 82 patients with indirect CCFs. This population was divided in 2 groups: patients without new-onset/worsening of sixth nerve palsy and patients with this postprocedural complication. Our main endpoints were the potential differences between patients with or without recanalization of IPS and between those who underwent or not an embolization with Onyx-18. We did not find any statistically meaningful difference between the 2 groups concerning the necessity of IPS recanalization (P > 0.999, odds ratio 0.97, 95% confidence interval 0.32-2.96) or with the use of Onyx-18 as an embolic agent (P = 0.56; odds ratio 1.41, 95% confidence interval 0.41-2.45). The recanalization of a thrombosed IPS does not increase the risk of procedural sixth nerve damage. The initial injury seems to relate with development/worsening of a sixth nerve palsy. Copyright © 2018 Elsevier Inc. All rights reserved.

Gamma knife radiosurgery for benign cavernous sinus tumors. Treatment concept and outcomes in 120 cases

International Nuclear Information System (INIS)

Hayashi, Motohiro; Chernov, Mikhail; Tamura, Noriko

2012-01-01

Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS TM ; Elekta Instruments AB, Stockholm, Sweden) and Perfexion TM (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications. (author)

Fractionated stereotactic radiation therapy in the management of benign cavernous sinus meningiomas. Long-term experience and review of the literature

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Milker-Zabel, S.; Zabel-du Bois, A.; Debus, J. [Heidelberg Univ. (Germany). Dept. of Radiation Oncology; Huber, P. [Heidelberg Univ. (Germany). Dept. of Radiotherapy; Schlegel, W. [German Cancer Research Center, Heidelberg (Germany). Dept. of Medical Physics

2006-11-15

Purpose: To analyze own long-term results with fractionated stereotactic radiotherapy (FSRT) in patients with benign meningiomas of the cavernous sinus and to review the literature on these rare lesions. Patients and Methods: 57 patients were treated with FSRT for benign meningiomas of the cavernous sinus between 01/1990 and 12/2003 at the authors' institution. Histology was WHO grade I in 28/57 lesions, and undetermined in 29/57 lesions. 29 patients received radiotherapy as primary treatment, ten following surgery, and 18 patients were irradiated for recurrent disease. Median target volume was 35.2 cm{sup 3}. Median total dose was 57.6 Gy with 1.8 Gy per fraction. 51/57 patients showed clinical symptoms before radiotherapy like reduced vision (n=19), diplopia (n=25), or trigeminal hyp-/dysesthesia (n=17). Results: Median follow-up period was 6.5 years. 50/57 patients were followed for >36 months. Overall local tumor control was 100%. 39/57 patients had stable disease based on CT/MRI, while 18/57 had a partial remission of tumor volume. Overall survival for patients with WHO grade I meningiomas was 95.5% after 5 and 10 years. Two patients died 2.8 and 4.1 years after radiotherapy due to cardiac failure. In 11/57 patients, preexisting neurologic deficits improved. There was one patient with recurrent hyperlacrimation of one eye on the side of the irradiated meningioma. Three patients complained about subjective visual deterioration after FSRT without any objective findings in an ophthalmologic examination. No late toxicity RTOG{>=} III was seen. Conclusion: These data demonstrate that FSRT is an effective and safe treatment modality for local control of benign cavernous sinus meningiomas with a minimal risk of significant late toxicity. (orig.)

Ehlers-Danlos syndrome type IV and recurrent carotid-cavernous fistula: review of the literature, endovascular approach, technique and difficulties

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Desal, H.A.; Toulgoat, F.; Raoul, S.; Guillon, B.; Bommard, S.; Naudou-Giron, E.; Auffary-Calvier, E.; Kersaint-Gilly, A. de [Department of Neuroradiology, Laennec Hospital, University of Nantes (France); 1

2005-04-01

We report the follow-up of a previously published case (Forlodou et al. Neuroradiology 38:595-597, 1996) of carotido-cavernous fistulas (CCFs) in a patient presenting with type IV Ehlers-Danlos syndrome (EDS 4) that were successfully treated twice by an endovascular approach. Initial treatment with a detachable balloon was in 1994 for a right CCF, and, 8 years later, a left CCF was treated by selective transarterial occlusion of the cavernous sinus with coils. Unfortunately, the patient suffered from a spontaneous post-operative intracranial haemorrhage in the left hemisphere and died. Review of the literature, technical considerations for bilateral CCF and complication are discussed.

Ehlers-Danlos syndrome type IV and recurrent carotid-cavernous fistula: review of the literature, endovascular approach, technique and difficulties

International Nuclear Information System (INIS)

Desal, H.A.; Toulgoat, F.; Raoul, S.; Guillon, B.; Bommard, S.; Naudou-Giron, E.; Auffary-Calvier, E.; Kersaint-Gilly, A. de

2005-01-01

We report the follow-up of a previously published case (Forlodou et al. Neuroradiology 38:595-597, 1996) of carotido-cavernous fistulas (CCFs) in a patient presenting with type IV Ehlers-Danlos syndrome (EDS 4) that were successfully treated twice by an endovascular approach. Initial treatment with a detachable balloon was in 1994 for a right CCF, and, 8 years later, a left CCF was treated by selective transarterial occlusion of the cavernous sinus with coils. Unfortunately, the patient suffered from a spontaneous post-operative intracranial haemorrhage in the left hemisphere and died. Review of the literature, technical considerations for bilateral CCF and complication are discussed

The importance of venous hypertension in the formation of dural arteriovenous fistulas: a case report of multiple fistulas remote from sinus thrombosis

International Nuclear Information System (INIS)

Kusaka, N.; Sugiu, K.; Katsumata, A.; Nakashima, H.; Tamiya, T.; Ohmoto, T.

2001-01-01

Various hypotheses have been reported concerning the pathogenesis of dural arteriovenous fistulas (DAVFs). However, it is still controversial whether sinus thrombosis or venous hypertension has a greater influence on the formation of DAVFs. We present a rare case of multiple DAVFs that developed after sinus thrombosis. Chronic venous hypertension secondary to sinus thrombosis in the left transverse-sigmoid sinus induced the multiple DAVFs, including one in the right cavernous sinus, which was remote from the occluded sinus. This case indicates the importance of venous hypertension in the formation of DAVFs. (orig.)

Petrosal sinus sampling: technique and rationale.

Science.gov (United States)

Miller, D L; Doppman, J L

1991-01-01

Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior

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

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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.

Superior Sagittal Sinus Thrombosis Complicating Typhoid Fever in a Teenager

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P. O. Okunola

2012-01-01

Full Text Available Cerebral venous sinus (sinovenous thrombosis (CSVT is a rare life-threatening disorder in childhood that is often misdiagnosed. CSVT encompasses cavernous sinus thrombosis, lateral sinus thrombosis, and superior sagittal sinus thrombosis (SSST. We present an adolescent girl who was well until two weeks earlier when she had a throbbing frontal headache and fever with chills; she later had dyspnoea, jaundice, melena stool, multiple seizures, nuchal rigidity, and monoparesis of the right lower limb a day before admission. Urine test for Salmonella typhi Vi antigen was positive, and Widal reaction was significant. Serial cranial computerized tomography scans revealed an expanding hypodense lesion in the parafalcine region consistent with SSST or a parasagittal abscess. Inadvertent left parietal limited craniectomy confirmed SSST. She recovered completely with subsequent conservative management. Beyond neuropsychiatric complications of Typhoid fever, CSVT should be highly considered when focal neurologic deficits are present.

The association of carotid cavernous fistula with Graves′ ophthalmopathy

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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.

The association of carotid cavernous fistula with Graves’ ophthalmopathy

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Celik, Ozlem; Buyuktas, Deram; Islak, Civan; Sarici, A Murat; Gundogdu, A Sadi

2013-01-01

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. PMID:23571267

Possible role of the cavernous sinus veins in cerebrospinal fluid absorption

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Koh Lena

2007-04-01

Full Text Available Abstract The purpose of this investigation was to enhance our understanding of cerebrospinal fluid (CSF absorption pathways. To achieve this, Microfil (a coloured silastic material was infused into the subarachnoid space (cisterna magna of sheep post mortem, and the relevant tissues examined macroscopically and microscopically. The Microfil was taken up by an extensive network of extracranial lymphatic vessels in the olfactory turbinates. In addition however, Microfil also passed consistently through the dura at the base of the brain. Microfil was noted in the spaces surrounding the venous network that comprises the cavernous sinus, in the adventitia of the internal carotid arteries and adjacent to the pituitary gland. Additionally, Microfil was observed within the endoneurial spaces of the trigeminal nerve and in lymphatic vessels emerging from the epineurium of the nerve. These results suggest several unconventional pathways by which CSF may be removed from the subarachnoid space. The movement of CSF to locations external to the cranium via these routes may lead to its absorption into veins and lymphatics outside of the skull. The physiological importance of these pathways requires further investigation.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity.

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Aggarwal, Karun; Rastogi, Sanjay; Joshi, Atul; Kumar, Ashish; Chaurasia, Archana; Prakash, Rajat

2017-10-01

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

Endovascular treatment of a cavernous sinus dural arteriovenous fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein

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Venturi, C.; Bracco, S.; Cerase, A.; Gennari, P.; Lore, F.; Polito, E.; Casasco, A.E.

2003-01-01

We describe a new approach for transvenous embolisation of cavernous sinus dural arteriovenous fistulae through the superior ophthalmic vein (SOV), i.e., via percutaneous cannulation of a frontal vein. Modern neurointerventional angiographic materials make it possible to reach the SOV in this way without puncturing it in the orbit or a surgical exposure. Orbital phlebography should still be in the repertoire of interventional neuroradiology units in large centres. (orig.)

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

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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.

Clinical features and management of cavernous and venous angiomas in the head

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Tokunaga, Koji; Date, Isao

2011-01-01

Cerebral cavernous angiomas consist of well-circumscribed collections of thin-walled sinusoidal vascular channels lacking the intervening brain tissue. They are present in 0.4-0.8% of the population, and can occur in a sporadic or familial form. Most common symptoms are seizures, hemorrhage, and focal neurological deficits. The annual bleeding rate of the patient is reported to be 0.25%-20%. High-resolution magnetic resonance imaging (MRI) is a useful diagnostic tool with a high degree of sensitivity and specificity. Microsurgical excision of the lesion is a good treatment choice for cavernous angiomas in the brain, even in the brainstem. Although stereotactic radiosurgery may reduce the incidence of rebleeding and the frequency of seizures, its indication should be carefully investigated because of the relatively high rate of radiation-induced side effects. Less frequently, cavernous angiomas can be located at the extra-axial regions of the head, which include the cavernous sinus, the orbit, and the cranial nerves. Cavernous angiomas in the cavernous sinus pose a neurosurgical challenge due to the high vascularity and involvement of the neurovascular structures, and stereotactic radiosurgery is considered as an additional option. Surgical resection is recommended for symptomatic cavernous angiomas in the orbit; however, the rate of complications after resection is not necessarily low for cavernous angiomas within the apex. Venous angiomas are anomalies of normal venous drainage, which show characteristic appearance of the drainage system in the late phase of angiography (caput medusae). They are found either alone or in combination with other vascular malformations. Conservative treatment is recommended except for patients with a large hematoma or with a coexisting cavernous angioma. (author)

SU-E-T-304: Dosimetric Comparison of Cavernous Sinus Tumors: Heterogeneity Corrected Pencil Beam (PB-Hete) Vs. X-Ray Voxel Monte Carlo (XVMC) Algorithms for Stereotactic Radiotherapy (SRT)

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Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Saleh, H; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

2015-06-15

Purpose: To compare dose distributions calculated using PB-hete vs. XVMC algorithms for SRT treatments of cavernous sinus tumors. Methods: Using PB-hete SRT, five patients with cavernous sinus tumors received the prescription dose of 25 Gy in 5 fractions for planning target volume PTV(V100%)=95%. Gross tumor volume (GTV) and organs at risk (OARs) were delineated on T1/T2 MRI-CT-fused images. PTV (range 2.1–84.3cc, mean=21.7cc) was generated using a 5mm uniform-margin around GTV. PB-hete SRT plans included a combination of non-coplanar conformal arcs/static beams delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000 MU/min) beam. Plans were re-optimized using XVMC algorithm with identical beam geometry and MLC positions. Comparison of plan specific PTV(V99%), maximal, mean, isocenter doses, and total monitor units(MUs) were evaluated. Maximal dose to OARs such as brainstem, optic-pathway, spinal cord, and lenses as well as normal tissue volume receiving 12Gy(V12) were compared between two algorithms. All analysis was performed using two-tailed paired t-tests of an upper-bound p-value of <0.05. Results: Using either algorithm, no dosimetrically significant differences in PTV coverage (PTVV99%,maximal, mean, isocenter doses) and total number of MUs were observed (all p-values >0.05, mean ratios within 2%). However, maximal doses to optic-chiasm and nerves were significantly under-predicted using PB-hete (p=0.04). Maximal brainstem, spinal cord, lens dose and V12 were all comparable between two algorithms, with exception of one patient with the largest PTV who exhibited 11% higher V12 with XVMC. Conclusion: Unlike lung tumors, XVMC and PB-hete treatment plans provided similar PTV coverage for cavernous sinus tumors. Majority of OARs doses were comparable between two algorithms, except for small structures such as optic chiasm/nerves which could potentially receive higher doses when using XVMC algorithm. Special attention may need to be paid on a case

Gamma Knife radiosurgery for hemangioma of the cavernous sinus.

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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.

Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

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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.

Cavernous sinus thrombosis syndrome and brainstem involvement in patient with leptospirosis: Two rare complications of leptospirosis

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Shahriyar Alian

2014-01-01

Full Text Available Leptospirosis is a bacterial disease that is caused by pathogenic spirochetes of the genus Leptospira. It can affect humans and animals. In humans, it can lead to a wide spectrum of symptoms. It is known as the most common zoonosis in the world. The typical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Less common clinical manifestations may result from involvement of different human body systems. In many places, this disease may be under-diagnosed, especially when associated with neurological complications. Moreover, without treatment, leptospirosis can lead to organ damages, and even death. Neurological complications are uncommon and are reported in a few cases. Cavernous sinus thrombosis syndrome and brainstem involvement are rare complications of leptospirosis and are associated with a high mortality risk. To our knowledge, no such cases have been reported in the literature.

Transvenous embolization of indirect carotid-cavernous fistula via upper ophthalmic/facial vein - Case report and literature review

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Sirakov, S.; Penkov, M.; Sirakov, A.; Kamenov, B.; Todorov, Y.; Ninov, K.; Bachvarov, Ch.

2015-01-01

Indirect carotid-cavernous fistula or dural arterio-venous fistula of cavernous sinus is relatively rare pathologic finding. Different classifications of carotid-cavernous fistulae are proposed. Now days more and more they are treated by endovascular approach. A case of authors' practice of transvenous embolization of carotid-cavernous fistula via upper ophthalmic vein in 52 year old female is presented with review of the literature. A week later ocular symptoms of the patient regressed. Control angiography at the third month follow up does not visualize fistula. The transvenous approach in management of carotid cavernous fistulae is safe and effective in cases direct arterial approach is absent or technically impossible. Key words: Indirect Carotid-Cavernous Fistula. Embolization. Transvenous Approach

Subdural hematoma from a cavernous malformation.

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Schmitt, Anne J; Mitha, Alim P; Germain, Rasha; Eschbacher, Jennifer; Spetzler, Robert F

2014-01-01

To present a case of a cavernous malformation presenting with a subdural hematoma. A 27-year-old woman was admitted with progressively worsening headache, vomiting, weakness, and word-finding difficulties 1 week after she was discharged from an outside hospital, where she was managed conservatively for a presumed traumatic subdural hematoma. Computed tomography revealed an enlarging subacute left hemispheric subdural hematoma for which she underwent drill craniostomy. Postprocedural magnetic resonance imaging showed a posterior left temporal lobe mass consistent with a cavernous malformation juxtaposed with the subdural hematoma. Craniotomy for resection of the lesion was performed. She had an uncomplicated postoperative course and experienced a good recovery. The signs and symptoms, diagnostic imaging, and intraoperative findings suggest that the subdural hematoma was caused by extralesional hemorrhage of the cavernous malformation, which is a rare finding associated with these malformations. The clinical course, radiologic, and intraoperative findings suggest that the subdural hemorrhage was caused by extralesional hemorrhage of the cavernous malformation. Copyright © 2014 Elsevier Inc. All rights reserved.

Estudo micro-mesoscópico da parede lateral do seio cavernoso humano Human cavernous sinus: micro-mesoscopic study of the lateral wall

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Renato Paulo Chopard

1996-12-01

Full Text Available Os autores estudam as estruturas contidas no seio cavernoso humano, tanto em seu interior como na sua parede lateral, através de cortes frontais seriados espessos. Mostram a importância desta parede que é freqüentemente usada como via de acesso cirúrgico às afecções presentes nesta estrutura venosa da dura-máterThe authors studied the structures of human cavernous sinus in its interior as well as on the lateral wall, utilizing thick, frontal, sequential sections. They show the significance of this wall, frequently used as surgical accessway to diseases encountered within this venous structure of the dura-mater.

Neuroradiological diagnosis and interventional therapy of carotid cavernous fistulas

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Struffert, T.; Engelhorn, T.; Doelken, M.; Doerfler, A.; Holbach, L.

2008-01-01

Carotid cavernous fistulas are pathologic connections between the internal and/or external carotid artery and the cavernous sinus. According to Barrow one can distinguish between direct (high flow) and indirect (low flow) fistulas, whereby direct fistulas are often traumatic while indirect fistulas more frequently occur spontaneously in postmenopausal women. Diagnosis can easily be established using MRI and angiography, which allow exact visualization of the anatomy of fistulas to plan the interventional neurological therapy that in recent years has replaced surgical therapy. This article provides an overview on imaging findings, diagnosis using MRI and angiography as well as interventional treatment strategies. (orig.) [de

Wolff-Parkinson-White syndrome with an unroofed coronary sinus without persistent left superior vena cava treated with catheter cryoablation

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Andrei Catanchin

2008-08-01

Full Text Available Coronary sinus anomalies are rare congenital defects which are usually coexistent with a persistent left superior vena cava and may be associated with cardiac arrhythmias. We report an unroofed coronary sinus without persistent left superior vena cava diagnosed during a catheter ablation procedure for Wolff-Parkinson-White syndrome. Diagnostic and therapeutic options and outcomes are discussed. This condition is of relevance to electrophysiologists performing catheter-based procedures, as well as cardiologists implanting coronary sinus pacing leads, who may encounter this anomaly in their practice.

Flow diversion in the treatment of carotid injury and carotid-cavernous fistula after transsphenoidal surgery

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Lum, Cheemum; Ahmed, Muhammad E; Glikstein, Rafael; dos Santos, Marlise P; Lesiuk, Howard; Labib, Mohamed; Kassam, Amin B

2015-01-01

We describe a case of iatrogenic carotid injury with secondary carotid-cavernous fistula (CCF) treated with a silk flow diverter stent placed within the injured internal carotid artery and coils placed within the cavernous sinus. Flow diverters may offer a simple and potentially safe vessel-sparing option in this rare complication of transsphenoidal surgery. The management options are discussed and the relevant literature is reviewed. PMID:26015526

Rupture of Sinus of Valsalva Aneurysm Associated with Left Ventricular Noncompaction and Mitral Valve Prolapse

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Sinan Aydoğdu

2011-08-01

Full Text Available We report a 27-year-old patient with ruptured sinus Valsalva aneurysm (SVA, left ventricular noncompaction and mitral valve prolapse. Whether the coexistence of ruptured SVA, left ventricular noncompaction and mitral valve prolapse is coincidental or due to a defect in a common developmental pathway requires further research.

Ruptured Sinus of Valsalva Aneurysm into the Left Atrium with Multiple Fistulous Communications: A Rare Cause of Heart Failure

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Yashwant Agrawal

2015-01-01

Full Text Available Ruptured noncoronary sinus of valsalva aneurysm with fistulous connections to multiple cardiac chambers has not been reported previously. We report a 66-year-old man who presented with worsening cough and exertional dyspnea. Transesophageal echocardiogram confirmed a large aneurysm involving the noncoronary cusp of the aortic sinus with aneurysmal extension to the left atrium. There were also two fistulous communications with the left atrium and one small fistulous connection with the right atrium. Open-heart surgery with aortic root replacement and reimplantation of coronary arteries along with primary closure and repair of aorta to the left atrial fistula was performed.

Anomalous origin of right coronary artery from left coronary sinus.

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Hamzeh, Gadah; Crespo, Alex; Estarán, Rafael; Rodríguez, Miguel A; Voces, Roberto; Aramendi, José I

2008-08-01

Anomalous aortic origin of the coronary arteries is uncommon but clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe 4 patients, aged 34 to 59 years, who were diagnosed with right coronary artery arising from the left sinus of Valsalva, confirmed by coronary angiography, which was surgically repaired. Three patients presented dyspnea and angina, and one with acute myocardial infarction. At operation, the right coronary artery was dissected at the take-off from the intramural course, and reimplanted into the right sinus of Valsalva. There was no mortality. One patient had associated coronary artery disease that required stent placement postoperatively. This reimplantation technique provides a good physiological and anatomical repair, eliminates a slit-like ostium, avoids compression of the coronary artery between the aorta and the pulmonary artery, and gives superior results to coronary artery bypass grafting or the unroofing technique.

The anterior medullary-anterior pontomesencephalic venous system and its bridging veins communicating to the dural sinuses: normal anatomy and drainage routes from dural arteriovenous fistulas

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Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Okahara, Mika; Kashiwagi, Junji; Mori, Hiromu; Hori, Yuzo; Nagatomi, Hirofumi

2008-01-01

We evaluated the normal venous anatomy of the anterior medullary/anterior pontomesencephalic venous (AMV/APMV) system and bridging veins connected to the dural sinuses using magnetic resonance (MR) imaging and demonstrated cases of dural arteriovenous fistulas (DAVFs) with bridging venous drainage. MR images obtained using a 3D gradient echo sequence in 70 patients without lesions affecting the deep or posterior venous channels were reviewed to evaluate the normal anatomy of the AMV/APMV system and bridging veins. MR images and digital subtraction angiography in 80 cases with intracranial or craniocervical junction DAVFs were reviewed to evaluate the bridging venous drainage from DAVFs. MR images clearly revealed AMV/APMV in 35 cases. Fifteen cases showed a direct connection between AMV and APMV, while 15 cases showed an indirect communication via the transverse pontine vein or the bridging vein. In the five remaining cases, the AMV and APMV end separately to the bridging vein or the transverse pontine vein. Bridging veins were identified in 34 cases, connecting to the cavernous sinus in 33, to the suboccipital cavernous sinus in 11, and the inferior petrosal sinus in five cases. In 80 DAVF cases, seven of 40 cavernous sinus DAVFs, two craniocervical junction DAVFs, and one inferior petrosal sinus DAVF drained via bridging veins to the brain stem. The AMV/APMV and bridging veins showed various anatomies and frequently showed a connection to the cavernous sinus. Knowledge of the venous anatomy is helpful for the diagnosis and intravascular treatment of DAVFs. (orig.)

Multidetector CT angiography in the diagnosis and classification of carotid–cavernous fistula

International Nuclear Information System (INIS)

Lee, J.Y.; Jung, C.; Ihn, Y.K.; Kim, D.J.; Seong, S.O.; Kwon, B.J.

2016-01-01

Aim: To evaluate the performance of multidetector computed tomography angiography (MDCTA) in identifying and classifying carotid–cavernous fistulas (CCFs). Materials and methods: The neuro-interventional database was searched for patients with CCFs at four different institutions and for normal controls at one of the four institutions. Thirty-four patients were divided into the case group (direct type, n=8; indirect type, n=8) and the control group (n=18). Two readers retrospectively evaluated thin-section CTA images for the presence and laterality of four findings: (1) engorged ophthalmic vein, (2) engorged cavernous sinus, (3) similar enhancement of the cavernous sinus (CS) and internal carotid artery (ICA), and (4) greater enhancement of the CS than the transverse sinus (TS). Dehiscent ICA for the direct type was assessed only in the case group. Sensitivity, specificity, and inter-reader agreement were determined. Attenuation differences between the ICA and CS and between the CS and TS were compared across groups. Results: The sensitivity/specificity for two engorgement and two enhancement findings were 81%/100%, 88%/94%, 100%/100%, and 88%/100%, respectively, for Reader 1, and 75%/100%, 75%/100%, 88%/100%, and 88%/100%, respectively, for Reader 2. Agreement between readers was excellent for all findings (κ>0.80). Dehiscent ICA identified the direct type with a sensitivity/specificity of 100%/75% for Reader 1 and 100%/88% for Reader 2 (κ=0.871). In the case group, the difference between ICA and CS attenuation values was significantly lower (180.1±76.6 versus 7.5±23.7; ⤳<0.001) and that between CS and TS were higher (–31.2±69 versus 102.6±59.3; ⤳<0.001). The area under the curve for the latter values was 0.95. Conclusion: The engorgement and enhancement categories in MDCTA may perform comparably in identifying CCFs and measurements of vessel attenuation differences may be of high diagnostic value. Dehiscent ICA can greatly aid in identifying the

Anomalous Origin of the Left Coronary Artery from the Right Sinus of Valsalva and Sever Mitral Stenosis

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Abdi, Ahmadnoor; Hashemi Fard, Omid

2011-01-01

Congenital coronary anomalies are presented in approximately1% of patient referred for cardiac catheterization. Among the congenital coronary anomalies, a separated anomalous origin of all the coronary arteries from the right sinus of valsalva is very uncommon. We report a rare occurance of simultaneous occurence of mitral stenosis with ectopic origin of left main stem coronary artery from right sinus of Valsalva. PMID:22577434

DURAL CAROTID-CAVERNOUS FISTULAS

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Barbara Cvenkel

2002-12-01

Full Text Available Background. Dural carotid-cavernous sinus fistulas (CCF are communications fed by meningeal branches of the intracavernous internal carotid artery (ACI or/and external carotid artery (ACE. In contrast to typical CCF, the arteriovenous shunting of blood is usually low flow and low pressure. Spontaneous dural CCF are more common in postmenopausal women. Aetiology is unknown, but congenital malformation or rupture of thin-walled dural arteries within venous sinuses is believed to be the cause.Case reports. 3 cases lacking the typical clinical signs of CCF who had been treated as chronic conjunctivitis, myositis of the extraocular muscle and orbital pseudotumour are presented. Clinical presentation depends on the direction and magnitude of fistular flow and on the anatomy of the collateral branches. If increased blood flow is directed anteriorly in ophthalmic veins the signs of orbito-ocular congestion are present (»redeyed shunt syndrome«. Drainage primarly in the inferior petrosal sinus may cause painful oculomotor and abducens palsies without signs of ocular congestion (»white-eyed shunt syndrome«. Also different therapeutic approaches as well as possible complications are described.Conclusions. For definite diagnosis angiography is obligatory and is also therapeutic as one third to one half of dural CCF close spontaneously. Because of potential severe eye and systemic complications, surgical intervention is indicated only in cases with uncontrolled secondary glaucoma and hypoxic retinopathy.

Gamma radiosurgery combined with trans-sphenoidal surgery for pituitary tumor involved to the cavernous sinus

International Nuclear Information System (INIS)

Ikeda, Hidetoshi; Yoshimoto, Takashi; Shirokura, Hidefumi.

1995-01-01

Ten patients (2 males and 8 females with an average age of 39 years) were treated with combined trans-sphenoidal surgery and gamma radiosurgery for pituitary tumor involved to the cavernous sinus. A Follow-up period ranged from 7 to 29 months, with a mean of 21 months. Therapeutic effects were assessed using magnetic resonance imaging (MRI) every 3 months, endocrine examination, optical examination for visual field, and auditory test. Pituitary tumor after radiosurgery was shown as hypointensity on T1-weighted images and hyperintensity on T2-weighted images. Tumor response could be classified on MRI into (1) a remarkably decreased tumor in size with increased contrast enhancement (n=6), (2) a remarkably decreased tumor in size with unchanged contrast enhancement (n=one), (3) a slightly decreased tumor in size with increased spotted contrast enhancement (n=2), and (4) unchanged tumor in size with decreased contrast enhancement (n=one). Of 6 Type 1 patients, 5 had growth hormone production. Growth hormone production tended to be associated with favorable response to radiosurgery. In 3 patients who showed endocrinologically favorable response (such as increased growth hormone in blood and somatomedin C value), complete regression of tumor was achieved at a 20-month follow-up period. Radiosurgery also seemed to be useful for treating hormone active tumors. (N.K.)

Long-Term Outcomes of Stereotactic Radiosurgery for Treatment of Cavernous Sinus Meningiomas

International Nuclear Information System (INIS)

Santos, Marcos Antonio dos; Bustos Pérez de Salcedo, José; Gutiérrez Diaz, José Angel; Calvo, Felipe A.; Samblás, José; Marsiglia, Hugo; Sallabanda, Kita

2011-01-01

Purpose: Patients with cavernous sinus meningiomas (CSM) have an elevated risk of surgical morbidity and mortality. Recurrence is often observed after partial resection. Stereotactic radiosurgery (SRS), either alone or combined with surgery, represents an important advance in CSM management, but long-term results are lacking. Methods and Materials: A total of 88 CSM patients, treated from January 1991 to December 2005, were retrospectively reviewed. The mean follow-up was 86.8 months (range, 17.1–179.4 months). Among the patients, 22 were followed for more than 10 years. There was a female predominance (84.1%). The age varied from 16 to 90 years (mean, 51.6). In all, 47 patients (53.4%) received SRS alone, and 41 patients (46.6%) had undergone surgery before SRS. A dose of 14 Gy was prescribed to isodose curves from 50% to 90%. In 25 patients (28.4%), as a result of the proximity to organs at risk, the prescribed dose did not completely cover the target. Results: After SRS, 65 (73.8%) patients presented with tumor volume reduction; 14 (15.9%) remained stable, and 9 (10.2%) had tumor progression. The progression-free survival was 92.5% at 5 years, and 82.5% at 10 years. Age, sex, maximal diameter of the treated tumor, previous surgery, and complete target coverage did not show significant associations with prognosis. Among the 88 treated patients, 17 experienced morbidity that was related to SRS, and 6 of these patients spontaneously recovered. Conclusions: SRS is an effective and safe treatment for CSM, feasible either in the primary or the postsurgical setting. Incomplete coverage of the target did not worsen outcomes. More than 80% of the patients remained free of disease progression during long-term follow-up.

Long-Term Outcomes of Stereotactic Radiosurgery for Treatment of Cavernous Sinus Meningiomas

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Santos, Marcos Antonio dos, E-mail: marcosrxt@gmail.com [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Bustos Perez de Salcedo, Jose; Gutierrez Diaz, Jose Angel [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain); Calvo, Felipe A. [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Department of Oncology, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Samblas, Jose [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain); Marsiglia, Hugo [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Sallabanda, Kita [Radiotherapy Department, Instituto Madrileno de Oncologia/Grupo IMO, Madrid (Spain); Neurosurgery Department, Sanatorio San Francisco de Asis, Madrid (Spain)

2011-12-01

Purpose: Patients with cavernous sinus meningiomas (CSM) have an elevated risk of surgical morbidity and mortality. Recurrence is often observed after partial resection. Stereotactic radiosurgery (SRS), either alone or combined with surgery, represents an important advance in CSM management, but long-term results are lacking. Methods and Materials: A total of 88 CSM patients, treated from January 1991 to December 2005, were retrospectively reviewed. The mean follow-up was 86.8 months (range, 17.1-179.4 months). Among the patients, 22 were followed for more than 10 years. There was a female predominance (84.1%). The age varied from 16 to 90 years (mean, 51.6). In all, 47 patients (53.4%) received SRS alone, and 41 patients (46.6%) had undergone surgery before SRS. A dose of 14 Gy was prescribed to isodose curves from 50% to 90%. In 25 patients (28.4%), as a result of the proximity to organs at risk, the prescribed dose did not completely cover the target. Results: After SRS, 65 (73.8%) patients presented with tumor volume reduction; 14 (15.9%) remained stable, and 9 (10.2%) had tumor progression. The progression-free survival was 92.5% at 5 years, and 82.5% at 10 years. Age, sex, maximal diameter of the treated tumor, previous surgery, and complete target coverage did not show significant associations with prognosis. Among the 88 treated patients, 17 experienced morbidity that was related to SRS, and 6 of these patients spontaneously recovered. Conclusions: SRS is an effective and safe treatment for CSM, feasible either in the primary or the postsurgical setting. Incomplete coverage of the target did not worsen outcomes. More than 80% of the patients remained free of disease progression during long-term follow-up.

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...

Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

International Nuclear Information System (INIS)

Erol, Ilknur; Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

2006-01-01

A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

Drainage of the Left Hepatic Vein into the Coronary Sinus, a Rare Intraoperative Finding.

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Morshuis, Wouter G; de Lind van Wijngaarden, Robert A F; Kik, Charles; Bogers, Ad J J C

2015-11-01

In a 76-year-old female undergoing coronary artery bypass surgery, a persistent left hepatic vein was observed. Draining of this vein into the coronary sinus is an extremely rare embryological malformation and this is the first case to be reported as a solitary malformation in absence of other cardiac malformations. © 2015 Wiley Periodicals, Inc.

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

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Nagaraja Moorthy

2013-09-01

Full Text Available Persistence of a left-sided superior vena cava (PLSVC with absent right superior vena cava (isolated PLSVC is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS. The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus.

Aspergilloma of the maxillary sinus: report of a case

International Nuclear Information System (INIS)

Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan; Yu, Jae Jung

2010-01-01

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

Cataract surgery in a case of carotid cavernous fistula

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Nair, Akshay Gopinathan; Praveen, Smita Vittal; Noronha, Veena Olma

2014-01-01

A carotid-cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF. PMID:25370401

Laser-Doppler Flowmetry and Horner’s Syndrome in Patients with Complete Unilateral Damage to the Parasellar Sympathetic Fibers During Cavernous Sinus Surgery

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Benedičič, Mitja; Debevc, David; Dolenc, Vinko V.; Bošnjak, Roman

2006-01-01

Aim To determine ocular, sudomotor, and vasomotor components of Horner’s syndrome resulting from complete unilateral intraoperative damage to the parasellar sympathetic fibers during cavernous sinus surgery. Methods Complete damage to the parasellar sympathetic fibers was found in four patients operated for central skull base lesions. Pupilometry, eyelid fissure measurement, Hertel’s exophthalmometry, starch iodine sweat test, and laser-Doppler perfusion assessment of bilaterally symmetrical forehead and cheek areas were performed. Results Pupil diameter was smaller and the eyelid fissure was >2 mm narrower on the affected side in all four patients. Exophthalmometry after the operation never revealed >1 mm difference. Anhydrosis was localized to the medial forehead in three and to the entire forehead in one patient. Average perfusion did not significantly differ between the affected and opposite side of the forehead or cheek. Conclusions The parasellar sympathetic fibers exclusively innervate the orbit and variably innervate the forehead sweat glands. No conclusion regarding their contribution to the facial vasomotor control could be established. PMID:16625695

Aspergilloma of the maxillary sinus: report of a case

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Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

2010-12-15

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.

Science.gov (United States)

Vanikieti, Kavin; Poonyathalang, Anuchit; Jindahra, Panitha; Cheecharoen, Piyaphon; Chokthaweesak, Wimonwan

2018-02-02

Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V 1 ) and maxillary (V 2 ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral

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

International Nuclear Information System (INIS)

Kim, Jae Hyung; Na, Dong Gyu; Byun, Hong Sik; Ryoo, Jae Wook

2000-01-01

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

A Case of Pyriform Sinus Fistula Infection with Double Tracts

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Masato Shino

2014-01-01

Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

[Extensive tumor of the skull base: sphenoid sinus adenocarcinoma].

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Kallel, Souha; Sellami, Moncef

2017-01-01

We report a rare case of adenocarcinoma of the sphenoid sinus manifesting as extended skull base tumor. The patient included in the study was a 42-year old woman presenting with unilateral right symptomatology consisting of nasal obstruction, diplopia and hemifacial neuralgias. Clinical examination showed paralysis of the cranial nerve pairs V and VI. Brain scanner showed voluminous heterogeneous sphenoid and clival mass reaching the right cavernous sinus, with a peripheral tissue component at the level of the sphenoid sinus. Biopsy was performed under general anesthesia, through endonasal sphenoidotomy approach. Histological examination showed non-intestinal adenocarcinoma. The patient died due to impaired general condition occurred during examinations. Skull base adenocarcinomas mainly occur in the ethmoid bone. Sphenoid origin is exceptional. Radiological appearance is not specific and suggests malignancy. Diagnosis should be suspected in patients with aggressive tumor, even when it occurs in the midline skull base.

Dural sinus filling defect: intrasigmoid encephalocele

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Karatag, Ozan; Cosar, Murat; Kizildag, Betul; Sen, Halil Murat

2013-01-01

Filling defects of dural venous sinuses are considered to be a challenging problem especially in case of symptomatic patients. Many lesions have to be ruled out such as sinus thrombosis, arachnoid granulations and tumours. Encephalocele into dural sinus is also a rare cause of these filling defects of dural sinuses. Here, we report an extremely rare case with spontaneous occult invagination of temporal brain tissue into the left sigmoid sinus and accompanying cerebellar ectopia. PMID:24311424

Modified three-dimensional skull base model with artificial dura mater, cranial nerves, and venous sinuses for training in skull base surgery: technical note.

Science.gov (United States)

Mori, Kentaro; Yamamoto, Takuji; Oyama, Kazutaka; Ueno, Hideaki; Nakao, Yasuaki; Honma, Keiichirou

2008-12-01

Experience with dissection of the cavernous sinus and the temporal bone is essential for training in skull base surgery, but the opportunities for cadaver dissection are very limited. A modification of a commercially available prototype three-dimensional (3D) skull base model, made by a selective laser sintering method and incorporating surface details and inner bony structures such as the inner ear structures and air cells, is proposed to include artificial dura mater, cranial nerves, venous sinuses, and the internal carotid artery for such surgical training. The transpetrosal approach and epidural cavernous sinus surgery (Dolenc's technique) were performed on this modified model using a high speed drill or ultrasonic bone curette under an operating microscope. The model could be dissected in almost the same way as a real cadaver. The modified 3D skull base model provides a good educational tool for training in skull base surgery.

Cavernous sinus syndrome due to rhino-orbital-cerebral mucormycosis

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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.

Orthopantomographic study of the maxillary sinus

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Joo; Yu, Dong Su [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1971-11-15

The author has observed the orthopantomograms of the maxillary sinus which were taken by special exposure method to study mesiodistal dimension, shape, symmetrical relationship, bony septum of the maxillary sinus and relationship between upper lst molar and the maxillary sinus, that were selected 56 cases of 23 to 27 years old male, who have good systemic conditions and no missing teeth on upper posterior molar in normal occlusion, and obtained following conclusions: 1. Mesiodistal dimensions of the maxillary sinus are shown as follows; The mean of left dimension is 50.94 {+-} 8.34 mm and of right dimension is 49.50 {+-} 9.87 mm. 2. To the shape of the maxillary sinus, V or U shape are 33 cases(29.5%) and W shape are 77 cases (70.5%). 3. In the ralationship between upper lst molar and floor of the maxllary sinus, superimposition are 62 cases (55.36%) a nd approach are 50 cases (44.64%). 4. In the right and left symmetrical relationship of the maxillary sinus, symmetry are 37 cases (66.07%) and asymmetry are 19 cases (33.93%). 5. The bony septums in the maxillary sinuses revealed that presence of bony septums are 29 cases (25.8%) and absence ar e 83 cases (74.11%).

Clinical importance of the basal cavernous sinuses and cavernous carotid arteries relative to the pituitary gland and macroadenomas: quantitative analysis of the complete anatomy.

Science.gov (United States)

Yilmazlar, Selcuk; Kocaeli, Hasan; Eyigor, Ozhan; Hakyemez, Bahattin; Korfali, Ender

2008-08-01

macroadenomas, some part of the CA's diameter was located below the line passing from the basal dural layer ranging from 12.5% to 100%. Our results indicate that a working area of 15.0 +/- 2.6 x 10.3 +/- 2.1 mm is safe during TSS. The position of the CCA posterior segment was notably more caudal than the anterior segment with respect to the basal dura, which should be taken into account during extended exposure. Also, preoperative recognition of the anatomical variations is beneficial for detection of the boundaries of dissection, which is particularly important in the BCS, where variable course of CCAs may transform the anatomical configuration. Slowly growing pituitary adenomas stretch out both CCAs considerably from medial to lateral directions, and they cause widening of intercarotid distances in all segments. Processing of fixation, decalcification, and paraffin embedding for the cadaveric tissue in contrast to physiologically hydrated tissues may change the accuracy of measurements. These measurements are significantly different than those in the radiologic images when arterial blood under pressure is in the CCA as well as when venous blood fills the cavernous sinus as is the case in vivo. In clinical practice, these facts must be taken into consideration in the cadaveric measurements.

Multiple cavernous malformations presenting in a patient with Poland syndrome: A case report

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De Salles Antonio AF

2011-09-01

Full Text Available Abstract Introduction Poland syndrome is a congenital disorder related to chest and hand anomalies on one side of the body. Its etiology remains unclear, with an ipsilateral vascular alteration (of unknown origin to the subclavian artery in early embryogenesis being the currently accepted theory. Cavernous malformations are vascular hamartomas, which have been linked to a genetic etiology, particularly in familial cases, which commonly present with multiple lesions. Our case report is the first to describe multiple cavernous malformations associated with Poland syndrome, further supporting the vascular etiology theory, but pointing to a genetic rather than a mechanistic factor disrupting blood flow in the corresponding vessels. Case presentation A 41-year-old Caucasian man with Poland syndrome on the right side of his body presented to our hospital with a secondary generalized seizure and was found to have multiple cavernous malformations distributed in his brain, cerebellum, and brain stem, with a predominance of lesions in the left hemisphere. Conclusion The distribution of cavernous malformations in the left hemisphere and the right-sided Poland syndrome in our patient could not be explained by a mechanistic disruption of one of the subclavian arteries. A genetic alteration, as in familial cavernous malformations, would be a more appropriate etiologic diagnosis of Poland syndrome in our patient. Further genetic and pathological studies of the involved blood vessels in patients with Poland syndrome could lead to a better understanding of the disease.

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

International Nuclear Information System (INIS)

1976-01-01

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

Relation between intraocular pressure and size of transverse sinuses

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Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan [Atatuerk University, Department of Radiology, Medical Faculty, Erzurum (Turkey); Dane, Senol; Gumustekin, Kenan [Atatuerk University, Department of Physiology, Medical Faculty, Erzurum (Turkey); Aslankurt, Murat [Atatuerk University, Department of Ophtalmatology, Medical Faculty, Erzurum (Turkey); Yazici, Ahmet Taylan [Beyoglu Goez Egitim ve Arastirma Hastanesi, Istanbul (Turkey)

2005-01-01

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean{+-}SD; 19.72{+-}0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)

Relation between intraocular pressure and size of transverse sinuses

International Nuclear Information System (INIS)

Kantarci, Mecit; Onbas, Omer; Alper, Fatih; Okur, Adnan; Dane, Senol; Gumustekin, Kenan; Aslankurt, Murat; Yazici, Ahmet Taylan

2005-01-01

There are asymmetries in the sizes of transverse sinus and intraocular pressure. The purpose of this study was to investigate possible relationships between the asymmetry of transverse sinuses in TOF MR venography and intraocular pressures of right and left eyes. In this study, subjects were 63 male and 42 female medical school students, aged 18-21 years (mean±SD; 19.72±0.67 years). Subjects with neurological and ophthalmologic disease, particularly dural sinus thrombosis, myopia, trauma and glaucoma, were excluded the study. Subjects were divided into five groups according to the magnitudes of the right- and left-transverse sinuses in MR venography results. There is a functional relation between intraocular pressures of the right and left eyes and asymmetry of the transverse sinus. If the transverse sinus on one side is larger and its venous drainage is greater, the intraocular pressure of the eye on this side is lower. It can be speculated that the transverse sinus size may be associated with pathogenesis of diseases with increased intraocular pressure such as glaucoma. We aim to determine the relation between the size and drainage of transverse sinuses in TOF MR venography and intraocular pressure in patients with open-angle glaucoma in our next study. (orig.)

Radiological evaluation of sinus valsalva rupture

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Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1984-03-15

We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

Radiological evaluation of sinus valsalva rupture

International Nuclear Information System (INIS)

Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

1984-01-01

We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality

Endovascular management of a carotid aneurysm into the sphenoid sinus presenting with epistaxis.

Science.gov (United States)

Akkari, Mohamed; Gascou, Grégory; Trévillot, Vincent; Bonafé, Alain; Crampette, Louis; Machi, Paolo

2015-12-01

Non-traumatic cavernous internal carotid artery (ICA) aneurysms are rare, and favour the occurrence of massive recurrent epistaxis, which is associated with a high mortality rate. We report the case of a 67-year-old woman presenting a ruptured ICA aneurysm extending into the sphenoid sinus, revealed by epistaxis. Selective coil embolization of the aneurysm was performed. Flow-diverter stents were deployed in order to utterly exclude the aneurysm and prevent revascularization. Anti-platelet treatment was provided to lower the risk of in-stent thrombosis. A left frontal hematoma associated with a subarachnoid haemorrhage occurred at day 2. Outcome was favourable with no neurological sequelae, and no clinical recurrence of epistaxis occurred. A 4 months follow-up digital subtraction angiography showed a complete exclusion of the aneurysm. In addition, a magnetic resonance cerebral angiography at 16 months showed stable results. Thus, this two-stage endovascular procedure has proven its effectiveness in preventing epistaxis recurrence while preserving the ICA patency. © The Author(s) 2015.

Recurrent Syncope Due to Carotid Sinus Hypersensitivity and Sick Sinus Syndrome

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Feng-Yu Kuo

2008-10-01

Full Text Available Syncope is a sudden and brief loss of consciousness with postural tone. Its recovery is usually spontaneous. There are various causes of syncope including cardiac, vascular, neurologic, metabolic and miscellaneous origins. The tracing is usually time-consuming and costly. The diagnosis of carotid sinus syncope may sometimes be difficult since the symptoms are nonspecific, especially in older persons. Here, we report the case of a 72-year-old woman who sought medical attention at our hospital due to repeated syncope episodes over the previous 5 years. Neurologic examinations showed negative results (including brain computed tomography. Twenty-four-hour ambulatory electrocardiogram monitoring showed atrial and ventricular premature contractions only. Electrophysiologic study disclosed prolonged corrected sinus node recovery time (1,737 ms with poor atrioventricular conduction. Drop of blood pressure together with sinus bradycardia developed after left side carotid sinus massage. Both carotid sinus hypersensitivity with sick sinus syndrome contributed to this patient's syncope, and after pacemaker placement together with selective serotonin reuptake inhibitor treatment, she was free from syncope thereafter.

Simultaneous and sequential hemorrhage of multiple cerebral cavernous malformations: a case report.

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Louis, Nundia; Marsh, Robert

2016-02-09

The etiology of cerebral cavernous malformation hemorrhage is not well understood. Causative physiologic parameters preceding hemorrhagic cavernous malformation events are often not reported. We present a case of an individual with sequential simultaneous hemorrhages in multiple cerebral cavernous malformations with a new onset diagnosis of hypertension. A 42-year-old white man was admitted to our facility with worsening headache, left facial and tongue numbness, dizziness, diplopia, and elevated blood pressure. His past medical history was significant for new onset diagnosis of hypertension and chronic seasonal allergies. Serial imaging over the ensuing 8 days revealed sequential hemorrhagic lesions. He underwent suboccipital craniotomy for resection of the lesions located in the fourth ventricle and right cerebellum. One month after surgery, he had near complete resolution of his symptoms with mild residual vertigo but symptomatic chronic hypertension. Many studies have focused on genetic and inflammatory mechanisms contributing to cerebral cavernous malformation rupture, but few have reported on the potential of hemodynamic changes contributing to cerebral cavernous malformation rupture. Systemic blood pressure changes clearly have an effect on angioma pressures. When considering the histopathological features of cerebral cavernous malformation architecture, changes in arterial pressure could cause meaningful alterations in hemorrhage propensity and patterns.

Intracranial melanocytic meningeal tumours and melanosis oculi: case report and literature review

International Nuclear Information System (INIS)

Doglietto, Francesco; Colosimo, Cesare; Lauriola, Libero; Balducci, Mario; De Bonis, Pasquale; Montano, Nicola; Zadeh, Gelareh; Maira, Giulio; Pallini, Roberto

2012-01-01

Melanocytic meningeal tumours are rare extra-axial neoplasms of the nervous system, with only three reported cases in the cavernous sinus. Herein we describe for the first time the association of ocular melanosis and multiple intracranial melanocytic meningeal tumours, with the presenting lesion being in the cavernous sinus. The importance of this association is discussed together with the diagnostic and therapeutic challenges of the case. A 20-year-old man presented with a left sixth cranial nerve deficit; general examination documented only congenital melanosis of the homolateral eye. MRI examination showed a space occupying lesion in the left cavernous sinus, which was followed conservatively for 2 years, until a new space occupying lesion was evident at the level of the right frontal convexity: both lesions presented with neuroradiological characteristics suggestive of melanin content. The frontal convexity lesion was removed: intraoperatively the dura was markedly and diffusely melanotic. Histological examination documented a melanocytic meningeal tumour, with a proliferative index of 3 %. The patient underwent 3D-Conformal Radiation Therapy on the lesion of the cavernous sinus (total dose 5040 cGy), with initial tumour reduction. Three years later, due to a symptomatic growth, he underwent partial removal of the lesion in the cavernous sinus. Histological examination was unchanged. He then received adjuvant Temozolomide with Low Dose Fractionated Radiation Therapy (LD-FRT). Due to further disease progression cisplatin plus fotemustine were administered, concomitant with LD-FRT: after two cycles MRI documented significant disease regression. After a period of apparent disease control, the patient presented with persistent cough and evidence of multiple thoracic metastases, which lead to his death, seven years after presentation. Intracranial melanocytic meningeal tumours are challenging lesions, both from a diagnostic and therapeutic point of view; though rare

Frontal sinus asymmetry: Is it an effect of cranial asymmetry? X-ray analysis of 469 normal adult human frontal sinus

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Ayhan Kanat

2015-01-01

Full Text Available Background and Aims: There is no study in the literature that investigates an asymmetric morphological feature of the frontal sinus (FS. Materials and Methods: Four hundred and sixty-nine consecutive direct X-rays of FSs were analyzed for the asymmetry between the right and left sides. When an asymmetry in the height and contour of the FS existed, this difference was quantified. Results: Of the 469 patients, X-rays of 402 patients (85.7%, there was an asymmetry between right and left sides of the FS. Of these 235 (50.1% were dominant on the left side, whereas 167 (35.6% were dominant on the right, the sinuses of remaining 67 patients (14.3% was symmetric. Statistical Analysis: The comparisons between parameters were performed using Wilkinson signed rank test. The relationship between handedness and sinus asymmetry was also examined by two proportions test. There is statistically significant difference between the dominance of left and right FS. Conclusions: Hemispheric dominance may have some effect (s of on sinus asymmetry of the human cranium. Surgeons sometimes enter the cranium through the FS and knowledge of asymmetric FS is important to minimize surgical complications.

Brainstem edema caused by traumatic carotid-cavernous fistula: A case report and review of the literature

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YU, JINLU; GUO, YUNBAO; ZHAO, SHUJIE; XU, KAN

2015-01-01

Brainstem edema caused by traumatic carotid-cavernous fistula (TCCF) is rare, and there is little information available regarding its clinical characteristics. The present report describes the case of a 51-year-old man with TCCF, who presented with right exophthalmos and intracranial bruit for 1 week. One month prior to admission at hospital, he fractured the frontal and ethmoid sinuses. Digital subtraction angiography confirmed the diagnosis of TCCF, and magnetic resonance imaging (MRI) sugg...

The benign course of carotid-cavernous fistula in a child

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Kurul, Semra E-mail: skurul@hotmail.com; Cakmakci, Handan; Kovanlikaya, Arzu; Dirik, Eray

2001-08-01

Carotid-cavernous fistulas (CCF) are reported very rarely in childhood and their clinical course and prognosis are uncertain. We report a 9-year-old boy presented with left eye swelling, neck pain and headache. The MRI findings suggested a CCF with enlarged left superior ophthalmic vein. Ocular Doppler ultrasonography revealed enlarged left superior ophthalmic vein, and arterialization of Doppler wave form. The cerebral angiogram showed normal anatomy. Control Doppler examination findings supported the diagnosis of closure of fistula. The clinical and radiological findings of this unusual presentation are discussed.

The benign course of carotid-cavernous fistula in a child

International Nuclear Information System (INIS)

Kurul, Semra; Cakmakci, Handan; Kovanlikaya, Arzu; Dirik, Eray

2001-01-01

Carotid-cavernous fistulas (CCF) are reported very rarely in childhood and their clinical course and prognosis are uncertain. We report a 9-year-old boy presented with left eye swelling, neck pain and headache. The MRI findings suggested a CCF with enlarged left superior ophthalmic vein. Ocular Doppler ultrasonography revealed enlarged left superior ophthalmic vein, and arterialization of Doppler wave form. The cerebral angiogram showed normal anatomy. Control Doppler examination findings supported the diagnosis of closure of fistula. The clinical and radiological findings of this unusual presentation are discussed

Treatment of the superior sagittal sinus and transverse sinus thrombosis associated with intracranial hemorrhage with the mechanical thrombectomy and thrombolytics: Case report.

Science.gov (United States)

Liu, Yuchun; Li, Keqin; Huang, Yi; Sun, Jie; Gao, Xiang

2017-12-01

The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal. Computed tomography (CT) demonstrated both subarachnoid and intraparenchymal hemorrhage and brain edema at the right temporal lobe accompanied by high density shadow in the right transverse sinus. Digital subtraction angiography (DSA) revealed extensive thrombosis of the SSS and bilateral transverse sinus. The SSS and transverse sinus thrombosis, accompanied by right temporal lobe hemorrhage, subarachnoid hemorrhage (SAH). An emergent mechanical thrombectomy by placed Solitair AB stent in the SSS, respectively, passed left and right sigmoid sinus-transverse sinus route. We removed the most clots, DSA revealed recanalization of the SSS and left transverse sinus was seen with normalization of the venous outflow, the occlusion of right transverse sinus was still present. There were 4 hours after patient back to neurosurgical intensive care unit (NICU), patient appeared anisocoria (R/L:4.0/2.5 mm), bilateral light reflexes disappeared, then we took a CT reexamination revealed intraparenchymal hemorrhage increased, brain edema was aggravated at the left temporal lobe, and mild midline shift. Subsequently, we performed decompressive hemicraniectomy and puncture the hematoma supplemented by B ultrasonic. Anticoagulation treatment was initiated 24 hours after surgery, and follow-up DSA showed gradually improved patency in the SSS and bilateral transverse sinus. Despite occlusion of the SSS and bilateral transverse sinus, patient's symptoms resolved after the operations and he

Intracranial cavernous angioma

International Nuclear Information System (INIS)

Yuhi, Fumiaki; Gondou, Masazumi; Sasahira, Masahiro; Ichitsubo, Hidenori; Asakura, Tetsuhiko.

1986-01-01

The present authors have experienced 2 cases of intracranial cavernous angioma. Of these cases, one was admitted because of generalized convulsions, while the other was admitted because of headache. In both cases, neither plain X-ray films nor carotid angiography showed any abnormality, but computerized tomography (CT) revealed a slightly high-density area which was not enhanced with contrast media. Histologically, the tumors had many vascular cavities with walls lined with a single layer of endothelial cells and had no neural tissue between the vascular cavities; therefore, they were diagnosed as cases of cavernous angioma. The authors discussed the radiological findings of the intracranial cavernous angioma with a review of the literature and stressed the role of computerized tomography in the diagnosis of cavernous angioma. (author)

Measurement of maxillary sinus volume using Computed Tomography

International Nuclear Information System (INIS)

Park, Chang Hee; Kim, Kee Deog; Park, Chang Seo

2000-01-01

To propose a standard value for the maxillary sinus volume of a normal Korean adult by measuring the width and height of the sinus and analyzing their correlation and the difference of the sinus size respectively between sexes, and on the right and left sides. Fifty-two (95 maxillary sinuses) out of 20 years or over aged patients who had taken CT in the Department of Dental Radiology, Yonsei University, Dental Hospital, between February 1997 and July 1999 who were no specific symptom, prominent bony septa, pathosis, clinical asymmetry and history of surgery in the maxillary sinus were retrospectively analyzed. The mean transverse width, antero-posterior width, height and volume of the normal Korean adult's maxillary sinuses were 28.33 mm, 39.69 mm, 46.60 mm and 21.90 cm 3 , respectively. There was a significant sex difference in the sinus volume (p<0.05). In the mean antero-posterior width, height and volume of the sinus, no significant difference was observed between both sides. All four measurements showed a significant correlation between both sides (p<0.0001). The widths and height of the sinus all showed a significant correlation with the sinus volume (p<0.0001). In the Korean normal adult's maxillary sinus, males tended to be larger than females. Except for the transverse width, all of the measurements showed no significant difference between the right and left side, but significant correlations in the four measurements between both sides were observed. Thus, the overgrowth or undergrowth in the unilateral maxillary sinus may suggest a certain pathosis or developmental abnormalities in the maxillary sinus.

Midface swelling reveals nasofrontal dermal sinus

International Nuclear Information System (INIS)

Houneida, Zaghouani Ben Alaya; Manel, Limeme; Latifa, Harzallah; Habib, Amara; Dejla, Bakir; Chekib, Kraiem

2012-01-01

Nasofrontal dermal sinuses are very rare and generally occur in children. This congenital malformation can be revealed by midface swelling, which can be complicated by local infection or neuromeningitis. Such complications make the dermal sinus a life-threatening disease. Two cases of nasofrontal dermal sinuses are reported in this work. The first case is an 11-month-old girl who presented with left orbitonasal soft tissue swelling accompanied by inflammation. Physical examination found fever, left orbitonasal thickening, and a puncture hole letting out pus. Computed tomography revealed microabscesses located at the left orbitonasal soft tissues, a frontal bone defect, and an intracranial cyst. Magnetic resonance imaging showed the transosseous tract between the glabella and the brain and affirmed the epidermoid nature of the intracranial cyst. The second case is a 7-year-old girl who presented with a nasofrontal non-progressive mass that intermittently secreted a yellow liquid through an external orifice located at the glabella. MRI revealed a cystic mass located in the deep layer of the glabellar skin related to an epidermoid cyst with a nasofrontal dermal sinus tract. In both cases, surgical excision was performed, and pathological confirmation was made for the diagnoses of dermal sinuses. The postoperative course was favorable. Through these cases, the authors stress the role of imaging methods in confirming the diagnosis and looking for associated cysts (dermoid and epidermoid) to improve recognition of this rare disease. Knowledge of the typical clinical presentations, imaging manifestations, and most common sites of occurrence of this malformation are needed to formulate a differential diagnosis.

Preoperative Lateralization Modalities for Cushing Disease: Is Dynamic Magnetic Resonance Imaging or Cavernous Sinus Sampling More Predictive of Intraoperative Findings?

Science.gov (United States)

Sun, Hai; Yedinak, Chris; Ozpinar, Alp; Anderson, Jim; Dogan, Aclan; Delashaw, Johnny; Fleseriu, Maria

2015-06-01

Objective To analyze whether cavernous sinus sampling (CSS) and dynamic magnetic resonance imaging (dMRI) are consistent with intraoperative findings in Cushing disease (CD) patients. Design Retrospective outcomes study. Setting Oregon Health & Science University; 2006 and 2013. Participants A total of 37 CD patients with preoperative dMRI and CSS to confirm central adrenocorticotropic hormone (ACTH) hypersecretion. Patients were 78% female; mean age was 41 years (at diagnosis), and all had a minimum of 6 months of follow-up. Main Outcome Measures Correlations among patient characteristics, dMRI measurements, CSS results, and intraoperative findings. Results All CSS indicated presence of CD. Eight of 37 patients had no identifiable tumor on dMRI. Three of 37 patients had no tumor at surgery. dMRI tumor size was inversely correlated with age (rs = - 0.4; p = 0.01) and directly correlated to intraoperative lateralization (rs = 0.3; p < 0.05). Preoperative dMRI was directly correlated to intraoperative lateralization (rs = 0.5; p < 0.002). CSS lateralization showed no correlation with intraoperative findings (rs = 0.145; p = 0.40) or lateralization observed on preoperative dMRI (rs = 0.17; p = 0.29). Postoperative remission rate was 68%. Conclusion dMRI localization was most consistent with intraoperative findings; CSS results were less reliable. Results suggest that small ACTH-secreting tumors continue to pose a challenge to reliable preoperative localization.

Flow diversion in vasculitic intracranial aneurysms? Repair of giant complex cavernous carotid aneurysm in polyarteritis nodosa using Pipeline embolization devices: first reported case.

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Martinez Santos, Jaime; Kaderali, Zul; Spears, Julian; Rubin, Laurence A; Marotta, Thomas R

2016-07-01

Intracranial aneurysms in polyarteritis nodosa (PAN) are exceedingly rare lesions with unpredictable behavior that pose real challenges to microsurgical and endovascular interventions owing to their inflammatory nature. We introduce a safe and effective alternative for treating these aneurysms using Pipeline embolization devices (PEDs). A 20-year-old man presented with diplopia, headaches, chronic abdominal pain, and weight loss. Diagnostic evaluations confirmed PAN, including bilateral giant cavernous carotid aneurysms. Cyclophosphamide and steroids achieved significant and sustained clinical improvement, with a decision to follow the aneurysms serially. Seven years later the left unruptured aneurysm enlarged, causing a sudden severe headache and a cavernous sinus syndrome. Treatment of the symptomatic aneurysm was pursued using flow diversion (PED) and the internal carotid artery was successfully reconstructed with a total of four overlapping PEDs. At 6 months follow-up, complete exclusion of the aneurysm was demonstrated, with symptomatic recovery. This is the first description of using a flow-diverting technique in an inflammatory vasculitis. In this case, PEDs not only attained a definitive closure of the aneurysm but also reconstructed the damaged and fragile arterial segment affected with vasculitis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Vascular Complications of Intercavernous Sinuses during Transsphenoidal Surgery: An Anatomical Analysis Based on Autopsy and Magnetic Resonance Venography.

Science.gov (United States)

Deng, Xuefei; Chen, Shijun; Bai, Ya; Song, Wen; Chen, Yongchao; Li, Dongxue; Han, Hui; Liu, Bin

2015-01-01

Vascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV). Eighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV. Through dissection of the cadavers and CE-MRV, the location, shape, number, diameter and type of intercavernous sinuses were measured and compared. Different intercavernous sinuses were identified by their location and shape in all the cadavers and CE-MRV. Compared to the cadavers, CE-MRV revealed 37% of the anterior intercavernous sinus, 48% of the inferior intercavernous sinus, 30% of the posterior intercavernous sinus, 30% of the dorsum sellae sinus and 100% of the basilar sinus. The smaller intercavernous sinuses were not seen in the neuro-images. According to the presence of the anterior and inferior intercavernous sinus, four types of the intercavernous sinuses were identified in cadavers and CE-MRV, and the corresponding operative space in the transsphenoidal surgical approach was implemented. The morphology and classification of the cavernous sinus can be identified by CE-MRV, especially for the larger vessels, which cause bleeding more easily. Therefore, CE-MRV provides a reliable measure for individualized preoperative planning during transsphenoidal surgery.

Retrograde flow in the dural sinuses detected by three-dimensional time-of-flight MR angiography

International Nuclear Information System (INIS)

Uchino, Akira; Nomiyama, Keita; Takase, Yukinori; Nakazono, Takahiko; Tominaga, Yukiko; Imaizumi, Takeshi; Kudo, Sho

2007-01-01

Retrograde flow in the left dural sinuses is sometimes detected by three-dimensional time-of-flight (3D-TOF) magnetic resonance (MR) angiography. The purpose of this study was to evaluate the incidence of this phenomenon and its characteristic features on 3D-TOF MR angiograms. We retrospectively reviewed cranial MR angiography images of 1,078 patients examined at our institution. All images were obtained by the 3D-TOF technique with one of two 1.5-T scanners. Maximum intensity projection (MIP) images in the horizontal rotation view were displayed stereoscopically. We reviewed the source images, inferosuperior MIP images, and horizontal MIP images and identified retrograde flow in the dural sinuses. We found retrograde flow in the dural sinuses of 67 patients on the source images from 3D-TOF MR angiography; the incidence was 6.2%. In 47 of the 67 patients, retrograde flow was identified in the left inferior petrosal sinus, in 13, it was seen in the left sigmoid sinus, and in 6, it was seen in the left inferior petrosal and left sigmoid sinuses. The remaining patient had retrograde flow in the left inferior petrosal and left and right sigmoid sinuses. The mean age of the patients with retrograde flow was slightly greater than that of the patients without this phenomenon (70 years vs 63 years). Retrograde flow in the dural sinuses frequently occurs on the left side in middle-aged and elderly patients during 3D-TOF MR angiography performed with the patient in the supine position. This phenomenon should not be misdiagnosed as a dural arteriovenous fistula. (orig.)

CT-based manual segmentation and evaluation of paranasal sinuses.

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Pirner, S; Tingelhoff, K; Wagner, I; Westphal, R; Rilk, M; Wahl, F M; Bootz, F; Eichhorn, Klaus W G

2009-04-01

Manual segmentation of computed tomography (CT) datasets was performed for robot-assisted endoscope movement during functional endoscopic sinus surgery (FESS). Segmented 3D models are needed for the robots' workspace definition. A total of 50 preselected CT datasets were each segmented in 150-200 coronal slices with 24 landmarks being set. Three different colors for segmentation represent diverse risk areas. Extension and volumetric measurements were performed. Three-dimensional reconstruction was generated after segmentation. Manual segmentation took 8-10 h for each CT dataset. The mean volumes were: right maxillary sinus 17.4 cm(3), left side 17.9 cm(3), right frontal sinus 4.2 cm(3), left side 4.0 cm(3), total frontal sinuses 7.9 cm(3), sphenoid sinus right side 5.3 cm(3), left side 5.5 cm(3), total sphenoid sinus volume 11.2 cm(3). Our manually segmented 3D-models present the patient's individual anatomy with a special focus on structures in danger according to the diverse colored risk areas. For safe robot assistance, the high-accuracy models represent an average of the population for anatomical variations, extension and volumetric measurements. They can be used as a database for automatic model-based segmentation. None of the segmentation methods so far described provide risk segmentation. The robot's maximum distance to the segmented border can be adjusted according to the differently colored areas.

Cavernous hemangioma of the thoracic spinal cord

International Nuclear Information System (INIS)

Wang, A.M.; Lin, J.C.T.; Morris, J.H.; Fischer, E.G.; Petersen, R.

1988-01-01

A 25-year-old woman presented with a four-year history of progressive right-lower-extremity weakness and atrophy and a left hemisensory deficit was found. Metrizamide-enhanced spinal CT scan showed an intramedullary lesion at the level of T1-T2; this had expanded the cord in fusiform fashion but showed no evidence of a cystic component. Surgical resection was performed and the pathological diagnosis was cavernous hemangioma. Two and one-half years later, her left hemisensory deficit was worsening and a spinal MRI showed high signal intensity mass in the region of the previous surgery consistent with chronic hematoma which was re-evacuated with some improvement in the patient's neurological condition. (orig.)

Benign mass in tonsil- cavernous hemangioma.

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Joseph, Sumitha; Prakash, M; Mohammed, Hafida K; Govar, Aberna

2013-10-01

Cavernous hemangioma is also called as 'ANGIOMA CAVERNOSUM' or 'CAVERNOMA' as benign lesion of blood vessels. They are similar to strawberry hemangioma but deeply situated. Although most often associated with skin it is also sometimes found in mucous membrane, brain and the viscera. The diagnosis of hemangiomas is mainly based on clinical evaluation . Isolated hemangiomas in the tonsillar tissue is a rare occurance. In this we report had a case of adult tonsillar hemangioma of left side associated with recurrent tonsillitis . He was effectively managed surgically without any complications.

Unsuccessful lung scan due to major right-to-left shunt through a sinus venosus septal defect

International Nuclear Information System (INIS)

Brendel, A.J.; Larnaudie, B.; Lambert, B.; Leccia, F.; Barat, J.L.; Ducassou, D.; Fontan, F.

1985-01-01

In a patient with a prior history of cerebral abscess and cerebral ischemia, an unsuccessful perfusion lung scan led to a radionuclide angiocardiogram using an arm vein injection. This showed a total right-to-left (R-L) shunt from the superior vena cava (SVC) to the left atrium. Repeat radionuclide study, through a leg vein, demonstrated a moderate R-L shunt and an interpretable lung scan could be obtained. Catheterization and contrast cineangiogram did not provide the exact diagnosis, the preoperative conclusion being anomalous drainage of the SVC into the left atrium, with atrial septal defect (ASD) and partial anomalous pulmonary venous connection to the SVC. The operative diagnosis was high atrial (sinus venosus) septal defect. This example of major but clinically unsuspected R-L shunt emphasizes the value of performing a perfusion lung scan, preferably in conjunction with radionuclide angiocardiography in patients with a prior history of unexplained cerebral abscess or systemic ischemia. Implications of the site of an ASD on quantitation of L-R shunts by radionuclide methods are also discussed

Indirect carotid cavernous fistula mimicking ocular myasthenia.

Science.gov (United States)

Leishangthem, Lakshmi; Satti, Sudhakar Reddy

2017-10-19

71-year-old woman with progressive left-sided, monocular diplopia and ptosis. Her symptoms mimicked ocular myasthenia, but she had an indirect carotid cavernous fistula (CCF). She was diagnosed with monocular myasthenia gravis (negative acetylcholinesterase antibody) after a positive ice test and started on Mestinon and underwent a thymectomy complicated by a brachial plexus injury. Months later, she developed left-sided proptosis and ocular bruit. She was urgently referred to neuro-interventional surgery and was diagnosed with an indirect high-flow left CCF, which was treated with Onyx liquid and platinum coil embolisation. Mestinon was discontinued. Her ophthalmic symptoms resolved. However, she was left with a residual left arm and hand hemiparesis and dysmetria secondary to a brachial plexus injury. Indirect CCF usually can present with subtle and progressive symptoms leading to delayed diagnosis or misdiagnosis. It is important for ophthalmologists to consider this differential in a patient with progressive ocular symptoms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Vascular Complications of Intercavernous Sinuses during Transsphenoidal Surgery: An Anatomical Analysis Based on Autopsy and Magnetic Resonance Venography.

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Xuefei Deng

Full Text Available Vascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV.Eighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV. Through dissection of the cadavers and CE-MRV, the location, shape, number, diameter and type of intercavernous sinuses were measured and compared.Different intercavernous sinuses were identified by their location and shape in all the cadavers and CE-MRV. Compared to the cadavers, CE-MRV revealed 37% of the anterior intercavernous sinus, 48% of the inferior intercavernous sinus, 30% of the posterior intercavernous sinus, 30% of the dorsum sellae sinus and 100% of the basilar sinus. The smaller intercavernous sinuses were not seen in the neuro-images. According to the presence of the anterior and inferior intercavernous sinus, four types of the intercavernous sinuses were identified in cadavers and CE-MRV, and the corresponding operative space in the transsphenoidal surgical approach was implemented.The morphology and classification of the cavernous sinus can be identified by CE-MRV, especially for the larger vessels, which cause bleeding more easily. Therefore, CE-MRV provides a reliable measure for individualized preoperative planning during transsphenoidal surgery.

Study of mined storage caverns

International Nuclear Information System (INIS)

1975-06-01

All available information concerning 75 mined storage caverns as well as the investigative techniques utilized to determine the feasibility of a cavern site is presented. Potential new storage caverns may be for products such as high or low vapor pressure petroleum products, other chemical products, aid industrial or nuclear waste

Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

Directory of Open Access Journals (Sweden)

Hélio Utida

2002-06-01

Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

Successful endoscopic management with Mitomycin C application for sinusitis with orbital cellulitis

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Anil S Harugop

2013-01-01

Full Text Available Background: Sinusitis with orbital complication is a potentially fatal disease that has been known since the days of Hippocrates. Primary sinus infection is the most common cause of orbital cellulitis. It is an emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess. Surgical intervention is mandatory whenever antibiotic treatment fails. There are two surgical options for the drainage, an external approach via a Lynch incision and an intranasal endoscopic procedure. Materials and Methods: Five patients with orbital cellulitis secondary to acute on chronic rhinosinusitis were included in the study from the period of 2010 - 2011. All five patients did not respond to medical management and hence underwent endoscopic sinus surgery with treatment of orbital pathology. At the end of the surgical procedure Mitomycin C in a concentration of 0.4mg/ml was applied with a cottonoid for a period of 4 minutes to prevent chance of adhesion formation. Results: In this series 3 females and 2 male patient with orbital cellulitis secondary to acute on chronic rhinosinusitis underwent endoscopic sinus surgery with treatment of orbital pathology. All 5 patients showed subjective and objective improvement within one week of endoscopic management. Conclusion: Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. The excellent results and the absence of any major complications of endoscopic sinus surgery and drainage of abscess with application of Mitomycin C can be recommended as the preferred surgical technique.

"Tepid" Geysers above salt caverns

Science.gov (United States)

Bérest, Pierre; Brouard, Benoît; Zakharov, Vassily

2018-06-01

The formation of a brine geyser erupting from the wellhead of a large underground salt cavern is described. In most cases, the brine outflow from an opened cavern is slow; it results from the cavern creep closure and the thermal expansion of the cavern brine. These two processes are smooth; however, the brine outflow often is bumpy, as it is modulated by atmospheric pressure variations that generate an elastic increase (or decrease) of both cavern and brine volumes. In addition, when the flow is fast enough, the brine thermodynamic behavior in the wellbore is adiabatic. The cold brine expelled from the cavern wellhead is substituted with warm brine entering the borehole bottom, resulting in a lighter brine column. The brine outflow increases. In some cases, the flow becomes so fast that inertia terms must be taken into account. A geyser forms, coming to an end when the pressure in the cavern has dropped sufficiently. A better picture is obtained when head losses are considered. A closed-form solution can be reached. This proves that two cases must be distinguished, depending on whether the cold brine initially contained in the wellbore is expelled fully or not. It can also be shown that geyser formation is a rare event, as it requires both that the wellbore be narrow and that the cavern be very compressible. This study stemmed from an actual example in which a geyser was observed. However, scarce information is available, making any definite interpretation difficult. xml:lang="fr"

Effect of the Size of the Left Atrium on Sustained Sinus Rhythm in Patients Undergoing Mitral Valve Surgery and Concomitant Bipolar Radiofrequency Ablation for Atrial Fibrillation.

Science.gov (United States)

Avdagić, Harun; Sijerčić Avdagić, Selma; Pirić Avdagić, Melika; Antonič, Miha

2017-12-01

Atrial fibrillation is associated with systemic embolization and complications due to anticoagulant therapy. Radiofrequency ablation has been established as an effective and safe method for the treatment of atrial fibrillation. The aim of this study was to evaluate the effect of the size of the left atrium on the outcome of surgical radiofrequency ablation. Forty patients scheduled for elective mitral valve surgery and radiofrequency ablation were enrolled in the study. Group 1 consisted of patients with a left atrium diameter ≤5 cm and group 2 of patients with left atrium diameter >5 cm. The primary endpoint of the study was stable sinus rhythm 6 months postoperatively. At 6 months postoperatively, sinus rhythm was present in significantly more group 1 patients as compared with group 2 patients, i.e. 15 (75%) vs. 8 (40%), p=0.025. Multivariate analysis proved the size of the left atrium to be an independent predictor of the radiofrequency ablation outcome. Accordingly, the size of the left atrium was demonstrated to be an important predictor of the outcome of radiofrequency ablation for atrial fibrillation. A lower cut-off value of surgical reduction of the atria than previously reported should be considered in order to improve the radiofrequency ablation outcome.

[Echocardiographic factors predictive of restoration and maintenance of sinus rhythm after reduction of atrial fibrillation].

Science.gov (United States)

Ben Khalfallah, A; Sanaa, I

2007-09-01

Atrial fibrillation (AF) is the most common cardiac arrhythmia. While the arrhythmia was initially thought to be little more than a nuisance, it is now clear that AF has a significant negative impact on quality of life and a corresponding increase in both morbidity and mortality. The aim of this study was to identify Doppler echographic patterns that allow prediction of atrial fibrillation reduction and maintenance of sinus rhythm within 12 months. One hundred and thirty patients having permanent atrial fibrillation, recent (51) or chronic (79) are included in the study, excepting those with valvular heart disease or thyroid dysfunction. The mean age was 63.5 +/- 11.3 years. Both transthoracic and transoesophageal echocardiography was performed using a Philips SONOS 5500 Echograph, before cardioversion. Were studied: end diastolic and systolic left ventricular diameters, left ventricular ejectionnal fraction, left atrial area (LAA), left atrial diameter, left atrial appendage area and peak emptying velocities of the left atrial appendage (PeV). Sinus rhythm was re-established in 102 patients (44 having recent and 58 chronic atrial fibrillation). Sinus rhythm was maintained for 12 months in 79 patients. Within the echographic parameters studied, the left atrial area (LAA) and peak emptying velocities of left atrial appendage (PeV) before cardioversion were the best predictors of restoration of sinus rhythm. On monovariate analysis, SOG is significantly lower and PicV is significantly higher in patients whose sinus rhythm had been restored in comparison with those with permanent atrial fibrillation. (Mean SOG: 27.7 +/- 7.62 vs. 34 +/- 7,6 cm2, ppredict on mono and multivariate analysis (p=0.05, OR=0.5, IC=0.36 à 3.56), re-establishing of sinus rhythm whereas in patients with chronic atrial fibrillation, peak emptying velocity of left atrial appendage predict better re-establishing of sinus rhythm (p=0.04, OR=1.29, IC=0.12 à 4.23). The threshold values of LAA and Pe

Chronic Granulomatous Tolosa-Hunt Syndrome (Case Report

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Dewa Purwa Samatra

2016-04-01

Full Text Available Background: Tolosa-Hunt syndrome is a rare case, characterized by tenderness, persistent around the affected eye and ophthalmoplegia /paresis caused by granulomatous inflammation in the cavernous sinus region, supra orbital or orbital fissure. Although spontaneous remission may occur, even corticosteroid therapy has a very satisfactory effect. However, relapse can occur after remission. We report a case of granulomatous Tolosa-Hunt syndrome in women aged 47 years who suffer from recurrent Tolosa-Hunt syndrome attacks for 4 years on his left eye, there was a significant recovery after receiving steroid therapy. Case:  We report A 47 years old with recurrent pain in the left eye since 4 years, pain episode duration of 1-2 weeks, accompanied by double vision when having long or short distance viewing, and when climbing stairs. The patient left eye was protruded with blurred vision and difficulty in distinguishing green color. Left eye examination vision 1/300, green color discromatopsia, normal funduscopic, ptosis, with paresis eye movement toward the superior, inferior, nasal and temporal. C-reactive protein and erythrocyte sedimentation rate were slightly elevated. ANA test was positive. In visual evoked potential, it showed latency elongation of the left face. Head MRI with contrast showed a isointense protrusion on the left cavernous sinus in axial cuts in T1 and T2. Head MRI T1 with contrast on coronal, axial cuts showed the appearance of convex lesions around the left cavernous sinus that enhanced with contrast. Conclusions: The result was clinically and radiographically diagnosed as Tolosa-Hunt Syndrome (THS. Therefore, 10 mg dexamethasone therapy, 4 times a day for 3 days was lowered to three times on day 4, 2 times on the fifth day and one time at day 6. The patient showed clinical improvement. The patient continued 48 mg oral methylprednisolone therapy up to 3 weeks which then gradually decreased and planned head MRI 3 months later.

Delayed effect of radiation therapy on extracerebral cavernous angioma in the middle fossa

International Nuclear Information System (INIS)

Shibata, Shobu; Mori, Kazuo

1988-01-01

This is a report of a case with extracerebral cavernous angioma in the middle fossa which had received radiation therapy. Follow-up study with serial computed tomography during and after irradiation were presented. A 62-year-old housewife complained of vertigo. CT scan revealed a slightly high density area in the left middle cranial fossa which was markedly enhanced with contrast media. Left carotid angiography demonstrated a large avascular mass in the left middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. Irradiation with a total dose of 50 Gy was delivered. At the end of radiation, CT scan revealed a slight decrease in size and CT number of the tumor. Follow-up CT scans 5 months later showed 50 % regression of the tumor and 19 months later were negative for tumor. It is concluded that in case of an extracerebral cavernous angioma with massive hemorrhage, radiation of up to 30 - 50 Gy was a method of choice. The treatment results in the possibility of eliminating surgery and the benefit of irradiation may not become evident until the first year. (author)

Stereotactic Radiosurgery for Benign (World Health Organization Grade I) Cavernous Sinus Meningiomas-International Stereotactic Radiosurgery Society (ISRS) Practice Guideline: A Systematic Review.

Science.gov (United States)

Lee, Cheng-Chia; Trifiletti, Daniel M; Sahgal, Arjun; DeSalles, Antonio; Fariselli, Laura; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Álvarez, Roberto Martínez; Paddick, Ian; Regis, Jean; Ryu, Samuel; Slotman, Ben; Sheehan, Jason

2018-03-15

Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. Articles published from January 1963 to December 2014 were systemically reviewed. Three electronic databases, PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials, were searched. Publications in English with at least 10 patients (each arm) were included. Of 569 screened abstracts, a total of 49 full-text articles were included in the analysis. All studies were retrospective. Most of the reports had favorable outcomes with 5-yr progression-free survival (PFS) rates ranging from 86% to 99%, and 10-yr PFS rates ranging from 69% to 97%. The post-SRS neurological preservation rate ranged from 80% to 100%. Resection can be considered for the treatment of larger (>3 cm in diameter) and symptomatic CS meningioma in patients both receptive to and medically eligible for open surgery. Adjuvant or salvage SRS for residual or recurrent tumor can be utilized depending on factors such as tumor volume and proximity to adjacent critical organs at risk. The literature is limited to level III evidence with respect to outcomes of SRS in patients with CS meningioma. Based on the observed results, SRS offers a favorable benefit to risk profile for patients with CS meningioma.

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.

A rare case of bilateral optic nerve sheath meningioma

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Somen Misra

2014-01-01

Full Text Available A 60-year-old female presented with gradual, painless, progressive diminution of vision, and progressive proptosis of left eye since 7 years. Ophthalmological examination revealed mild proptosis and total optic atrophy in the left eye. Magnetic resonance imaging (MRI and computed tomography (CT brain with orbit showed bilateral optic nerve sheath meningioma (ONSM involving the intracranial, intracanalicular, intraorbital part of the optic nerve extending up to optic chiasma and left cavernous sinus.

Tolosa-Hunt syndrome. A CT demonstration of a high-density lesion

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Hirata, Kazuhiro; Muramoto, Masato; Chiba, Yasuhiro; Yagishita, Saburo

1987-08-01

CT scan studies of the Tolosa-Hunt syndrome have seldom been reported; positive abnormal findings are especially rare. A 36-year-old man suffered from steady, boring pain behind the left eye for one year. On admission he complained of diplopia on the right lateral gaze and hypesthesea of the first and second divisions of the left trigeminal nerve. A CT scan demonstrated a slightly high-density lesion, which was homogeneously enhanced, in the left cavernous portion and the superior orbital fissure. Carotid angiograms demonstrated no abnormal finding, and the cavernous sinus venography revealed no filling of the left cavernous sinus. A left front-temporal craniotomy was performed for the purpose of biopsy. A histological examination revealed non-specific focal granulomatous pachymeningitis. He responded dramatically to systemic steroid therapy, and he became pain-free by the fourth post-operative day. This diagnosis of the Tolosa-Hunt syndrome was confirmed both clinically and etiologically; however, the CT scan after the treatment demonstrated no definitive change in the lesion. The CT scan is useful for the diagnosis of this syndrome. Considering the stage of the illness, it is possible that the high-resolution CT scan can demonstrate this lesion with an advanced technique. The clinical diagnosis is almost easy, and surgical exploration is not always necessary if there is a prompt remission upon systemic steroid therapy. However, this syndrome should be differentiated from the other causes by appropriate examinations. Some cases similar to ours, especially suspected tumors, need surgical exploration because these angiographic findings are not specific.

Report of a case of surgical ciliated cyst in the left maxillary sinus

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Amirhossein Pakravan

2017-06-01

Full Text Available Surgical ciliated cyst happens as a delayed complication in the maxillary sinus, and is more frequent in Asia in comparison with Western countries. We report a case of surgical ciliated cyst in maxillary sinus in a male patient after 30 years of surgery for sinusitis treatment. The patient had swelling and pain in the region, and his radiographic views showed a cystic lesion. Incisional biopsy was performed and surgical ciliated cyst was reported as diagnosis. Then, Enucleation with curettage was performed for him as treatment.

MR findings of cerebral venous sinus thrombosis

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Lim, Myung Kwan; Chang, Kee Hyun; Han, Moon Hee; Choi, Choong Gom [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1994-10-15

To describe MR findings of cerebral venous sinus thrombosis. We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow up study obtained in 4 patients. The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transverse sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1- and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was patients in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow up study of seven to 29 days intervals. It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thrombosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.

Characteristics and treatment of cavernous malformations

International Nuclear Information System (INIS)

Takagi, Kenji; Ishida, Mitsuaki; Okabe, Hidetoshi; Nozaki, Kazuhiko

2013-01-01

Cavernous malformations are clusters of dilated sinusoidal channels with thin walls devoid of elastin and smooth muscle. They have no intervening brain tissue. They occur both in sporadic and familial forms. The genes responsible for cavernous malformations have been identified. Recent reports show that mutations of these responsible genes are involved not only in familial but also in sporadic forms. Germline and somatic mutations may occur before cavernous malformations develop (two-hit mechanism). Two patterns, with mulberry-like and hematoma-like appearances, are seen intraoperatively, and from histological findings, mulberry-like appearance may change into hematoma-like one by intralesional hemorrhage. Cavernous malformation treatments include open surgery and radiosurgery. Open surgery is usually chosen for the treatment of symptomatic hemorrhagic cavernous malformations because post-radiosurgical annual bleeding risks at the early phase seem to be higher than those of open surgery. If open surgery has a high risk because of lesion location, radiosurgery becomes an effective alternative treatment. Brainstem cavernous malformations have high annual bleeding and re-bleeding incidence, so if the lesion is accessible with low risk, open surgery is recommended. (author)

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

The morphology of the coronary sinus in patients with congenitally corrected transposition: implications for cardiac catheterisation and re-synchronisation therapy.

Science.gov (United States)

Aiello, Vera D; Ferreira, Flávia C N; Scanavacca, Mauricio I; Anderson, Robert H; D'Avila, André

2016-02-01

Patients with congenitally corrected transposition frequently benefit from re-synchronisation therapy or ablation procedures. This is likely to require catheterisation of the coronary sinus. Its anatomy, however, is not always appreciated, despite being well-described. With this caveat in mind, we have evaluated its location and structure in hearts with congenitally corrected transposition in order to reinforce the guidance needed by the cardiac interventionist. We dissected and inspected the coronary sinus, the oblique vein of the left atrium, and the left-sided-circumflex venous channel in eight heart specimens with corrected transposition and eight controls, measuring the orifice and length of the sinus and the atrioventricular valves. In two-thirds of the malformed hearts, the sinus deviated from its anticipated course in the atrioventricular groove, ascending obliquely on the left atrial inferior wall to meet the left oblique vein. The maximal deviation coincided in all hearts with the point where the left oblique vein joined the left-sided-circumflex vein to form the coronary sinus. We describe a circumflex vein, rather than the great cardiac vein, as the latter venous channel is right-sided in the setting of corrected transposition. The length of the sinus correlated positively with the diameter of the tricuspid valve (p=0.02). Compared with controls, the left oblique vein in the malformed hearts joined the circumflex venous channel significantly closer to the mouth of the sinus. The unexpected course of the coronary sinus in corrected transposition and the naming of the cardiac veins have important implications for venous cannulation and interpretation of images.

Sigmoid Sinus Diverticulum, Dehiscence, and Venous Sinus Stenosis: Potential Causes of Pulsatile Tinnitus in Patients with Idiopathic Intracranial Hypertension?

Science.gov (United States)

Lansley, J A; Tucker, W; Eriksen, M R; Riordan-Eva, P; Connor, S E J

2017-09-01

Pulsatile tinnitus is experienced by most patients with idiopathic intracranial hypertension. The pathophysiology remains uncertain; however, transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence have been proposed as potential etiologies. We aimed to determine whether the prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence was increased in patients with idiopathic intracranial hypertension and pulsatile tinnitus relative to those without pulsatile tinnitus and a control group. CT vascular studies of patients with idiopathic intracranial hypertension with pulsatile tinnitus ( n = 42), without pulsatile tinnitus ( n = 37), and controls ( n = 75) were independently reviewed for the presence of severe transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence according to published criteria. The prevalence of transverse sinus stenosis and sigmoid sinus diverticulum/dehiscence in patients with idiopathic intracranial hypertension with pulsatile tinnitus was compared with that in the nonpulsatile tinnitus idiopathic intracranial hypertension group and the control group. Further comparisons included differing degrees of transverse sinus stenosis (50% and 75%), laterality of transverse sinus stenosis/sigmoid sinus diverticulum/dehiscence, and ipsilateral transverse sinus stenosis combined with sigmoid sinus diverticulum/dehiscence. Severe bilateral transverse sinus stenoses were more frequent in patients with idiopathic intracranial hypertension than in controls ( P tinnitus within the idiopathic intracranial hypertension group. Sigmoid sinus dehiscence (right- or left-sided) was also more common in patients with idiopathic intracranial hypertension compared with controls ( P = .01), but there was no significant association with pulsatile tinnitus within the idiopathic intracranial hypertension group. While our data corroborate previous studies demonstrating increased prevalence of sigmoid sinus diverticulum

Cerebral Cavernous Malformation and Hemorrhage

Science.gov (United States)

... Text Size: SMALL • LARGE Cerebral Cavernous Angioma and Hemorrhage By Jack Hoch; Reviewed by Dr. Issam Awad ... for years, the mechanism by which these lesions hemorrhage remains poorly understood. Hemorrhage Types Since cavernous angiomas ...

Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

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Yunus Feyyat Şahin

2012-01-01

Full Text Available Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

Hydrocarbon storage caverns overhaul: A case study

Energy Technology Data Exchange (ETDEWEB)

McDougall, N. [Bayer Inc., Sarnia, ON (Canada)

1998-09-01

Case studies of four hydrocarbon storage cavern overhauls by Bayer Inc., of Sarnia during the period 1993 to 1997 were reviewed and the lessons learned were discussed. Discussions included inspection requirements for each of the caverns, the logistics and planning plant production around the cavern outages, site and cavern preparation, including removal of the casing slips from the well heads. It was emphasized that cavern overhauls can be expensive operations, unless preceded by proper planning. The largest variable cost is likely to be rig time at about $ 2,000 per day. Planning for the unexpected with thoughtful contingencies can reduce costs and avoid expensive delays.

Historical Cavern Floor Rise for All SPR Sites

Energy Technology Data Exchange (ETDEWEB)

Moriarty, Dylan Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-09-01

The Strategic Petroleum Reserve (SPR) contains the largest supply is the largest stockpile of government-owned emergency crude oil in the world. The oil is stored in multiple salt caverns spread over four sites in Louisiana and Texas. Cavern infrastructure near the bottom of the cavern can be damaged from vertical floor movement. This report presents a comprehensive history of floor movements in each cavern. Most of the cavern floor rise rates ranged from 0.5-3.5 ft/yr, however, there were several caverns with much higher rise rates. BH103, BM106, and BH105 had the three highest rise rates. Information from this report will be used to better predict future vertical floor movements and optimally place cavern infrastructure. The reasons for floor rise are not entirely understood and should be investigated.

An interesting case of angiogenesis in cavernous hemangioma

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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.

Treatment of a direct carotid-cavernous fistula in a patient with type IV Ehlers-Danlos syndrome: a novel approach

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Hollands, J.K.; Santarius, T.; Kirkpatrick, P.J. [Addenbrooke' s Hospital, Department of Neurosurgery, Cambridge (United Kingdom); Higgins, J.N. [Addenbrooke' s Hospital, Department of Neuroradiology, Cambridge (United Kingdom)

2006-07-15

We report a case of a 34-year-old female with type IV Ehlers-Danlos syndrome diagnosed with a carotid cavernous fistula presenting with progressive proptosis. Endovascular embolization using balloons or coils carries a high risk of complications in this group of patients, owing to the extreme fragility of the blood vessels. Initial treatment was conservative until an intracerebral haemorrhage occurred. To avoid transfemoral angiography, the ipsilateral carotid arteries and the internal jugular vein were surgically exposed for insertion of two endovascular sheaths. The patient was transferred from theatre to the angiography suite and the sheaths were used for embolization access. The fistula was closed, with preservation of the carotid artery, using Guglielmi detachable coils deployed in the cavernous sinus from the arterial and venous sides. Rapid resolution of symptoms and signs followed, which was sustained at 6-month follow-up. This technique offers alternative access for endovascular treatment, which may reduce the high incidence of mortality associated with catheter angiography in this condition. (orig.)

Treatment of a direct carotid-cavernous fistula in a patient with type IV Ehlers-Danlos syndrome: a novel approach

International Nuclear Information System (INIS)

Hollands, J.K.; Santarius, T.; Kirkpatrick, P.J.; Higgins, J.N.

2006-01-01

We report a case of a 34-year-old female with type IV Ehlers-Danlos syndrome diagnosed with a carotid cavernous fistula presenting with progressive proptosis. Endovascular embolization using balloons or coils carries a high risk of complications in this group of patients, owing to the extreme fragility of the blood vessels. Initial treatment was conservative until an intracerebral haemorrhage occurred. To avoid transfemoral angiography, the ipsilateral carotid arteries and the internal jugular vein were surgically exposed for insertion of two endovascular sheaths. The patient was transferred from theatre to the angiography suite and the sheaths were used for embolization access. The fistula was closed, with preservation of the carotid artery, using Guglielmi detachable coils deployed in the cavernous sinus from the arterial and venous sides. Rapid resolution of symptoms and signs followed, which was sustained at 6-month follow-up. This technique offers alternative access for endovascular treatment, which may reduce the high incidence of mortality associated with catheter angiography in this condition. (orig.)

MRI findings in Tolosa-Hunt syndrome before and after systemic corticosteroid therapy

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Cakirer, Sinan E-mail: scakirer@yahoo.com

2003-02-01

Tolosa-Hunt syndrome (THS) is characterized by painful ophthalmoplegia due to a granulomatous inflammation in the cavernous sinus. Corticosteroid therapy dramatically resolves both the clinical and radiological findings of THS. We present MRI findings of six patients with a clinical history of at least one episode of unilateral or bilateral orbital-periorbital pain, clinical findings of associated paresis of one or more of 3rd, 4th, 5th or 6th cranial nerves. All of the patients revealed an enlargement of the symptomatic cavernous sinus on magnetic resonance imaging (MRI) scans. Five patients revealed total resolution of the clinical findings within 1-8 weeks, following systemic corticosteroid treatment. One patient revealed only minor regression of clinical findings within 2 weeks after the initiation of the treatment, so the cavernous sinus lesion was reevaluated as meningioma on MRI, and the patient underwent surgical resection of the mass with resultant histopathological finding of cavernous sinus meningioma. A follow-up MRI scan was performed for five patients at the end of 8-weeks of steroid therapy. Three of these five patients showed total resolution of the cavernous sinus lesions whereas two of them revealed a partial regression of the cavernous sinus lesions. MRI findings before and after systemic corticosteroid therapy are important diagnostic criteria to put the definitive diagnosis of THS and to differentiate it from other cavernous sinus lesions that simulate THS both clinically and radiologically.

Sinus Microanatomy and Microbiota in a Rabbit Model of Rhinosinusitis

Science.gov (United States)

Cho, Do-Yeon; Mackey, Calvin; Van Der Pol, William J.; Skinner, Daniel; Morrow, Casey D.; Schoeb, Trenton R.; Rowe, Steven M.; Swords, William E.; Tearney, Guillermo J.; Woodworth, Bradford A.

2018-01-01

Background: Rabbits are useful for preclinical studies of sinusitis because of similar physiologic features to humans. The objective of this study is to develop a rabbit model of sinusitis that permits assessment of microanatomy and sampling for evaluating shifts in the sinus microbiota during the development of sinusitis and to test how the mucociliary clearance (MCC) defect might lead to dysbiosis and chronic rhinosinusitis (CRS). Methods: Generation of CRS was accomplished with an insertion of a sterile sponge into the left middle meatus of New Zealand white rabbits (n = 9) for 2 weeks. After sponge removal, 4 rabbits were observed for another 10 weeks and evaluated for CRS using endoscopy, microCT, visualization of the functional micro-anatomy by micro-optical coherence tomography (μOCT), and histopathological analysis of the sinus mucosa. Samples were taken from the left middle meatus and submitted for microbiome analysis. Results: CT demonstrated opacification of all left sinuses at 2 weeks in all rabbits (n = 9), which persisted in animals followed for another 12 weeks (n = 4). Histology at week 2 showed mostly neutrophils. On week 14, significant infiltration of plasma cells and lymphocytes was noted with increased submucosal glands compared to controls (p = 0.02). Functional microanatomy at 2 weeks showed diminished periciliary layer (PCL) depth (p < 0.0001) and mucus transport (p = 0.0044) compared to controls despite a thick mucus layer. By 12 weeks, the thickened mucus layer was resolved but PCL depletion persisted in addition to decreased ciliary beat frequency (CBF; p < 0.0001). The mucin fermenting microbes (Lactobacillales, Bacteroidales) dominated on week 2 and there was a significant shift to potential pathogens (e.g., Pseudomonas, Burkholderia) by week 14 compared to both controls and the acute phase (p < 0.05). Conclusion: We anticipate this reproducible model will provide a means for identifying underlying mechanisms of airway-surface liquid

Sinus Microanatomy and Microbiota in a Rabbit Model of Rhinosinusitis

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Do-Yeon Cho

2018-01-01

Full Text Available Background: Rabbits are useful for preclinical studies of sinusitis because of similar physiologic features to humans. The objective of this study is to develop a rabbit model of sinusitis that permits assessment of microanatomy and sampling for evaluating shifts in the sinus microbiota during the development of sinusitis and to test how the mucociliary clearance (MCC defect might lead to dysbiosis and chronic rhinosinusitis (CRS.Methods: Generation of CRS was accomplished with an insertion of a sterile sponge into the left middle meatus of New Zealand white rabbits (n = 9 for 2 weeks. After sponge removal, 4 rabbits were observed for another 10 weeks and evaluated for CRS using endoscopy, microCT, visualization of the functional micro-anatomy by micro-optical coherence tomography (μOCT, and histopathological analysis of the sinus mucosa. Samples were taken from the left middle meatus and submitted for microbiome analysis.Results: CT demonstrated opacification of all left sinuses at 2 weeks in all rabbits (n = 9, which persisted in animals followed for another 12 weeks (n = 4. Histology at week 2 showed mostly neutrophils. On week 14, significant infiltration of plasma cells and lymphocytes was noted with increased submucosal glands compared to controls (p = 0.02. Functional microanatomy at 2 weeks showed diminished periciliary layer (PCL depth (p < 0.0001 and mucus transport (p = 0.0044 compared to controls despite a thick mucus layer. By 12 weeks, the thickened mucus layer was resolved but PCL depletion persisted in addition to decreased ciliary beat frequency (CBF; p < 0.0001. The mucin fermenting microbes (Lactobacillales, Bacteroidales dominated on week 2 and there was a significant shift to potential pathogens (e.g., Pseudomonas, Burkholderia by week 14 compared to both controls and the acute phase (p < 0.05.Conclusion: We anticipate this reproducible model will provide a means for identifying underlying mechanisms of airway

A 12-year cavern abandonment test

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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.

Secondary adult encephalocele with abscess formation of calcified frontal sinus mucocele.

Science.gov (United States)

Oh, Byeong Ho; Lee, Ok-Jun; Park, Young Seok

2016-07-01

Although encephalocele is a rare congenital abnormality, secondary encephalocele is extremely rare and can cause fatal complications. Here, we report a case of secondary encephalocele caused by frontal sinus wall defect due to chronic sinusitis, which was completely removed by cranialization with autologous bone graft. A 50-year-old man with a 10-year history of chronic sinusitis visited our hospital due to suddenly altered mentality characterized by stupor. Computerized tomography scanning and magnetic resonance imaging revealed an enlarged left frontal sinus with sinusitis. The frontal sinus cavity was calcified, and the left frontal lobe had herniated into the cavity accompanied by yellow pus. A large dural defect was also found around the frontal sinus area. After removal of the abscess and some of the frontal lobe, frontal skull base repair by cranialization was performed using autologous bone graft. Streptococcus pneumoniae was cultured from the cerebrospinal fluid (CSF), necessitating treatment with antibiotics. After the operation, the mental status of the patient improved and no CSF leakage was observed. In addition to correct diagnosis and early treatment including antibiotics, the surgical repair of defects is needed in patients with secondary encephalocele to prevent further episodes of meningitis. Surgical correction of frontal sinus encephalocele can be achieved through bifrontal craniotomy or endoscopic transnasal repair. If a patient has CSF leakage, open craniotomy may facilitate repair of the dural defect and allow for cranialization of the sinus. Removal of dysplastic herniated brain tissue and cranialization of the frontal sinus may be a good option for treating secondary encephalocele and its associated complications, including meningitis, abscess formation, and infarction of the herniated brain parenchyma.

Genetics Home Reference: cerebral cavernous malformation

Science.gov (United States)

... Additional NIH Resources (1 link) National Institute of Neurological Disorders and Stroke Educational Resources (7 links) Boston Children's Hospital: Cavernous Malformations Disease InfoSearch: Cerebral Cavernous Malformation ...

Genetic Analysis of Multiple Endocrine Neoplasia Type 1 ( Leads to Misdiagnosis of an Extremely Rare Presentation of Intrasellar Cavernous Hemangioma as MEN1

Directory of Open Access Journals (Sweden)

Dong Min Lee

2014-06-01

Full Text Available BackgroundMultiple endocrine neoplasia type 1 (MEN1 is a rare inherited disorder characterized by the simultaneous occurrence of endocrine tumors in target tissues (mainly the pituitary, endocrine pancreas, and parathyroid glands. MEN1 is caused by mutations in the MEN1 gene, which functions as a tumor suppressor and consists of one untranslated exon and nine exons encoding the menin protein. This condition is usually suspected when we encounter patients diagnosed with tumors in multiple endocrine organs, as mentioned above.MethodsA 65-year-old woman who underwent surgery for a pancreatic tumor (serous cystadenoma 5 years previously was referred to our hospital due to neurologic symptoms of diplopia and left ptosis. Brain magnetic resonance imaging revealed a 3.4-cm lesion originating from the cavernous sinus wall and extending into the sellar region. It was thought to be a nonfunctioning tumor from the results of the combined pituitary function test. Incidentally, we found that she also had a pancreatic tumor, indicating the necessity of genetic analysis for MEN1.ResultsGenomic analysis using peripheral leukocytes revealed a heterozygous c.1621G>A mutation in the MEN1 gene that was previously reported to be either a pathogenic mutation or a simple polymorphism. We pursued a stereotactic approach to the pituitary lesion, and microscopic findings of the tumor revealed it to be an intrasellar cavernous hemangioma, a rare finding in the sellar region and even rarer in relation to oculomotor palsy. The patient recovered well from surgery, but refused further evaluation for the pancreatic lesion.ConclusionThere is great emphasis placed on genetic testing in the diagnosis of MEN1, but herein we report a case where it did not assist in diagnosis, hence, further discussion on the role of genetic testing in this disease is needed. Also, in cases of pituitary tumor with cranial nerve palsy, despite its low prevalence, intrasellar cavernous hemangioma

Maxillary sinus volumes of patients with unilateral cleft lip and palate.

Science.gov (United States)

Erdur, Omer; Ucar, Faruk Izzet; Sekerci, Ahmet Ercan; Celikoglu, Mevlut; Buyuk, Suleyman Kutalmıs

2015-10-01

Studies about maxillary sinuses of cleft lip-palate patients have increased since sinusitis is commonly observed in these patients. It is evident that maxillary sinus will be morphologically affected in these patients. And anatomic differences may be a cause or at least a contributor of sinusitis. The aim of this study was to compare maxillary sinus volumes of the non-syndromic patients with unilateral cleft lip-palate and control group by using Cone-Beam computed tomography. Tomography scans of 44 unilateral cleft lip-palate patients (18 right and 26 left) with age and gender matched 45 control patients were evaluated for the study. The images used in the study were part of the diagnostic records collected due to dental treatment needs. All tomographs were obtained in supine position by using Cone-Beam computed tomography (NewTom 5G, QR, Verona, Italy). The patient-specific Hounsfield values were set to include the largest amount of voxels in the sinuses volume calculation individually. All data were measured in mm(3). There was no statistically difference between the gender and age distributions of the groups. No statistically significant difference was found on the cleft and non-cleft side, the right and left side of the unilateral cleft lip-palate patients and the control group (P>0.05). For the inter group comparison, mean maxillary sinus volumes volume of unilateral cleft lip-palate patients (9894.55±4171.44mm(3)) was statistically smaller than the control group (11,977.90±4484.93mm(3)) (Pcleft lip-palate patients when compared with the healthy control group. No difference was found on the cleft, non-cleft side and the right-left side of the unilateral cleft lip-palate patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

Brain abscess following dental implant placement via crestal sinus lift - a case report.

Science.gov (United States)

Manor, Yifat; Garfunkel, Adi A

2018-01-01

To describe a rare case of odontogenic brain abscess. A healthy, 35-year-old male had two dental implants placed in a simultaneously augmented maxillary sinus. One implant failed and the patient developed a maxillary sinusitis that failed to improve following antibiotic treatment at home. The neglected sinus infection led to formation of a brain abscess. The patient was hospitalised only when he had pan sinusitis with neurological signs. Symptoms were headache attacks, a subfebrile fever and a purulent secretion from the left nostril. The osteomeatal complex was blocked, the maxillary sinus was filled with pus and the Schneiderian membrane thickened. The patient was treated with intravenous antibiotic treatment. Computerised tomography (CT) and magnetic resonance imaging (MRI) scans and functional endoscopic sinus surgery (FESS), were implemented. When his conditions worsened, the patient underwent a left frontal mini craniotomy. Following the craniotomy and antibiotic treatment, there was a gradual resolution and the patient was dismissed after 2 months in hospital with no neurological deficit or signs of sinusitis. Maxillary sinusitis following dental implant insertion and concomitant maxillary sinus elevation should be treated immediately and thoroughly since untreated sinusitis may cause life-threatening situations such as a brain abscess. In case of severe infection, clinicians should refer immediately the patient to hospital specialists. Conflict-of-interest statement: The authors have stated explicitly that there are no conflicts of interest. The manuscript was self-funded.

Dynamic MR imaging in Tolosa-Hunt syndrome

Energy Technology Data Exchange (ETDEWEB)

Haque, Tabassum Laz; Miki, Yukio; Kashii, Satoshi; Yamamoto, Akira; Kanagaki, Mitsunori; Takahashi, Takahiro; Fushimi, Yasutaka; Asato, Reinin; Murase, Nagako; Shibasaki, Hiroshi; Konishi, Junji

2004-09-01

Objective: To evaluate the cavernous sinuses with dynamic magnetic resonance (MR) imaging in patients with Tolosa-Hunt syndrome (THS). Methods: The sellar and parasellar regions of five patients with THS and 12 control subjects were examined with dynamic MR (1.5 T) imaging in the coronal plane. Dynamic images were obtained with spin-echo (SE) sequences in three patients, and with fast spin-echo (FSE) sequences in two patients and control subjects. Conventional MR images of the cranium including sellar and parasellar regions were also obtained on T1-weighted pre- and post-contrast SE, and T2-weighted FSE sequences in the coronal plane. Results: MR images revealed affected cavernous sinus with bulged convex lateral wall in three patients and concave lateral wall in two patients. In all control subjects, cavernous sinuses were observed with concave lateral wall. The signal intensity on T1- and T2-weighted images and contrast enhancement on post-contrast images of the affected cavernous sinuses in patients were similar to those of the unaffected cavernous sinuses in patients and control subjects. The dynamic images in all patients disclosed small areas adjacent to the cranial nerve filling-defects within the enhanced venous spaces of the affected cavernous sinus, which showed slow and gradual enhancement from the early to the late dynamic images. No such gradually enhancing area was observed in control subjects except one. The follow-up dynamic MR images after corticosteroid therapy revealed complete resolution of the gradually enhancing areas in the previously affected cavernous sinus. Conclusion: Dynamic MR imaging may facilitate the diagnosis of THS.

Dynamic MR imaging in Tolosa-Hunt syndrome

International Nuclear Information System (INIS)

Haque, Tabassum Laz; Miki, Yukio; Kashii, Satoshi; Yamamoto, Akira; Kanagaki, Mitsunori; Takahashi, Takahiro; Fushimi, Yasutaka; Asato, Reinin; Murase, Nagako; Shibasaki, Hiroshi; Konishi, Junji

2004-01-01

Objective: To evaluate the cavernous sinuses with dynamic magnetic resonance (MR) imaging in patients with Tolosa-Hunt syndrome (THS). Methods: The sellar and parasellar regions of five patients with THS and 12 control subjects were examined with dynamic MR (1.5 T) imaging in the coronal plane. Dynamic images were obtained with spin-echo (SE) sequences in three patients, and with fast spin-echo (FSE) sequences in two patients and control subjects. Conventional MR images of the cranium including sellar and parasellar regions were also obtained on T1-weighted pre- and post-contrast SE, and T2-weighted FSE sequences in the coronal plane. Results: MR images revealed affected cavernous sinus with bulged convex lateral wall in three patients and concave lateral wall in two patients. In all control subjects, cavernous sinuses were observed with concave lateral wall. The signal intensity on T1- and T2-weighted images and contrast enhancement on post-contrast images of the affected cavernous sinuses in patients were similar to those of the unaffected cavernous sinuses in patients and control subjects. The dynamic images in all patients disclosed small areas adjacent to the cranial nerve filling-defects within the enhanced venous spaces of the affected cavernous sinus, which showed slow and gradual enhancement from the early to the late dynamic images. No such gradually enhancing area was observed in control subjects except one. The follow-up dynamic MR images after corticosteroid therapy revealed complete resolution of the gradually enhancing areas in the previously affected cavernous sinus. Conclusion: Dynamic MR imaging may facilitate the diagnosis of THS

Assessment of human sinus cavity air volume using tunable diode laser spectroscopy, with application to sinusitis diagnostics.

Science.gov (United States)

Huang, Jing; Zhang, Hao; Li, Tianqi; Lin, Huiying; Svanberg, Katarina; Svanberg, Sune

2015-11-01

Sinusitis is a very common disease and improved diagnostic tools are desirable also in view of reducing over-prescription of antibiotics. A non-intrusive optical technique called GASMAS (GAs in Scattering Media Absorption Spectroscopy), which has a true potential of being developed into an important complement to other means of detection, was utilized in this work. Water vapor in the frontal sinuses, related to the free gas volume, was studied at around 937 nm in healthy volunteers. The results show a good stability of the GASMAS signals over extended times for the frontal sinuses for all volunteers, showing promising applicability to detect anomalies due to sinusitis. Measurements were also performed following the application of a decongestion spray. No noticeable signal change was observed, which is consistent with the fact that the water vapor concentration is given by the temperature only, and is not influenced by changes in cavity ventilation. Evaluated GASMAS data recorded on 6 consecutive days show signal stability for the left and right frontal sinus in one of the test volunteers. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

Bilateral Orbital Cellulitis: A Case Report and Management ...

African Journals Online (AJOL)

drainage of subperiosteal or orbital abscess when required.[2,3] The patient stays admitted in the ... The vertical cup disc ratio was 0.7 in the right eye and 0.4 in the left eye. Neither disc edema nor engorged retinal ... characteristically have no valves, drain into the pterygoid plexus or the cavernous sinus.[10,11] The spread ...

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.

Imaging findings of pulsatile tinnitus caused by sigmoid sinus abnormalities

International Nuclear Information System (INIS)

Liang Xihong; Wang Zhenchang; Gong Shusheng; Xia Yin; Wang Zhengyu; Yang Bentao; Yan Fei; Li Jing; Xian Junfang; Chen Guangli

2010-01-01

Objective: To study a rare CT finding of pulsatile tinnitus (PT) caused by sigmoid sinus abnormalities. Methods: The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients (15 female). The median age was 45 years (24 to 63 years). The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years (median time, 2.0 years). The tinnitus was at left side in 5 patients and right side in 10 patients. Fifteen patients underwent HRCT of the temporal bone. Of them, 12 patients underwent cerebral CT angiography and CT venogram (CTA/CTV), and 9 patients underwent cerebral digital subtraction angiography (DSA). Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus. Of them, the tinnitus was at left side in 2 patients and right side in 7 patients. Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results: On HRCT, foca bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients. On CTA/CTV, the sigmoid sinus focally protuded into the adjacent mastoid air cells and formed diverticulum in 10 patients. The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients. The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6 (41.5-96.2)mm 2 , it was 77.0 (92.1-122.4)mm 2 in the nonmal side (Z=2.158, P=0.031). Conclusion: Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus, which can be easily identified by imaging examination. (authors)

Imaging findings of pulsatile tinnitus caused by sigmoid sinus abnormalities

Energy Technology Data Exchange (ETDEWEB)

Xihong, Liang; Zhenchang, Wang; Shusheng, Gong; Yin, Xia; Zhengyu, Wang; Bentao, Yang; Fei, Yan; Jing, Li; Junfang, Xian; Guangli, Chen [Department of Radiology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing (China)

2010-04-15

Objective: To study a rare CT finding of pulsatile tinnitus (PT) caused by sigmoid sinus abnormalities. Methods: The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients (15 female). The median age was 45 years (24 to 63 years). The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years (median time, 2.0 years). The tinnitus was at left side in 5 patients and right side in 10 patients. Fifteen patients underwent HRCT of the temporal bone. Of them, 12 patients underwent cerebral CT angiography and CT venogram (CTA/CTV), and 9 patients underwent cerebral digital subtraction angiography (DSA). Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus. Of them, the tinnitus was at left side in 2 patients and right side in 7 patients. Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results: On HRCT, foca bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients. On CTA/CTV, the sigmoid sinus focally protuded into the adjacent mastoid air cells and formed diverticulum in 10 patients. The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients. The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6 (41.5-96.2)mm{sup 2}, it was 77.0 (92.1-122.4)mm{sup 2} in the nonmal side (Z=2.158, P=0.031). Conclusion: Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus, which can be easily identified by imaging examination. (authors)

Allowable pillar to diameter ratio for strategic petroleum reserve caverns.

Energy Technology Data Exchange (ETDEWEB)

Ehgartner, Brian L.; Park, Byoung Yoon

2011-05-01

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

The diagnostic value of multi-slice CT on the congenital malformation of coronary sinus

International Nuclear Information System (INIS)

Li Wei; Ma Xiaojing; Sun Qingjun

2012-01-01

Objective: To investigate the application value of multi-slice spiral CT on the congenital malformation of coronary sinus. Methods: MSCT finding of 98 patients with coronary sinus malformation confirmed by surgery were retrospectively analyzed,and the cases were divided into four categories based on the Mantini theory and comparison was made between the diagnosis from ultrasound and CT. A 2 × 2 table for Chi-square test was also used for statistics analysis. Results: Among 98 patients,there were 72 patients with persistent left superior vena cava reflowed to right atria through coronary sinus, with 48 patients diagnosed by ultrasound and 72 patients by MSCT; there were 13 patients with anomalous pulmonary venous connection to coronary sinus, with 12 patients diagnosed by ultrasound and 13 patients by MSCT diagnosis; there were 10 patients with unroofed coronary sinus syndrome, with 6 patients diagnosed by ultrasound and 8 patients by MSCT, there were 2 patients with coronary sinus atresia, all diagnosed by MSCT; there were 1 patient with coronary sinus anomaly reflow to left arita. The significant difference between 2 modalities (χ 2 =22.7, P<0.01) shows that CT is superior to ultrasound. Conclusion: MSCT is much more better than ultrasound in the diagnosis of malformation of coronary sinus and it can provide reliable diagnosis prior to surgery or interventional therapy. (authors)

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.

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.

Cone Beam Computed Tomography Analysis of Incidental Maxillary Sinus Pathologies in North Indian Population

Directory of Open Access Journals (Sweden)

Sangeeta S Malik

2017-01-01

Full Text Available Introduction: Maxillary sinus can be visualized in both two-dimensional and three-dimensional images. Computed tomography (CT is considered the gold standard method for the examination of maxillary sinus. Cone beam computed tomography (CBCT addresses the limitation of CT and provides many dental advantages. It can provide valuable knowledge about the pathology with limited exposure and low cost compared with other imaging used for diagnostic purposes. Aims and Objectives: The aim of the study is to analyze the prevalence of pathological changes in maxillary sinus of asymptomatic cases using CBCT for diagnostic purposes. Materials and Methods: This retrospective study evaluated 231 patients for incidental maxillary sinus pathologies. Pathological findings were categorized as mucosal thickening, polypoid mucosal thickening, radiopacification, and no pathological findings. Evaluation of pathological findings was done using factors of age and gender. Results: The present study showed 86 cases with maxillary sinus pathology and 145 cases with no pathological findings. Patients with maxillary sinus pathology were mostly diagnosed with mucosal thickening on both sides. In right maxillary sinus, 45 cases (52.3% showed mucosal thickening, and on the left side 36 cases (41.9% were diagnosed with mucosal thickening. Among 86 cases reported, 20 right maxillary sinus (23.3% and 25 left maxillary sinus (29.1% showed no signs of pathology. Conclusion: The incidental maxillary sinus pathologies are highly prevalent in asymptomatic patients. Therefore, oral radiologists should be aware of these incidental findings which will help in early diagnosis and treatment of disease.

Anatomical Variations of Carotid Artery and Optic Nerve in Sphenoid Sinus Using Computerized Tomographic Imaging

Directory of Open Access Journals (Sweden)

Nikakhlagh

2014-12-01

Full Text Available Background Sphenoid sinus is surrounded by many vital vascular and nervous structures. In more than 20% of patients with chronic sinusitis, involvement of sphenoid sinus has been observed. Besides, sphenoid sinus is an appropriate route to access anterior and middle cranial fossa in surgery. Therefore, it is important to have an adequate knowledge about the contents of sphenoid sinus and its proximity for nasal endoscopy, sinus surgeries and neurosurgeries. Objectives The aim of this study was to study sphenoid sinus proximity with carotid artery and the optic nerve using computerized tomographic imaging. Materials and Methods In this prospective study, computerized tomographic images of sphenoid sinus of patients referred to Imam Khomeini and Apadana hospitals were studied. The images were studied regarding any bulging, as well as not having a bone covering in sphenoid sinus regarding internal carotid artery and optic nerve. Furthermore, unilateralness or bilateralness of their relationships was studied. Results Among 468 coronal and axial CT scan images of sphenoid sinus, 365 (78% showed post-sellar pneumatization and 103 (22% pre-sellar pneumatization. Regarding existence of internal septa, 346 (74% cases showed multiple septation, and the remaining images were reported to have a single septum. According to the reports of CT scan images, the existence of bulging as a result of internal carotid artery and uncovered artery were 4.22% and 5.8% in the right sinus, 4.9% and 5.4% in the left sinus, and 4.34% and 4.6% in both sinuses, respectively. According to the reports of CT scan images, existence of bulging as a result of optic nerve and uncovered nerve were 5.7% and 4.3% in the right sinus, 6% and 5.4% in the left sinus, and 12% and 3.2% in both sinuses, respectively. Conclusions Due to variability of sphenoid sinus pneumatization and the separator blade of the two sinus cavities, careful attention is required during sinus surgery to avoid

Arachnoid Pit and Extensive Sinus Pnematization as the Cause of Spontaneous Lateral Intrasphenoidal Encephalocele

Directory of Open Access Journals (Sweden)

Ali AlMontasheri

2012-01-01

Full Text Available Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF rhinorrhea. Computed tomography demonstrated bilateral arachnoid pit, extensive sphenoid sinus pneumatization, and a defect in the superior wall of the left lateral recess of the sphenoid sinus. Magnetic resonance imaging demonstrated anteromedial temporal lobe herniating through the bony defect.

Pilot abandonment test of a very deep gas storage salt cavern

International Nuclear Information System (INIS)

Durup, J.G.; Vidal, F.; Rolin, C.

2007-01-01

As a result of knowledge gained initially from a series of succinct sealed well and cavern field tests performed in the late 1980's and early 1990's by Gaz de France (EZ58; EZ53), issues related to the long term abandonment of salt caverns became more focused. The tests were performed in cooperation with Ecole Polytechnique (France) and were partially funded by the Solution Mining Research Institute (USA). The long-term abandonment (sealing or plugging) of a solution-mined cavern in a salt formation that has been used for mineral production, hydrocarbon storage, or waste disposal has been a contemporary topic for many years. Sealing and abandonment of caverns in salt formations differs from sealing of an oil and gas well principally for two reasons: - cavern wells are generally completed with much larger casings than oil and gas exploration and production wells; - the cavern fluid pressure rises after sealing. The first difference is not a significant deterrent to effective cavern sealing and abandonment. Essentially all of the uncertainties and complexities associated with cavern sealing and abandonment are a direct result of the second difference - the fact that the cavern fluid pressure rises through time. After a short introduction to solution mining of salt caverns and their use as underground gas storages, the paper will first discuss the factors affecting cavern fluid pressure increase after sealing. The second part of the paper will highlight the practical impacts of these factors on a deep salt cavern abandonment experiment (Cavern TE02; 1500 meters deep), currently being performed on the natural gas storage of Tersanne operated for over 35 years by Gaz de France. (authors)

[A case of traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side].

Science.gov (United States)

Takeuchi, Satoru; Takasato, Yoshio; Masaoka, Hiroyuki; Hayakawa, Takanori; Otani, Naoki; Yoshino, Yoshikazu; Yatsushige, Hiroshi; Sugawara, Takashi; Aoyagi, Chikashi; Suzuki, Go

2009-10-01

A rare case of a traumatic middle meningeal arteriovenous fistula on the side of the head opposite to the injured side was reported. A 21-year-old man was admitted to our hospital after a traffic accident in which the right side of his head was hit. CT scans and MR images on admission showed a right temporal bone fracture, traumatic subarachnoid hemorrhage, and a left frontal lobe contusion. Three months after the head injury, he complained of tinnitus and exophthalmos. One year after the head injury, left external carotid angiograms showed a dural arteriovenous fistula fed by the left dilated middle meningeal artery and draining into the middle meningeal vein. Early filling of the sphenoparietal sinus, cavernous sinus, superior ophthalmic vein, and the cortical vein were also detected. Transarterial embolization of the left middle meningeal fistula was performed, resulting in the disappearance of the lesion. The postoperative course was uneventful.

Right Valsalva Sinus Aneurysm Protruding Into the Right Ventricle: A Case Report

Directory of Open Access Journals (Sweden)

Ata H. Afshar

2015-09-01

Full Text Available A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85% but it has been seen rarely in non-coronary (10%-30%or Left coronary sinus (<5%. The most common complication is rupture of the Aneurysm. We present an 80-year-old male with expanding right Valsalva sinus aneurysm and protruding into right ventricle. The conventional treatment is surgical repair under cardio-pulmonary bypass or percutaneous catheter closure. The aneurysm was successfully excised surgically under direct guidance of trans-esophageal echocardiography (TEE.

Sequestration of CO2 in salt caverns

International Nuclear Information System (INIS)

Dusseault, M.B.; Rothenburg, L.; Bachu, S.

2002-01-01

The greenhouse effect is thought to be greatly affected by anthropogenic and naturally generated gases, such as carbon dioxide. The reduction of greenhouse gas emissions in the atmosphere could be effected through the permanent storage of carbon dioxide in dissolved salt caverns. A large number of suitable salt deposits are located in Alberta, especially the Lotsberg Salt of east-central Alberta. A major advantage of this deposit is its proximity to present and future point sources of carbon dioxide associated with fossil fuel development projects. Using the perspective of the long term fate of the stored carbon dioxide, the authors presented the characteristics of the Lotsberg Salt and the overlying strata. A high level of security against leakage and migration of the gas back to the biosphere is ensured by several features discussed in the paper. The authors propose a procedure that would be applicable for the creation, testing, and filling of a salt cavern. Achieving a long term prediction of the behavior of the cavern during slow closure, coupled to the pressure and volume behavior of the gas within the cavern represents the critical factor. The authors came up with an acceptable prediction by using a semi-analytical model. The use of salt caverns for the permanent sequestration of carbon dioxide has not yet faced technical obstacles that would prevent it. The authors argue that sequestration of carbon dioxide in salt caverns represents an environmentally acceptable option in Alberta. 11 refs., 3 figs

The huge ATLAS cavern now fully excavated

CERN Multimedia

2002-01-01

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

Gas monitoring in human sinuses using tunable diode laser spectroscopy.

Science.gov (United States)

Persson, Linda; Andersson, Mats; Cassel-Engquist, Märta; Svanberg, Katarina; Svanberg, Sune

2007-01-01

We demonstrate a novel nonintrusive technique based on tunable diode laser absorption spectroscopy to investigate human sinuses in vivo. The technique relies on the fact that free gases have spectral imprints that are about 10.000 times sharper than spectral structures of the surrounding tissue. Two gases are detected; molecular oxygen at 760 nm and water vapor at 935 nm. Light is launched fiber optically into the tissue in close proximity to the particular maxillary sinus under study. When investigating the frontal sinuses, the fiber is positioned onto the caudal part of the frontal bone. Multiply scattered light in both cases is detected externally by a handheld probe. Molecular oxygen is detected in the maxillary sinuses on 11 volunteers, of which one had constantly recurring sinus problems. Significant oxygen absorption imprint differences can be observed between different volunteers and also left-right asymmetries. Water vapor can also be detected, and by normalizing the oxygen signal on the water vapor signal, the sinus oxygen concentration can be assessed. Gas exchange between the sinuses and the nasal cavity is also successfully demonstrated by flushing nitrogen through the nostril. Advantages over current ventilation assessment methods using ionizing radiation are pointed out.

[Experimental evaluation of the role of the coronary sinus pressure in the regulation of coronary return volume via the coronary sinus. Surgical considerations in atrio-pulmonary diversion procedures].

Science.gov (United States)

Fantidis, P; Fernández Ruiz, M A; Madero Jarabo, R; Moreno Granados, F; Cordovilla Zurdo, G; Sanz Galeote, E

1990-11-01

In order to find out the validity of the vascular waterfall mechanism in coronary venous circulation, the role of coronary sinus pressure in the regulation of coronary return volume via the coronary sinus is studied in healthy animals. An experimental model of pressure regulation in the coronary sinus was prepared, and aortic pressure, EKG and the cardiac output (measured by thermodilution) were recorded. The return volume via the coronary sinus was measured at coronary sinus pressure of 10 or less, 15, 20, and 25 mmHg or more, for a total of 36 determinations. Increased coronary sinus pressure did not produce significant changes in aortic pressure, heart rate, cardiac index or coronary return volume via coronary sinus. When coronary sinus pressure was 25 mmHg or more, there was a significant decline in the average of coronary return volume via coronary sinus. Nevertheless, stepwise variant regression showed that the coronary sinus pressure per se does not condition the volume of coronary return via the coronary sinus. Our results suggest that in the healthy animals, the vascular waterfall mechanism in coronary venous circulation is not valid. Our results suggest that in the correction of congenital cardiac malformations using atriopulmonary anastomosis procedures, employing techniques that ensure coronary sinus drainage into the left atrium, in order to avoid the hemodynamic repercussions attributable to the vascular waterfall mechanism, is not justified.

Mapping of the left-sided phrenic nerve course in patients undergoing left atrial catheter ablations.

Science.gov (United States)

Huemer, Martin; Wutzler, Alexander; Parwani, Abdul S; Attanasio, Philipp; Haverkamp, Wilhelm; Boldt, Leif-Hendrik

2014-09-01

Catheter ablation of atrial fibrillation has been associated with left-sided phrenic nerve palsy. Knowledge of the individual left phrenic nerve course therefore is essential to prevent nerve injury. The aim of this study was to test the feasibility of an intraprocedural pace mapping and reconstruction of the left phrenic nerve course and to characterize which anatomical areas are affected. In patients undergoing left atrial catheter ablation, a three-dimensional map of the left atrial anatomical structures was created. The left-sided phrenic nerve course was determined by high-output pace mapping and reconstructed in the map. In this study, 40 patients with atrial fibrillation or atrial tachycardias were included. Left phrenic nerve capture was observed in 23 (57.5%) patients. Phrenic nerve was captured in 22 (55%) patients inside the left atrial appendage, in 22 (55%) in distal parts, in 21 (53%) in medial parts, and in two (5%) in ostial parts of the appendage. In three (7.5%) patients, capture was found in the distal coronary sinus and in one (2.5%) patient in the left atrium near the left atrial appendage ostium. Ablation target was changed due to direct spatial relationship to the phrenic nerve in three (7.5%) patients. No phrenic nerve palsy was observed. Left-sided phrenic nerve capture was found inside and around the left atrial appendage in the majority of patients and additionally in the distal coronary sinus. Phrenic nerve mapping and reconstruction can easily be performed and should be considered prior catheter ablations in potential affected areas. ©2014 Wiley Periodicals, Inc.

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.

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

International Nuclear Information System (INIS)

Elcock, D.

1998-01-01

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

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

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

International Nuclear Information System (INIS)

Elcock, D.

1998-01-01

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

Transient behaviour of deep underground salt caverns

International Nuclear Information System (INIS)

Karimi-Jafari, M.

2007-11-01

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.)

The classification of frontal sinus pneumatization patterns by CT-based volumetry.

Science.gov (United States)

Yüksel Aslier, Nesibe Gül; Karabay, Nuri; Zeybek, Gülşah; Keskinoğlu, Pembe; Kiray, Amaç; Sütay, Semih; Ecevit, Mustafa Cenk

2016-10-01

We aimed to define the classification of frontal sinus pneumatization patterns according to three-dimensional volume measurements. Datasets of 148 sides of 74 dry skulls were generated by the computerized tomography-based volumetry to measure frontal sinus volumes. The cutoff points for frontal sinus hypoplasia and hyperplasia were tested by ROC curve analysis and the validity of the diagnostic points was measured. The overall frequencies were 4.1, 14.2, 37.2 and 44.5 % for frontal sinus aplasia, hypoplasia, medium size and hyperplasia, respectively. The aplasia was bilateral in all three skulls. Hypoplasia was seen 76 % at the right side and hyperplasia was seen 56 % at the left side. The cutoff points for diagnosing frontal sinus hypoplasia and hyperplasia were '1131.25 mm(3)' (95.2 % sensitivity and 100 % specificity) and '3328.50 mm(3)' (88 % sensitivity and 86 % specificity), respectively. The findings provided in the present study, which define frontal sinus pneumatization patterns by CT-based volumetry, proved that two opposite sides of the frontal sinuses are asymmetric and three-dimensional classification should be developed by CT-based volumetry, because two-dimensional evaluations lack depth measurement.

Physical and Numerical Modeling of the Stability of Deep Caverns in Tahe Oil Field in China

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Chao Wang

2017-06-01

Full Text Available Cave collapses emerge during the process of oil reservoir development, seriously affecting oil production. To reveal the collapse and failure mechanism of the carbonate cavern with a buried depth of 5600 m in Tahe Oil Field, using a self-developed ultra-high pressure model test system with the intelligent numerical control function, the model simulation material of carbonate rocks developed to carry out the 3D geo-mechanical model test. The model test and numerical results indicate that: (1 collapse and failure mechanism of the deep-buried caves mainly involve the failure mode of tensile shear. The rupture plane on the side wall is approximately parallel to the direction of maximum principal compressive stress. The V-type tension and split rupture plane then emerges. (2 In the process of forming holes in the model caverns, micro cracks are generated at the foot of the left and right side walls of the caverns, and the roof panels are constantly moving downward. The shorter the distance to the cave wall, the severer the destructiveness of the surrounding rocks will be. (3 The displacement of the top of the model cavern is relatively large and uniform, indicating that the cave roof moves downward as a whole. The area of the cavity suffering damage is 2.3 times as large as the cave span. The research results in this paper lay a solid test basis for revealing the cave collapse and failure mechanism in super depth.

Prevalence Of Maxillary Sinus Jaw Mucuous Cysts In University Dental Radiology Service

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Joaquim Lira Saraiva Neto

2017-07-01

Full Text Available Background: Mucosal cyst of the maxillary sinus or antral pseudocyst is one of great importance injury, being the pathology that affects more the maxillary sinus. Their discovery, in most cases, it is for the interpretation of the images in routine panoramic radiography. Aims: The research aimed to evaluate the prevalence of mucous cyst in maxillary sinus in radiology clinic at Ceara Federal University. Material and Methods: To this study conduction, were analyzed 1996 panoramic radiographs from a digital file obtained between April 2011 to April 2013 Results:. Aspects as gender, affected side and teeth absence next to the cyst in the respective quadrant were evaluated.It was observed in the sample the occurrence of 45 patients with suggested images of mucous cysts in maxillary sinus,making a prevalence of 2,25%. From them, 26 (57,8%were female and 19 (42,2% were male. 48 maxillary sinuswere affected with the wound, from which28 (58,3% it was in the left side and 20 (41,7% in the right site. Three patients presented the wound in both sides, what represents 6,7% of the affected patients. From those 48 Mucous retention cyst, 40 (83,3% were not related to an edentulous area in ipsilateral quadrant and 8 (16,7% were shown next to an edentulous area. Conclusion: The conclusion was that the cyst of retention mucous in the maxillary sinus had prevalence in males and in the left side of the maxillary sinus. It was not found a relation between the cyst and the edentulous area.

Tolosa-Hunt syndrome: MRI appearances

International Nuclear Information System (INIS)

Jain, R.; Sawhney, S.; Koul, R. L.; Chand, P.

2008-01-01

Full text: A review of MRI findings in seven patients with Tolosa-Hunt syndrome was carried out. Seven patients presented with unilateral painful ophthalmoplegia. Magnetic resonance imaging studies were carried out to evaluate the cavernous sinuses and orbits. Coronal fast spin-echo T 2 -weighted images and fat-saturated T 1 -weighted coronal and transverse images with and without contrast enhancement were obtained for the cavernous sinuses and orbits. All patients showed focal-enhancing masses expanding the ipsilateral cavernous sinus. In one patient the mass was extending to the orbital apex and intraorbital. All patients recovered on corticosteroid therapy and resolution of the masses was documented on follow-up MRI studies in five patients. One patient had a relapse of symptoms after discontinuing therapy. Magnetic resonance imaging studies of the cavernous sinus and orbital apex show high sensitivity for the detection and follow up of inflammatory mass lesions in Tolosa-Hunt syndrome. Magnetic resonance imaging should be the initial screening study in these patients.

Sexual dimorphism of maxillary sinus using cone beam computed tomography

Directory of Open Access Journals (Sweden)

Shahnaz S. Tambawala

2016-06-01

The overall values of the parameters were significantly greater in the males as compared to the females with the right height (90.0% and the left height (83.3% being the best predictors. This study proposes the importance of sexual dimorphism of maxillary sinus dimensions particularly the sinus height, when other methods used in the field of forensics seem to be indecisive. It suggests the use of CBCT in forensics thus obviating the complete dependence on the usage of conventional CT.

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.

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.

Metastases in the cavernous synus

International Nuclear Information System (INIS)

Victoria Fernandez, C.; Gonzalez Patino, E.; Pereiro Zabala, I.; Lopez Vazquez, M.D.; Cascallar Caneda, L.; Porto Vazquez, M.C.

1993-01-01

We report four cases of metastases in the cavernous synus in patients with primary tumors of parotid gland, lymphatic system, breast and colon. In spite of the similarity in the presentation clinic, the diagnosis wasn't carried out in all the cases with the required celerity, specially in the case of the first presentation of metastasis disease. Three of them response. We analyze the clinic and radiologic data characteristical in cavernous synus metastases, highliting the importance of diagnostic techniques, facilitating as soon as possible the suitable treatment. (Author)

Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome.

Science.gov (United States)

Benevides, Gabriel Núncio; Salgado, German Alcoba; Ferreira, Cristiane Rúbia; Felipe-Silva, Aloísio; Gilio, Alfredo Elias

2015-01-01

The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case.

Fungus ball of the paranasal sinuses: Report of two cases and literature review

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Bosi, Guilherme Rasia

2012-01-01

Full Text Available Introduction: Fungal ball of the sinuses is a not invasive infection that if characterizes for its chronicity, being the majority related with previous endodontic treatment. Affect mainly the breasts to maxillary; even so all the breasts can be involved. The main etiological agent is the Aspergillus spp. The computed tomography, had to characteristic the radiological presentations, suggests the diagnosis that is carried through definitively through histopathological analyses. The treatment standard-gold is the sinus surgery with average meatal antrostomy. Objective: Reporting two cases of fungal ball of the sinuses and to stand out important aspects of this pathology. Story of the Cases: Case 1 Patient of the feminine sex, 78 years old, presented itself with complaints of face pain has 6 months and previous history of endodontic treatment. To the physical examination it was evidenced purulent secretion presence in left average meatus. Ray X presented complete veiling of the breasts to maxillary left, while the computed tomography showed injury calcified in this place. Sinusotomy was become fulfilled that evolved well. Case 2 Patient of the feminine sex, 70 years old, looked attendance for history of sinusitis of repetition. To the physical examination no particularity was not perceived. The computed tomography, as well as the magnetic resonance, detected thickening of the mucous wall of the breasts to maxillary left, beyond a calcified mass. It was become fulfilled same sequence of treatment and the patient also evolved well. Final Considerations: The fungal infection must be considered in the patients who if present with chronic sinusitis, that they do not answer to the antibiotic use and that they possess history of endodontic manipulation.

Pediatric Sinusitis

Science.gov (United States)

... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

[Traumatic intracerebral pneumocephalus communicating with two different paranasal sinuses: a case report].

Science.gov (United States)

Wakamoto, H; Miyazaki, H; Hayashi, T; Shimamoto, Y; Ishiyama, N

1998-02-01

We report a case of a 17-year-old male who had hit the front of his head in a traffic accident. CT scan revealed contusional hemorrhage and pneumocephalus of the left frontal lobe 10 hours after the accident. A month later he complained of rhinorrhea and CT scan revealed intracerebral pneumocephalus. One day he complained of headache and began to vomit after he sneezed. CT scan revealed that the pneumocephalus had become worse and air had spread throughout the subarachnoid space. Bone CT scan revealed the air communicated from the frontal sinus to the intracerebral air cavity. 3D-CT scan revealed bone defect in the roof of the ethmoid sinus. The intraoperative findings revealed that the intracerebral air cavity communicated with the frontal sinus and ethmoid sinus. Though the brain which dropped into the paranasal sinus, adhered to the dura mater around the bone defect, a part of the brain had come off from the dura mater around the frontal sinus. We suspected that the intracerebral air cavity communicated with the frontal sinus initially. When the air cavity communicated with the ethmoid sinus secondarily, intracranial pressure abated and air came into the subarachnoid space from the frontal sinus.

A new shape design method of salt cavern used as underground gas storage

International Nuclear Information System (INIS)

Wang, Tongtao; Yan, Xiangzhen; Yang, Henglin; Yang, Xiujuan; Jiang, Tingting; Zhao, Shuai

2013-01-01

Graphical abstract: Safety factor contours of four salt cavern gas storages after running 10 years. Highlights: ► We propose a new model to design the shape of salt cavern gas storage. ► The concepts of slope instability and pressure arch are introduced into the shape design. ► The max. gas pressure determines the shapes and dimensions of cavern lower structure. ► The min. gas pressure decides the shapes and dimensions of cavern upper structure. - Abstract: A new model used to design the shape and dimension of salt cavern gas storage is proposed in the paper. In the new model, the cavern is divided into two parts, namely the lower and upper structures, to design. The concepts of slope instability and pressure arch are introduced into the shape design of the lower and upper structures respectively. Calculating models are established according to the concepts. Field salt cavern gas storage in China is simulated as examples, and its shape and dimension are proposed. The effects of gas pressure, friction angle and cohesion of rock salt on the cavern stability are discussed. Moreover, the volume convergence, displacement, plastic volume rate, safety factor, and effective strain are compared with that of three other existing shapes salt caverns to validate the performance of newly proposed cavern. The results show that the max. gas pressure determines the shape and dimension of cavern lower structure, while the min. gas pressure decides that of cavern upper structure. With the increase of friction angle and cohesion of rock salt, the stability of salt cavern is increased. The newly proposed salt cavern gas storage has more notable advantages than the existing shapes of salt cavern in volume convergence, displacement, plastic volume rate, safety factor, and effective strain under the same conditions

Effect of accessory ostia on maxillary sinus ventilation: a computational fluid dynamics (CFD) study.

Science.gov (United States)

Zhu, Jian Hua; Lee, Heow Pueh; Lim, Kian Meng; Gordon, Bruce R; Wang, De Yun

2012-08-15

We evaluated, by CFD simulation, effects of accessory ostium (AO) on maxillary sinus ventilation. A three-dimensional nasal model was constructed from an adult CT scan with two left maxillary AOs (sinus I) and one right AO (sinus II), then compared to an identical control model with all AOs sealed (sinuses III and IV). Transient simulations of quiet inspiration and expiration at 15 L/min, and nasal blow at 48 L/min, were calculated for both models using low-Reynolds-number turbulent analysis. At low flows, ventilation rates in sinuses with AOs (I ≈ 0.46 L/min, II ≈ 0.54 L/min), were both more than a magnitude higher than sinuses without AOs (II I ≈ 0.019 L/min, IV ≈ 0.020 L/min). Absence of AO almost completely prevented sinus ventilation. Increased ventilation of sinuses with AOs is complex. Under high flow conditions mimicking nose blowing, in sinuses II, III, and IV, the sinus flow rate increased. In contrast, the airflow direction through sinus I reversed between inspiration and expiration, while it remained almost constant throughout the respiration cycle in sinus II. CFD simulation demonstrated that AOs markedly increase maxillary sinus airflow rates and alter sinus air circulation patterns. Whether these airflow changes impact maxillary sinus physiology or pathophysiology is unknown. Copyright © 2012 Elsevier B.V. All rights reserved.

Air quality in the Carlsbad cavern

International Nuclear Information System (INIS)

Cheng, Yung-Seng; Chen, Tou-Rong; Wasiolek, P.T.

1994-01-01

The air quality in the Carlsbad Cavern has been investigated, but there are no reports on radon progeny and aerosols. The purpose of this experiment was to determine the activity size distribution of radon progeny and the air exchange rate inside the Cavern. Teams from ITRI and New Mexico Institute of Mining and Technology (NMT) conducted the field study in July 1994. The ITRI graded diffusion battery (GDB) was used to determine the activity size distribution, progeny concentration, equilibrium factor, and unattached fraction of the radon progeny. The design, calibration, and performance of the GDB have been described. For this study, each stage of the GDB contained one stainless steel screen, with the mesh sizes arranged in a series of 30, 50, 145, 200, and 635 mesh from the air inlet to the outlet. A 47-nm type A/E glass fiber filter was used to collect all particles that penetrated the screens. The flow rate was 5 L/min. The average ventilation rate in the cavern is 0.0026 V/hr. Our results showed that the cavern atmosphere may be quite different from other underground environments. The atmosphere in the summer is stable and relatively free of airborne particles, partly due to the extremely slow air exchange rate

Late Diagnosis of Anomalous Aortic Origin of a Coronary Artery from the Inappropriate Sinus of Valsalva during Investigation of Chest Pain

Directory of Open Access Journals (Sweden)

Brunna Priscylla Américo Carvalho

2018-01-01

Full Text Available In this work are reported two cases of anomalous aortic origin of a coronary artery (AAOCA, with the left main coronary artery (LMCA arising at the right sinus of Valsalva in a 77-year-old woman and in a 79-year-old man submitted to angiography after positive ischemic tests. The origin of the LMCA or the left descendant artery (LDA from the right sinus of Valsalva has a prevalence of 0.2%, the origin of the circumflex artery (CXA from the right sinus 0.5%, and the origin of the right coronary artery (RCA from the left sinus of Valsalva has a prevalence of 0.3%. It is the subgroup of the coronary anomalies that has the greatest potential for clinical repercussions, especially the sudden cardiac death (SCD. We discuss the diagnostic methods and treatment options for this kind of coronary anomaly in symptomatic cases.

Maxillary sinusitis from Microascus cinereus and Aspergillus repens.

Science.gov (United States)

Aznar, C; de Bievre, C; Guiguen, C

1989-02-01

Microascus was associated with Aspergillus repens in a left maxillary sinus. Tissue contained septale filaments of two types, conidia, ostiolate perithecia containing ascospores corresponding to Microascus cinereus which was identified by culture. The abundance of sexual fructifications in the tissue indicates that pathogenicity is due to Microascus cinereus.

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

Energy Technology Data Exchange (ETDEWEB)

Munson, Darrell E.

2007-07-01

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

EPITHELIAL MYOEPITHELIAL CARCINOMA OF MAXILLARY SINUS —A DIAGNOSTIC DILEMMA

OpenAIRE

Rajeev Sen; Sumiti Gupta; Kanika Taneja; Nisha Marwah; Sonia Chhabra; Sonia Hasija

2015-01-01

Epithelial – Myoepithelial Carcinoma (EMC) is a rare malignant salivary gland neoplasm that most commonly occurs in the Parotid gland, but can also arise in the Minor Salivary Glands. EMC of the maxillary sinus extremely rare. We describe here a case of a 74-year-old patient who presented with maxillary swelling for 4months and nasal discharge for 3 months. Computed Tomography Scan revealed an expansile soft tissue mass in the left maxillary sinus eroding all its walls. In View of high sus...

Left atrial isolation associated with mitral valve operations.

Science.gov (United States)

Graffigna, A; Pagani, F; Minzioni, G; Salerno, J; Viganò, M

1992-12-01

Surgical isolation of the left atrium was performed for the treatment of chronic atrial fibrillation secondary to valvular disease in 100 patients who underwent mitral valve operations. From May 1989 to September 1991, 62 patients underwent mitral valve operations (group I); 19, mitral valve operations and DeVega tricuspid annuloplasty (group II); 15, mitral and aortic operations (group III); and 4, mitral and aortic operations and DeVega tricuspid annuloplasty (group IV). Left atrial isolation was performed, prolonging the usual left paraseptal atriotomy toward the left fibrous trigone anteriorly and the posteromedial commissure posteriorly. The incision was conducted a few millimeters apart from the mitral valve annulus, and cryolesions were placed at the edges to ensure complete electrophysiological isolation of the left atrium. Operative mortality accounted for 3 patients (3%). In 79 patients (81.4%) sinus rhythm recovered and persisted until discharge from the hospital. No differences were found between the groups (group I, 80.7%; group II, 68.5%; group III, 86.7%; group IV, 75%; p = not significant). Three late deaths (3.1%) were registered. Long-term results show persistence of sinus rhythm in 71% of group I, 61.2% of group II, 85.8% of group III, and 100% of group IV. The unique risk factor for late recurrence of atrial fibrillation was found to be preoperative atrial fibrillation longer than 6 months. Due to the satisfactory success rate in recovering sinus rhythm, we suggest performing left atrial isolation in patients with chronic atrial fibrillation undergoing valvular operations.

Penile cavernous hemangioma

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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.

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

International Nuclear Information System (INIS)

Michael S. Bruno

2005-01-01

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

The anatomical location and laterality of orbital cavernous haemangiomas.

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McNab, Alan A; Selva, Dinesh; Hardy, Thomas G; O'Donnell, Brett

2014-10-01

To determine the anatomical location and laterality of orbital cavernous haemangiomas (OCH). Retrospective case series. The records of 104 patients with OCH were analyzed. The anatomical location of each OCH defined by the location of a point at the centre of the lesion, and its laterality. There were 104 patients included in the study. No patient had more than one lesion. Sixteen (15.4%) were located in the anterior third of the orbit, 74 (71.2%) were in the middle third, and 14 (13.5%) in the posterior third. In the middle third, 10 of 74 (13.5%) were extraconal and 64 intraconal (86.5%), with 30 of 64 (46.9%) middle third intraconal lesions lying lateral to the optic nerve. Of 104 lesions, 56 (53.8%) were left sided, showing a trend towards a predilection for the left side (p = 0.065). If data from other published series which included data on laterality is added to our own data and analysed, 270 of 468 (57.7%) OCH occurred in the left orbit (p lateral to the optic nerve. This may reflect an origin of these lesions from the arterial side of the circulation, as there are more small arteries in the intraconal space lateral to the optic nerve than in other locations. A predilection for the left orbit remains unexplained.

Atypical Case of Three Dental Implants Displaced into the Maxillary Sinus

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João Felipe Bonatto Bruniera

2015-01-01

Full Text Available Oral rehabilitation with dental implants has become a routine treatment in contemporary dentistry. The displacement of dental implants into the sinus membrane, a complication related to the maxillary sinus, is one of the most common accidents reported in the literature. The treatment for this complication is the surgical removal of the implant. A 60-year-old woman with three dental implants displaced into the maxillary sinus (one implant displaced into the left maxillary sinus and two implants displaced into the right maxillary sinus underwent surgery for removal of the implants. The surgery to remove the implants was performed under local anesthesia through the Caldwell-Luc technique. The patient was subsequently administered antibiotic, anti-inflammatory, and analgesic drugs. The patient returned 7 days after the surgery for suture removal and is being regularly monitored to determine whether future rehabilitation of the edentulous area is necessary. In conclusion, surgical removal of the dental implant displaced into the maxillary sinus is the treatment of choice. This technique is appropriate because it allows the use of local anesthesia and provides direct visualization for the removal of the implants.

Complex carotid cavernous sinus fistulas Barrow type D: endovascular treatment via the ophthalmic vein, imaging control with standardized MRI, long-term results; Interdisziplinaere Embolisation spontaner Karotis-Cavernosus-Fisteln Typ D nach Barrow ueber die Vena ophthalmica: klinische Langzeitergebnisse und kernspintomografische Befunde

Energy Technology Data Exchange (ETDEWEB)

Struffert, T.; Grunwald, I.Q.; Reith, W. [Abteilung fuer Diagnostische und Interventionelle Neuroradiologie, Universitaetsklinikum des Saarlandes (Germany); Muecke, I. [Klinik fuer Augenheilkunde, Universitaetsklinikum des Saarlandes (Germany)

2007-04-15

Purpose: Since feeding arteries from both the internal and external carotid artery are common, cavernous fistulas of Barrow type D are difficult to treat. Embolization using the transarterial approach is considered to be the standard therapy. However, it is often impossible to embolize feeders from the internal carotid artery. The transorbital approach after anterior orbitotomy through the ophthalmic vein is an alternative in this complex situation. The following reports our experience with three female patients who underwent transvenous embolization. Procedural success was documented using standardized MRI and clinical reevaluation. Materials and Methods: Three female patients between 57 and 78 years of age were diagnosed with carotid cavernous fistulas by conventional angiogram. All patients were suffering from exophthalmus and visual impairment. Two patients showed secondary glaucoma and diplopia. In one patient we performed a technically successful transarterial embolization using particles, but no relevant improvement of the patient's condition was seen. Transfemoral transvenous access via the sinus petrosus was not possible in any patient. All patients were then embolized via the ophthalmic vein using GDC detachable coils. All patients were clinically reevaluated by an ophthalmologist. Also a standardized MRI was performed for documentation. Follow-up was performed for the first patient for 32 months, for the second patient for 34 months and for the third patient for 50 months. Results: Transvenous embolization was technically successful in all three cases. Clinical symptoms disappeared rapidly. Postprocedural MRI showed a symmetric diameter of the ophthalmic vein. Venous congestion of the orbit caused by fatty tissue edema regressed completely. Contrast-enhanced magnetic resonance angiography showed normal arterial vessels without evidence of fistula. (orig.)

Restenosis of the sigmoid sinus after stenting for treatment of intracranial venous hypertension: case report

International Nuclear Information System (INIS)

Tsumoto, T.; Miyamoto, T.; Shimizu, M.; Inui, Y.; Nakakita, K.; Hayashi, S.; Terada, T.

2003-01-01

We report what we believe to be the first case of restenosis of the sigmoid sinus after stenting, in a 42-year-old man with an arteriovenous malformation with progressive right hemiparesis secondary to venous hypertension. Angiography revealed severe stenosis of the left sigmoid sinus, which was dilated with a self-expandable stent. Six months after the procedure, however, the sinus was again severely stenosed. Intravascular sonography revealed intimal proliferation in the stented sinus. It was dilated percutaneously, and the venous pressure decreased from 51 to 33 mmHg. On sonography, the intimal tissue decreased in thickness and the diameter of the stent enlarged a little. (orig.)

Restenosis of the sigmoid sinus after stenting for treatment of intracranial venous hypertension: case report

Energy Technology Data Exchange (ETDEWEB)

Tsumoto, T.; Miyamoto, T.; Shimizu, M.; Inui, Y.; Nakakita, K.; Hayashi, S. [Department of Neurosurgery, Minami Wakayama National Hospital, Wakayama (Japan); Terada, T. [Department of Neurological Surgery, Wakayama Medical University, Wakayama (Japan)

2003-12-01

We report what we believe to be the first case of restenosis of the sigmoid sinus after stenting, in a 42-year-old man with an arteriovenous malformation with progressive right hemiparesis secondary to venous hypertension. Angiography revealed severe stenosis of the left sigmoid sinus, which was dilated with a self-expandable stent. Six months after the procedure, however, the sinus was again severely stenosed. Intravascular sonography revealed intimal proliferation in the stented sinus. It was dilated percutaneously, and the venous pressure decreased from 51 to 33 mmHg. On sonography, the intimal tissue decreased in thickness and the diameter of the stent enlarged a little. (orig.)

Cemento-ossifying Fibroma Of Paranasal Sinus Presenting Acutely As Orbital Cellulitis.

Science.gov (United States)

Khanna, Maneesh; Buddhavarapu, Shanker Rao; Hussain, Sheik Akbar; Amir, Emran

2009-01-01

Fibro-osseous lesions of the face and paranasal sinuses are relatively uncommon. These lesions have overlapping clinical, radiologic and pathologic features causing difficulty in diagnosis. Neoplastic fibro-osseous paranasal sinus lesions can be benign or malignant. The benign fibro-osseous lesions described are: ossifying fibroma (and its histologic variants) and fibrous dysplasia. The variants of ossifying fibroma differ in the nature of calcified material (i.e. cementum versus bone), in the location of the lesion (oral versus paranasal sinus or orbital), other morphologic variations (presence of psammomatoid concretions) and biologic behavior (aggressive versus stable). Presence of cementum or bone classifies the lesion as cementifying fibroma or ossifying fibroma respectively while lesions with mixture of both cementum and bone are called cemento-ossifying fibroma. We describe a case of a young adult male with cemento-ossifying fibroma of paranasal sinus presenting acutely as left orbital cellulitis with proptosis.

Cavernous transformation of the portal vein

International Nuclear Information System (INIS)

Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

1995-01-01

In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

A morphological comparison of the piriform sinuses in head-on and head-rotated views of seated subjects using cone-beam computed tomography

International Nuclear Information System (INIS)

Yamashina, Atsushi; Tanimoto, Keiji; Ohtsuka, Masahiko; Nagasaki, Toshikazu; Sutthiprapaporn, Pipop; Iida, Yukihiro; Katsumata, Akitoshi

2008-01-01

Food flow in the oropharynx changes when the head is rotated. The purpose of this study was to evaluate morphological differences in the upper and lower piriform sinuses in head-on (HO) versus head-rotated (HR) positions. Ten healthy adult volunteers with no previous history of dysphagia were subjected to cone-beam computed tomography (CBCT) in the HO and HR positions. Binary CBCT images were created at 50% gray scale to examine morphological changes in the lower piriform sinuses. Upon rotation to the right, the cross-sectional area of the left lower piriform sinus increased significantly (P=0.037). The depth of the right lower piriform sinus also increased significantly (P=0.011) upon rotation. The volume of the lower piriform sinuses increased significantly on both sides (right, P=0.009; left, P=0.013). The upper piriform sinuses acquired a teardrop shape, with the rotated side narrowed and opposite side enlarged. These results suggest that changes in food flow during head rotation result mainly from changes in the size and shape of the upper piriform sinuses. (author)

Systematic Evaluation of Salt Cavern Well Integrity

Science.gov (United States)

Roberts, B. L.; Lord, D. L.; Lord, A. S.; Bettin, G.; Sobolik, S. R.; Park, B. Y.

2017-12-01

The U.S. Strategic Petroleum Reserve (SPR) holds a reserve of crude oil ( 700 million barrels) to help ease any interruptions in oil import to the United States. The oil is stored in a set of 63 underground caverns distributed across four sites along the U.S. Gulf Coast. The caverns were solution mined into salt domes at each of the four sites. The plastic nature of the salt is beneficial for the storage of crude oil as it heals any fractures that may occur in the salt. The SPR is responsible for operating and maintaining the nearly 120 wells used to access the storage caverns over operational lifetimes spanning decades. Salt creep can induce deformation of the well casing which must be remediated to insure cavern and well integrity. This is particularly true at the interface between the plastic salt and the rigid caprock. The Department of Energy, the SPR Management and Operations contractor, and Sandia National Laboratories has developed a multidimensional well-grading system for the salt cavern access wells. This system is designed to assign numeric grades to each well indicating its risk of losing integrity and remediation priority. The system consists of several main components which themselves may consist of sub-components. The main components consider such things as salt cavern pressure history, results from geomechanical simulations modeling salt deformation, and measurements of well casing deformation due to salt creep. In addition, the geology of the salt domes and their overlying caprock is also included in the grading. These multiple factors are combined into summary values giving the monitoring and remediation priority for each well. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International Inc. for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA0003525.

MRI of growth hormone-secreting pituitary adenomas: factors determining pretreatment hormone levels

Energy Technology Data Exchange (ETDEWEB)

Saeki, N.; Iuchi, T.; Eda, M.; Yamaura, A. [Dept. of Neurological Surgery, Chiba University School of Medicine (Japan); Isono, S. [Dept. of Neurological Surgery, Anesthesiology, Chiba University School of Medicine, Chiba (Japan)

1999-10-01

Preoperative serum growth hormone (GH) level is one of the most important determinants of outcome. Our aim was to assess MRI findings which may correlate with pretreatment GH levels in GH-secreting adenomas. We retrospectively studied 29 patients with acromegaly caused by a pituitary adenoma. Tumor size (height, width, thickness and volume), suprasellar extension, sphenoid or cavernous sinus invasion, signal intensity and contrast enhancement were studied. Linear regression analysis or Fisher's exact probability test was used for statistical analysis. Factors related to high GH levels were the maximum dimension of the tumour (r = 0.496, P < 0.01), its volume (r = 0.439, P < 0.05), spenoid sinus invasion (P < 0.01) and intracavernous carotid artery encasement (P < 0.01). The other items were not related to serum GH levels. Since we believe surgery is the first choice of treatment and the cavernous sinus is difficult of access with a conventional surgical approach, preoperative assessment of invasion into the cavernous sinus is critical for predicting the surgical outcome. Low GH levels (5-50 ng/ml) were found with tumours medial to the intercarotid line and high levels (more than 101 ng/ml) with invasive tumours with carotid artery encasement. Variable GH levels were noted with tumours extending beyond the intercarotid line. Because functioning adenomas invading the cavernous sinus tend to have markedly high hormone levels, and only patients with carotid artery encasement showed markedly elevated GH levels, we believe carotid artery encasement a reliable MRI indicator of cavernous sinus invasion. (orig.)

Incidence of enhancement of the optic nerve/sheath complex in fat-suppression orbit MRI

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Lee, Ho Kyu; Yoon, Kwon Ha; Choi, Choong Gon; Suh, Dae Chul [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

1995-04-15

To elucidate the incidence of Gd-DTPA enhancement of the optic nerve/sheath complex (ONC) in patients with various ophthalmopathies using fat-suppression MRI. Orbit MRI with fat-suppression technique (ChemSat) was performed in 58 patients with normal and various orbital lesions. The fat-suppression MR was done with and without Gd-DTPA injection in all cases. MR findings were reviewed retrospectively in a blind fashion with respect to presence or absence of contrast enhancement of the ONC. Contrast enhancement of the ONC was seen in 86% (6/7) of cavernous sinus lesions, 80% (8/10) of intraconal lesions excluding the ONC, 57% (16/28) of ONC lesions, 38% (3/8) of ocular lesions, and 2% (1/55) of normal orbits. The ONC enhancement was the most common in optic nerve/sheath tumors (10/10), and pseudotumors (6/6), cavernous sinus dural arteriovenous malformations (3/3) and cavernous sinus thrombosis (2/2), and less frequently seen in optic neuritis (3/14). Enhancement of the ONC may be seen in lesions of the cavernous sinus and orbit other than optic nerve/sheath lesion.

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.

Automated Cross-Sectional Measurement Method of Intracranial Dural Venous Sinuses.

Science.gov (United States)

Lublinsky, S; Friedman, A; Kesler, A; Zur, D; Anconina, R; Shelef, I

2016-03-01

MRV is an important blood vessel imaging and diagnostic tool for the evaluation of stenosis, occlusions, or aneurysms. However, an accurate image-processing tool for vessel comparison is unavailable. The purpose of this study was to develop and test an automated technique for vessel cross-sectional analysis. An algorithm for vessel cross-sectional analysis was developed that included 7 main steps: 1) image registration, 2) masking, 3) segmentation, 4) skeletonization, 5) cross-sectional planes, 6) clustering, and 7) cross-sectional analysis. Phantom models were used to validate the technique. The method was also tested on a control subject and a patient with idiopathic intracranial hypertension (4 large sinuses tested: right and left transverse sinuses, superior sagittal sinus, and straight sinus). The cross-sectional area and shape measurements were evaluated before and after lumbar puncture in patients with idiopathic intracranial hypertension. The vessel-analysis algorithm had a high degree of stability with <3% of cross-sections manually corrected. All investigated principal cranial blood sinuses had a significant cross-sectional area increase after lumbar puncture (P ≤ .05). The average triangularity of the transverse sinuses was increased, and the mean circularity of the sinuses was decreased by 6% ± 12% after lumbar puncture. Comparison of phantom and real data showed that all computed errors were <1 voxel unit, which confirmed that the method provided a very accurate solution. In this article, we present a novel automated imaging method for cross-sectional vessels analysis. The method can provide an efficient quantitative detection of abnormalities in the dural sinuses. © 2016 by American Journal of Neuroradiology.

Prevalence of anatomical variations in maxillary sinus using cone beam computed tomography

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Deepjyoti K Mudgade

2018-01-01

Full Text Available Introduction: The maxillary sinuses (MS are of particular importance to dentist because of their close proximity to the teeth and their associated structures, so increased risk of maxillary sinusitis has been reported with periapical abscess, periodontal diseases, dental trauma, tooth extraction, and implant placement. Complications of MS are related to its anatomic and pathologic variations. Thus, study was conducted to assess the prevalence of anatomic variations in MS by using cone-beam computerized tomography (CBCT. Aims and Objectives: To determine different anatomical variations in MS by using CBCT. Materials and Methods: CBCT scans of 150 subjects were collected between the age group of 18 years to 70 years and were analyzed for MS anatomical variation. Statistical Analysis: The distribution of age, sex, reasons for CBCT, and dimensions of sinus calculated using descriptive statistics and distribution of other anatomic findings using Chi-square test. Results: Prevalence of obstructed ostium is 23.3% and septa is 66.7%. Average height, width, and antero-posterior (A-P dimensions for right MS are 34.13 mm, 26.09 mm, 37.39 mm and that of left MS are 33.24 mm, 26.11 mm, 37.72 mm respectively. Average distance between lower border of ostium to sinus floor in right MS is 32.17 mm and that of left is 32.69 mm. Average diameter of ostium in right MS is 1.88 mm and that of left is 1.67 mm. Conclusion: Study highlights the importance of accurate assessment of MS and its variations in order to properly differentiate the pathologic lesions from anatomic variations avoiding unnecessary surgical explorations.

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

Association of A Dilated Coronary Sinus in the Fetus with Actual and Apparent Coarctation of the Aorta and Diminutive Left Heart Structures.

Science.gov (United States)

Ramaswamy, Prema; Rafii, Daniela; Osmolovsky, Marina; Agarwal, Arpit; Amirtharaj, Cynthia

2016-12-01

Evidence suggests an association between left heart obstructive lesions and dilated coronary sinus (DCS), but this has not been studied in fetuses. A retrospective review of fetal echocardiograms (FE) over an 8-year period was conducted, and patients with DCS were identified and confirmed postnatally. There were 5840 FE performed on 4920 women during this period. Of 49 patients with DCS, 22 had normal intracardiac anatomy and 27 patients had congenital heart disease (CHD) yielding an incidence of 4.6 % in the presence of CHD (27/584). Of 27 patients with DCS and CHD, approximately a third had either hypoplastic left ventricles and/or coarctations (10/27, 37 %). The incidence of left heart obstructive lesions was much higher in the presence of a DCS (37 % vs 45/557, 8 %, p < 0.0001). The odds ratio of left heart hypoplasia in fetuses with CHD and a DCS was 6.6 (95 % CI 2.8-15.3). Comparison of patients with postnatally confirmed coarctation with those with normal intracardiac anatomy with DCS, revealed that in the former, the right ventricle (p = 0.005), pulmonic valve annulus (p = 0.0001) and the tricuspid inflow were larger (p = 0.001) compared to corresponding left-sided structures. The size of the DCS was not significantly different between the two groups, but in the former, the DCS was more closely related to the posterior leaflet of the mitral valve and caused a significant diminution of the mitral inflow. Our study suggests a strong association, possibly causal, between left heart obstructive lesions and DCS in utero.

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)

MRI findings of intracranial cavernous malformations

International Nuclear Information System (INIS)

Han, Byoung Hee; Kim, Dong Ik; Cho, Yong Kuk

1995-01-01

To analyze the variable MRI features and clinical significance of intracranial cavernous malformations. Forty patients(mean age 35.4) with cavernous malformation were evaluated by MRI. Eleven patients were surgically confirmed. Cavernous malformations were divided into four categories on the basis of the MR imaging characteristics, especially on T2-weighted image. Type I lesion was defined as an extralesional subacute hemorrhage outside the low signal rim, type II as an intralesional hemorrhage surrounded by low signal rim, type III lesion as an intralesional thrombosis with variegated central core surrounded by low signal rim, and type IV lesion as a focal old hemorrhagic core with small low signal intensity. Type IV was further divided into IVa and IVb, whether the lesion has small iso-or hypersignal central core (IVa) or not (IVb). Follow-up MRI was evaluated in 12 patients who were managed conservatively. Follow-up intervals ranged from 2 weeks to 29 months (mean 6 months). Total 80 lesions were detected in 40 patients. Multiple lesions were noted in 10 patients. The topography of the cavernous malformations was supratentorial in 75% and infratentorial in 23%. There were 10 lesions in type I, 15 in type II, 21 in type III, 14 in type IVa, and 20 in type IVb. Type I lesions mainly showed mass effect and edema. Type III lesions showed minimal contrast enhancements in 7 lesions on delayed images. Type II lesions showed the characteristics of both type I and type III lesions. On follow up images, decrease in size in 5, change of type in 7, rebleeding in 2 and no change in 12 lesions were demonstrated. Hemorrhage, edema and mass effect were combined in the cases of rebleeding. On follow-up study, the estimated risk of bleeding was 32.3%/person-year and 13.7%/lesion-year. Cavernous malformations show as variable appearance, on MR imaging suggesting variable stages of evolution. The MR morphologic classification and evaluation of secondary findings are helpful to

Sinus Anatomy

Science.gov (United States)

... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Size + - Home > ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

Endoscopic partial medial maxillectomy with mucosal flap for maxillary sinus mucoceles.

Science.gov (United States)

Durr, Megan L; Goldberg, Andrew N

2014-01-01

To describe a technique of endoscopic medial maxillectomy with mucosal flap for postoperative maxillary sinus mucoceles and to present a case series of subjects who underwent this procedure. This case series includes four subjects with postoperative maxillary sinus mucoceles who underwent resection via endoscopic partial medial maxillectomy with a mucosal flap. We will discuss the clinical presentation, imaging characteristics, operative details, and outcomes. Four subjects are included in this study. The average age at the time of medial maxillectomy was 52 years (range 35-65 years). Three subjects (75%) were female. One subject (25%) had bilateral postoperative maxillary sinus mucoceles. Two subjects (50%) had unilateral right sided mucoceles, and the remaining subject had a unilateral left sided mucocele. All subjects had a history of multiple sinus procedures for chronic sinusitis including Caldwell-Luc procedures ipsilateral to the postoperative mucocele. All subjects underwent endoscopic medial maxillectomy without complication and were symptom free at the last follow up appointment, average 24 months (range 3-71 months) after medial maxillectomy. For postoperative maxillary sinus mucoceles in locations that are difficult to access via the middle meatus antrostomy, we recommend endoscopic medial maxillectomy with mucosal flap. Our preliminary experience with four subjects demonstrates complete resolution of symptoms after this procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

Feasibility of Using Intravascular Ultrasonography for Assessment of Giant Cavernous Aneurysm after Endovascular Treatment: A Technical Report

Science.gov (United States)

Majidi, Shahram; Grigoryan, Mikayel; Tekle, Wondwossen G; Watanabe, Masaki; Qureshi, Adnan I

2012-01-01

Introduction Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported. Methods A 41 years old man who had been treated using stent assisted coil embolization for cavernous segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck. Results The angiographic images were limited because of superimposition of the aneurysm on the parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent. Conclusion In this case report, we observed that adjunct use of IVUS can provide valuable information not ascertained by angiography during follow up assessment of coil embolized aneurysm. PMID:22737259

The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis.

Science.gov (United States)

Aral, Murat; Keles, Erol; Kaygusuz, Irfan

2003-01-01

To investigate aerob-anaerob microorganisms growth in maxillary and ethmoid sinuses by evaluating aspiration materials from patients with chronic sinusitis. The study was performed prospectively, and there were 31 patients (23 men, 8 women; mean age, 31.4+/-14.15, between 18-65 years) who had endoscopic sinus surgery because of chronic sinusitis. During the operation, when the maxillary sinus ostium and ethmoid sinus were opened, readily aspirated materials from sinuses were evaluated regarding aerob and anaerob bacteria. Nose and throat swap samples were collected preoperatively to determine the upper respiratory tract flora and also to understand the relationship between the flora and the microorganisms aspirated from sinuses. Total aerob bacteria count, which was isolated from preoperative nasal swab cultures, was 36, and aerob-anaerob bacteria count that included cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery was 42. For each 2 samples, the most common isolated aerob bacteria were coagulase (-) staphylococci. Microorganisms were isolated in 87.0% of 27 patients, in which cultures taken from maxillary and ethmoid sinuses during the functional endoscopic sinus surgery were included. It is determined that the isolated aerob bacteria rate was 90.4%, and the isolated anaerob bacteria rate was 14.2%. All of the 6 samples in which anaerob bacteria isolated were all maxillary sinus aspiration materials. Microorganisms that isolated from the nose and the sinuses were similar with the rate of 25.8%, and microorganisms that isolated from the throat cultures and sinuses were similar with the rate of 22.5%. This study reveals the aerob and anaerob microbiology of the maxillary and ethmoid sinuses so the treatment of chronic sinusitis will be easier.

Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material.

Science.gov (United States)

Jeong, Seung-Mi; Lee, Chun-Ui; Son, Jeong-Seog; Oh, Ji-Hyeon; Fang, Yiqin; Choi, Byung-Ho

2014-09-01

Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa

International Nuclear Information System (INIS)

Shibata, Shobu; Kurihara, Masaki; Mori, Kazuo; Amamoto, Yuhei.

1981-01-01

This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to success because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation. CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of a extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor. (author)

Reconstruction of the Terminal of an Abandoned Fractured Unipolar Coronary Sinus Lead: a Feasible Solution to Restore Effective Cardiac Resynchronization Therapy

Directory of Open Access Journals (Sweden)

Armando Gardini, MD

2013-05-01

Full Text Available Complications related to coronary sinus lead are not infrequent in recipients of cardiac resynchronization devices. We describe the case of a patient with a biventricular implantable cardioverter defibrillator with persistent phrenic nerve stimulation, previous coronary sinus lead fracture, and severe left subclavian vein stenosis. The reimplantation of a new coronary sinus lead on the left side, ipsilateral to the original implant, was unsuccessful. In order to avoid more complex and risky procedures, we performed the repair of the fractured abandoned lead with the reconstruction of the unipolar lead terminal. Effective biventricular pacing was obtained with satisfactory electrical parameters and it was maintained at twelve months follow-up.

Sinus cut-off sign: A helpful sign in the CT diagnosis of diaphragmatic rupture associated with pleural effusion

International Nuclear Information System (INIS)

Kaya, Seyda Ors; Karabulut, Nevzat; Yuncu, Gokhan; Sevinc, Serpil; Kiroglu, Yilmaz

2006-01-01

The objective of our study was to describe the 'sinus cut-off' sign at CT in the diagnosis of diaphragmatic rupture in patients with blunt abdominal trauma complicated with pleural effusion, and evaluate its utility in an experimental model. Between January 2004 and March 2005, we observed an unusual interruption of costophrenic sinus at CT in three patients with blunt abdominal trauma accompanied with pleural effusion. This observation prompted us to evaluate the utility of this sign in an experimental model. Laparotomically, we created 2 cm diapragmatic lacerations at each hemidiaphragm in two rabbits and pushed up the abdominal viscera with omentum through the defect. To simulate hemothorax, we also injected 5-10 mL of diluted contrast material into the pleural space. Using a dual-slice helical CT scanner, limited thoracoabdominal CT examination was performed before and after injection of intrapleural contrast material. The images were analyzed for the presence of CT signs for diaphragmatic injury. The left posterior costophrenic sulcus was interrupted in all of the three patients with left pleural effusion. While it was associated with other findings of diaphragmatic injury, the 'sinus cut-off sign' was the sole finding in one patient. The sinus cut-off sign was observed on the CT scans of 100% of the rabbits with a left and right sided diaphragmatic rupture. The 'sinus cut-off sign' is useful and can increase the CT detection of acute diaphragmatic injury associated with pleural effusion

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.

Cerebral cavernous malformations. Serial magnetic resonance imaging findings in patients with and without gamma knife surgery

International Nuclear Information System (INIS)

Yoon Pyeong-Ho; Kim, Dong-Ik; Jeon Pyoung; Ryu, Young-Hoon; Hwang, Geum-Joo; Park, Sang-Joon

1998-01-01

To classify the cerebral cavernous malformations and to investigate the natural history of cavernous malformations according to the classification, 41 patients with 61 cavernous malformations (40 cavernous malformations from 22 patients treated with gamma knife surgery) were regularly followed up using MR imaging for a mean period of 25.5 months in treated cavernous malformations and 20.7 months in untreated cavernous malformations, respectively. Cavernous malformations were classified into four types. Follow-up MR images were analyzed to evaluate changes in size, signal intensity, rebleeding, and perilesional adverse reaction of irradiation. A total of 61 cavernous malformations including 17 in type I, 23 in type II, 10 in type III, and 11 in type IV showed usual degradation of blood product in 22 cavernous malformations, no change in shape and signal intensity in 31 cavernous malformations, and eight cavernous malformations with rebleedings in the serial MR images. In these eight cavernous malformations with rebleedings, six occurred in type II and two in type III, but none in type I or IV. Rebleedings were more frequent in type II than in other types. Adverse reaction of irradiation was observed in five of 22 patients treated with gamma knife surgery. Although most cerebral cavernous malformations showed evolution of hemorrhage or no change in size or shape on follow-up MR images, cerebral cavernous malformations represented as mixture of subacute and chronic hemorrhage with hemosiderin rim (type II) have a higher frequency to rebleed than other types of cerebral cavernous malformations. Cerebral cavernous malformations represented as hemosiderin deposition without central core (type IV) have a lower tendency to rebleed than other types and do not need any treatment. Most of the adverse reaction of irradiation after gamma knife surgery around cavernous malformations are transient findings and are considered to be perilesional edema. (K.H)

Surgical treatment of a large congenital cavernous hemangioma on the thorax of a foal

DEFF Research Database (Denmark)

Jacobsen, Stine; Christophersen, Mogens Teken; Tnibar, Aziz

2018-01-01

A 3-day-old male foal was presented with a fluctuant 25 × 15 cm mass on the thorax. The mass had increased in size since birth. The mass did not respond to conservative treatment consisting of aspiration of serohaemorrhagic contents and compression bandages, and it was therefore surgically removed...... when the foal was approximately 2½ weeks. A histopathological diagnosis of cavernous haemangioma was made. Healing progressed without complications despite a large surgical wound left to heal by second intention. Recurrence was not observed during the 1.5-year follow-up period....

Analysis of SPR salt cavern remedial leach program 2013.

Energy Technology Data Exchange (ETDEWEB)

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

2013-09-01

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

Trigemino-cardiac reflex: occurrence of asystole during trans-sphenoidal adenomectomy: a case report.

Science.gov (United States)

Jeon, Dae Geun; Kang, Bong Jin; Hur, Tae Won

2014-09-01

The trigemino-cardiac reflex has been reported to occur during various craniofacial surgeries or procedures including manipulation of the trigeminal ganglion, tumor resection in the cerebellopontine angle, various facial reconstructions and trans-sphenoidal adenomectomy. Regarding risk factors during trans-sphenoidal adenomectomy, invasiveness closely related to the size of tumor and the degree of manipulation of cavernous sinus wall have been reported. We report the case of a 40-year-old female patient who had a relatively small-sized (trans-sphenoidal operation of the wall of the cavernous sinus, which strongly suggests the importance of careful manipulation of the cavernous sinus wall. In addition to reporting this rare complication of trans-sphenoidal adenomectomy, we reviewed its clinical management by performing a literature search.

Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

NARCIS (Netherlands)

Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

Radiation-induced optic neuropathy 4 years after radiation: report of a case followed up with MRI

International Nuclear Information System (INIS)

Piquemal, R.; Renard, J.P.; Cottier, J.P.; Herbreteau, D.; Arsene, S.; Rospars, C.; Lioret, E.; Jan, M.

1998-01-01

We report a case of radiation-induced optic neuropathy in a 32-year-old man with Cushing's disease and a recurrent tumour of the left cavernous sinus. The patient experienced rapid, painless loss of vision 4 years after treatment without recurrence of tumour or other visual disorder. MRI showed enlargement and contrast enhancement of the optic chiasm. A year later the patient was almost blind and MRI showed atrophy and persistent contrast enhancement of the chiasm. (orig.)

Variations in reciprocal distances between the ethmoidal sinus, sphenoidal sinus and posterior orbit. Measurement on CTscans

Energy Technology Data Exchange (ETDEWEB)

Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou [Juntendo Univ., Tokyo (Japan). School of Medicine

2003-05-01

In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis

Temporo-sylvian arachnoidal cyst and an extreme pneumatization of the cranial sinuses: a case report.

Science.gov (United States)

Zara, Gabriella; Ponza, Isabella; Citton, Valentina; Manara, Renzo

2010-11-01

We present a patient who showed MRI evidence of a giant temporo-sylvian arachnoidal cyst of the left hemisphere and an extreme pneumatization of the sphenoid and frontal sinuses. No sign of mass effect or cerebral atrophy was detected. This patient presented a deficit of memory and control functions, but quality of life was not affected. Surgery was not performed. Arachnoidal cyst and anatomic variants of the sinus region have not a common etiology. This is the first report that describes a giant temporo-sylvian arachnoidal cyst with anatomic variants of the paranasal sinuses. Copyright © 2010 Elsevier B.V. All rights reserved.

Venous sinus stenting for pseudotumour cerebri with venous sinus stenosis

International Nuclear Information System (INIS)

Chen Huairui; Bai Rulin; Wu Xiaojun; Qi Xiangqian; Mei Qiyong; Lu Yicheng

2011-01-01

Objective: To explore the relation between venous sinus stenosis and pseduotumour cerebri and to discuss the efficacy and strategy of venous sinus stenting for its treatment. Methods: Venous sinus stenting was performed in a total of 9 patients with pseudotumour cerebri accompanied by dural sinus stenosis. The clinical data, including the clinical presentations, intracranial pressure, angiographic findings, pressure of dural sinus,methods of treatment and the therapeutic results, were retrospectively analyzed. Results: Bilateral disc edema was seen in all patients. The pressure gradient in the lateral sinuses was obviously high before stenting (22.67±7.25)mmHg in all patients and a reduction in intra-sinus pressure and pressure gradient was also found (5.78±3.77)mmHg. The symptoms associated with intracranial hypertension were gradually improved or disappeared in two weeks after the placement of the stent in all cases, and the intracranial pressure dropped evidently (12.78±5.97)cm H 2 O. Vision was improved in 7 cases at three months, whereas it remained poor in 2 cases despite normalized intracranial pressure. There was no other permanent procedure-related morbidity. The patients were followed up for 3 months to 5 years, and no recurrence developed. Conclusion: Lateral sinus stenting is an effective method for the treatment of pseudotumour cerebri with dural sinus stenosis. (authors)

Preliminary long-term stability criteria for compressed air energy storage caverns in salt domes

Energy Technology Data Exchange (ETDEWEB)

Thoms, R.L.; Martinez, J.D.

1978-08-01

Air storage caverns, which are an essential and integral component of a CAES plant, should be designed and operated so as to perform satisfactorily over the intended life of the overall facility. It follows that the long-term ''stability'' of air storage caverns must be considered as a primary concern in projecting the satisfactory operation of CAES facilities. As used in the report, ''stability'' of a storage cavern implies the extent to which an acceptable amount of cavern storage volume can be utilized with routine maintenance for a specified time interval, e.g., 35 years. In this context, cavern stability is relative to both planned utilization and time interval of operation. The objective of the study was to review the existing literature and consult knowledgeable workers in the storage industry, and then report state-of-the-art findings relative to long-term stability of compressed air energy storage caverns in salt domes. Further, preliminary cavern stability criteria were to be presented in a form consistent with the amount of information available on cavern performance in salt domes. Another objective of the study was to outline a methodology for determining the long-term stability of site-specific CAES cavern systems in salt domes.

Perforation of the sinus membrane during sinus floor elevation

DEFF Research Database (Denmark)

von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M

2014-01-01

PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...

Sinusitis

Science.gov (United States)

... cause. Acute viral sinusitis does not benefit from antibiotics, but may be treated using pain relievers, steroid nasal sprays, or salt water irrigation in the nose. These treatments are good options for acute bacterial sinusitis too, but in ...

Brain abscess associated with ethmoidal sinus osteoma: A case report

Directory of Open Access Journals (Sweden)

Hiroaki Nagashima

2014-12-01

Full Text Available Osteoma of the paranasal sinus is uncommon, and the occurrence of brain abscess associated with ethmoidal osteoma is particularly rare. We report here a case of a brain abscess complicating an ethmoidal osteoma in a 68-year-old man who presented with high-grade fever and disturbance in the level of consciousness. Computed tomography scanning and magnetic resonance imaging revealed a ring-enhancing mass in the left frontal lobe with surrounding edema and a bony mass in the ethmoidal sinus. We scheduled a two-stage operation. First, emergency aspiration and drainage of the abscess via the forehead were performed to reduce the abscess volume. These were followed by a left frontal craniotomy to totally remove both the brain abscess and the bony mass. The bony mass had breached the dura mater. After removing the bony mass, we repaired the anterior skull base using a pericranial flap. Pathological findings of the bony tumor were consistent with osteoma. The postoperative course was uneventful. In the case of a huge brain abscess associated with an ethmoidal osteoma, volume reduction by drainage followed by surgical removal of both lesions may help to control infection and achieve a cure. Use of a vascularized pericranial flap is important to prevent direct communication between the paranasal sinuses and the cranial cavity.

Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach.

Science.gov (United States)

Burrows, Anthony M; Rayan, Tarek; Van Gompel, Jamie J

2017-08-01

Extradural approach to the cavernous sinus, the "Dolenc" approach recognizing its developing Dr. Vinko Dolenc, is a critically important skull base approach. However, resection of the lateral wall of the cavernous sinus, most commonly for cavernous sinus meningiomas, results commonly in a defect that often cannot be reconstructed in a water-tight fashion. This may result in troublesome pseudomeningocele postoperatively. To describe a technique designed to mitigate the development of pseudomeningocele. We found the Dolenc approach critical for resection of cavernous lesions. However, a number of pseudomeningoceles were managed with prolonged external pressure wrapping in the early cohort. Therefore, we incorporated subgaleal to muscular sutures, which were designed to close this potential space and retrospectively analyzed our results. Twenty-one patients treated with a Dolenc approach and resection of the lateral wall of the cavernous sinus over a 2-year period were included. Prior to incorporation of this technique, 12 patients were treated and 3 (25%) experienced postoperative pseudomeningoceles requiring multiple clinic visits and frequent dressing. After incorporation of subgaleal retention sutures, no patient (0%) experienced this complication. Although basic, subgaleal to temporalis muscle retention sutures likely aid in eliminating this potential dead space, thereby preventing patient distress postoperatively. This technique is simple and further emphasizes the importance of dead space elimination in complex closures. Copyright © 2017 by the Congress of Neurological Surgeons

Columellar sinus: A rare congenital isolated sinus

Directory of Open Access Journals (Sweden)

Anindita Datta

2016-07-01

Full Text Available Midline congenital malformation of the nose is a very rare presentation and it's midline situation seems curious and is very difficult to explain on the basis of the present day conception of the embryology of the nose. The prevalence of lower lip sinuses has been estimated to be about 0.001 % of the general population. Upper lip sinuses are even more uncommon. We herein report a case of a 13 years old girl having congenital sinus affecting the upper part of the columella.

Thermo-mechanical modelling of salt caverns due to fluctuating loading conditions.

Science.gov (United States)

Böttcher, N.

2015-12-01

This work summarizes the development and application of a numerical model for the thermo-mechanical behaviour of salt caverns during cyclic gas storage. Artificial salt caverns are used for short term energy storage, such as power-to-gas or compressed air energy storage. Those applications are characterized by highly fluctuating operation pressures due to the unsteady power levels of power plants based on renewable energy. Compression and expansion of the storage gases during loading and unloading stages lead to rapidly changing temperatures in the host rock of the caverns. This affects the material behaviour of the host rock within a zone that extends several meters into the rock mass adjacent to the cavern wall, and induces thermo-mechanical stresses and alters the creep response.The proposed model features the thermodynamic behaviour of the storage medium, conductive heat transport in the host rock, as well as temperature dependent material properties of rock salt using different thermo-viscoplastic material models. The utilized constitutive models are well known and state-of-the-art in various salt mechanics applications. The model has been implemented into the open-source software platform OpenGeoSys. Thermal and mechanical processes are solved using a finite element approach, coupled via a staggered coupling scheme. The simulation results allow the conclusion, that the cavern convergence rate (and thus the efficiency of the cavern) is highly influenced by the loading cycle frequency and the resulting gas temperatures. The model therefore allows to analyse the influence of operation modes on the cavern host rock or on neighbouring facilities.

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.

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

Sinusitis

Science.gov (United States)

... sinuses: Apply a warm, moist washcloth to your face several times a day. Drink plenty of fluids to thin ... do help, they may only slightly reduce the time it takes for the ... the face Severe swelling around the eyes Acute sinusitis should ...

A rare complication in a child undergoing chemotherapy for acute lymphoblastic leukemia: Superior sagittal sinus thrombosis

Directory of Open Access Journals (Sweden)

Ting-Yao Wang

2011-04-01

Full Text Available We report the case of a 4-year-old boy with acute lymphoblastic leukemia in high-risk group who suffered from generalized tonic-colonic seizure evolving into status epilepticus, and subsequent left hemiparesis during his first reinduction chemotherapy, consisting of dexamethasone, vincristine, l-asparaginase, and epirubicin. Superior sagittal sinus and cerebral venous thrombosis, predominantly in right side, were proved by brain magnetic resonance imaging. After aggressive treatment with low-molecular weight heparin (LMWH, left hemiparesis improved in 1 week. And he was fully ambulatory 3 weeks later. The second cycle of reinduction chemotherapy was conducted smoothly with the concomitant use of LMWH. This case illustrates the strong correlation of the rare thrombotic complication, superior sagittal sinus thrombosis, and hypercoagulable status secondary to combination use of l-asparaginase and corticosteroid. Early and vigilant recognition of superior sagittal sinus thrombosis and prompt anticoagulation with LMWH may prevent further neurological damage.

Japan's exploration of vertical holes and subsurface caverns on the Moon and Mars

Science.gov (United States)

Haruyama, J.; Kawano, I.; Kubota, T.; Yoshida, K.; Kawakatsu, Y.; Kato, H.; Otsuki, M.; Watanabe, K.; Nishibori, T.; Yamamoto, Y.; Iwata, T.; Ishigami, G.; Yamada, T. T.

2013-12-01

Recently, gigantic vertical holes exceeding several tens of meters in diameter and depth were discovered on the Moon and Mars. Based on high-resolution image data, lunar holes and some Martian pits (called 'holes' hereafter) are probably skylights of subsurface caverns such as lava tubes or magma chambers. We are starting preparations for exploring the caverns through the vertical holes. The holes and subsurface caverns have high potential as resources for scientific studies. Various important geological and mineralogical processes could be uniquely and effectively observed inside these holes and subsurface caverns. The exposed fresh lava layers on the vertical walls of the lunar and Martian holes would provide information on volcanic eruption histories. The lava layers may also provide information on past magnetic fields of the celestial bodies. The regolith layers may be sandwiched between lava layers and may preserve volatile elements including solar wind protons that could be a clue to understanding past solar activities. Water molecules from solar winds or cometary/meteorite impacts may be stored inside the caverns because of mild temperatures there. The fresh lava materials forming the walls and floors of caverns might trap endogenic volatiles from magma eruptions that will be key materials for revealing the formation and early evolution of the Moon and Mars. Furthermore, the Martian subsurface caverns are highly expected to be life cradles where the temperatures are probably stable and that are free from ultra-violet and other cosmic rays that break chemical bonds, thus avoiding polymerization of molecules. Discovering extraterrestrial life and its varieties is one of our ultimate scientific purposes for exploring the lunar and Martian subsurface caverns. In addition to scientific interests, lunar and Martian subsurface caverns are excellent candidates for future lunar bases. We expect such caverns to have high potential due to stable temperatures; absence

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

Optical Coherence Tomography Angiography of Retinal Cavernous Hemangioma.

Science.gov (United States)

Pierro, Luisa; Marchese, Alessandro; Gagliardi, Marco; Bandello, Francesco

2017-08-01

Retinal cavernous hemangioma is a rare, benign, retinal tumor characterized by angiomatous proliferation of vessels within the inner retina or the optic disc.1 Here we report a case of retinal cavernous hemangioma on the margin of the optic disc in the right eye of a 61-year-old asymptomatic female. The lesion was studied with multimodal imaging which included structural optical coherence tomography, fluorescein angiography, blue fundus auto-fluorescence, optical coherence tomography angiography (OCTA) (DRI OCT Triton; Topcon, Tokyo, Japan) and visual field examination. Blood circulation inside retinal cavernous hemangioma lesion is typically low-stagnant.2 However, OCTA demonstrated blood flow inside the lesion, illustrating its vascular circulation.3 Visual field was within the normal limits, except from a slight enlargement of the blind spot. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:684-685.]. Copyright 2017, SLACK Incorporated.

Evaluation of the effect of hemoglobin or hematocrit level on dural sinus density using unenhanced computed tomography.

Science.gov (United States)

Lee, Seung Young; Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

2013-01-01

To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.

Unroofed coronary sinus in a patient with neurofibromatosis type 1

Directory of Open Access Journals (Sweden)

Luciano Pereira Bender

2013-12-01

Full Text Available OBJECTIVE: To report the uncommon association between neurofibromatosis type 1 (NF1 and unroofed coronary sinus. CASE DESCRIPTION: Girl with four years and six months old who was hospitalized for heart surgery. The cardiac problem was discovered at four months of life. On physical examination, the patient presented several café-au-lait spots in the trunk and the limbs and freckling of the axillary and groin regions. Her father had similar skin findings, suggesting the NF1 diagnosis. The cardiac evaluation by echocardiography disclosed an atrial septal defect of unroofed coronary sinus type. This cardiac finding was confirmed at surgery. The procedure consisted of the atrial septal defect repair with autologous pericardium. COMMENTS: NF1 is a common autosomal dominant disorder caused by mutations in the NF1 gene. Among the NF1 findings, congenital heart defects are considered unusual. In the literature review, there was no association between NF1 and unroofed coronary sinus, which is a rare cardiac malformation, characterized by a communication between the coronary sinus and the left atrium, resultant from the partial or total absence of the coronary sinus roof. It represents less than 1% of atrial septal defect cases. More reports are important to determine if this association is real or merely casual, since NF1 is a common condition.

Changes in gonadotropin-releasing hormone and gonadotropin-releasing hormone receptor gene expression after an increase in carbon monoxide concentration in the cavernous sinus of male wild boar and pig crossbread.

Science.gov (United States)

Romerowicz-Misielak, M; Tabecka-Lonczynska, A; Koziol, K; Gilun, P; Stefanczyk-Krzymowska, S; Och, W; Koziorowski, M

2016-06-01

Previous studies indicate that there are at least a few regulatory systems involved in photoperiodic synchronisation of reproductive activity, which starts with the retina and ends at the gonadotropin-releasing hormone (GnRH) pulse generator. Recently we have shown indicated that the amount of carbon monoxide (CO) released from the eye into the ophthalmic venous blood depends on the intensity of sunlight. The aim of this study was to test whether changes in the concentration of carbon monoxide in the ophthalmic venous blood may modulate reproductive activity, as measured by changes in GnRH and GnRH receptor gene expression. The animal model used was mature male swine crossbred from wild boars and domestic sows (n = 48). We conducted in vivo experiments to determine the effect of increased CO concentrations in the cavernous sinus of the mammalian perihypophyseal vascular complex on gene expression of GnRH and GnRH receptors as well as serum luteinizing hormone (LH) levels. The experiments were performed during long photoperiod days near the summer solstice (second half of June) and short photoperiod days near the winter solstice (second half of December). These crossbred swine demonstrated a seasonally-dependent marked variation in GnRH and GnRH receptor gene expression and systemic LH levels in response to changes in CO concentration in ophthalmic venous blood. These results seem to confirm the hypothesis of humoral phototransduction as a mechanism for some of bright light's effects in animal chronobiology and the effect of CO on GnRH and GnRH receptor gene expression.

Instability risk analysis and risk assessment system establishment of underground storage caverns in bedded salt rock

Science.gov (United States)

Jing, Wenjun; Zhao, Yan

2018-02-01

Stability is an important part of geotechnical engineering research. The operating experiences of underground storage caverns in salt rock all around the world show that the stability of the caverns is the key problem of safe operation. Currently, the combination of theoretical analysis and numerical simulation are the mainly adopts method of reserve stability analysis. This paper introduces the concept of risk into the stability analysis of underground geotechnical structure, and studies the instability of underground storage cavern in salt rock from the perspective of risk analysis. Firstly, the definition and classification of cavern instability risk is proposed, and the damage mechanism is analyzed from the mechanical angle. Then the main stability evaluating indicators of cavern instability risk are proposed, and an evaluation method of cavern instability risk is put forward. Finally, the established cavern instability risk assessment system is applied to the analysis and prediction of cavern instability risk after 30 years of operation in a proposed storage cavern group in the Huai’an salt mine. This research can provide a useful theoretical base for the safe operation and management of underground storage caverns in salt rock.

Orbital apex cyst: a rare cause of compressive optic neuropathy post-functional endoscopic sinus surgery

Directory of Open Access Journals (Sweden)

Koh YN

2017-07-01

Full Text Available Yi Ni Koh,1,2 Shu Fen Ho,2 Letchumanan Pathma,3 Harvinder Singh,3 Embong Zunaina1 1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Department of Ophthalmology, 3Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia Abstract: There are various causes that can lead to compressive optic neuropathy. We present here orbital apex cyst as an unusual cause of compressive optic neuropathy in a 49-year-old male. He presented with 2 weeks painless loss of vision in the left eye with left-sided headache. He had had left functional endoscopic sinus surgery for left nasal polyps 4 years earlier. Magnetic resonance imaging of brain and orbit revealed a left discrete orbital nodule, possibly orbital cyst or mucocele, which was compressing on the left optic nerve. Left eye vision improved markedly from hand movement to 6/36 pinhole 6/18 after initiation of intravenous dexamethasone. A subsequent endoscopic endonasal left optic nerve decompression found the orbital nodule lesion to be an orbital cyst. Marsupialization was performed instead of excision, as the cyst ruptured intraoperatively. Postoperative vision improved to 6/7.5 with normal optic nerve function postoperatively. Possible cause of orbital apex cyst is discussed. Keywords: orbital cyst, compressive optic neuropathy, functional endoscopic sinus surgery

Persistent left superior vena cava: a case report and review of literature

Directory of Open Access Journals (Sweden)

Verma Gita

2008-10-01

Full Text Available Abstract Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress. It is most commonly observed in isolation but can be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. The presence of PLSVC can render access to the right side of heart challenging via the left subclavian approach, which is a common site of access utilized when placing pacemakers and Swan-Ganz catheters. Incidental notation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography.

Variations in reciprocal distances between the ethmoidal sinus, sphenoidal sinus and posterior orbit. Measurement on CTscans

International Nuclear Information System (INIS)

Hayakawa, Kimiko; Yoshikawa, Hiroshi; Suzuki, Miyako; Yokoi, Hidenori; Hosokawa, Akira; Hagiwara, Akiko; Ichikawa, Ginichirou

2003-01-01

In concluding surgery of the paranasal sinuses (anterior and posterior) and the sphenoidal sinus, caution is demanded because intraorbital complications may develop in the skull. It is well-known that there is substantial variation in the form of the internal wall of the orbit, and the anterior and posterior walls of the sphenoidal sinus. In the present study, we measured the size of the structure around the paranasal sinus on patient CTscans to be used in surgery on the paranasal sinuses. A total of 387 people (184 males and 203 females) with no destructive bone lesions who visited the Juntendo University Hospital between 1999 and June 2002 were investigated. A plane was selected 14 mm above a line drawn between the medial angle and the external acoustic orifice on CTscans performed using axial projection. This framework was used to conduct the measurements. We employed this method because we consider it ideal for rendering the ethmoidal sinuses, the internal wall of the orbit, medial rectus muscle, optic nerve, and the anterior and posterior walls of the sphenoidal sinus most clearly visible. We measured the length between these anatomically important regions. We measured 1) the length of a line drawn between the opening of the nose and the line drawn between the right and left optic canals, 2) the length between the nasal opening and the posterior wall of the sphenoidal sinus, on the same horizontal line drawn between the posterior end of the eyeball and the nasal septum, 3) the length of a line from the site where the optic nerve adheres to the nasal septum, 4) the length between the lateral wall of the ethmoidal sinus, 5) the length between the nasal septum and the medial side of the medial rectus muscle, 6) the length between the medial side of the medial rectus muscle and the medial side of the optic nerve. The measurements were performed on both sides. We analyzed the above results statistically according to gender and age. The results of the analysis

Endovascular stent-support angioplasty for cerebral venous sinus stenosis

Directory of Open Access Journals (Sweden)

Xin-feng LI

2011-06-01

Full Text Available Objective To investigate the pathophysiological features of cerebral venous sinus stenosis,and the modus and therapeutic effect of stent-support angioplasty.Methods The clinical data of 36 patients with cerebral venous sinus stenosis,admitted to Neurosurgical Department of General Hospital of PLA from Dec.2001 to Jun.2010,were retrospectively analyzed.Of the 36 cases,10 were males and 26 females,aged from 14 to 57 years with a mean of 37.8 years,and the disease course ranged from 4 days to 9 years.The main clinical manifestations included headache,vomiting,optical visual blurring,and limb weakness with anesthesia in some patients.The diagnosis of all patients was confirmed by digital subtraction angiography,and the results showed that the local stenosis located in right transverse-sigmoid sinus in 21 cases,left transverse-sigmoid sinus in 12 cases,and on both sides in 3 cases.All patients received thrombolytic therapy via carotid artery or a microcatheter inserted in the venous sinus,followed by stent angioplasty of venous sinus.Meanwhile,general anticoagulant and antiplatelet therapy were essential.Results All the 36 patients were successively treated with balloon dilatation and stent angioplasty of venous sinus with exception of 3 cases,who failed because of the circuitous jugular foramen preventing the insertion of the stent.The successful rate was 91.7%.The cerebrospinal fluid pressure of the patients was lowered from 374.7±82.9mmH2O before operation to 230.3±48.1mmH2O after operation.Thirty-three patients were followed-up for 1 month to 8 years by brain angiography and examinations in the outpatient clinic.Among them 32 showed persistent relief of clinical symptoms.The remaining patient presented severe headache and optical visual blurring 1 month after stent implantation,however the symptoms were alleviated obviously after thrombolytic therapy via the carotid artery with adequate anticoagulation.Conclusions Stent angioplasty of venous

Radiation-induced optic neuropathy 4 years after radiation: report of a case followed up with MRI

Energy Technology Data Exchange (ETDEWEB)

Piquemal, R.; Renard, J.P. [Service de Medecine Interne A, Hopital Bretonneau, Tours (France); Cottier, J.P.; Herbreteau, D. [Service de Neuroradiologie, Hopital Bretonneau, Tours (France); Arsene, S.; Rospars, C. [Service d`Ophthalmologie, Hopital Bretonneau, Tpurs (France); Lioret, E.; Jan, M. [Service de Neurochirurgie, Hopital Bretonneau, Tours (France)

1998-07-01

We report a case of radiation-induced optic neuropathy in a 32-year-old man with Cushing`s disease and a recurrent tumour of the left cavernous sinus. The patient experienced rapid, painless loss of vision 4 years after treatment without recurrence of tumour or other visual disorder. MRI showed enlargement and contrast enhancement of the optic chiasm. A year later the patient was almost blind and MRI showed atrophy and persistent contrast enhancement of the chiasm. (orig.) With 3 figs., 13 refs.

Novel Technique for the UX15 Cavern Vault Support System

CERN Document Server

Rammer, H

2000-01-01

The overall LHC project schedule requires the civil engineering work to begin before the final LEP shutdown. The new caverns for the ATLAS experiment will be built in and around the existing underground structures at point 1. In order to make the best possible use of the time available for the LHC civil engineering before the shutdown of LEP, a particular arrangement for the construction of the UX15 cavern vault has been developed. The basic concept of this arrangement consists of the excavation of the cavern top heading and the installation of the concrete vault immediately afterwards, prior to the subsequent bench excavation after LEP shutdown. A temporary support of the dead weight of the concrete roof will be achieved by the suspension of the roof by 38 no. pre-stressed ground anchors of 225 tons capacity each. This support system will work up to the construction of the cavern base slab and walls and the completion of the permanent concrete lining.

Endovascular treatment of carotid-cavernous vascular lesions

Directory of Open Access Journals (Sweden)

GUILHERME BRASILEIRO DE AGUIAR

Full Text Available ABSTRACT Objective: to evaluate the endovascular treatment of vascular lesions of the cavernous segment of the internal carotidartery (ICA performed at our institution. Methods: 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. Results: 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. Conclusion: the endovascular treatment significantly improved the symptoms in the patients studied, especially those related to pain and oculomotor nerve dysfunction.

Maxillary sinus function after sinus lifts for the insertion of dental implants

NARCIS (Netherlands)

Timmenga, NM; Raghoebar, GM; Boering, G; VanWeissenbruch, R

Purpose: The influence of bone augmentation of the floor of the maxillary sinus for the insertion of denial implants on sinus function has not been well investigated, In this study, the influence of the sinus lift on the development of maxillary sinus pathology was evaluated using generally accepted

Intractable hiccup as the presenting symptom of cavernous hemangioma in the medulla oblongata: a case report and literature review.

Science.gov (United States)

Lee, Kyung-Hwa; Moon, Kyung-Sub; Jung, Min-Young; Jung, Shin

2014-06-01

A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem.

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the sinuses ... CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known ...

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.

Coronal CT of the paranasal sinuses before and after functional endoscotic sinus surgery

International Nuclear Information System (INIS)

Mantoni, M.; Larsen, P.; Hansen, H.; Tos, M.; Berner, B.; Oerntoft, S.

1996-01-01

Coronal CT of the paranasal sinuses and the ostiomeatal complex (OMC) was performed before and 12 months after bilateral functional endoscopic sinus surgery (FESS) in 30 patients with sinusitis and 12 patients with nasal polyposis. The extent of sinus mucosal thickening was graded, and the patency of the OMC was evaluated. After FESS, the percentage of open OMCs had increased from 42% to 83% in the sinusitis group, and from 8% to 45% in the polyposis group. There was only a small improvement in mucosal score in sinuses with opened OMC, so that the overall extent of sinus opacification before and after FESS was almost the same. Despite this, 91% of the patients reported clinical relief of symptoms. Preoperative coronal CT of the paranasal sinuses serves as an anatomical map for the surgeon, but there is no benefit of routine postoperative CT. (orig.)

from left to right : Mr Michel Della Negra (Last spokeperson of CMS), Prof. Tejinder ("Jim") Virdee (actual spokeperson of CMS), Mr Robert Aymar (CERN Director General) and Mr Sigurd Lettow (Chief Financial Officer of CERN) assist to the Lowering of the final element (YE-1) of the Compact Muon Solenoid (CMS) detector into its underground experimental cavern.

CERN Multimedia

Maximilien Brice

2008-01-01

from left to right : Mr Michel Della Negra (Last spokeperson of CMS), Prof. Tejinder ("Jim") Virdee (actual spokeperson of CMS), Mr Robert Aymar (CERN Director General) and Mr Sigurd Lettow (Chief Financial Officer of CERN) assist to the Lowering of the final element (YE-1) of the Compact Muon Solenoid (CMS) detector into its underground experimental cavern.

Silent internal sinus of the pyriform fossa: a rare adult manifestation of a branchial anomaly.

Science.gov (United States)

Lin, Chao-Jung; Lin, Yaoh-Shiang; Kang, Bor-Hwang; Lee, Jin-Chin

2003-03-01

Branchial anomalies present with a wide range of pathologic characteristics, including cysts, fistulas, and sinuses of the head and neck region. Branchial cysts are most commonly diagnosed during the second through fourth decades of life, while branchial sinuses and fistulas are diagnosed almost exclusively in children with infection episodes. Only rarely has an internal sinus of a third or fourth branchial anomaly manifested in adults as a noninfectious swelling in the neck during swallowing. In this report, we describe our experience treating a 21-year-old man with a left-sided swallowing-induced neck protrusion of 10 years' duration. Findings of physical examination, videolaryngoscopy, and a pharyngoesophagogram confirmed the diagnosis of internal sinus of the pyriform fossa, with uncertain origin of a third or fourth branchial anomaly. The patient underwent regular follow-up as an outpatient and experienced no further infectious episodes.

Added value of contrast-enhanced CISS imaging in relation to conventional MR images for the evaluation of intracavernous cranial nerve lesions

Energy Technology Data Exchange (ETDEWEB)

Yagi, Akiko; Takahashi, Ayako; Morita, Hideo; Amanuma, Makoto; Endo, Keigo [Gunma University School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Gunma (Japan); Sato, Noriko [National Center Hospital of Neurology and Psychiatry, Department of Radiology, Kodaira, Tokyo (Japan); Takeuchi, K. [Takasaki University of Health and Welfare, Department of Health and Welfare, Gunma (Japan)

2010-12-15

The normal cranial nerves (CNs) of the cavernous sinus can be clearly demonstrated using contrast-enhanced constructive interference in steady-state (CISS) magnetic resonance imaging (MRI). This study used the method to evaluate pathological CNs III, IV, V{sub 1}, V{sub 2}, and VI in cavernous sinuses affected by inflammatory and neoplastic diseases. MR images from 17 patients with diseases involving the cavernous sinuses and/or causing neuropathy in CNs III-VI were retrospectively evaluated. The patients were divided into inflammatory (n = 11) and neoplastic (n = 6) groups. We defined CNs as abnormal when they exhibited enlargement or enhancement. CNs were evaluated using both contrast-enhanced CISS and T1-weighted MRI. In the inflammatory group, abnormal CNs were identified by contrast-enhanced CISS MRI in 13 of 25 symptomatic CNs (52%) in eight patients, but in only two CNs (8%) in two patients by contrast-enhanced T1-weighted MRI. In the neoplastic group, both sequences of contrast-enhanced CISS and T1-weighted MRI detected abnormalities in the same three of eight symptomatic CNs (37.5%), i.e., the three CNs were all in the same patient with adenoid cystic carcinoma. Contrast-enhanced CISS MRI is useful for detecting CN abnormalities in inflammatory pathological conditions of the cavernous sinuses. (orig.)

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of the sinuses is now widely available ...

Lined rock caverns for the storage of hazardous waste

International Nuclear Information System (INIS)

Semprich, S.; Speidel, S.R.; Schneider, H.J.

1987-01-01

For reasons of environmental protection the storage of hazardous waste in unlined rock caverns is possible to a very limited extent only. Therefore, the authors have recently developed technologies for the lining and sealing of rock caverns. In the process, sealing systems of synthetic materials or metals have proved suitable. Synthetic materials can be used in the form of either sheets or coatings with various materials such as epoxy resins, polyethylenes etc. being used. Metal sealings consist of thin sheets or foils which are either welded or bonded. In either case, the structural design must provide for a leakage control possibility. The article describes the design principles, the structural and operational aspects as well as the control measures with regard to the planning and execution of lined rock caverns for the storage of hazardous waste

Crestal Sinus Augmentation in the Presence of Severe Sinus Mucosal Thickening: A Report of 3 Cases.

Science.gov (United States)

Fang, Yiqin; An, Xueyin; Jeong, Seung-Mi; Choi, Byung-Ho

2018-06-01

In the presence of severe sinus mucosal thickening, the ostium can be blocked when the sinus membrane is lifted, causing drainage disturbances and sinusitis. Here, we present 3 cases in which maxillary sinus floor elevation was performed using a crestal approach in the presence of severe sinus mucosal thickening (>10 mm). The effects of maxillary sinus floor elevation using the crestal approach technique on sinus mucosal thickening and bone formation in the sinus were evaluated using cone beam computed tomography. None of the patients exhibited an increase in sinus membrane thickness. No complications were encountered during the follow-up periods, and bone formation was observed around the implants at the sinus floor. All implants were functioning successfully. Maxillary sinus floor elevation using the crestal approach technique in the presence of severe sinus mucosal thickening allows for minimally invasive sinus grafting and simultaneous implant placement and does not increase sinus membrane thickness.

Sigmoid sinus diverticulum and pulsatile tinnitus - Analysis of CT scans from 15 cases

International Nuclear Information System (INIS)

Liu, Zhaohui; Wang, Zhenchang; Xian, Junfang; Wang, Yongzhe; Liang, Xihong; Chen, Chengfang; Gong, Shusheng; Ma, Xiaobo; Li, Yi

2013-01-01

Background: Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established. Purpose: To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. Material and Methods: Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization. Results: Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. Conclusion: Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum

Sigmoid sinus diverticulum and pulsatile tinnitus - Analysis of CT scans from 15 cases

Energy Technology Data Exchange (ETDEWEB)

Liu, Zhaohui; Wang, Zhenchang; Xian, Junfang; Wang, Yongzhe; Liang, Xihong [Dept. of Radiology, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China); Chen, Chengfang; Gong, Shusheng; Ma, Xiaobo; Li, Yi [Dept. of Otolaryngology Head and Neck Surgery, Capital Medical Univ., Beijing Tongren Hospital, Beijing (China)

2013-09-15

Background: Although the imaging features of sigmoid sinus diverticulum induced pulsatile tinnitus (PT) have been presented in some extent, detailed imaging findings still have not been systematically evaluated and precise diagnostic radiographic criteria has not been established. Purpose: To examine the computed tomography (CT) characteristics of sigmoid sinus diverticulum accompanied with PT. Material and Methods: Fifteen PT patients with sigmoid sinus diverticula proven by surgery were recruited after consenting. CT images of 15 patients were obtained and analyzed, including features of diverticula, brain venous systems, integrity of the sigmoid plate, and the degree of temporal bone pneumatization. Results: Sigmoid sinus diverticulum was located on the same side of PT in 15 patients. Diverticula originated at the superior curve of the sigmoid sinus in 11 patients and the descending segment of the sigmoid sinus in four patients. Sigmoid sinus diverticula focally eroded into the adjacent mastoid air cells in 12 patients and mastoid cortex in three patients. Among eight patients with unilateral dominant brain venous systems, the diverticula were seen on the dominant side in seven patients and non-dominant side in one patient. In contrast, the other seven patients showed co-dominant brain venous systems, with three presenting diverticula on the right side and four on the left. More notably, dehiscent sigmoid plate on the PT side was demonstrated in all patients. In addition, temporal bone hyper-pneumatization was found in nine patients, good and moderate pneumatization in three patients, respectively. Conclusion: Dehiscent sigmoid plate and extensive temporal bone pneumatization are two important imaging characteristics of the PT induced by sigmoid sinus diverticulum.

Angioplastia del seno coronario en el implante de electrodo del ventrículo izquierdo Angioplasty of coronary sinus in left ventricle electrode implant

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Alejandro Orjuela

2011-07-01

Full Text Available Con el incremento de implantes de dispositivos de estimulación cardíaca en pacientes con miocardiopatía dilatada, el diseno día a día más sofisticado de los mismos para satisfacer los requerimientos de los pacientes con cambios anatómicos que surgen como consecuencia de la misma dilatación cardíaca, tales como modificaciones en el calibre, curso, longitud y número de venas coronarias, cada vez se encuentran mayores dificultades para lograr los objetivos anatómicos, en particular el sitio ideal de posicionamiento del electrodo de estimulación ventricular izquierda en el seno coronario. Esta situación limita, en algunos casos, el beneficio terapéutico de esta técnica, viéndose, en ocasiones, en la necesidad de someter al paciente a toracotomía para posicionar el electrodo en el epicardio posterolateral del ventrículo izquierdo. Es así como, con el objetivo de abreviar los tiempos y la morbimortalidad e incrementar el éxito del implante, se disenó una estrategia basada en la técnica de hemodinámica para vencer las obstrucciones de las arterias coronarias y lograr, mediante angioplastia de las estrecheces del seno coronario, un abordaje más preciso a un determinado vaso epicárdico preseleccionado. Se describe la técnica usada en la angioplastia del seno coronario para este propósito.The design of devices of cardiac stimulation in patients with dilated cardiomyopathy has become more sophisticated due to the increment of its implantation, devices that must satisfy the requirements for patients with anatomical changes that appear as a consequence of the cardiac dilation such as caliber modifications, course, length and number of coronary veins. Every time is more difficult to achieve the anatomical objectives, particularly the ideal place for the left ventricular stimulation electrode position in the coronary sinus. This situation limits in some cases the therapeutical benefit of this technique, occasionally facing to the

Chapter 8: Invasive fungal rhinosinusitis.

Science.gov (United States)

Duggal, Praveen; Wise, Sarah K

2013-01-01

Invasive fungal rhinosinusitis (IFRS) is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in the acute fulminant form. Early symptoms can often mimic rhinosinusitis, while late symptoms can cause significant morbidity and mortality. Swelling and mucosal thickening can quickly progress to pale or necrotic tissue in the nasal cavity and sinuses, and the disease can rapidly spread and invade the palate, orbit, cavernous sinus, cranial nerves, skull base, carotid artery, and brain. IFRS can be life threatening if left undiagnosed or untreated. While the acute fulminant form of IFRS is the most rapidly progressive and destructive, granulomatous and chronic forms also exist. Diagnosis of IFRS often mandates imaging studies in conjunction with clinical, endoscopic, and histopathological examination. Treatment of IFRS consists of reversing the underlying immunosuppression, antifungal therapy, and aggressive surgical debridement. With early diagnosis and treatment, IFRS can be treated and increase patient survival.

Silent sinus syndrome an acquired condition and the essential role of otorhinolaryngologist consultation: a retrospective study.

Science.gov (United States)

Martínez-Capoccioni, Gabriel; Varela-Martínez, Ernesto; Martín-Martín, Carlos

2016-10-01

The silent sinus syndrome (SSS) is a rare clinical entity characterized by painless spontaneous enophthalmos, hypoglobus, and facial deformities secondary to chronic maxillary sinus atelectasis. The aim of this study was to present an SSS diagnostic feature and evaluate the relationship between nasal septum deviation and maxillary sinus volume. A retrospective chart review of the clinical characteristics of 20 patients diagnosed with SSS between January 2013 and July 2014 were analyzed by the Department of Otorhinolaryngology of University Hospital Complex of Santiago de Compostela. 14 patients were females and six males. The mean age was 43 years (range 28-67 years). The right maxillary sinus was involved in 12 patients and the left maxillary sinus in eight patients. There was no statistical difference between gender and the presence of SSS. Maxillary sinus sizes were significantly smaller on the same side as the deviation (p craneo-caudal photographs. The present study demonstrates that, in adult patients, SSS generally presents a septal deviation to the affected maxillary sinus. We recommend performing a paranasal sinus CT scan when the patient has a deviated nasal septum, retraction of the malar eminence (evidenced from the viewpoint cranio-caudal facial) and hypoglobus. FESS performing postero-anterior uncinectomy and enlargement of the maxillary ostium is recommended to restore sinus pressure and prevent progression of the enophthalmos, hypoglobus and facial deformities.

[Left versus bi-atrial radiofrequency ablation in the treatment of atrial fibrillation].

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Wang, Jian-Gang; Meng, Xu; Li, Hui

2008-11-25

To evaluate the effectiveness of radiofrequency modified maze operation for the treatment of atrial fibrillation (AF) and compare the results of the left versus bi-atrial procedures. 305 patients of organic heart disease combined with AF, 117 males and 188 females, aged (53 +/- 10), that underwent cardiac valve operation (n = 293) and/or coronary artery bypass graft surgery (n = 14), received concomitant atrial fibrillation, bi-atrial (n = 160) or left atrial (n = 145) with a mean duration of (36 +/- 43) months. Follow-up was conducted for (28 +/- 5) (3 - 42) months. Thirteen patients (4.3%) died postoperatively: 7 died of multisystem and organ failure, 3 of low cardiac output, 1 of rupture of left ventricle, 1 of arrhythmia, and 1 of sudden death. During the follow-up, 1 patient died of heart failure, 1 of encephalorrhagia and 1 of unknown reason in the bi-atrial group. At the end of the procedure 223 patients (73.1%) had sinus rhythm, with a sinus rhythm rate of 66.9% (107/160) in the bi-atrial group, significant lower than that in the left atrial group (80.0%, 116/145, P bi-atrial group was 80.0%, not significantly different from that of the left atrial group (81.9%, P > 0.05). The Kaplan-Meier survival analysis showed there was no significant difference in the AF rhythm rate between these 2 groups (P = 0.33). Logistic regression analysis showed that the left atrial diameter of >/= 80 mm was an independent predictor of AF recurrence. Both the left and bi-atrial procedures are successful in terms of restoring sinus rhythm. Left atrial ablation in severe cases and where the incision of right atrium is not needed is a reasonable choice.

Sinus Tumors

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... RESOURCES Medical Societies Patient Education About this Website Font Size + - Home > CONDITIONS > Sinus Tumors Adult Sinusitis Pediatric ... and they vary greatly in location, size and type. Care for these tumors is individualized to each ...

Large central lesions compressing the hypothalamus and brainstem. Operative approaches and combination treatment with radiosurgery

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Inoue, Hiroshi K.; Negishi, Masatoshi; Kohga, Hideaki; Hirato, Masafumi; Ohye, Chihiro [Gunma Univ., Maebashi (Japan). School of Medicine; Shibazaki, Tohru

1998-09-01

A major aim of minimally invasive neurosurgery is to preserve function in the brain and cranial nerves. Based on previous results of radiosurgery for central lesions (19 craniopharyngiomas, 46 pituitary adenomas, 9 meningeal tumors), combined micro- and/or radiosurgery was applied for large lesions compressing the hypothalamus and/or brainstem. A basal interhemispheric approach via superomedial orbitotomy or a transcallosal-transforaminal approach was used for these large tumors. Tumors left behind in the hypothalamus or cavernous sinus were treated with radiosurgery using a gamma unit. Preoperative hypothalamo-pituitary functions were preserved in most of these patients. Radiosurgical results were evaluated in patients followed for more than 2 years after treatment. All 9 craniopharyngiomas decreased in size after radiosurgery, although a second treatment was required in 4 patients. All 20 pituitary adenomas were stable or decreased in size and 5 of 7 functioning adenomas showed normalized values of hormones in the serum. All 3 meningeal tumors were stable or decreased in size after treatment. No cavernous sinus symptoms developed after radiosurgery. We conclude that combined micro- and radio-neurosurgery is an effective and less invasive treatment for large central lesions compressing the hypothalamus and brainstem. (author)

Large central lesions compressing the hypothalamus and brainstem. Operative approaches and combination treatment with radiosurgery

International Nuclear Information System (INIS)

Inoue, Hiroshi K.; Negishi, Masatoshi; Kohga, Hideaki; Hirato, Masafumi; Ohye, Chihiro; Shibazaki, Tohru

1998-01-01

A major aim of minimally invasive neurosurgery is to preserve function in the brain and cranial nerves. Based on previous results of radiosurgery for central lesions (19 craniopharyngiomas, 46 pituitary adenomas, 9 meningeal tumors), combined micro- and/or radiosurgery was applied for large lesions compressing the hypothalamus and/or brainstem. A basal interhemispheric approach via superomedial orbitotomy or a transcallosal-transforaminal approach was used for these large tumors. Tumors left behind in the hypothalamus or cavernous sinus were treated with radiosurgery using a gamma unit. Preoperative hypothalamo-pituitary functions were preserved in most of these patients. Radiosurgical results were evaluated in patients followed for more than 2 years after treatment. All 9 craniopharyngiomas decreased in size after radiosurgery, although a second treatment was required in 4 patients. All 20 pituitary adenomas were stable or decreased in size and 5 of 7 functioning adenomas showed normalized values of hormones in the serum. All 3 meningeal tumors were stable or decreased in size after treatment. No cavernous sinus symptoms developed after radiosurgery. We conclude that combined micro- and radio-neurosurgery is an effective and less invasive treatment for large central lesions compressing the hypothalamus and brainstem. (author)

ABDUCENS NERVE PALSY AND THROMBOSIS OF THE CEREBRAL VEINS AND SINUSES - A DIAGNOSTIC PITFALL

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Alexandra J. Tzoukeva

2012-12-01

Full Text Available Thrombosis of the cerebral veins and sinuses is an infrequent cerebrovascular disorder. Because the highly variable symptoms, recent neuroimaging plays a key role in the diagnosis. Abducens nerve palsy as a focal neurological deficit is a rare clinical manifestation in these patients. We present two cases with sudden onset of diplopia and headache. Case 1: A 3-year old girl with B cell lymphoblastic leukemia developed bilateral abducens deficit and bilateral optic disc edema after treatment including L-asparaginase. Thrombosis of the right jugular vein, sagittal and right sigmoid sinuses was visualized on magnetic resonance imaging (MRI and magnetic resonance venography (MRV. Symptoms gradually resolved after treatment with enoxiparine and MRV demonstrated recanalization.Case 2: A 75-year old female with medical history of arterial hypertension presented with headache and sudden left abduction deficit. Computerized tomography (CT scan was normal. MRI and MRV revealed aging brain and disruption of venous flow at the left internal jugular vein, suspecting thrombosis. Extracranial colour duplex sonography and CT angiography proved haemodinamic equivalent of left internal jugular vein thrombosis due to sclerotic pathology of aortic arch.Our first case illustrates the role of improved neuroimaging techniques as the best method for diagnosis of cerebral veins and sinuses thrombosis, presenting with abducens nerve palsy. With second case the potential neuroimaging pitfalls concerning the accurate diagnosis of these cerebrovascular disorders with neuro-ophthalmologic manifestation are discussed.

Literature Survey Concerning the Feasibility of Remedial Leach for Select Phase I Caverns

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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 .

Sinus Surgery

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... sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected ... altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image ...

The value of paramagnetic contrast agent gadolinium-DTPA in the diagnosis of pituitary adenomas

International Nuclear Information System (INIS)

Nakamura, T.; Schoerner, W.; Bittner, R.C.; Felix, R.

1988-01-01

The purpose of this study was to assess the role of MR imaging and the paramagnetic contrast agent Gadolinium-DYPA(Gd-DTPA) in the diagnosis of pituitary macroadenomas. 44 macroadenomas were examined with MRI before and after intravenous application of Gd-DTPA. Gd-DTPA produced excellent enhancement of solid adenoma. The best contrast between adenoma and surrounding structures could be gained on post-Gd T1-weighted images. Post-Gd images were equivalent to pre-Gd images in the evaluation of supra- and infrasellar extensions of macroadenomas. Post-Gd images had advantages in the evaluation of cavernous sinus invasion by adenoma. The difference in degree of contrast enhancement between adenoma and cavernous sinus facilitated the exact evaluation of lateral extension by adenoma in 18 cases. Almost equal degree of enhancement of both structures impaired tumor-sinus contrast in 2 cases. In the other 24 cases the tumor filled the cavernous sinus completely. It is our opinion that Gd-DTPA can be used on a widerspread basis because of its excellent capability to highlight and delineate pituitary adenomas. (orig.)

Mathematical model of salt cavern leaching for gas storage in high-insoluble salt formations.

Science.gov (United States)

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

2018-01-10

A mathematical model is established to predict the salt cavern development during leaching in high-insoluble salt formations. The salt-brine mass transfer rate is introduced, and the effects of the insoluble sediments on the development of the cavern are included. Considering the salt mass conservation in the cavern, the couple equations of the cavern shape, brine concentration and brine velocity are derived. According to the falling and accumulating rules of the insoluble particles, the governing equations of the insoluble sediments are deduced. A computer program using VC++ language is developed to obtain the numerical solution of these equations. To verify the proposed model, the leaching processes of two salt caverns of Jintan underground gas storage are simulated by the program, using the actual geological and technological parameters. The same simulation is performed by the current mainstream leaching software in China. The simulation results of the two programs are compared with the available field data. It shows that the proposed software is more accurate on the shape prediction of the cavern bottom and roof, which demonstrates the reliability and applicability of the model.

Correlation between presumed sinusitis-induced pain and paranasal sinus computed tomographic findings.

Science.gov (United States)

Mudgil, Shikha P; Wise, Scott W; Hopper, Kenneth D; Kasales, Claudia J; Mauger, David; Fornadley, John A

2002-02-01

The correlation between facial and/or head pain in patients clinically suspected of having sinusitis and actual localized findings on sinus computed tomographic (CT) imaging are poorly understood. To prospectively evaluate the relationship of paranasal sinus pain symptoms with CT imaging. Two hundred consecutive patients referred by otolaryngologists and internists for CT of the paranasal sinuses participated by completing a questionnaire immediately before undergoing CT. Three radiologists blinded to the patients' responses scored the degree of air/fluid level, mucosal thickening, bony reaction, and mucus retention cysts using a graded scale of severity (0 to 3 points). The osteomeatal complexes and nasolacrimal ducts were also evaluated for patency. Bivariate analysis was performed to evaluate the relationship between patients' localized symptoms and CT findings in the respective sinus. One hundred sixty-three patients (82%) reported having some form of facial pain or headache. The right temple/forehead was the most frequently reported region of maximal pain. On CT imaging the maxillary sinus was the most frequently involved sinus. Bivariate analysis failed to show any relationship between patient symptoms and findings on CT. Patients with a normal CT reported a mean 5.88 sites of facial or head pain versus 5.45 sites for patients with an abnormal CT. Patient-based responses of sinonasal pain symptoms fail to correlate with findings in the respective sinuses. CT should therefore be reserved for delineating the anatomy and degree of sinus disease before surgical intervention.

Anatomical Variation of the Maxillary Sinus in Cone Beam Computed Tomography

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Marcelo Lupion Poleti

2014-01-01

Full Text Available Purpose. The aim of this paper is to report a case in which the cone beam computed tomography (CBCT was important for the confirmation of the presence of maxillary sinus septum and, therefore, the absence of a suspected pathologic process. Case Description. A 27-year-old male patient was referred for the assessment of a panoramic radiograph displaying a radiolucent area with radiopaque border located in the apical region of the left upper premolars. The provisional diagnosis was either anatomical variation of the maxillary sinuses or a bony lesion. Conclusion. The CBCT was important for an accurate assessment and further confirmation of the presence of maxillary septum, avoiding unnecessary surgical explorations.

Pitx2 confers left morphological, molecular, and functional identity to the sinus venosus myocardium

Czech Academy of Sciences Publication Activity Database

Ammirabile, G.; Tessari, A.; Pignataro, V.; Szumska, D.; Sardo, F.S.; Beneš Jr., Jiří; Balistreri, M.; Bhattacharya, S.; Sedmera, David; Campione, M.

2012-01-01

Roč. 93, č. 2 (2012), s. 291-301 ISSN 0008-6363 R&D Projects: GA ČR(CZ) GA304/08/0615 Institutional research plan: CEZ:AV0Z50110509 Keywords : Pitx2 * sinus venosus myocardium * optical mapping * mouse cardiac development Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 5.940, year: 2012

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.

A Direct Carotid-Cavernous Fistula due to Penetrating Trauma by a Knitting Needle to the Temporal Region

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Selcuk Gocmen

2012-08-01

Full Text Available Traumatic carotid-cavernous and #64257;stulas (CCF usually occur after closed head injuries. In addition, CCFs can also be caused by penetrating injuries with stab or gunshot injuries. We present the case of traumatic CCF that was caused with a knitting needle directly penetrating through the temporal region. A 46-year-old man consulted with a progressive left swollen eye. His head computed tomography (CT revealed a left temporal lobe contusion and fracture of the left temporal bone. Digital subtraction angiography (DSA showed a direct high-flow fistula (Type-A lesion. After the balloon occlusion test, which was well tolerated by the patient, the internal carotid artery was occluded by the interventional radiologist. A review of the literature demonstrated that all of the traumatic CCFs occurred due to penetrating stab injuries through the orbita. To our knowledge, such a case has not been previously reported. [Arch Clin Exp Surg 2012; 1(4.000: 261-264

Frontal sinus osteoma with pneumocephalus: A rare cause of progressive hemiparesis

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Ashwini Bakde Umredkar

2017-01-01

Full Text Available Osteomas of paranasal sinuses are common benign tumors and are diagnosed incidentally. However, osteomas complicated by pneumocephalus with air fluid level presenting with progressive hemiparesis is rare. Here, we present a case report of a 22-year-old male who presented with left-sided progressive hemiparesis with history of generalized headache since 2 years.

Acute presentation of solitary spinal epidural cavernous angioma in a child

International Nuclear Information System (INIS)

Khalatbari, M.R.; Moharamzad, Y.; Hamidi, M.

2013-01-01

Solitary spinal epidural cavernous angiomas are rare lesions, especially in paediatric age group. They are infrequently considered in the differential diagnosis of spinal epidural masses in children. We report a case of solitary epidural cavernous angioma of the thoracic spine in a child presenting with acute onset of back pain and myelopathy. Magnetic resonance imaging of the thoracic spine demonstrated a posterior epidural mass at T6-T8 levels with compression of the spinal cord. Using microsurgical technique and bipolar coagulation, total excision of the lesion was achieved. Histopathological examination confirmed the diagnosis of cavernous angioma. At the five-year follow-up, there was no recurrence of the tumour. (author)

Research progress in hepatic cavernous hemangiomas: a comprehensive review with graphics

International Nuclear Information System (INIS)

Ouyang Yong; Zhang Xuejun; Ouyang Xuehui; Chao Lumeng

2012-01-01

The common benign tumor of the liver, cavernous hemangioma, has already been confirmed, both embryologically and pathologically, to be not a neoplasm, but a congenital vascular malformation of the liver which is resulted from the arrested development of hepatic sinusoids at embryologic stage. This paper aims to make a comprehensive description of the cavernous hemangiomas of the liver, including the lesion's blood supply, the hemodynamics, the imaging features, the classification and its interventional therapy. The relevant example illustrations, figures and graphics are accompanied with the text in order to provide the readers with an complete and up-to-date understanding of the hepatic cavernous hemangiomas. (authors)

[The staphylococcal enterotoxin burden determines the ultrastructure of ciliated epithelia and inflammatory changes in maxillary sinus mucosa of rabbits].

Science.gov (United States)

Wei, Hongqi; Zhu, Zhengwen; Cao, Zhongsheng; Liu, Zhiyong; Wu, Xiaofan; Yuan, Hui

2014-12-01

To investigate the ultrastructure of ciliated epithelia and inflammatory changes upon repeated exposure to staphylococcal enterotoxin A (SEA) of different concentrations in the maxillary sinus mucosa of rabbits. The rabbits were randomly divided into 2 groups (24 rabbits per group): low-dose SEA group and high-dose SEA group. The low-dose SEA group and high-dose SEA group received daily injections of 0.6 ng of SEA (2 ml) and 60 ng of SEA (2 ml) into the left maxillary sinus of rabbits for 28 days, respectively. Concurrent treatment of the right maxillary sinus with normal saline was used as control. Six rabbits chosen randomly in two groups were examined by computed tomography (CT) scans and then sacrificed to obtain the sinus mucosa from the two-side of maxillary sinuses for histological assessment on days 3, 7, 14 and 28. To characterize the inflammatory changes of the sinus mucosa examined using light microscope, hematoxylin and eosin (HE) and toluidine blue staining was performed. Scanning and transmission electron microscopy were performed to observe ultrastructure of ciliated epithelia in the maxillary sinus mucosa. SPSS 13.0 software was used to analyze the data. On days 14 and 28, CT images showed opacification of the left maxillary sinus in the high-dose SEA group. The percentage of epithelial disruption was (22.73 ± 5.72) % and (30.79 ± 4.30)% in the high-dose SEA group respectively, and were significantly greater than those in the low-dose SEA group (5.12% ± 1.98% and 5.38% ± 1.64%, q value was 10.079 and 19.132) and control group (4.08% ± 1.29% and 4.81% ± 1.62%, q value was 11.016 and 19.592, respectively, all P microscope, loss of cilia was observed, a few compound cilia and cytoplasmic protrusion were found, an obvious stretching of the endoplasmic reticulum and an obvious turgescence of the mitochondria was also observed. However, in the low-dose SEA group on days 14 and 28, CT scan of the left maxillary sinus showed transparency; light

The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula

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David B. Kamadjaja

2008-09-01

Full Text Available Background: Oroantral communication (OAC is one of the possible complications after extraction of the upper teeth. If not identified and treated properly, a large OAC may develop into oroantral fistula (OAF which means that there is a permanent epithelium-lined communication between antrum and oral cavity. Such fistulas may cause ingress of microorganism from oral cavity into the antrum leading to maxillary sinusitis. Oroantral fistula usually persists if the infection in the maxillary antrum is not eliminated. Therefore, treatment of oroantral fistula should include management of maxillary sinusitis in which surgical closure of oroantral fistula should be done only when the sinusitis has been cured. Purpose: This case report emphasizes on the importance of proper management of maxillary sinusitis in the healing of oroantral fistula. Case: A case of an oroantral fistula following removal of upper left third molar is presented. As the maxillary sinusitis was not identified pre-operatively, two surgical procedures to close the fistula had ended up in dehiscence. Case management: The diagnosis of maxillary sinusitis was finally made and the sinusitis subsequently treated with combination of trans-alveolar sinus wash out, insertion of an acrylic splint, and two series of nasal and sinus physiotherapy procedures. The size of the defect decreased gradually during the treatment of the sinusitis and finally closed up without any further surgical intervention. Conclusion: This case report points out that it is important to detect intraoperatively an antral perforation after any surgery of the maxillary teeth and to close any oroantral communication as early as possible and that it is important to treat properly any pre-existing maxillary sinusitis before any surgical method is done to close the fistula.

Assessment of maxillary sinus wall thickness with paranasal sinus digital tomosynthesis and CT

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Byun, Ji Eun; Shim, Sung Shine; Kim, Yoo Kyung; Kong, Kyoung Ae [Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2017-05-15

This study was performed to compare paranasal sinus tomosynthesis with computed tomography (CT) imaging as a radiologic tool to evaluate the paranasal sinuses, using measurement of the soft tissue thickness of the maxillary sinus. A total of 114 patients with sinusitis who underwent both paranasal sinus digital tomosynthesis (DT) and CT were enrolled in this retrospective study. Two observers independently assessed soft tissue thickness in both maxillary sinus chambers using both DT and CT images. The mean difference in soft tissue thickness measured by each observer was −0.31 mm on CT and 0.15 mm on DT. The mean differences in soft tissue thickness measured with DT and CT were −0.15 by observer 1 and −0.31 by observer 2. Evaluation of the agreement in measurement of soft tissue thickness in the maxillary sinus using DT and CT showed a high intraclass correlation, with the 95% limit of agreement ranging from −3.36 mm to 3.06 mm [intraclass correlation coefficient (ICC), 0.994: p<0.01] for observer 1 and from −5.56 mm to 4.95 mm (ICC, 0.984: p<0.01) for observer 2. As an imaging tool, DT is comparable to CT for assessing the soft tissue thickness of maxillary sinuses in patients with sinusitis.

Clinical consideration of fungal paranasal sinusitis

International Nuclear Information System (INIS)

Okuni, Tsuyoshi; Asakura, Koji; Homma, Tomo; Kawaguchi, Ryuichi; Ishikawa, Tadataka; Yamazaki, Norikazu; Himi, Tetsuo

2008-01-01

Fungal paranasal sinusitis is included in the differential diagnosis of unilateral paranasal lesion. Recently the incidence of fungal paranasal sinusitis has been increasing. We reviewed 24 patients (9 males and 15 females) with fungal paranasal sinusitis treated at Muroran City Hospital between January 2001 and May 2006, and clinical presentation and CT findings with those of 56 patients (36 males and 20 females) with chronic unilateral sinusitis. Fungal sinusitis patients ranged in age from 45 to 87, and the average age was 65.9 years old. In contrast, the age of chronic sinusitis patients ranged from 24 to 83, and the average age was 54.4 years old. The chief complaint of both fungal sinusitis and chronic sinusitis included rhinorrhea, nasal obstruction and post nasal discharge. CT exam was performed in all patients. In 23 cases of paranasal fungal sinusitis and 54 cases of chronic sinusitis the findings involved the maxillary sinus. The most common observation (69.6%) was bone density within the affected sinus in fungal sinusitis. However, only 2 cases of chronic sinusitis (3.9%) showed calcification. All cases of fungal sinusitis were diagnosed by pathological examinations. Most cases were proved to be aspergillus, while only one case was mucor. We treated all cases surgically, 18 cases underwent Caldwell-Luc's procedure and 5 cases underwent endoscopic sinus surgery under local anesthesia. (author)

How does nose blowing effect the computed tomography of paranasal sinuses in chronic sinusitis?

International Nuclear Information System (INIS)

Savranlar, Ahmet; Uzun, Lokman; Ugur, Mehmet Birol; Mahmutyazicioglu, Kamran; Ozer, Tulay; Gundogdu, Sadi

2005-01-01

Objective: Our aim was to determine whether inward or outward movement of the secretions in the paranasal sinuses due to nose blowing after nasal decongestion has any effect on the paranasal sinus computed tomography (CT) images in patients with sinusitis and to asses whether nose blowing may result in misdiagnosis or overdiagnosis in radiological evaluation of sinusitis. Materials and methods: Twenty-four patients with chronic sinusitis were evaluated in an academic tertiary care hospital and data were collected prospectively. After coronal sinus computed tomography scans were performed at 100 mA setting which was half the value of the standard radiation dose suggested by the manufacturer, topical decongestion was applied to each nostril followed by nose blowing 10 min later. Sinus CT scans were then repeated at the same setting. We evaluated the mucosal thickness of medial, lateral, superior and inferior maxillary and frontal sinus walls and the maximal thickness in anterior ethmoidal cells. The measurements prior to and following nose blowing were compared with Wilcoxon signed ranks test. The obtained images were also staged using Lund-McKay staging system separately and the scores were compared with Student's t-test. Results: We observed a tendency towards reduction in mucosal thickness after nose blowing. There were statistically significant differences between maxillary sinus inferior wall and frontal sinus inferior wall mucosal thickness values prior to and after nose blowing. The difference however was very small, about 0.5 mm in magnitude and Lund-McKay score did not change in any of the patients after nose blowing. Conclusion: Nose blowing and topical nasal decongestion does not have any effect on the diagnostic accuracy of sinus CT in chronic sinusitis patients

Anomalous Coronary Artery From the Opposite Sinus (ACAOS): Technical Challenges During Percutaneous Coronary Intervention.

Science.gov (United States)

Sinha, Santosh Kumar; Razi, Mahmodula; Mahrotra, Anupam; Aggarwal, Puneet; Singh, Anupam; Rekwal, Lokendra; Tripathi, Sunil; Abhishekh, Nishant Kumar; Krishna, Vinay

2018-04-01

Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Ectopic origin of right coronary artery (RCA) from opposite sinus is one of the most common and they are mainly benign, but at times may be malignant. We report a case of a 69-year-old male who underwent early invasive percutaneous coronary intervention for non-ST-segment elevation myocardial infarction (NSTEMI) where RCA arising from left sinus at the root of left main artery was culprit and various technical challenges were encountered while intervening in form of cannulation to tracking of hardwares. RCA was cannulated with floating wire technique using hockey stick guide catheter and revascularized by deployment of 3.5 × 38 mm Promus Premier Everolimus eluting stent (Boston Scientific, USA). To the best of our knowledge, this is the first ever report of ectopic RCA being revascularized by using hockey stick catheter.

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... diagnose sinusitis . evaluate sinuses that are filled with fluid or thickened sinus membranes . detect the presence of ... other in a ring, called a gantry. The computer workstation that processes the imaging information is located ...

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... CT of the sinuses is primarily used to: help diagnose sinusitis . evaluate sinuses that are filled with ... elevated. Straps and pillows may be used to help the patient maintain the correct position and to ...

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... about tumors of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page ... for sinusitis. CT of the sinuses can help plan the safest and most effective surgery. CT of ...

Cone-Beam Computed Tomography Analysis of Mucosal Thickening in Unilateral Cleft Lip and Palate Maxillary Sinuses.

Science.gov (United States)

Kula, Katherine; Hale, Lindsay N; Ghoneima, Ahmed; Tholpady, Sunil; Starbuck, John M

2016-11-01

  To compare maxillary mucosal thickening and sinus volumes of unilateral cleft lip and palate subjects (UCLP) with noncleft (nonCLP) controls.   Randomized, retrospective study of cone-beam computed tomographs (CBCT).   University.   Fifteen UCLP subjects and 15 sex- and age-matched non-CLP controls, aged 8 to 14 years.   Following institutional review board approval and reliability tests, Dolphin three-dimensional imaging software was used to segment and slice maxillary sinuses on randomly selected CBCTs. The surface area (SA) of bony sinus and airspace on all sinus slices was determined using Dolphin and multiplied by slice thickness (0.4 mm) to calculate volume. Mucosal thickening was the difference between bony sinus and airspace volumes. The number of slices with bony sinus and airspace outlines was totaled. Right and left sinus values for each group were pooled (t tests, P > .05; n = 30 each group). All measures were compared (principal components analysis, multivariate analysis of variance, analysis of variance) by group and age (P ≤ .016 was considered significant).   Principal components analysis axis 1 and 2 explained 89.6% of sample variance. Principal components analysis showed complete separation based on the sample on axis 1 only. Age groups showed some separation on axis 2. Unilateral cleft lip and palate subjects had significantly smaller bony sinus and airspace volumes, fewer bony and airspace slices, and greater mucosal thickening and percentage mucosal thickening when compared with controls. Older subjects had significantly greater bony sinus and airspace volumes than younger subjects.   Children with UCLP have significantly more maxillary sinus mucosal thickening and smaller sinuses than controls.

Radiodense concrements in sinus maxillaris-CT diagnosis of sinus aspergillosis

International Nuclear Information System (INIS)

Krennmair, G.; Lugmayr, H.; Lenglinger, F.

1993-01-01

11 patients with radiodense concrements in the sinus maxillaris underwent a preoperative computertomographic examination of the sinus maxillaris and the sinus concrements. 8 patients (72.7%) with the occurrence of radiodense concrements presented postoperative a histological and microbiological infection with aspergillus fumigatus. The CT-numbers of radiodense concrements in patients with aspergillus were 2802±302.4 HU (Hounsfield Unit). Concrements of patients without aspergillus infection (n=3) had lower density (368.6±149.1 HU; p [de

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face ... paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the ...

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.

海绵窦内海绵状血管瘤

Institute of Scientific and Technical Information of China (English)

史继新; 王汉东; 杭春华; 潘云曦; 刘承基; 张祖喧

1999-01-01

Extra-axial cavemous hemangiomas are rare lesions and have a propensity to occur within the cavernous sinus. Clinical presentations of cavernous hemangiomas include headache and cranial nerve deficits. As the tumors grow, the internal carotid artery(ICA) and cranial

Maxillary Sinus Floor Augmentation

DEFF Research Database (Denmark)

Starch-Jensen, Thomas; Jensen, Janek Dalsgaard

2017-01-01

, radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without...

Epstein-Barr virus associated central nervous system leiomyosarcoma occurring after renal transplantation: case report and review of the literature

International Nuclear Information System (INIS)

Tahri, A.; Noel, G.; Feuvret, L.; Jauffret, E.; Brun, B.; Mazeron, J.J.; Baillet, F.; Noel, G.; Mazeron, J.J.; Feuvret, L.; Figuerella-Branger, D.; Goncalves, A.

2003-01-01

Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immuno-deficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the onco-genesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed. (authors)

Epstein-Barr virus associated central nervous system leiomyosarcoma occurring after renal transplantation: case report and review of the literature; Leiomyosarcome primitif du systeme nerveux central associe au virus d'Epstein-Barr (EBV) et survenu apres transplantation renale: a propos d'un cas et revue de la litterature

Energy Technology Data Exchange (ETDEWEB)

Tahri, A.; Noel, G.; Feuvret, L.; Jauffret, E.; Brun, B.; Mazeron, J.J.; Baillet, F. [Centre des Tumeurs, Groupe Hospitalier Universitaire Pitie-Salpetriere, 75 - Paris (France); Feuvret, L. [Centre de Protontherapie d' Orsay, 91 (France); Figuerella-Branger, D. [Hopital de la Timone, Service d' Anatomopathologie, 13 - Marseille (France); Goncalves, A. [Institut Paoli-Calmettes, Service d' Oncologie Medicale, 13 - Marseille (France)

2003-10-01

Central nervous system leiomyosarcomas are extremely rare, however, they became more frequent among immuno-deficient patients, either in a patients infected with human immunodeficiency virus (HIV), or after organ transplantation. The data of the literature indicate that the infection by Epstein-Barr virus (EBV) plays a causal role in the development of these tumours but its precise role in the onco-genesis remains unresolved. We report a new case of EBV associated leiomyosarcoma of the left cavernous sinus occurring after renal transplantation. The epidemiological, clinical, pathological and therapeutic characteristics of these tumours are discussed. (authors)

How does nose blowing effect the computed tomography of paranasal sinuses in chronic sinusitis?

Energy Technology Data Exchange (ETDEWEB)

Savranlar, Ahmet; Uzun, Lokman; Ugur, Mehmet Birol; Mahmutyazicioglu, Kamran; Ozer, Tulay; Gundogdu, Sadi

2005-02-01

Objective: Our aim was to determine whether inward or outward movement of the secretions in the paranasal sinuses due to nose blowing after nasal decongestion has any effect on the paranasal sinus computed tomography (CT) images in patients with sinusitis and to asses whether nose blowing may result in misdiagnosis or overdiagnosis in radiological evaluation of sinusitis. Materials and methods: Twenty-four patients with chronic sinusitis were evaluated in an academic tertiary care hospital and data were collected prospectively. After coronal sinus computed tomography scans were performed at 100 mA setting which was half the value of the standard radiation dose suggested by the manufacturer, topical decongestion was applied to each nostril followed by nose blowing 10 min later. Sinus CT scans were then repeated at the same setting. We evaluated the mucosal thickness of medial, lateral, superior and inferior maxillary and frontal sinus walls and the maximal thickness in anterior ethmoidal cells. The measurements prior to and following nose blowing were compared with Wilcoxon signed ranks test. The obtained images were also staged using Lund-McKay staging system separately and the scores were compared with Student's t-test. Results: We observed a tendency towards reduction in mucosal thickness after nose blowing. There were statistically significant differences between maxillary sinus inferior wall and frontal sinus inferior wall mucosal thickness values prior to and after nose blowing. The difference however was very small, about 0.5 mm in magnitude and Lund-McKay score did not change in any of the patients after nose blowing. Conclusion: Nose blowing and topical nasal decongestion does not have any effect on the diagnostic accuracy of sinus CT in chronic sinusitis patients.

RIght VErsus Left Apical transvenous pacing for bradycardia: Results of the RIVELA randomized study

Directory of Open Access Journals (Sweden)

Haran Burri

2017-11-01

Full Text Available Aims: To compare cardiac function when pacing from the right or left ventricular apex in patients with preserved left ventricular systolic function, at 1-year follow-up. Methods: Prospective, multicentre centre randomizing conventional right ventricular apical (RVA versus left ventricular apical (LVA pacing using a coronary sinus lead in patients requiring ventricular pacing for bradycardia. Follow-up was performed using 3D-echocardiography at 6 and 12 months. Results: A total of 36 patients (age 75.4 ± 8.7 years, 21 males were enrolled (17 patients in the RVA group and 19 patients in the LVA group. A right ventricular lead was implanted in 8 patients in the LVA group, mainly because of high capture thresholds. There were no differences in the primary endpoint of LVEF at 1 year (60.4 ± 7.1% vs 62.1 ± 7.2% for the RVA and LVA groups respectively, P = 0.26 nor in any of the secondary endpoints (left ventricular dimensions, left ventricular diastolic function, right ventricular systolic function and tricuspid/mitral insufficiency. LVEF did not change significantly over follow-up in either group. Capture thresholds were significantly higher in the LVA group, and two patients had unexpected loss of capture of the coronary sinus lead during follow-up. Conclusions: Left univentricular pacing seems to be comparable to conventional RVA pacing in terms of ventricular function at up to 1 year follow-up, and is an option to consider in selected patients (e.g. those with a tricuspid valve prosthesis. Keywords: Ventricular pacing, Right ventricle, Left ventricle, Coronary sinus, Ventricular function

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".

A structural behavior study of rock caverns considering the effects of discontinuities

International Nuclear Information System (INIS)

Kim, Jhin Wung; Kim, Sun Hoon; Seo, Jeong Moon; Choi, Kyu Seop; Kim, Dae Hong; Lee, Kyung Jin; Choi, In Gil; Lee, Dong Yong

1990-06-01

The objective of this study is to understand the effects of discontinuities within rock masses on the structural behavior of underground rock caverns for radioactive waste disposal, and then develop a computer program for the structural analysis of rock caverns considering these effect of discontinuities. The behavior of rock masses, such as strength, deformation modes, ect., is very difficult to predict because discontinuities in the form of microcracks or joints are randomly distributed within rock masses. Discontinuties existing around the rock cavern for underground radioactive waste disposal may become the main transport pathways of radionuclides, and reduce the strength of rock masses eventually causing the rock cavern structure unstable. Therefore, a comprehensive understanding of the mechanical properties and behavior of discontinuous rock masses and an improvement of structural analysis methods are essential in order to understand the behavior of underground rock cavern structures properly in order to design safe and economic understanding the behavior of discontinuous rock masses is essential. Therfore, this study includes literature review on mechanical properties of and computational models for discontinuous rock masses, and on structures. Then, bases on the engineering judgement a suitable selection and slight modifications on computational models and analysis methods have been made before developing the structural analysis computer program for underground radioactive waste disposal structures. (author)

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...

Familial cerebral cavernous haemangioma diagnosed in an infant with a rapidly growing cerebral lesion

International Nuclear Information System (INIS)

Ng, B.H.K.; Pereira, J.K.; Ghedia, S.; Pinner, J.; Mowat, D.; Vonau, M.

2006-01-01

Cavernous haemangiomas of the central nervous system are vascular malformations best imaged by MRI. They may present at any age, but to our knowledge only 39 cases in the first year of life have previously been reported. A familial form has been described and some of the underlying genetic mutations have recently been discovered. We present the clinical features and serial MRI findings of an 8-week-old boy who presented with subacute intracranial haemorrhage followed by rapid growth of a surgically proven cavernous haemangioma, mimicking a tumour. He also developed new lesions. A strong family history of neurological disease was elucidated. A familial form of cavernous haemangioma was confirmed by identification of a KRIT 1 gene mutation and cavernous haemangiomas in the patient and other family members. We stress the importance of considering cavernous haemangiomas in the context of intracerebral haemorrhage and in the differential diagnosis of rapidly growing lesions in this age group. The family history is also important in screening for familial disease

Use of Frontal Sinus and Nasal Septum Pattern as an Aid in Personal Identification and Determination of Gender: A Radiographic Study.

Science.gov (United States)

Verma, Kavita; Nahar, Prashant; Singh, Mohit Pal; Mathur, Hemant; Bhuvaneshwari, S

2017-01-01

Personal identification and gender determination of unknown person has a vital importance in forensic investigation. Human skull radiography is a useful tool in human identification in natural disaster, in any accidents such as fire accident and road traffic accident where body remains become degraded or severely destroyed. Present study was performed to evaluate the measurement of frontal sinus, uniqueness of various pattern of nasal septum when combined with frontal sinus observed on posterio anterior cephalogram for sex determination as well as personal identification. A total of 80 individuals, 40 males and 40 females, between the age ranges of 18-30 years were selected. The selected individuals had their Posterio Anterior (PA) cephalogram performed after taking their informed consent. Right and left areas and the maximum height and width of the frontal sinus were determined and septum patterns were evaluated and both patterns were also combined and compared. The radiographs were taken on Xtropan 2000 OPG X-ray machine with cephalography attachment and KODAK CR 7400 digital radiography system. Mean and SD values of the greatest height and width of frontal sinus in male and female patients were thus evaluated. The mean values of the frontal sinus were greater in males and the left area was larger than the right area, based on student's t-test at the 5% level of significance. The combination of Frontal Sinus Patterns and Nasal Septum Patterns (FP+NSP) were assessed and found that there were nine classifiable patterns in 26 (32.5%) individuals (12 males and 14 females), each of which had common representations in more than one individual. Besides these patterns, there were unique unclassifiable patterns in 54 (67.5%) individuals. The present study supports the use of radiographic evaluation of frontal sinus dimensions, frontal sinus patterns, nasal septum deviations and the combination FP+NSP patterns for personal identification and gender determination in

Direct-puncture approach to the extraconal portion of the superior ophthalmic vein for carotid cavernous fistulae

International Nuclear Information System (INIS)

Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K.; Kan, S.

2009-01-01

The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)

Evaluation of the factors predicting the outcome of transsphenoidal microsurgery in patients with premenopausal microprolactinoma

International Nuclear Information System (INIS)

Tsugu, Hitoshi; Emoto, Makoto; Oshiro, Shinya; Komatsu, Fuminari; Sakamoto, Seisaburo; Ohta, Mika; Fukushima, Takeo

2008-01-01

Although cabergoline is an effective first-line treatment for prolactinoma, transsphenoidal microsurgery remains useful for the treatment of microprolactinoma. We investigated the factors that predict the outcome of transsphenoidal microsurgery and also evaluated indications for this method in patients with prolactinoma. We reviewed the cases of 21 premenopausal patients with prolactinoma, who had undergone magnetic resonance imaging (MRI). The clinical characteristics, preoperative prolactin level, adenoma size, MIB-1 labeling index, and cavernous sinus invasion were evaluated. Cavernous sinus invasion was graded according to Knosp's MRI classification. The preoperative prolactin level (P=0.0268) and grade of cavernous sinus invasion (P=0.0284) were statistically significant predictors of a surgical cure for patients with prolactinoma. As a result, transsphenoidal microsurgery is considered to be an effective therapy for appropriately selected premenopausal patients with prolactinoma. We believe that patients with either low Knosp's grade (0 or 1) and/or a preoperative prolactin level of <100 ng/ml would benefit most from transsphenoidal microsurgery as a first-line treatment. (author)

Trigeminofacial reflex: a means of detecting proximity to ophthalmic and maxillary divisions of the trigeminal nerve during surgery.

Science.gov (United States)

AlMasri, Omar A; Brown, Emma E; Forster, Alan; Kamel, Mahmoud H

2014-11-01

The aim in this paper was to localize and detect incipient damage to the ophthalmic and maxillary branches of the trigeminal nerve during tumor surgery. This was an observational study of patients with skull base, retroorbital, or cavernous sinus tumors warranting dissection toward the cavernous sinus at a university hospital. Stimuli were applied as normal during approach to the cavernous sinus to localize cranial nerves (CNs) III, IV, and VI. Recordings were also obtained from the facial muscles to localize CN VII. The trigeminofacial reflex was sought simply by observing a longer time base routinely. Clear facial electromyography responses were reproduced when stimuli were applied to the region of V1, V2, and V3. Response latency was increased compared with direct CN VII stimuli seen in some cases. Responses gave early warning of approach to these sensory trigeminal branches. The authors submit this as a new technique, which may improve the chances of preserving trigeminal sensory branches during surgery in this region.

[Improved methods for researching isolated carotid sinus baroreceptors automatically controlling for sinus pressure].

Science.gov (United States)

Wei, Hua; Zhao, Hai-Yan; Liu, Ping; Huang, Hai-Xia; Wang, Wei; Fu, Xiao-Suo; Niu, Wei-Zhen

2013-01-01

To develop a system for automatically controlling carotid sinus pressure in the study on baroreceptors. The preparation containing carotid sinus with parts of the connected vessels and carotid sinus nerve (CS-CSN) were isolated and perfused. A critical pressure controlling component (PRE-U, Hoerbiger, Deutschland) dictated by a computer was integrated into the system to clamp the intrasinus pressure. The pressure command and the relevant intrasinus pressure were compared to evaluate the validity of the pressure controlling system. A variety of sinus pressure-controlling patterns, including pulsation, ramp and step pressures, could be achieved accurately by using the system, and the pressure-dependent discharge activities of sinus nerve were confirmed. This system for clamping carotid sinus pressure could realize multiple pressure-controlling patterns and is a useful and flexible pressure controlling method that could applied in the study on mechano-electric transduction of baroreceptors.

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.

Absence of pulmonary aspiration of sinus contents in patients with asthma and sinusitis

International Nuclear Information System (INIS)

Bardin, P.G.; Van Heerden, B.B.; Joubert, J.R.

1990-01-01

The frequent association of asthma and paranasal sinusitis has been ascribed to a nasobronchial reflex, aspiration of sinus secretions, or enhanced beta-adrenergic blockade. We investigated possible pulmonary aspiration in a pilot study (eight patients) and follow-up study (13 patients) by means of a radionuclide technique. In the pilot study, the aim was to demonstrate aspiration as well as visibility of the radionuclide in the thorax during a period of 24 hours. The radionuclide was initially placed bronchoscopically in the bronchial tree in four patients and was still clearly visible in the same position after 24 hours in three patients. Aspiration from the nasopharynx was unequivocally demonstrated in two of four patients with depressed consciousness. The follow-up study population consisted of four patients with maxillary sinusitis only and nine patients with sinusitis and asthma. The radionuclide was placed in a maxillary sinus during therapeutic puncture. In the patients with only sinusitis as well as patients with asthma and sinusitis the radionuclide could be demonstrated in the maxillary sinus, nasopharynx, esophagus, and lower gastrointestinal tract during a 24-hour period. However, no pulmonary aspiration of radionuclide could be demonstrated in any patient. We conclude that seeding of the lower airways by mucopurulent secretions is unlikely to account for coexistent pulmonary disease. The association is probably related to generalized mucosal disease affecting both upper and lower airways

Prevalence of paranasal sinus opacification in infants and children without overt sinusitis using computed tomography

International Nuclear Information System (INIS)

Choi, Pil YouB; Kim, Hyung Jin; Park, Eui Dong; Kim, Jae Hyoung; Chung, Sung Hoon

1994-01-01

To evaluate the prevalence of the opacification of paranasal sinuses and to correlate the prevalence and severity of the sinus opacification with presence of upper respiratory infection (URI) in infants and children using CT. We analyzed CT scans of 162 children aged under 16 who have no signs and symptoms of paranasal sinusitis. Both sides of maxillary and ethmoidal sinuses were evaluated. We scored from 0 to 3 according to the degree of soft tissue opacification of each sinus and then summed up the scores of each sinus. We divided the children into 5 groups according to their age. We paid particular attention to the following respects: 1) the prevalence of the opacification of the paranasal sinuses in each group; 2) the difference in the prevalence between the children with and without URI; 3) the correlation between the severity of the sinus opacification and the presence of URI. Of 162 children, one or more paranasal sinus opacification was noted in 76(47%): 31(65%) less than 1 year old; 11(52%) between 1 and 2 years old; 16(53%) between 2 and 6 years old; 15(28%) between 6 and 12 years old; and 3(33%) above 12 years old. In children less than 1 year old, no significant difference in the prevalence of the sinus opacification was found between URI-positive(71%) and URI-negative(58%) subgroups. In children between 1 and 12 years old, although the prevalence of the sinus opacification in URI-positive subgroups was much greater than that in URI-negative subgroup, statistically significant difference was noted only in children between 2 and 6 years old. As to the correlation between the severity of the sinus opacification and the presence of URI, these was a statistically significant difference in children between 2 and 6 years old and between 6 and 12 years old. Although the exact pathophysiology is not fully understood, the opacification of the paranasal sinuses is not an uncommon finding at CT in children without the signs and symptoms of sinusitis. We thick that

VACUUM THERAPY – PREVENTION OF HYPOXIA OF CAVERNOUS TISSUE PATIENTS AFTER RADICAL PROSTATECTOMY

Directory of Open Access Journals (Sweden)

A. E. Osadchinskii

2018-01-01

Full Text Available Patients, after radical prostatectomy with the use of nerve-sparing techniques, without carrying out penile rehabilitation, are at risk of forming cavernous fibrosis with the emergence of subsequent persistent erectile dysfunction. In order to minimize damage to cavernous tissue and early restoration of erectile function during the period of neuropraxia, it is necessary to ensure a sufficient level of oxygenation. The role of applying vacuum in penile rehabilitation for the prevention of hypoxia of cavernous tissue is not fully understood, due to the lack of data on the gaseous composition of the blood at the time of reaching the vacuum of erection. The purpose of this work was to review the scientific studies devoted to the study of vacuum induced penile erection in animals or humans, which indicates high results due to increased oxygenation of cavernous tissue.

Fracture and Healing of Rock Salt Related to Salt Caverns

International Nuclear Information System (INIS)

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

1999-01-01

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

Laterally situated sinus pericranii

International Nuclear Information System (INIS)

Koshu, K.; Takahashi, S.

1981-01-01

Sinus pericranii has been reported to be situated usually along the midline. Two cases of laterally situated sinus pericranii are presented. Venous blood was obtained by puncturing the tumors directly. Injection of contrast medium into the tumors demonstrated a communication between the tumors and the intracranial venous sinuses through marked diploic veins. (orig.)

Endoanal pilonidal sinus: case report and literature review

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Carolina Talini

2015-07-01

Full Text Available Pilonidal sinus is a term first used by Hodges in 1880 to describe granulomatous lesions containing hairs in its interior. The presence of endoanal pilonidal sinus is rare and only nine cases have been reported in medical literature. This article describes a male, 42 years, initially submitted to fistulotomy with seton placement that four years later evolved with complaints of anal purulent discharge associated with painful anal groin. During the first evaluation a small endoanal tumor was found. It was located in posterolateral anus position and contained hair in its interior, without purulent discharge at that moment. Underwent surgery that confirmed the presence of endoanal pilonidal sinus. The sinus was opened and left to heal by secondary intention. The patient had good outcome with no signs of recurrence. Resumo: O termo cisto pilonidal foi descrito pela primeira vez por Hodges em 1880 para descrever lesões granulomatosas contendo pêlos em seu interior. A presença de cisto pilonidal endoanal é rara e existem apenas nove casos relatados na literatura médica. Descreve-se um caso masculino, 42 anos, em acompanhamento há 5 anos no serviço. Submetido inicialmente à fistulotomia em dois tempos com sedenho, evoluindo 4 anos depois com queixas de secreção purulenta intermitente por via anal associada a presença de tumoração dolorosa. No exame físico constatou-se presença de orifício contendo pêlos em seu interior, sem secreção purulenta no momento do exame. Foi encaminhado para tratamento cirúrgico que confirmou diagnóstico de cisto pilonidal endoanal. No procedimento foi realizada abertura do cisto que foi deixado para cicatrizar por segunda intenção. O paciente apresentou boa evolução, sem sinais de recidiva local. Keywords: Pilonidal sinus, Rectal fistula, Transrectal ultrasound, Palavras-chave: Cisto pilonidal, Fístula anal, Ultrassom endoanal

Associations between inflammatory cells infiltrating the ethmoid sinus mucosa, and nasal polyp size and grade of ethmoid sinus opacification on CT images in chronic sinusitis

International Nuclear Information System (INIS)

Imajima, Naotoshi; Watanabe, So; Furuta, Atsuko; Shimizu, Toshiyuki; Yamada, Naohiro; Mochizuki, Yuichiro; Suzaki, Harumi

2009-01-01

We investigated the types and numbers of inflammatory cells that infiltrated the ethmoid sinus mucosa in cases of chronic sinusitis in order to identify any associations with nasal polyp size and the grade of ethmoid sinus opacification on computer tomography images. The subjects were patients with chronic sinusitis who underwent endoscopic sinus surgery. Seventeen subjects also had bronchial asthma as a complication (six with aspirin-induced asthma, 11 with another form of asthma) and 24 did not have bronchial asthma as a complication (16 with allergic rhinitis, 8 with chronic sinusitis alone). The nasal polyps in the patients with bronchial asthma were significantly larger than those in the patients without bronchial asthma. Investigation of the numbers of infiltrating inflammatory cells according to polyp size revealed significantly more eosinophils as polyp size increased. In addition, infiltration of significantly more mast cells was observed when the polyps were large. Assessment of the grade of opacification of the ethmoid sinuses on computer tomography images showed a significantly higher grade of opacification in the patients with bronchial asthma than in the patients without bronchial asthma. Comparisons between the grade of opacification of the ethmoid sinuses and the number of infiltrating inflammatory cells revealed significantly more infiltrating eosinophils and mast cells in the patients with intense ethmoid sinus opacification. The above findings suggest that eosinophils and mast cells play a major role in forming the persistent inflammation of the sinus mucosa and nasal polyp tissue of patients with chronic sinusitis complicated by bronchial asthma. (author)

Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

Energy Technology Data Exchange (ETDEWEB)

Jalali, Elnaz; Tadinada, Aditya [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States)

2015-03-15

Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

Epicardial Breakthrough Waves During Sinus Rhythm: Depiction of the Arrhythmogenic Substrate?

Science.gov (United States)

Mouws, Elisabeth M J P; Lanters, Eva A H; Teuwen, Christophe P; van der Does, Lisette J M E; Kik, Charles; Knops, Paul; Bekkers, Jos A; Bogers, Ad J J C; de Groot, Natasja M S

2017-09-01

Epicardial breakthrough waves (EBW) during atrial fibrillation are important elements of the arrhythmogenic substrate and result from endo-epicardial asynchrony, which also occurs to some degree during sinus rhythm (SR). We examined the incidence and characteristics of EBW during SR and its possible value in the detection of the arrhythmogenic substrate associated with atrial fibrillation. Intraoperative epicardial mapping (interelectrode distances 2 mm) of the right atrium, Bachmann's bundle, the left atrioventricular groove, and the pulmonary vein area was performed during SR in 381 patients (289 male, 67±10 years) with ischemic or valvular heart disease. EBW were referred to as sinus node breakthrough waves if they were the earliest right atrial activated site. A total of 218 EBW and 57 sinus node breakthrough waves were observed in 168 patients (44%). EBW mostly occurred at right atrium (N=105, 48%) and left atrioventricular groove (N=67, 31%), followed by Bachmann's bundle (N=27, 12%) and pulmonary vein area (N=19, 9%; P <0.001). EBW occurred most often in ischemic heart disease patients (N=114, 49%) compared with (ischemic and) valvular heart disease patients (N=26, 17%; P <0.001). EBW electrograms most often consisted of double and fractionated potentials (N=137, 63%). In case of single potentials, an R wave was observed in 88% (N=71) of EBW, as opposed to 21% of sinus node breakthrough waves (N=5; P <0.001). Fractionated EBW potentials were more often observed at the right atrium and Bachmann's bundle ( P <0.001). During SR, EBW are present in over a third of patients, particularly in thicker parts of the atrial wall. Features of SR EBW indicate that muscular connections between endo- and epicardium underlie EBW and that a slight degree of endo-epicardial asynchrony required for EBW to occur is already present in some areas during SR. Hence, an anatomic substrate is present, which may enhance the occurrence of EBW during atrial fibrillation, thereby

Entire lacrimal sac within the ethmoid sinus: outcomes of powered endoscopic dacryocystorhinostomy

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Ali MJ

2016-07-01

Full Text Available Mohammad Javed Ali, Swati Singh, Milind N NaikInstitute of Dacryology, LV Prasad Eye Institute, Hyderabad, India Background: The aim of this study was to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR in patients with lacrimal sac within the sinus.Materials and methods: Retrospective analysis was performed on all patients who underwent PEnDCR and were intraoperatively documented to have complete lacrimal sac in sinus. Data collected included demographics, clinical presentations, associated lacrimal and nasal anomalies, intraoperative findings, intraoperative guidance, complications, postoperative ostium behavior, and anatomical and functional success. A minimum follow-up of 6 months postsurgery was considered for final analysis.Results: A total of 17 eyes of 15 patients underwent PEnDCR using standard protocols, but with additional intraoperative guidance where required and careful maneuvering in the ethmoid sinus. The mean age of the patients was 37.2 (range 17–60 years. Of the unilateral cases, 69% (nine of 13 showed left-side predisposition; 80% of patients showed regurgitation on pressure over the lacrimal sac area. Associated lacrimal and nasal anomalies were observed in 13.3% (two of 15 and 40% (six of 15, respectively. At a mean follow-up of 6.6 months, anatomical and functional success were observed in 93.3% (14 of 15. One patient showed failure secondary to cicatricial closure of the ostium.Conclusion: An entire sac within an ethmoid sinus poses a surgical challenge. Good sinus-surgery training, thorough knowledge of endoscopic anatomy, careful maneuvering, and use of intraoperative navigation guidance result in good outcomes with PEnDCR.Keywords: lacrimal sac, ethmoid sinus, endoscopic, DCR

Simulation of Mechanical Processes in Gas Storage Caverns for Short-Term Energy Storage

Science.gov (United States)

Böttcher, Norbert; Nagel, Thomas; Kolditz, Olaf

2015-04-01

In recent years, Germany's energy management has started to be transferred from fossil fuels to renewable and sustainable energy carriers. Renewable energy sources such as solar and wind power are subjected by fluctuations, thus the development and extension of energy storage capacities is a priority in German R&D programs. This work is a part of the ANGUS+ Project, funded by the federal ministry of education and research, which investigates the influence of subsurface energy storage on the underground. The utilization of subsurface salt caverns as a long-term storage reservoir for fossil fuels is a common method, since the construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to solution mining. Another advantage of evaporate as host material is the self-healing behaviour of salt rock, thus the cavity can be assumed to be impermeable. In the framework of short-term energy storage (hours to days), caverns can be used as gas storage reservoirs for natural or artificial fuel gases, such as hydrogen, methane, or compressed air, where the operation pressures inside the caverns will fluctuate more frequently. This work investigates the influence of changing operation pressures at high frequencies on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. The salt behaviour is described by well-known constitutive material models which are capable of predicting creep, self-healing, and dilatancy processes. Our simulations include the thermodynamic behaviour of gas storage process, temperature development and distribution on the cavern boundary, the deformation of the cavern geometry, and the prediction of the dilatancy zone. Based on the numerical results, optimal operation modes can be found for individual caverns, so the risk of host rock damage

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...

Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

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Pooja Binnani

2012-01-01

Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

Assessment of the Available Drawdowns for Oil Storage Caverns at the West Hackberry SPR Site

Energy Technology Data Exchange (ETDEWEB)

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

2016-03-01

The Department of Energy, in response to requests from the U.S. Congress, wishes to maintain an up-to-date table documenting the number of available full drawdowns of each of the caverns owned by the Strategic Petroleum Reserve. This information is important for assessing the SPR’s ability to deliver oil to domestic oil companies expeditiously if national or world events dictate a rapid sale and deployment of the oil reserves. What factors go into assessing available drawdowns? The evaluation of drawdown risks require the consideration of several factors regarding cavern and wellbore integrity and stability, including stress states caused by cavern geometry and operations, salt damage caused by dilatant and tensile stresses, the effect on enhanced creep on wellbore integrity, the sympathetic stress effect of operations on neighboring caverns. Based on the work over the past several months, a consensus has been built regarding the assessment of drawdown capabilities and risks for the SPR caverns. This paper draws upon the recently West Hackberry model upgrade and analyses to reevaluate and update the available drawdowns for each of those caverns. Similar papers for the Bryan Mound, Big Hill, and Bayou Choctaw papers will be developed as the upgrades to those analyses are completed. The rationale and documentation of the methodology is described in the remainder of this report, as are the updated estimates of available drawdowns for the West Hackberry caverns.

Patient's dose assessment during sinus X-rays radiography at 'Hopital du Point G'

International Nuclear Information System (INIS)

Sidibe, S.; Sacko, B.Y.; Doucoure, M.; Traore, B.; Traore, I.

2001-01-01

Objective: To evaluate the patient's X-rays dose during head radiography for sinusitis; To precise the influence of source-image distance on the patient's dose. Material and method: From May 1997 to January 1999, 83 patients with clinical suspicious sinusitis have been included in this study. Skull radiography in 3 positions (posterior, lateral and Blondeau view) have been achieved for each patient on 24x30 centimeters size films. These radiographies were realised on a Diagnost 7 Masio Philip X-rays machine. Three TLD dosimeters were pasted against every patient target organs (thyroid, right and left eyes). The source-image distance (SID) was 100 centimeters for the first group (35 patients) and 125 centimeters for the second group (48 patients). The selected parameters (high voltage and charge) were as follows: Skull postero-anterior view: 65 to 85 kV, 80 mAs; Skull lateral view: 60 to 75 kV, 80 mAs; Blondeau view (paranasal sinuses): 90 to 95 kV, 100 mAs. Results: All the radiographies were analysed by the same radiologist who didn't know the SID. All the films were of good quality. The patient's dose in millisievert for each target organ were: Group I (SID = 100 cm): Left eye 3,2 (+ ou - 0,66); Right eye 3, 0 (+ ou - 0,82); Thyroid 0,62 (+ ou - 0,09). Group II (SID = 125 cm): Left eye 1,9 (+ ou - 0,48); Right eye 1, 86 (+ ou - 0,50); Thyroid 0,39 (+ ou - 0,08). In conclusion, the increase of SID from 100 to 125 centimeters allows patient's dose reduction by a factor of 1.6 without the alteration of the films quality, hence the reliability of the diagnosis. (author)

The effects of gender and age on forensic personal identification from frontal sinus in a Turkish population.

Science.gov (United States)

Tatlisumak, Ertugrul; Asirdizer, Mahmut; Bora, Aydin; Hekimoglu, Yavuz; Etli, Yasin; Gumus, Orhan; Keskin, Siddik

2017-01-01

To define the dimensions of the frontal sinus in groups standardized for age and gender and to discuss the reasons and the effects of the variations. Methods: Frontal sinus measurements were obtained from paranasal CTscans of 180 males and 180 females in the Radiology Department of Dursun Odabas Medical Center of Yuzuncu Yil University, Van, which is located in Eastern Turkey, between February and March 2016. The width and height of sinuses were measured on a coronal plane, and the anteroposterior length was measured on an axial plane. Volumes were calculated using the Hospital Information Management Systems and Image Archiving and Management Systemprogram. The Statistical Package of the Social Science version 13 was used for statistical analyses.  Results: We determined differences in the frontal sinus measurements of different age groups in a Turkish adult population. Frontal sinus dimensions were usually higher in females and lower in males after 40-49 years of age than their younger counterparts, but the measurements were lower in females and higher in males in 70≤ years of age group than 60-69 years of age. Left frontal sinus was dominant in young age groups but right frontal sinus was dominant in groups 40-49 years of age or older.  Conclusion: We observed crossing of the measurements between the different age groups, which we could not find clear explanations. The results of such studies may affect forensic identification from frontal sinus measurements.

Strains and stresses in the rock around and unlined hot water cavern

Science.gov (United States)

Rehbinder, Göran

1984-07-01

Hot water stored in an unlined rock cavern is an efficient energy storage. A research program has been carried out with a test plant at the city of Avesta, Sweden. The plant consists of a rock cavern, the volume of which is 15000 m3, which serves as an energy buffer in the district heating system of the city. The water is heated from a garbage incinerator located close to the cavern. During the first test period the temperature of the stored water has varied between 40°C and 95°C. The heating of the rock causes strains and stresses in the rock. The measurements show that the state in the rock does mainly respond to the average temperature and not to the fluctuations. The maximum thermal stress is 9 MPa occurring at the wall of the cavern. The heave of the ground is less than 5 mm. The development of stress and strain will continue after the first test period since thermal equilibrium was not reached during this period.

Carcinome adenoïde kystique du sinus maxillaire : a propos d'une ...

African Journals Online (AJOL)

Le scanner du massif facial avait montré un comblement de la fosse nasale et du sinus maxillaire gauches avec érosion osseuse. Une biopsie de la lésion était en faveur d'un ... A computed tomography performed, showed a filling of left sinonasal cavities with bone invasion. A biopsy made the diagnosis of plémorphic ...

Reflux venous flow in dural sinus and internal jugular vein on 3D time-of-flight MR angiography

International Nuclear Information System (INIS)

Jang, Jinhee; Kim, Bum-soo; Kim, Bom-yi; Choi, Hyun Seok; Jung, So-Lyung; Ahn, Kook-Jin; Byun, Jae Young

2013-01-01

Reflux venous signal on the brain and neck time-of-flight magnetic resonance angiography (TOF MRA) is thought to be related to a compressed left brachiocephalic vein. This study is aimed to assess the prevalence of venous reflux flow in internal jugular vein (IJV), sigmoid sinus/transverse sinus (SS/TS), and inferior petrosal sinus (IPS) on the brain and neck TOF MRA and its pattern. From the radiology database, 3,475 patients (1,526 men, 1,949 women, age range 19-94, median age 62 years) with brain and neck standard 3D TOF MRA at 3 T and 1.5 T were identified. Rotational maximal intensity projection images of 3D TOF MRA were assessed for the presence of reflux flow in IJV, IPS, and SS/TS. Fifty-five patients (1.6 %) had reflux flow, all in the left side. It was more prevalent in females (n = 43/1,949, 2.2 %) than in males (n = 12/1,526, 0.8 %) (p = 0.001). The mean age of patients with reflux flow (66 years old) was older than those (60 years old) without reflux flow (p = 0.001). Three patients had arteriovenous shunt in the left arm for hemodialysis. Of the remaining 52 patients, reflux was seen on IJV in 35 patients (67.3 %). There were more patients with reflux flow seen on SS/TS (n = 34) than on IPS (n = 25). Venous reflux flow on TOF MRA is infrequently observed, and reflux pattern is variable. Because it is exclusively located in the left side, the reflux signal on TOF MRA could be an alarm for an undesirable candidate for a contrast injection on the left side for contrast-enhanced imaging study. (orig.)

Cutaneous squamous cell carcinoma presenting as a wound with discharging sinus tracts in a wild African lion (Panthera leo).

Science.gov (United States)

Mwase, M; Mumba, C; Square, D; Kawarai, S; Madarame, H

2013-11-01

A female wild African lion (Panthera leo) was presented with an 8-month history of a wound with multiple discharging sinus tracts on the left paw. Microscopical examination revealed squamous cell carcinoma (SCC). To the best of our knowledge, this is the first report of cutaneous SCC in an African lion. Cutaneous SCC presenting as discharging sinus tracts lined by neoplastic squamous cells has not been reported previously in animals. Copyright © 2013 Elsevier Ltd. All rights reserved.

[A case of multiple cavernous angioma with dementia].

Science.gov (United States)

Kariya, S; Kawahara, M; Suzumura, A

2000-10-01

We reported a 65-year-old man who developed dementia since 50 years of age. His consciousness was clear but he was indifferent to his illness. Also, the luck of attention was recognized when we underwent examinations and the result of intellectual test varied every time we performed. His memory function was almost normal on the examination which was performed when he was cooperative. Magnetic resonance imaging (MRI) disclosed multiple tiny lesions (more than 130 in all) in cerebrum, brainstem, cerebellum and spinal cord. These lesions were compatible with multiple cavernous angioma. Most of lesions manifested high-density area on cranial CT. Though the multiplicity of foci indicated the possibility of familial occurrence, he was considered to be a sporadic case on his lineage investigation and the brain MRI of his only son. In this case, neither headache nor seizures which were known as the major clinical features of intracerebral cavernous angioma was observed. He was diagnosed as having white matter dementia characterized by attentional dysfunction, decrement of volition and less memory disturbance. We speculated that he developed symptomatic dementia by the sum of multiple minor degeneration, especially in frontal lobe white matter, caused by repeated minor bleeding from cavernous angiomas.

Stent-assisted coil embolization for cavernous carotid artery aneurysms.

Science.gov (United States)

Kono, Kenichi; Shintani, Aki; Okada, Hideo; Tanaka, Yuko; Terada, Tomoaki

2014-01-01

Internal carotid artery (ICA) occlusion with or without a bypass surgery is the traditional treatment for cavernous sinus (CS) aneurysms with cranial nerve (CN) dysfunction. Coil embolization without stents frequently requires retreatment because of the large size of CS aneurysms. We report the mid-term results of six unruptured CS aneurysms treated with stent-assisted coil embolization (SACE). The mean age of the patients was 72 years. The mean size of the aneurysms was 19.8 mm (range: 13-26 mm). Before treatment, four patients presented with CN dysfunction and two patients had no symptoms. SACE was performed under local or general anesthesia in three patients each. Mean packing density was 29.1% and tight packing was achieved. There were no neurological complications. CN dysfunction was cured in three patients (75%) and partly resolved in one patient (25%). Transient new CN dysfunction was observed in two patients (33%). Clinical and imaging follow-up ranged from 6 to 26 months (median: 16 months). Recanalization was observed in three patients (50%; neck remnant in two patients and dome filling in one patient), but no retreatment has yet been required. No recurrence of CN dysfunction has occurred yet. In summary, SACE increases packing density and may reduce requirement of retreatment with an acceptable cure rate of CN dysfunction. SACE may be a superior treatment for coiling without stents and be an alternative treatment of ICA occlusion for selected patients, such as older patients and those who require a high-flow bypass surgery or cannot receive general anesthesia.

Persistent left superior vena cava with absent right superior vena cava: image findings

International Nuclear Information System (INIS)

Araujo Junior, Cyrillo Rodrigues de; Carvalho, Tarcisio Nunes; Fraguas Filho, Sergio Roberto; Costa, Marlos Augusto Bitencourt; Jacob, Beatriz Mahmud; Machado, Marcio Martins; Teixeira, Kim-Ir-Sen Santos; Ximenes, Carlos Alberto

2003-01-01

Persistent left superior vena cava absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus. (author)

Single coronary artery from right aortic sinus in a very elderly patient

Directory of Open Access Journals (Sweden)

Prashanth Panduranga

2016-10-01

Full Text Available In the absence of other associated cardiac anomalies, single coronary artery (SCA per se is a rare anomaly detected during coronary angiography or autopsy. Various types of SCA detected during coronary angiography have already been described. We herein report a type of SCA originating from the right sinus of Valsalva, with the right circumflex, left circumflex, and left anterior descending coronary arteries arising from the proximal part of the SCA in a 76-year-old female patient. She developed ventricular fibrillation during coronary angiography, which calls for caution while performing a coronary angiogram in such patients.

Right Site, Wrong Route - Cannulating the Left Internal Jugular Vein.

Science.gov (United States)

Paik, Peter; Arukala, Sanjay K; Sule, Anupam A

2018-01-09

Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed. On chest radiography for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region. It did not take the expected course across the midline toward the right and into the superior vena cava (SVC). A review of a computed tomography (CT) scan of the chest with contrast done on a prior admission revealed a duplicated SVC on the left side that had not been reported in the original CT scan interpretation. A left-sided SVC is present in approximately 0.3% to 0.5% of the population, with 90% of these draining into the coronary sinus. During placements of central venous lines and pacemakers, irritation of the coronary sinus may result in hypotension, arrhythmia, myocardial ischemia, or cardiac arrest. A widened mediastinum can be an indication of a duplicated SVC. When attempting a left internal jugular vein central venous catheter placement, it is important to be aware of venous anomalies in order to prevent complications.

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.)

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

Sinusitis with eosinophilic otitis media

International Nuclear Information System (INIS)

Kawano, Toshiro; Ishitoya, Junichi; Tsukuda, Mamoru

2007-01-01

Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

Sinusitis with eosinophilic otitis media

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Kawano, Toshiro; Ishitoya, Junichi [Yokohama City Univ., Medical Center, Yokohama, Kanagawa (Japan); Tsukuda, Mamoru [Yokohama City Univ., Graduate School of Medicine, Yokohama, Kanagawa (Japan)

2007-09-15

Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

Fistule carotido-caverneuse indirecte post traumatique: diagnostic ...

African Journals Online (AJOL)

The indirect carotido-cavernous fistula is an abnormal communication between multiple arterioles coming from dural or meningeal branches of the external carotid artery and/or of the internal carotid artery and the cavernous sinus. Its definitive diagnosis relies on carotid angiography showing the fistula. This imaging ...

Pilonidal Sinus of the Penis

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Hugh F. O'Kane

2004-01-01

Full Text Available A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin.

Study on the development of frontal sinuses by morphometric analysis of the skull - doi: 10.4025/actascibiolsci.v35i2.13334

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Carolina Peixoto Magalhães

2013-05-01

Full Text Available The frontal sinuses are cranial areas of clinical, forensic and pathology importance whose development mechanisms are still poorly defined. Nasal airflow and brain development are two of the main theories. Current analysis debates whether they are the real determinants of frontal sinuses growth, which may be proved by the skull’s morphometric analysis. Four groups of measures related to the external cranial architecture, the pyriform aperture, orbital cavities and frontal sinuses were defined. Thirty-three skulls of individuals, mean age 68 years, from the Laboratory of Anatomy of the Academic Centre of Victoria – UFPE – Brazil, were used. Statistical analysis showed total agenesis of the frontal sinus in 18.2% of the skulls. There was significant correlation between the development of the right frontal sinus and the pyriform aperture, and between the left frontal sinus and two cranial measurements (p ≤ 0.05. Significant differences between mean of pyriform aperture areas of the skulls with or without sinuses were also reported (p ≤ 0.01. Results supported the fact that there was a modulation activity by nasal aeration and brain formation in the development of frontal sinuses.

Maxillary sinus augmentation

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A B Tarun Kumar

2015-01-01

Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

Development of a posterior cerebral artery aneurysm subsequent to occlusion of the contralateral internal carotid artery for giant cavernous aneurysm

International Nuclear Information System (INIS)

Wolf, R.L.; Hurst, R.W.; Imbesi, S.G.; Galetta, S.L.; Sinson, G.P.; Grossman, R.I.

2002-01-01

We report a case of a patient who developed a left posterior cerebral artery aneurysm 5 years after balloon occlusion of the right internal carotid artery for a giant cavernous aneurysm. The location of the new aneurysm was outside of the primary collateral pathways to the contralateral, proximally occluded, anterior circulation, illustrating the complexity of hemodynamic factors contributing to the development of intracranial saccular aneurysms. The appearance of an aneurysm in this setting supports the hypothesis that degenerative factors and hemodynamic stresses are important in the etiology of intracranial aneurysms. (orig.)

Migraine-like headache in cerebral venous sinus thrombosis.

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Tan, Funda Uysal; Tellioglu, Serdar; Koc, Rabia Soylu; Leventoglu, Alev

2015-01-01

A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72 h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70-140%), homocystein was minimally elevated (12.7 μmol/L, normal 0-12 μmol/L) and anti-cardiolipin IgM antibody was close to the upper limit. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Rhinogenic intracranial complication with postoperative frontal sinus pyocele and inverted papilloma in the nasal cavity: A case report and literature review

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Michitsugu Kawada

2016-02-01

Full Text Available We report a patient who had rhinogenic intracranial complication with postoperative frontal sinus pyocele and inverted papilloma in the nasal cavity. A 72-year-old woman had undergone surgery for frontal sinusitis via external incision at another hospital 13 years previously. Left-sided hemiparesis appeared in the patient and gradually worsened. Five days later, she exhibited disorientation, abnormal behavior, poor articulation, and difficulty in standing. Therefore, she was taken to the neurosurgery department by ambulance. An extensive frontal sinus pyocele was suspected, and a cerebral abscess and edema of the frontal lobe were observed on magnetic resonance imaging. After antibiotics, steroid and glycerol were administered for a few weeks; disorientation and left hemiparesis improved. Next, craniotomy for complete removal of the brain abscess by neurosurgeons and endoscopic endonasal surgery by otolaryngologists were carried out at the same surgery. From the analysis of the pathological mucosa sample taken from the right ethomoidal sinus during surgery, an inverted papilloma was diagnosed. The patient completely recovered and is currently receiving follow-up examination. Regarding rhinogenic intracranial complications, ascertaining clinical condition in order to determine the need for either immediate radical surgery, or for curative surgery after waiting for improvement of the overall body condition by conservative management, is still needed.

Rhinogenic intracranial complication with postoperative frontal sinus pyocele and inverted papilloma in the nasal cavity: A case report and literature review

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Kawada, Michitsugu; Yokoi, Hidenori; Maruyama, Keisuke; Matsumoto, Yuma; Yamanaka, Hidetaka; Ikeda, Tetsuya; Shiokawa, Yoshiaki; Saito, Koichiro

2016-01-01

We report a patient who had rhinogenic intracranial complication with postoperative frontal sinus pyocele and inverted papilloma in the nasal cavity. A 72-year-old woman had undergone surgery for frontal sinusitis via external incision at another hospital 13 years previously. Left-sided hemiparesis appeared in the patient and gradually worsened. Five days later, she exhibited disorientation, abnormal behavior, poor articulation, and difficulty in standing. Therefore, she was taken to the neurosurgery department by ambulance. An extensive frontal sinus pyocele was suspected, and a cerebral abscess and edema of the frontal lobe were observed on magnetic resonance imaging. After antibiotics, steroid and glycerol were administered for a few weeks; disorientation and left hemiparesis improved. Next, craniotomy for complete removal of the brain abscess by neurosurgeons and endoscopic endonasal surgery by otolaryngologists were carried out at the same surgery. From the analysis of the pathological mucosa sample taken from the right ethomoidal sinus during surgery, an inverted papilloma was diagnosed. The patient completely recovered and is currently receiving follow-up examination. Regarding rhinogenic intracranial complications, ascertaining clinical condition in order to determine the need for either immediate radical surgery, or for curative surgery after waiting for improvement of the overall body condition by conservative management, is still needed. PMID:27489711

An unusual case of total ophthalmoplegia

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Chowdhury Ravindra

2009-01-01

Full Text Available An eight-year-old male child presented with drooping of the left eyelid with a history of penetrating injury of hard palate by an iron spoon seven days ago, which had already been removed by the neurosurgeon as the computed tomography scan revealed a spoon in the left posterior ethmoid and sphenoid bone penetrating into the middle cranial fossa. On examination, visual acuity was 20/20 in each eye and left eye showed total ophthalmoplegia. Oral cavity revealed a hole in the left lateral part of the hard palate. We managed the case with tapering dose of systemic prednisolone. The total ophthalmoplegia was markedly improved in one month. Cases of foreign bodies in the orbit with intracranial extension are not unusual, but the path this foreign body traveled through the hard palate without affecting the optic nerve, internal carotid artery or cavernous sinus makes an interesting variation.

Virtual endoscopy and 3D volume rendering in the management of frontal sinus fractures.

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Belina, Stanko; Cuk, Viseslav; Klapan, Ivica

2009-12-01

Frontal sinus fractures (FSF) are commonly caused by traffic accidents, assaults, industrial accidents and gunshot wounds. Classical roentgenography has high proportion of false negative findings in cases of FSF and is not particularly useful in examining the severity of damage to the frontal sinus posterior table and the nasofrontal duct region. High resolution computed tomography was inavoidable during the management of such patients but it may produce large quantity of 2D images. Postprocessing of datasets acquired by high resolution computer tomography from patients with severe head trauma may offer a valuable additional help in diagnostics and surgery planning. We performed virtual endoscopy (VE) and 3D volume rendering (3DVR) on high resolution CT data acquired from a 54-year-old man with with both anterior and posterior frontal sinus wall fracture in order to demonstrate advantages and disadvantages of these methods. Data acquisition was done by Siemens Somatom Emotion scanner and postprocessing was performed with Syngo 2006G software. VE and 3DVR were performed in a man who suffered blunt trauma to his forehead and nose in an traffic accident. Left frontal sinus anterior wall fracture without dislocation and fracture of tabula interna with dislocation were found. 3D position and orientation of fracture lines were shown in by 3D rendering software. We concluded that VE and 3DVR can clearly display the anatomic structure of the paranasal sinuses and nasopharyngeal cavity, revealing damage to the sinus wall caused by a fracture and its relationship to surrounding anatomical structures.

Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

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Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

2016-01-15

Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

International Nuclear Information System (INIS)

Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M.

2016-01-01

Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

Modeling deformation processes of salt caverns for gas storage due to fluctuating operation pressures

Science.gov (United States)

Böttcher, N.; Nagel, T.; Goerke, U.; Khaledi, K.; Lins, Y.; König, D.; Schanz, T.; Köhn, D.; Attia, S.; Rabbel, W.; Bauer, S.; Kolditz, O.

2013-12-01

In the course of the Energy Transition in Germany, the focus of the country's energy sources is shifting from fossil to renewable and sustainable energy carriers. Since renewable energy sources, such as wind and solar power, are subjected to annual, seasonal, and diurnal fluctuations, the development and extension of energy storage capacities is a priority in German R&D programs. Common methods of energy storage are the utilization of subsurface caverns as a reservoir for natural or artificial fuel gases, such as hydrogen, methane, or the storage of compressed air. The construction of caverns in salt rock is inexpensive in comparison to solid rock formations due to the possibility of solution mining. Another advantage of evaporite as a host material is the self-healing capacity of salt rock. Gas caverns are capable of short-term energy storage (hours to days), so the operating pressures inside the caverns are fluctuating periodically with a high number of cycles. This work investigates the influence of fluctuating operation pressures on the stability of the host rock of gas storage caverns utilizing numerical models. Therefore, we developed a coupled Thermo-Hydro-Mechanical (THM) model based on the finite element method utilizing the open-source software platform OpenGeoSys. Our simulations include the thermodynamic behaviour of the gas during the loading/ unloading of the cavern. This provides information on the transient pressure and temperature distribution on the cavern boundary to calculate the deformation of its geometry. Non-linear material models are used for the mechanical analysis, which describe the creep and self-healing behavior of the salt rock under fluctuating loading pressures. In order to identify the necessary material parameters, we perform experimental studies on the mechanical behaviour of salt rock under varying pressure and temperature conditions. Based on the numerical results, we further derive concepts for monitoring THM quantities in the

Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

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Kanno, Takahiro; Mitsugi, Masaharu; Paeng, Jun-Young; Sukegawa, Shintaro; Furuki, Yoshihiko; Ohwada, Hiroyuki; Nariai, Yoshiki; Ishibashi, Hiroaki; Katsuyama, Hideaki; Sekine, Joji

2012-01-01

We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants) were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n = 4). A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80) after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation. PMID:22792105

Simultaneous Sinus Lifting and Alveolar Distraction of a Severely Atrophic Posterior Maxilla for Oral Rehabilitation with Dental Implants

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Takahiro Kanno

2012-01-01

Full Text Available We retrospectively reviewed a new preimplantation regenerative augmentation technique for a severely atrophic posterior maxilla using sinus lifting with simultaneous alveolar distraction, together with long-term oral rehabilitation with implants. We also analyzed the regenerated bone histomorphologically. This study included 25 maxillary sinus sites in 17 patients. The technique consisted of alveolar osteotomy combined with simultaneous sinus lifting. After sufficient sinus lifting, a track-type vertical alveolar distractor was placed. Following a latent period, patient self-distraction was started. After the required augmentation was achieved, the distractor was left in place to allow consolidation. The distractor was then removed, and osseointegrated implants (average of 3.2 implants per sinus site, 80 implants were placed. Bone for histomorphometric analysis was sampled from six patients and compared with samples collected after sinus lifting alone as controls (n=4. A sufficient alveolus was regenerated, and all patients achieved stable oral rehabilitation. The implant survival rate was 96.3% (77/80 after an average postloading followup of 47.5 months. Good bone regeneration was observed in a morphological study, with no significant difference in the rate of bone formation compared with control samples. This new regenerative technique could be a useful option for a severely atrophic maxilla requiring implant rehabilitation.

Single coronary artery originating from the right sinus Valsalva and ability to work.

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De Rosa, Roberto; Ratti, Gennaro; Gerardi, Donato; Tedeschi, Carlo; Lamberti, Monica

2015-01-01

We present a case of a 56-year-old male electrician who was admitted to the hospital with atrial fibrillation, atypical chest pain and dyspnea. He gave a history that on the morning he had working for almost 4 hours carrying out various activities with considerable physical effort. After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva. The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM). The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

[A case of sphenoid sinusitis which could be diagnosed by orbital computed tomography after detected Strepotococcus pneumoniae from blood culture].

Science.gov (United States)

Kimura, Takuma; Aoki, Makoto; Aoki, Yasuko; Tonhyo, Chong

2005-03-01

We report a case of sphenoid sinusitis which could be diagnosed by orbital CT after detecting Strepotococcus pneumoniae from blood culture. A previously healthy 47 year-old Japanese male was admitted to our hospital with severe left-sided headache of 2 days duration. From 9 days before hospitalization (1st day), the patient complained of cough and sputum. On physical examination, his neck was supple and his temperature was 38.3 degrees C. The rest of the examination was normal. A chest radiograph, sinus radiograph, and head computed tomographic (CT) scan without contrast material disclosed no abnormalities. Lumbar puncture was done and cerebrospinal fluid was clear and cell counts and the levels of glucose and protein were normal. The peripheral white blood cell count was 14,400/fl, and the C-reactive protein level was 9.6 mg/dl. After blood, urine, pharyngeal mucus and cerebrospinal fluid cultures were obtained, empirical antibiotic therapy with 2 gms of piperacillin twice daily was begun. He complained sever left-sided retro-orbital headahe on the next day too. The lumbar puncture and head CT scan with contrast material was done again but gave no diagnostic clues. The examinations by the otolaryngologist, ophthalmologist and dentist found no abnormal findings. On the 3rd hospitalized day, Strepotococcus pneumoniae was detected from the blood culture taken on the 1st hospitalized day. A CT scan focused on orbita was done and revealed a low density area of the left sphenoid sinus. The dose of piperacillin was increased to 4 gms twice daily and continued for 24 days. The patient's headache improved and piperacillin was changed to oral levofloxacin 100 mg, three times daily on the 26th day. The medication was stopped on the 73th day. Isolated sphenoid sinusitis is rare, but crtitical complications such as cranial nerve involvement, brain abscess, and bacterial meningitis may happen. It is necessary to also think of sphenoid sinusitis in practices of patients with

Pregnancy-related spinal epidural capillary-cavernous haemangioma: magnetic resonance imaging and differential diagnosis

International Nuclear Information System (INIS)

Hakan, T.; Berkman, M.Z.; Demir, M.K.; Aker, F.V.

2007-01-01

Full text: Epidural haemangiomas are very rare tumours of the spine. Only a few case reports have been published and most of them were cavernous or capillary. To the best of our knowledge, we report the first case of a histologically confirmed epidural capillary-cavernous haemangioma of the thoracic spine presented in the MRI

Sinusitis Q and A

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... surgery is to restore normal function to the blocked sinuses. During the procedure, the surgeon locates and enlarges the small natural drainage passageways of the sinuses. Very rarely patients with ...

Bilateral Postoperative Cyst after Maxillary Sinus Surgery: Report of a Case and Systematic Review of the Literature

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Boris-Mark Niederquell

2016-01-01

Full Text Available Purpose. We present a case of a bilateral postoperative maxillary cyst (PMC and discuss this with a systemic review. Case Report and Literature Review. A 68-year-old female with pain and swelling on the right side of the face. MRI and CT showed a cystic tumors of the right and left maxillary sinus. Radical maxillary surgery via a Caldwell-Luc procedure had been performed 55 years ago and bilateral PMC was diagnosed. The PubMed database was searched for PMC within the last 30 years. Results. Together with the current case, we found 23 reports including 284 patients describing PMC. It was diagnosed at a mean time of 22 years after causal surgery at a mean age of 47 years. Initial symptoms were mostly pain with or without swelling. The main radiological sign was a unilocular radiolucency with a slight preference for the left side. Discussion. PMC is a long-term complication that can occur after maxillary sinus surgery and a second surgical approach is required in order to stop cystic expansion. Therefore, patients’ informed consent on this complication as well as a prolonged follow-up is recommended. Simple paranasal ultrasound or paranasal sinus plain radiography may lead to an earlier detection reducing interventional morbidity.

Stenting of Anomalous Left Main Coronary Artery Stenosis in an Adult with a Retroaortic Course

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Lanjewar Charan

2011-01-01

Full Text Available Coronary bypass graft has been the conventional treatment of choice in anomalous left man coronary artery stenosis. We are reporting an interesting case with anomalous left main coronary artery originating from right aortic sinus having retroaortic course complicated by significant atherosclerotic narrowing of the vessel and its percutaneous management.

Tightness and suitability evaluation of abandoned salt caverns served as hydrocarbon energies storage under adverse geological conditions (AGC)

International Nuclear Information System (INIS)

Wei, Liu; Jie, Chen; Deyi, Jiang; Xilin, Shi; Yinping, Li; Daemen, J.J.K.; Chunhe, Yang

2016-01-01

Highlights: • Tightness conditions are set to assess use of old caverns for hydrocarbons storage. • Gas seepage and tightness around caverns are numerically simulated under AGC. • κ of interlayers act as a key factor to affect the tightness and use of salt cavern. • The threshold upper permeability of interlayers is proposed for storing oil and gas. • Three types of real application are introduced by using the tightness conditions. - Abstract: In China, the storage of hydrocarbon energies is extremely insufficient partially due to the lack of storage space, but on the other side the existence of a large number of abandoned salt caverns poses a serious threat to safety and geological environments. Some of these caverns, defined as abandoned caverns under adverse geological conditions (AGC), are expected to store hydrocarbon energies (natural gas or crude oil) to reduce the risk of potential disasters and simultaneously support the national strategic energy reserve of China. Herein, a series of investigations primarily related to the tightness and suitability of the caverns under AGC is performed. Laboratory measurements to determine the physical and mechanical properties as well as porosity and permeability of bedded salt cores from a near target cavern are implemented to determine the petro-mechanical properties and basic parameters for further study. The results show that the mechanical properties of the bedded rock salts are satisfactory for the stability of caverns. The interface between the salt and interlayers exhibits mechanical properties that are between those of rock salt and interlayers and in particular is not a weak zone. The silty mudstone interlayers have relatively high porosity and permeability, likely due to their low content of clay minerals and the presence of halite-filled cracks. The conditions for evaluating the tightness and suitability of a cavern for storing hydrocarbons are proposed, including “No tensile stress,” �

Endoscope-assisted resection of cavernous angioma at the foramen of Monro: a case report.

Science.gov (United States)

Matsumoto, Yuji; Kurozumi, Kazuhiko; Shimazu, Yousuke; Ichikawa, Tomotsugu; Date, Isao

2016-01-01

Intraventricular cavernous angiomas are rare pathological entities, and those located at the foramen of Monro are even rarer. We herein present a case of cavernous angioma at the foramen of Monro that was successfully treated by neuroendoscope-assisted surgical removal, and review the relevant literature. A 65-year-old woman had experienced headache and vomiting for 10 days before admission to another hospital. Magnetic resonance imaging (MRI) showed a mass at the foramen of Monro, and obstructive hydrocephalus of both lateral ventricles. The patient was then referred to our hospital. Neurological examination on admission to our hospital showed memory disturbance (Mini-Mental State Examination 20/30) and wide-based gait. A cavernous angioma at the foramen of Monro was diagnosed based on the typical popcorn-like appearance of the lesion on MRI. The lesion was completely removed by neuroendoscope-assisted transcortical surgery with the Viewsite Brain Access System (Vycor Medical Inc., Boca Raton, FL), leading to a reduction in the size of the ventricles. The resected mass was histologically confirmed to be cavernous angioma. The patient's symptoms resolved immediately and there were no postoperative complications. Minimally invasive neuroendoscope-assisted surgery was used to successfully treat a cavernous angioma at the foramen of Monro.

[Radiologic picture of maxillary sinus aspergilloma].

Science.gov (United States)

Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

2010-06-01

Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to

Abdominal wall sinus due to impacting gallstone during laparoscopic cholecystectomy: an unusual complication.

Science.gov (United States)

Pavlidis, T E; Papaziogas, B T; Koutelidakis, I M; Papaziogas, T B

2002-02-01

During laparoscopic cholecystectomy, perforation of the gallbladder can occurs in extraction of the gallbladder. The fate of such lost gallstones, which can lead to the formation of an abscess, an abdominal wall mass, or a persistent sinus, has not been studied adequately. Herein we report the case of a persistent sinus of the abdominal wall after an emergent laparoscopic cholecystectomy in an 82-year-old woman with gangrenous cholecystitis and perforation of the friable wall in association with an empyema of the gallbladder. The culture of the obtained pus was positive for Escherichia coli. After a small leak of dirty fluid from the wound of the epigastric port site of 4 months' duration, surgical exploration under local anesthesia revealed that the sinus was caused by spilled gallstones impacting into the abdominal wall between the posterior sheath and left rectus abdominalis muscle. The removal of the stones resulted in complete healing. Long-term complications after laparoscopic cholecystectomy involving the abdominal wall are rare but important possible consequences that could be avoided.

Management of iatrogenically exposed maxillary sinus with a broken periosteal elevator trapped inside

Directory of Open Access Journals (Sweden)

Nureldeen Elhammali

2017-01-01

Full Text Available Foreign bodies may be ingested after being inserted into an oral cavity or deposited in the body by traumatic or iatrogenic injury. Accidentally left out foreign materials are common complications of dental procedures including apical deposition of endodontic materials, sub-mucosal amalgam pieces, graphite tattoos and traumatically introduced dental materials and instruments. Once a foreign material is left behind within a soft and/or hard tissue, it promotes local inflammation and infection that may cause pain and/or destruction within the surrounding tissues. This article presents a case of retrieval of iatrogenically broken periosteal elevator trapped in the maxillary sinus.

Mucocele of the sphenoid sinus

Energy Technology Data Exchange (ETDEWEB)

Haloi, Achyut K.; Ditchfield, Michael [Royal Children' s Hospital, Department of Medical Imaging, Melbourne (Australia); Maixner, Wirginia [Royal Children' s Hospital, Department of Neurosurgery, Melbourne (Australia)

2006-09-15

The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months. (orig.)

Mucocele of the sphenoid sinus

International Nuclear Information System (INIS)

Haloi, Achyut K.; Ditchfield, Michael; Maixner, Wirginia

2006-01-01

The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months. (orig.)

Managment of frontal sinus fracture: obliteration sinus with cancellous bone graft.

Science.gov (United States)

Muminagic, Sahib; Masic, Tarik; Babajic, Emina; Asotic, Mithat

2011-01-01

Frontal sinus fractures make up about 2-15% of all facial fractures.This is relatively low frequency of occurrence, but it has a large potential of complication and may involve not only the frontal sinuse but more importantly the brain and the eyes. The management depends of the complexity. If anterior wall is fractured with grossly involved nasofrontal duct (NFD) in the injury it is paramount to occlude NFD. Very often, sinus obliteration is done at the same time. In our expirience autogenous cancellous bone graft is considered to be the best grafting material. It has the less short - or long-term complications and the donor site morbidity is insignificant.

Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa. Follow-up study with computed tomography

Energy Technology Data Exchange (ETDEWEB)

Shibata, S; Kurihara, M; Mori, K [Nagasaki Univ. (Japan). School of Medicine; Amamoto, Y

1981-02-01

This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to succeed because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of an extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor.

Computed Tomography (CT) -- Sinuses

Medline Plus

Full Text Available ... Computed tomography (CT) of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the ...

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.

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.

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.

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.

Study of the coronary sinus and its tributaries in colombian subjects

International Nuclear Information System (INIS)

Ballesteros, Luis E; Ramirez; Luis M; Forero, Pedro L.

2010-01-01

The morphological expression of the coronary sinus is characterized by its great variability, especially with regard to length, caliber, drainage territories and frequency of its tributaries. We assessed the variants in the coronary sinus of 68 fresh hearts from Colombian subjects (56 men, 12 women), from autopsy material. The sinuses were injected with synthetic resin and its anatomic characteristics were recorded. The average length of the coronary sinuses was 25.96 mm ± 6.34 with a distal diameter of 8.94 mm (± 1.66). The shapes were cylindrical, funnel-shaped and flattened in 67.6%, 23.5% and 8.9% respectively. The great cardiac vein originated from the cardiac apex in 57.4% of cases and in the lower third of the anterior interventricular sulcus in 39.7%. At the atrioventricular groove level, it had a caliber of 5.47 mm (± 0.72). In 77.9%, the great cardiac vein was located to the left of the anterior interventricular artery. The arterio-venous trigone of the heart was present in 58.8%. The middle cardiac vein had its origin in the lower third of the anterior ventricular surface (53%) and the cardiac apex (47%). This drained directly into the right atrium in 17% of cases. Its caliber in the segment close to the sinus was 4 mm (± 0.77). Anastomosis of the great and middle cardiac veins was present in 58.8%;33.8% in the heart apex and in the anterior interventricular sulcus. In a significant number of cases, the presence of a short great cardiac vein and an elongated middle cardiac vein was highlighted. Similarly, the drainage of the middle cardiac vein into the right atrium was present in almost one fifth of the hearts studied.

Odontogenic sinus tracts: a cohort study.

Science.gov (United States)

Slutzky-Goldberg, Iris; Tsesis, Igor; Slutzky, Hagay; Heling, Ilana

2009-01-01

To determine the prevalence,location, and distribution of sinus tracts in patients referred for endodontic consultation. This cohort study included 1,119 subjects referred for endodontic consultation, 108 of whom presented with sinus tracts. Following clinical and radiographic examination, the diameter of the rarifying osteitis lesion on the radiograph was measured and the path and origin of the sinus tracts determined. Signs and symptoms, tooth site,buccal/lingual location, and diameter were recorded. Data were statistically analyzed using Pearson chi-square test. Sinus tracts originated mainly from maxillary teeth (63.1%); only 38.9% originated from mandibular teeth. Chronic periapical abscess was the most prevalent diagnosed origin (71.0%). Broken restorations were highly associated with the presence of sinus tracts (53.0%). The most frequent site of orifices was buccal(82.4%), followed by lingual or palatal (12.0%). Orifices on the lingual aspect of the gingiva were observed in mandibularmolars. There was an 86.8% correlation between the occurrence of an apically located sinus tract and apical rarifying osteitis(P<.01). Sinus tract in the lingual or palatal aspect of the gingiva is relatively common. Practitioners should look for signs of sinus tract during routine examination

[The occipital sinus: a radioanatomic study].

Science.gov (United States)

Gaumont-Darcissac, M; Viart, L; Foulon, P; Le Gars, D; Havet, E; Peltier, J

2015-03-01

The aim of this study was to assess the presence of an occipital sinus in both children and adults, and to detail its main associated anatomical characteristics. One hundred of patients' MRI (3D T1 EG) between 0 and 86 years old were studied, in sagittal and axial sections, with the software DxMM. Occipital sinus length, perimeter, and cerebellar falx length measurements were performed with the software's tools. Forty-three percent of patients had an occipital sinus (average perimeter was 3.02 mm, average length was 19.85 mm), and 23.26% of these patients had a cerebellar falx, 30.23% of these patients had one vein or more draining into the occipital sinus. Sixty-two percent of children had an occipital sinus (average perimeter was 2.87 mm, average length was 21.63 mm), and 29.03% of them had a cerebellar falx. Twenty-four percent of adults had an occipital sinus (average perimeter was 3.4mm, average length was 15.28 mm), and 8.33% of them had a cerebellar falx. This work highlights a link between the age and the occipital sinus existence. The perimeter of this sinus seems to be superior for adults, but its length seems to be superior for children. A cerebellar falx with the occipital sinus was found more frequently for children. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Small hepatocellular carcinoma versus small cavernous hemangioma

International Nuclear Information System (INIS)

Choi, B.I.; Park, H.W.; Kim, S.H.; Han, M.C.; Kim, C.W.

1989-01-01

To determine the optimal pulse sequence for detection and differential diagnosis of small hepatocellular carcinomas and cavernous hemangiomas less than 5 cm in diameter, the authors have analyzed spin-echo (SE) images of 15 small hepatocellular carcinomas and 31 small cavernous hemangiomas obtained at 2.0 T. Pulse sequences used included repetition times (TRs) of 500 and 2,000 msec and echo times (TEs) of 30,60,90,120,150, and 180 msec. Mean tumor-liver contrast-to-noise ratios on the SE 2,000/60 (TR msec/TE msec) sequence were 23.90 ± 16.33 and 62.10 ± 25.94 for small hepatocellular carcinomas and hemangiomas, respectively, and were significantly greater than for all other pulse sequences. Mean tumor-liver signal intensity ratios on the SE 2,000/150 sequence were 2.34 ± 1.72 and 6.04 ± 2.72 for small hepatocellular carcinomas and hemangiomas, respectively, and were significantly greater than for all other pulse sequences in hemangiomas

Intramedullary cavernous angiomas of the spinal cord. Clinical characteristics of 13 lesions

International Nuclear Information System (INIS)

Aoyama, Takeshi; Hida, Kazutoshi; Houkin, Kiyohiro

2011-01-01

Magnetic resonance imaging has increased the incidence of the diagnosis of intramedullary cavernous angioma. Surgical therapy tends not to be recommended for asymptomatic lesions, but symptomatic lesions that bleed recurrently should be treated. The natural course of intramedullary cavernous angioma remains unknown and arguments have been raised against the surgical treatment of symptomatic lesions. We reviewed the clinical features of 13 intramedullary cavernous angiomas in 12 patients surgically treated between 1988 and 2009. The 7 men and 5 women were aged from 14 to 60 years, the preoperative interval ranged from 0 to 161 months, and the mean number of hemorrhages in the 13 lesions was 2.5. Sixteen operations were performed to treat the 13 lesions. The surgical approach depended on the lesion location. The outcome of patients with mild to moderate preoperative symptoms (McCormick grades I-III) was significantly better than that of patients with severe symptoms (McCormick grade IV) (p<0.05). Symptomatic intramedullary cavernous angioma tends to bleed repeatedly. The lesion should be surgically removed to avoid further deterioration due to recurrent hemorrhages. The shortest path approach should be selected based on preoperative images and complete removal should be attempted. Residual lesion may be masked by surrounding gliosis, so careful postoperative follow up is necessary. (author)

[Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

Science.gov (United States)

Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

1997-07-01

A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.