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Sample records for sagittal sinus thrombosis

  1. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) is much rarer, more so when it occurs in the setting of puerperium. Although cerebral sagittal sinus thrombosis can occur at any time during life, women are particularly vulnerable before delivery and ...

  2. Puerperal Superior Sagittal Sinus Thrombosis and Pulmonary ...

    African Journals Online (AJOL)

    Superior sagittal sinus thrombosis is a rare and often misdiagnosed disorder. Its occurrence with pulmonary embolism (PE) .... and prolonged immobilization, hence, the possibility that her PE could have resulted from superior ... been forgotten and was alluded to by Diaz etal., as “a syndrome rediscovered in their report.”[20].

  3. Noninvasive diagnosis of superior sagittal sinus thrombosis in a neonate.

    Science.gov (United States)

    Govaert, P; Voet, D; Achten, E; Vanhaesebrouck, P; van Rostenberghe, H; van Gysel, D; Afschrift, M

    1992-05-01

    A newborn boy presented within the first day of life with moaning, anemia, and thrombocytopenia. The clinical syndrome resulted from thrombosis of the posterior part of the superior sagittal sinus due to impression at birth of the tip of the occipital squama. Both computed tomography and ultrasound scans were valuable noninvasive tools for documentation of the thrombus itself and the cerebral sequelae. Color Doppler ultrasound scan confirmed the absence and reappearance of flow in the superior sagittal sinus.

  4. 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.

  5. Sagittal venous sinus thrombosis after cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  6. Superior sagittal sinus thrombosis: a rare complication in a child with nephrotic syndrome

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    Pirogovsky, A.; Adi, M.; Barzilai, N. [Dept. of Radiology, Kaplan Medical Center, Rehovot (Israel); Dagan, A.; Sinai, L.; Sthoeger, D. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Tabachnik, E. [Div. of Paediatrics, Kaplan Medical Center, Rehovot (Israel); Paediatric ICU, Kaplan Hospital, Rehovot (Israel)

    2001-10-01

    A 2-year-old boy with new-onset nephrotic syndrome developed recurrent vomiting, apathy and papilloedema. Superior sagittal sinus thrombosis was diagnosed on cranial CT and MRI. He gradually recovered after treatment with heparin, fresh frozen plasma and warfarin with complete resolution of the thrombosis after 1 month. Superior sagittal sinus thrombosis is an extremely rare complication of nephrotic syndrome in children. Early diagnosis is essential for institution of anticoagulation therapy and a successful outcome. (orig.)

  7. [Superior sagittal sinus thrombosis in a case of longstanding systemic lupus erythematosus].

    Science.gov (United States)

    Ohsaka, Misuzu; Nonaka, Tadashi; Oka, Shinichi; Minamida, Yoshihiro; Mikami, Takeshi

    2006-01-01

    A 33-year-old female who had been on a steroid treatment for the past 14 years due to systemic lupus erythematosus (SLE) visited our hospital complaining of mild headache. No neurological deficit and no positive serologic tests for lupus anticoagulants (LAC) and anticardiolipin antibodies (aCL) were noted. Only a mild inflammatory change was observed on routine hematological examination. On neuroradiological examination, MRI revealed thickened falx cerebri and tentorium cerebelli, and an empty delta sign. These findings were suggestive of sinus thrombosis of superior sagittal sinus (SSS). Angiograms clearly demonstrated occlusion of the posterior part of superior sagittal sinus and transeverse sinus (TS). Conservative treatment was chosen because of no evidence of intracranial hypertension. There was no deterioration in her general and neurological status during her hospital stay and she was discharged. Longstanding vasculitis and pachymeningitis related to lupus erythematosus might be the probable cause of the sinus thrombosis in this case.

  8. [Progressive Intracranial Hypertension due to Superior Sagittal Sinus Thrombosis Following Mild Head Trauma: A Case Report].

    Science.gov (United States)

    Suto, Yuta; Maruya, Jun; Watanabe, Jun; Nishimaki, Keiichi

    2015-07-01

    Cerebral venous sinus thrombosis after mild head trauma without skull fracture or intracranial hematoma is exceptionally rare. We describe an unusual case of progressive intracranial hypertension due to superior sagittal sinus thrombosis following mild head trauma. A 17-year-old boy presented with nape pain a day after a head blow during a gymnastics competition (backward double somersault). On admission, he showed no neurological deficit. CT scans revealed no skull fractures, and there were no abnormalities in the brain parenchyma. However, his headache worsened day-by-day and he had begun to vomit. Lumbar puncture was performed on Day 6, and the opening pressure was 40 cm of water. After tapping 20 mL, he felt better and the headache diminished for a few hours. MR venography performed on Day 8 revealed severe flow disturbance in the posterior third of the superior sagittal sinus with multiple venous collaterals. Because of the beneficial effects of lumbar puncture, we decided to manage his symptoms of intracranial hypertension conservatively with repeated lumbar puncture and administration of glycerol. After 7 days of conservative treatment, his symptoms resolved completely, and he was discharged from the hospital. Follow-up MR venography performed on Day 55 showed complete recanalization of the superior sagittal sinus. The exact mechanism of sinus thrombosis in this case is not clear, but we speculate that endothelial damage caused by shearing stress because of strong rotational acceleration or direct impact to the superior sagittal sinus wall may have initiated thrombus formation.

  9. Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

    Science.gov (United States)

    Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

    2016-01-01

    A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

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    Zylfije Hundozi

    2016-12-01

    Full Text Available Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS thrombosis (SSST developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk.

  11. Moyamoya disease and sagittal sinus thrombosis in a child with Down's syndrome

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    Del-Rio Camacho, G.; Leal Orozco, A.; Camino Lopez, M.; Ruiz-Moreno, M. [Dept. of Paediatrics, Fundacion Jimenez Diaz, Madrid (Spain); Perez-Higueras, A.; Al-Assir, I. [Dept. of Neuroradiology, Fundacion Jimenez Diaz, Madrid (Spain)

    2001-02-01

    A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy. (orig.)

  12. [Vasculo-Behçet's disease with superior sagittal sinus thrombosis--case report (author's transl)].

    Science.gov (United States)

    Ueda, T; Gondo, M; Kitano, I; Kinoshita, K; Kikuchi, I

    1982-04-01

    The patient is a 30-year-old man who has suffered from recurrent attacks of tonsilitis, oral aphthae and scrotal ulcerations, erythema nodosum and thrombophlebitis. In April, 1980, he gradually developed headache and visual disturbance. On April 14, 1980, he was pointed out remarked bilateral choked disc by an ophthalmologist and then admitted to the Miyazaki Medical College Hospital. On admission to our service, he showed atypical symptoms of Behçet's disease, namely, oral aphthae and scrotal ulcerations, erythema nodosum and bilateral choked disc. Laboratory data demonstrated hyperimmunoglobulinemia, increased clotting factors and decreased fibrinolytic activity. Immunogenetically, HLA BW51 type was demonstrated. The angiograms showed complete obstructions of the superior sagittal sinus and the common trunk of the femoral artery. Histological examination of the skin lesion demonstrated atypical chronic inflammation and thrombophlebitis. A diagnosis of atypical Vasculo-Behçet's disease was made. The response to the steroid therapy was dramatic, though the fibrinolytic drugs, anticoagulants and vasodilators were not effective. Thrombophlebitis is a well recognized complication of Behçet's disease occurring in major vessels, however thrombosis of the dural sinus has rarely reported. This case may be the first one which had superior sagittal sinus thrombosis with Vasculo-Behçet's disease in literature. We discussed the mechanism of the thrombogenesis, the relationship to HLA, the coexistence of Neuro-Behçet's disease and the therapy of Vasculo-Behçet's disease.

  13. Trombosis del seno sagital en un neonato Sagittal sinus thrombosis in a newborn

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    Lisett Hernández León

    2012-12-01

    Full Text Available La trombosis de los senos venosos durales es una rara y devastadora enfermedad. Se presenta generalmente en mujeres y ancianos, y no es frecuente en niños, aunque se reconoce ya como una causa de morbilidad y mortalidad en la población pediátrica. Se han reportado pocos casos en el mundo de neonatos afectados por esta entidad, en su mayoría fatales e insuficientemente investigados. A continuación se presenta el caso de un recién nacido con una trombosis del seno sagital que sobrevivió. Los factores predisponentes para la aparición de la enfermedad en este caso fueron la asfixia neonatal, la deshidratación severa unida al uso de una línea venosa central, y la inmovilización prolongada. Aunque la TAC contrastada no es el estudio ideal para su diagnóstico, permitió realizarlo oportunamente en este caso. El tratamiento temprano con anticoagulantes permitió una rápida recuperación y favoreció la recanalización venosa del seno involucrado. Hasta el momento no se han detectado secuelas neurológicas y el paciente tiene buen desarrollo psicomotor.Dural venous sinus thrombosis is a rare devastating disease. It is generally found in females and old people, but is infrequent in children; however, it is already recognized as a morbidity and mortality cause in the pediatric population. Few cases of newborns with this disease have been reported worldwide; most of them were poorly studied and had fatal outcomes. Here is the presentation of a newborn with sagittal sinus thrombosis, who managed to survive. The predisposing factors for the disease were neonatal asphyxia, severe dehydration together with the use of central venous line and extended immobilization. Although contrast CAT is not the ideal study, it helped to promptly arrive at the right diagnosis in this case. The early treatment based on anticoagulants allowed rapid recovery and facilitated venous retaking of the involved venous sinus. No neurological sequels have been so far

  14. Cavernous sinus thrombosis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001628.htm Cavernous sinus thrombosis To use the sharing features on this page, please enable JavaScript. Cavernous sinus thrombosis is a blood clot in an ...

  15. cerebral venous sinus thrombosis

    African Journals Online (AJOL)

    2010-05-05

    May 5, 2010 ... day history of generalised tonic clonic seizures. The seizures were noted to last 5 minutes and followed ... the lateral and third ventricles was seen. Contrast enhanced CT scans showed the empty ... and absence of flow (Figure 3D) within the superior sagittal and right transverse sinuses. The patient was ...

  16. Pediatric cavernous sinus thrombosis

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    Vossough, Arastoo; Vorona, Gregory A.; Beslow, Lauren A.; Ichord, Rebecca N.; Licht, Daniel J.

    2015-01-01

    Objective: To describe clinical characteristics, imaging findings, morbidity, and mortality in a single-center cohort of 12 pediatric cavernous sinus thrombosis cases and to review all cases available in recent English literature. Methods: Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. A literature search and review was conducted, with additional cases pooled with the new cohort for an aggregate analysis. Results: Twelve cases of cavernous sinus thrombosis in children from the Children's Hospital of Philadelphia between January 1, 2000, and December 31, 2013, were reviewed. All patients survived to discharge; 3 of 12 (25%) experienced neurologic morbidity. Contrast-enhanced MRI and contrast-enhanced head CT were 100% sensitive for detecting cavernous sinus thrombosis, while noncontrast time-of-flight magnetic resonance venography (TOF MRV) and noncontrast head CT were 0% sensitive. Literature review produced an additional 40 cases, and the aggregate mortality rate was 4 of 52 (8%) and morbidity rate was 10 of 40 (25%). Outcomes did not vary by treatment or with unilateral vs bilateral cavernous sinus involvement. There was a trend toward worse outcomes with fungal infections. Conclusion: Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed. PMID:26231260

  17. Intracranial hypertension caused by a depressed skull fracture resulting in superior sagittal sinus thrombosis in a pediatric patient: treatment with ventriculoperitoneal shunt insertion.

    Science.gov (United States)

    Forbes, Jonathan A; Reig, Adam S; Tomycz, Luke D; Tulipan, Noel

    2010-07-01

    Intracranial hypertension resulting from compression of the superior sagittal sinus (SSS) by an overlying depressed calvarial fracture is a rare condition. Primary surgical treatment for the symptomatic patient in this setting traditionally involves elevation of the fracture, which often carries significant associated morbidity. The authors report a case involving a 6-year-old boy who suffered a closed, depressed, parietooccipital fracture as the result of an unhelmeted all-terrain vehicle accident. This fracture caused compression and subsequent thrombosis of the SSS, which resulted in CSF malabsorption and progressive intracranial hypertension. Initially headache free following the injury, he had developed severe and unremitting headaches by postinjury Day 7. A CT angiography study of the head obtained at this time exhibited thrombosis of the SSS underlying the depressed calvarial fracture. Subsequent lumbar puncture demonstrated markedly elevated intrathecal pressures. Large volumes of CSF were removed, with temporary improvement in symptoms. After medical management with anticoagulation failed, the decision was made to proceed with image-guided ventriculoperitoneal shunt insertion. The patient's headaches resolved immediately following the procedure, and anticoagulation therapy was reinstituted. Follow-up images obtained 4 months after the injury demonstrated evidence of resolution of the depressed fracture, with recanalization of the SSS. The anticoagulation therapy was then discontinued. To the authors' knowledge, this report is the first description of ventriculoperitoneal shunt insertion as the primary treatment of this infrequent condition. This report demonstrates that select patients with this presentation can undergo CSF diversion in lieu of elevation of the depressed skull fracture-a surgical procedure shown to be associated with increased risks when the depressed fracture overlies the posterior SSS. The literature on this topic is reviewed and

  18. Cavernous sinus thrombosis: current therapy.

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    Desa, Valmont; Green, Ryan

    2012-09-01

    Cavernous sinus thrombosis represents a rare but devastating disease process that may be associated with significant long-term patient morbidity or mortality. The prompt recognition and management of this problem is critical. However, most of the literature involves case-specific discussions. The purpose of this article was to review the literature and present current recommendations for the treatment of cavernous sinus thrombosis. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Unilateral papilledema in cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Girish Baburao Kulkarni

    2017-01-01

    Full Text Available In the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster–Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis. The risk factors found on evaluation were Vitamin B12 deficiency and hyperhomocysteinemia. On optic fundus examination, she had swollen optic disc on the right side with normal fundus on the left side, confirmed with the orbital ultrasound B-scan and optic coherence tomography. Her magnetic resonance imaging showed features of raised intracranial pressure with thrombosis of the superior sagittal and bilateral lateral sinus thrombosis. She was treated with anticoagulation (heparin followed by oral anticoagulants, antiedema measures, and vitamin supplementation for hyperhomocysteinemia. She improved over time and was asymptomatic during follow-up. We discuss the possible mechanisms described in the literature for unilateral papilledema. This report highlights the need for carefully performing bilateral fundus examination so as not to miss the vision or life-threatening causes of a headache.

  20. Cerebral venous sinus thrombosis: a report of two cases | Onyambu ...

    African Journals Online (AJOL)

    Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse ...

  1. Nonseptic and Septic Lateral Sinus Thrombosis: A Review

    OpenAIRE

    Viswanatha, B.; Thriveni, C. N.; Naseeruddin, Khaja

    2011-01-01

    Thrombosis of the lateral sinus can be classified into nonseptic lateral sinus thrombosis and septic lateral sinus thrombosis. Nonseptic lateral sinus thrombosis differs from septic lateral sinus thrombosis in that it is not associated with ear or sinus infection. Etiologies of these conditions are different and hence the management of these conditions is different. Nonseptic lateral sinus thrombosis requires medical line of management and anticoagulant therapy, where as septic lateral sinus ...

  2. Cerebral venous sinus thrombosis presenting with diplopia in pregnancy: a case report

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    Munira Yusoff

    2012-10-01

    Full Text Available Abstract Introduction Cerebral venous sinus thrombosis is a rare condition. The most frequent symptoms and signs are headache, focal seizures with or without secondary generalization, unilateral or bilateral paresis and papilledema. We report a case of transverse sinus and superior sagittal sinus thrombosis that presented with diplopia in a pregnant woman. Case presentation A 34-year-old Malay woman, gravida 3 para 2 at 8 weeks of pregnancy, was admitted for hyperemesis gravidarum, presented with sudden onset of diplopia, blurring of vision and headache. A magnetic resonance scan of her brain showed the presence of cerebral edema with no space occupying lesion, but magnetic resonance venography ultimately revealed right transverse sinus and superior sagittal sinus thrombosis. The patient was treated with anticoagulation for 1 year, after which the patient recovered fully. Conclusion Due to its diverse and varied neurological presentation, cerebral venous sinus thrombosis should be considered in almost any brain syndrome.

  3. Neck massage induced dural sinus thrombosis

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    Verma Ashish

    2007-01-01

    Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

  4. An incidental persistent falcine sinus with dominant straight sinus and hypoplastic distal superior sagittal sinus

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    Manoj, Krishnan Sarojam [Metroscans, Trivandrum (India); Krishnamoorthy, Thamburaj; Thomas, Bejoy; Kapilamoorthy, Tirur Raman [Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Imaging Sciences and Interventional Radiology, Trivandrum (India)

    2006-01-01

    An incidental persistent falcine sinus was detected in an otherwise normal brain on MRI in a 12-year-old girl who underwent imaging after clinical suspicion of acute disseminated encephalomyelitis. The falcine sinus was associated with a hypoplastic posterior third of the superior sagittal sinus and a dominant straight sinus. Generally, atresia or hypoplasia of the straight sinus is associated with a persistent falcine sinus in postnatal life; otherwise, the falcine sinus disappears before birth. We discuss the embryological basis for such an association in this case. (orig.)

  5. MR findings of septic cavernous sinus thrombosis

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    Lee, Hyeong Lae; Lee, Nam Joon; Lee, Jung Hee; Pyo, Hyeon Soon; Eo, Geun; Kim, Kyo Nam; Kim, Young Soon; Kim, Jang Min [Kwang Myung Sung Ae Hospital, Kwang Myung (Korea, Republic of); Lee, Don Young [Korea University Anam Hospital, Seoul (Korea, Republic of)

    2000-08-01

    To evaluate the MR findings of septic thrombosis of the cavernous sinus. Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings. (author)

  6. Cerebral and Sinus Vein Thrombosis

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    ... The typical target INR is 2.0 to 3.0. One of the newer oral blood thinners (rivaroxaban [ ... the Council on Epidemiology and Prevention . Diagnosis and management of cerebral venous thrombosis: a statement for healthcare ...

  7. Cerebral Venous Sinus Thrombosis, a Nonenhanced CT Diagnosis?

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    Ali Alsafi

    2015-01-01

    Full Text Available Purpose. Retrospectively evaluate the density of cerebral venous sinuses in nonenhanced head CTs (NCTs and correlate these with the presence or absence of a cerebral venous sinus thrombus (CVST. Materials and Methods. Institutional review board approval was obtained and informed consent waived prior to commencing this retrospective study. Over a two-year period, all CT venograms (CTVs performed at our institution were retrieved and the preceding/subsequent NCTs evaluated. Hounsfield Units (HUs of thrombus when present as well as that of normal superior sagittal and sigmoid sinuses were measured. HU of thrombus was compared to that of normal vessels with and without standardisation to the average HU of the internal carotid arteries. Results. 299 CTVs were retrieved, 26 with a thrombus. Both raw and standardised HU measurements were significantly higher in CVST (p<0.0001 compared to normal vessels. Both raw and standardised HUs are good predictors of CVST. A HU of ≥67 and a standardised measurement of ≥1.5 are associated with high probability of CVST on NCT. Conclusion. Cerebral venous sinus HU measurements may help improve sensitivity and specificity of NCT for venous sinus thrombosis and avoid potentially unnecessary follow-up examinations.

  8. Cerebral venous sinus thrombosis following sildenafil administration; a case report

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    Daryoosh Afshari

    2010-09-01

    Full Text Available Background: Sildenafil is a selective inhibitor of phosphodiesterase type 5 (PDE5 which currently used for the treatment of erection dysfunction (ED. Medicine approved by the FDA for treatment of pulmonary hypertension. Although there is no evidence of hypercoagulation states being associated with the use of PDE5 inhibitors, several animal studies suggest that PDE5 inhibitors may cause arterial and venous thrombotic or embolic events. Case report: The patient was a 37 year old man who had suffered sever headache and tonic- clonic generalized seizure. In neurological examination, he had decreased level of consciousness and he had no other positive finding in examination. The patient has been constantly taken 100 mg of Sildenafil once a day without medical supervision over the last month. Brain computerized tomography (CT showed a small hemorrhage in left frontal lobe with suspicious to cerebral venous sinus thrombosis (CVST lumbar puncture was performed. Increased cerebrospinal fluid pressure suggested the probability of CVST. Brain MRI result confirmed superior sagittal sinus thrombosis. Conclusion: Cerebral venous sinus thromboses need to be considered a potential side effect of Sildenafil administration.

  9. LATERAL SINUS THROMBOSIS IN OTOLOGY: A REVIEW

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    B Visavanatha

    2010-09-01

    Full Text Available Lateral sinus thrombosis (LST is usually occurs as a complication of middle ear infection .The involvement of lateral sinus during the course of ear infection was a well known complication in preantibiotic days .The decrease in the incidence of LST is due to the introduction of broad-spectrum antibiotics, early diagnosis and surgical treatment. Now, it is a rare complication of otitis media and poses a serious threat that warrants immediate medical and surgical treatment. The classical clinical picture is often changed by previous antibiotic therapy. An awareness of this rare potentially devastating condition and its varied presentations is necessary for early diagnosis and treatment. LST can also occur after head injury.

  10. Neurological Manifestations of Dural Sinus Thrombosis | Ali | Sudan ...

    African Journals Online (AJOL)

    ... head ache, neck pain and stiffness were the frequent neurological symptoms. Papilledema was the commonest neurological finding. Saggital sinus thrombosis was found to be the major radiological finding and great majority of patients showed remarkable improvement with treatment. Conclusion: Dural sinus thrombosis ...

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

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    D. Swaminath

    2014-01-01

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

  12. Clinical analysis of cerebral venous sinus thrombosis and its combined treatment of anticoagulation and endovascular thrombolysis

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    Yun JIANG

    2018-01-01

    Full Text Available Objective To investigate the clinical and imaging manifestations of cerebral venous sinus thrombosis (CVST, and the clinical effect of combined treatment of anticoagulation and endovascular thrombolysis. Methods and Results The clinical manifestations of 22 CVST patients were highly variable. Headache (90.91%, 20/22 was the most frequent symptom, and conscious disturbance, seizure and focal neurological deficits were commonly present. Plasma D-dimer level was elevated in 12 patients (54.55%. Lumbar puncture was performed in 14 patients, in whom intracranial hypertension was present in 9 patients (9/14 with no characteristic changes in routine and biochemical examination of cerebrospinal fluid (CSF. Brain CT/MRI and CTV/MRV showed direct signs of CVST in all 22 patients, involving superior sagittal sinus, transverse sinus, sigmoid sinus, straight sinus and cortex veins, parenchymal lesions (infarction, hemorrhage and white matter abnormalities in 13 patients (59.09%, subarachnoid hemorrhage (SAH in 2 patients (9.10% and subdural hematoma in one patient (4.55%. The involved cerebral sinuses revealed by DSA were superior sagittal sinus in 13 patients (59.09% , transverse sinus in 17 patients (77.27%, sigmoid sinus in 14 patients (63.64%, inferior sagittal sinus in 2 patients (9.10%, straight sinus in 4 patients (18.18%, vein of Galen in one patient (4.55% and jugular vein in one patient (4.55%. Two thrombosed sinuses were found in 9 patients (40.91% and 3 or more thrombosed sinuses in 8 patients (36.36% . As no clinical improvements and progressive exacerbation were observed several days after heparin sodium intravenous drip or lower molecular weight heparin (LMWH hypodermic injection with oral warfarin anticoagulant therapy, urokinase thrombolysis in venous sinus or artery was applied in 21 patients (95.45%. After (25.70 ± 12.18 d treatment with anticoagulation, the modified Rankin Scale (mRS score of 13 patients (59.09% reached 0-1, 4 patients

  13. BILATERAL INTRAOCULAR HEMORRHAGE SECONDARY TO CEREBRAL VENOUS SINUS THROMBOSIS.

    Science.gov (United States)

    Kunle-Hassan, Feyi; Dattani, Minaxi; Snead, Martin; Subash, Mala

    2016-10-05

    To report a case of bilateral intraocular hemorrhage secondary to cerebral venous sinus thrombosis with no associated intracranial hemorrhage. Case report. A 32-year-old Asian gentleman presented with left reduced vision as a result of a left subhyaloid macular hemorrhage associated with severe headache. Right retinal hemorrhages were also present. Magnetic resonance imaging and computed tomography brain imaging demonstrated cerebral transverse venous sinus thrombosis. Intraocular hemorrhage has previously been described in association with intracranial hemorrhage and in particular subarachnoid hemorrhage (Terson syndrome). We describe a similar clinical picture in the context of cerebral venous sinus thrombosis with no associated intracranial hemorrhage.

  14. Clinical associations, biological risk factors and outcomes of cerebral venous sinus thrombosis.

    Science.gov (United States)

    Gunes, Hafize Nalan; Cokal, Burcu Gokce; Guler, Selda Keskin; Yoldas, Tahir Kurtulus; Malkan, Umit Yavuz; Demircan, Cemile Sencer; Yon, Mehmet Ilker; Yoldas, Zeynep; Gunes, Gursel; Haznedaroglu, Ibrahim Celalettin

    2016-12-01

    Objective Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease affecting young adults. The majority of the patients are female. The aim of this study is to assess the clinical associations, risk factors and outcomes of the patients with CVST. Methods The data of 75 patients with CVST admitted to our hospital between 2006 and 2016 were reviewed. Demographic and clinical features and the thrombophilic risk factors of the patients were recorded. The localizations of the thrombi were determined and modified Rankin score at the time of onset and discharge were calculated. Results The majority of our patients (78.7%) were female. Median age was 35 years (16-76). The most common symptom was headache (86.7%). In 82.6% of our patients, inherited or acquired risk factors for thrombosis were detected. Transverse sinus was the most common site of thrombosis followed by sigmoid and superior sagittal sinuses. Two thirds of the patients had involvement of multiple sinuses. The patients with the involvement of sagittal sinus had better disability at the time of admittance ( p = 0.013) while the number of involved sinuses was correlated worse disability ( p = 0.015). The neurologic states in the majority of the patients were improved by the end of the hospitalization period ( p = 0.001). There was no significant difference in disability score at discharge between men and women ( p = 0.080). No patient with CVST died in the hospitalization period. Conclusions This study is one of the largest cohort studies on CVST in our region. The results of the study disclosed that CVST had wide range of clinical manifestations and non-specific symptoms at the beginning. For that reason, in especially high risk groups for thrombosis, the diagnosis of CVST should be kept in mind.

  15. MR imaging of dural sinus thrombosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si Kyung; Han, Chun Hwan; Lee, Moon Ok; Park, Kyung Joo; Lee, Joo Hyuk [Kang Nam General HosPital, Public Corporation, Seoul (Korea, Republic of)

    1993-01-15

    We present a case of angiographically confirmed transverse and sigmoid sinus thrombosis, image with MR, in a 20 year old male with a history of otitis media and maxillary sinusitis. T1-weighted image demonstrated an iso signal intensity mass with tubular-shaped low signal intensity in right transverse and sigmoid sinus. The thrombus had high signal intensity on T2-weighted image. The signal intensity of the thrombus on Gd-DTPA enhanced T1-weighted image was unusually high similar to that of transverse sinus. Although dural sinus thrombosis has a non-specific MR signal intensity, findings of MRI in this case may serve as an aid in future evaluation of venous thrombosis.

  16. Traumatic dural sinus thrombosis causing persistent headache in a child

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    Lakhkar Bhavana

    2010-01-01

    Full Text Available Dural venous sinus thrombosis following a mild head injury is increasingly recognized. We report case of a 9-year-old male child presented with progressive headache and vomiting following a minor fall. A diagnosis of sinus venous thrombosis was suspected on nonenhancing computed tomography, and that was confirmed with magnetic resonance venography. The child was managed with intravenous fluids, anticoagulation (injection heparin followed by oral anticoagulants-tab coumarin, antiedema measures (mannitol, and antiepileptics (phenytoin with good outcome.

  17. 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.

  18. Strategies in the treatment for intracranial venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    JIA Qiang

    2013-03-01

    Full Text Available Background Cerebral venous sinus thrombosis (CVST is a special type of cerebrovascular disease with high morbidity and mortality which often has an unpredictable outcome. It is usually misdiagnosed because of different causes and variable clinical manifestations. How to improve the diagnosis and therapy of CVST is always the hotspot in clinic. This article aims to investigate the effective and safe strategies in the treatment for CVST. Methods Clinical data of 52 patients diagnosed with CVST were retrospectively analyzed. These patients were subdivided into mild type and severe type according to the features of symptoms, signs, lumbar puncture pressure and imaging. The patients with mild type were treated with systemic anticoagulant therapy combined with intravenous thrombolysis [continuous intravenous infusion of heparin (12.50-25 × 103 U/d for 7-10 d followed by a continuous infusion of urokinase (0.50-0.75 ×106 U/d for 5-7d]. The patients with severe type were treated with endovascular thrombolysis [injection of urokinase (0.50-1 × 106 U, 0.10 × 106 U/min via carotid or vertebral artery; or intravenous infusion of urokinase 1 ×106 U/d and heparin 25 ×103 U/d for 5-7 d], and superior sagittal sinus cut-open/ intrasinus thrombolysis separately. All the patients took oral warfarin for 6-12 months, and follow-up was performed after operation by the method of magnetic resonance venography (MRV. Results Among the 27 cases of mild type receiving systemic anticoagulant agents and intravenous thrombolysis, 14 were cured; 9 were improved; 4 were ineffective. Among the 22 cases of severe type receiving systemic anticoagulant drugs and endovascular thrombolysis, 18 were cured; 3 were improved; 1 was dead. The left 3 cases with gravis type received superior sagittal sinus cut-open/intrasinus thrombolysis and were cured. The period of follow-up was between 6 months and 60 months (the median time was 36 months, and no recurrence happened. Conclusion

  19. Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging

    DEFF Research Database (Denmark)

    Gideon, P; Thomsen, C; Gjerris, F

    1996-01-01

    PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopath...... in the dural sinuses in various pathologies resulting in dural sinus occlusion, such as dural sinus thrombosis, and for following the progress of these patients while undergoing treatment....

  20. Neurological recovery after coma related to diffuse cerebral venous sinus thrombosis. Interest in thrombi-aspiration with Penumbra system.

    Science.gov (United States)

    Gariel, Florent; Berge, Jerome; Dousset, Vincent

    2015-04-01

    We report a young man with a history of deep coma secondary to an extensive superior sagittal sinus thrombosis despite full systemic anticoagulation. Endovascular treatment combining a 5 Max ACE reperfusion catheter (Penumbra) and Solitaire (Covidien) retrieval device permitted revascularization of the superior sagittal sinus with restoration of anterograde venous flow. This treatment led to the disappearance of cytotoxic edema on MRI and to a neurological improvement with a modified Rankin scale score of 2 after two months. Our experience shows that this technique provides a useful and safe tool after failure of anticoagulation in cerebral venous sinus thrombosis. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Traumatic dural venous sinus thrombosis: A Mini Review

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    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  2. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

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    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  3. Craniotomy of the Fused Sagittal Suture Over the Superior Sagittal Sinus Is a Safe Procedure.

    Science.gov (United States)

    Kölby, David; Fischer, Sara; Arab, Khalid; Maltese, Giovanni; Olsson, Robert; Paganini, Anna; Tarnow, Peter; Kölby, Lars

    2017-05-01

    Spring-assisted cranioplasty to correct sagittal synostosis is based on midline craniotomy through the closed sagittal suture, over the superior sagittal sinus (SSS). The aim of the present study was to evaluate the perioperative safety of this technique. This is a retrospective study of all patients operated with median craniotomy and springs from 1998 to the end of 2015. For comparison, all Pi-plasties performed during the same time interval were also evaluated. The safety measures were evaluated based on incidence of damage to SSS, incidence of dural tears, perioperative blood loss, operative time, and hospital stay. In the group that had undergone midline craniotomy combined with springs (n = 225), 4 perioperative damages to SSS and 1 dural tear were seen. The perioperative blood loss was 62.8 ± 65.3 mL (mean ± standard deviation). The operative time was 67.9 ± 21.5 minutes and the hospital stay was 4.8 ± 1.1 days. In the group that had undergone pi-plasty (n = 105), no damages to SSS but 3 dural tears were seen. The perioperative blood loss was 352.8 ± 174.4 mL. The operative time was 126.0 ± 31.7 minutes and the hospital stay was 7.1 ± 1.4 days. Craniotomy SSS in sagittal synostosis is a safe procedure with low morbidity in terms of damage to the SSS. Midline craniotomy combined with springs has significantly lower preoperative blood loss, operative time, and hospital stay (P < 0.001 for all) compared to pi-plasty.

  4. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

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    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  5. Delay in the Diagnosis of Cerebral Vein and Dural Sinus Thrombosis Influence on Outcome

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando; Massaro, Ayrton; Ducrocq, Xavier; Kasner, Scott E.

    2009-01-01

    Background and Purpose-Diagnostic delay of cerebral vein and dural sinus thrombosis may have an impact on outcome. Methods-In the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) cohort (624 patients with cerebral vein and dural sinus thrombosis), we analyzed the predictors

  6. Cerebral vein and dural sinus thrombosis in elderly patients

    NARCIS (Netherlands)

    Ferro, José M.; Canhão, Patrícia; Bousser, Marie-Germaine; Stam, Jan; Barinagarrementeria, Fernando

    2005-01-01

    Backgound and Purpose - The clinical features and prognosis of cerebral vein and dural sinus thrombosis (CVT) in elderly patients have not been previously described. Methods - In a multicenter prospective observational study, we compared clinical and imaging features, risk factors, and outcome of

  7. Reproduction of superior sagittal sinus animal model by bypass transplantation of biomaterial graft

    Directory of Open Access Journals (Sweden)

    Qing-yong LUO

    2011-03-01

    Full Text Available Objective To establish the beagles model of superior sagittal sinus bypass graft,and explore the feasibility of reconstruction of superior sagittal sinus with biomaterials using this model.Methods Eight adult male beagles(weight: 12.5-22.0kg were involved in the present study.The superior sagittal sinus was exposed and blocked via bone window,and then anastomosed side-to-end to the biomaterial graft under the dedicated microscope of neurosurgery surgery,expectant treatment such as anti-inflammatory was given for the animals.The digital subtraction venography(DSV and color Doppler flow imaging(CDFI of superior sagittal sinus were performed in 1,2,4 and 8 weeks after the operation.Eight weeks after the operation,all the animals were sacrificed and the material graft was examined histologically.Results The DSV and CDFI of superior sagittal sinus showed that the stomas of 2 beagles were with slight stenosis and high flow velocity,of 1 beagle with small leakage and low flow velocity,while of other 5 beagles were normal.The histological examination showed endothelial cells were growing on the graft and superior sagittal sinus,and crawling toward the lumen of graft 8 weeks after the operation.Conclusion The beagles model of superior sagittal sinus bypass graft was established successfully.The short-term effect of the model was satisfactory,while further work should be performed to determine the long-term effects.

  8. Lateral sinus thrombosis patient presenting with headache and vomiting

    OpenAIRE

    Ayşenur Paç Kısaarslan; Yasemin Altuner Torun; Hümeyra Aslaner; Mehmet Somtaş; Ümmügülsüm Gümüş

    2013-01-01

    Lateral sinus thrombosis is rare intracranial complicationsof otitis media. A 12 years old girl patient presented withcomplaints of vomiting and headeche. Patient treated withceftriaxone had lost seven kilograms in ten days. Therewere complaints of frequent upper way infection andotitis media. Physical examination of right ear was painfuland right tympanic membrane was pale. Laboratorytests shuch as hemogram, blood smear, Brucellatube agglütination test, biochemistry tests, abdomenultrasaund ...

  9. Quantitative assessment of the superior sagittal sinus on unenhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fanous, Randy, E-mail: randy.fanous@gmail.co [University of Toronto, Department of Medical Imaging (Canada); Leung, Andrew; Karlik, Stephen [University of Western Ontario, Department of Diagnostic Radiology and Nuclear Medicine (Canada)

    2010-09-15

    Purpose: To determine the relationship between hemoglobin levels and attenuation measurements of the superior sagittal sinus (SSS) on unenhanced computed tomography (UECT). Secondly, to determine if SSS attenuation values are normally distributed such that measurements below and above certain thresholds are suggestive of pathology, such as anemia or acute venous thrombosis respectively. Methods: Institutional review board approval was obtained for retrospective review of adult patients having both an UECT head examination and a complete blood count within 24 h of the scan. A cohort of 151 consecutive patients formed the study sample (76 males and 75 females, 17-91 years of age with a mean of 61). The dorsal aspect of the SSS was divided into upper, middle and lower segments. Using freehand and circle region of interest (ROI) techniques, a total of six attenuation measurements were obtained from each patient. Next, statistical analyses were preformed to assess the correlation between Hgb levels and attenuation values, and distribution curves were plotted to assess the normal range of SSS attenuation measurements. Results: There is a moderate, yet statistically significant (p < 0.001), correlation between Hgb levels and attenuation values in upper, middle and lower segments of the SSS (r = 0.487, 0.497 and 0.533 respectively). Based on the calculated mean, median and mode, the attenuation values are normally distributed. When using the freehand ROI technique, the mean value is 50 Hounsfield Units (HU) with a standard deviation (SD) of 7.5. Attenuation values less than 2 SDs (35 HU) are highly suggestive of anemia (specificity and PPV = 100%). Conclusion: There is a moderate, yet statistically significant, correlation between Hgb levels and attenuation of the SSS on UECT. Furthermore, attenuation measurements of the SSS are normally distributed with a mean of 50 HU and a SD of 7.5. Therefore, quantitative assessment of the SSS may prove useful in the clinical practice

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  11. Lateral sinus thrombosis patient presenting with headache and vomiting

    Directory of Open Access Journals (Sweden)

    Ayşenur Paç Kısaarslan

    2013-01-01

    Full Text Available Lateral sinus thrombosis is rare intracranial complicationsof otitis media. A 12 years old girl patient presented withcomplaints of vomiting and headeche. Patient treated withceftriaxone had lost seven kilograms in ten days. Therewere complaints of frequent upper way infection andotitis media. Physical examination of right ear was painfuland right tympanic membrane was pale. Laboratorytests shuch as hemogram, blood smear, Brucellatube agglütination test, biochemistry tests, abdomenultrasaund and chest X-ray were all normal. Besides aCRP was 65 mg/L and sedimantation rate was 26 mm/h.PT and PTT values were 15,1 and 29,8s respectively,fibrinogen was 280 mg/dl. In urine analysis +3 ketonbodies were observed. Homosistein level was normal,MTFHR gene polymorphism was heterozigot A1298C.Magnetic resonance imaging (MRI showed right chronicotitis media and thrombosis in both lateral and sigmoidsinuses. She was treated mastoidectomy and concurrentmiddle ear ventilation tubes. Enoxaparin was also startedin postoperative treatment. Intracranial problems must berapidly evaluated in patients with headache and vomiting.In this study we aimed to emphasize that lateral sinusthrombosis has to be taken into consideration in patientscomplainig intracranial problems with headache andvomiting.Key words: Otitis media, lateral sinus thrombosis,headache, vomiting

  12. Suction thrombectomy after balloon maceration for dural venous sinus thrombosis.

    Science.gov (United States)

    Lee, Chung-Wei; Liu, Hon-Man; Chen, Ya-Fang; Lin, Yen-Heng; Wang, Jaw-Lin

    2016-06-15

    To introduce the combination of suction thrombectomy (ST) and balloon maceration (BM) for the management of dural venous sinus thrombosis (DVST). Ten consecutive patients (average age, 53±15years; range, 30 to 73years) with DVST treated by ST after BM were evaluated including location of DVST, imaging presentation, procedural findings, and 3-month modified Rankin scale (mRS). All 10 patients had evidence of venous infarct on MR or CT. In addition, seven patients had intracerebral hemorrhage (ICH), one had subarachnoid hemorrhage (SAH), and one had both ICH and SAH. More than one sinus was involved in nine patients. ST after BM was technically successful in all patients, and angiographic relief of venous congestion and good outcome (3-month mRS 0 or 1) was achieved in eight patients (80%). The average procedural time was 73.5±24.7min. Two patients who were in coma status had negative outcomes, and one had a known chronic thrombotic segment refractory to treatment. No recurrent thrombosis of recanalized sinus was found on follow-up MR venography in six patients and CT venography in two patients. BM followed by ST is a promising technique for the treatment of acute DVST. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gideon, P. [Danish Research Centre of Magnetic Resonance, Hvidovre Hospital, Univ. of Copenhagen (Denmark); Thomsen, C. [Danish Research Centre of Magnetic Resonance, Hvidovre Hospital, Univ. of Copenhagen (Denmark); Gjerris, F. [Univ. Clinic of Neurosurgery, Rigshopitalet, Copenhagen (Denmark); Soerensen, P.S. [Univ. Clinic of Neurology, Rigshospitalet, Copenhagen (Denmark); Staahlberg, F. [Danish Research Centre of Magnetic Resonance, Hvidovre Hospital, Univ. of Copenhagen (Denmark); Henriksen, O. [Danish Research Centre of Magnetic Resonance, Hvidovre Hospital, Univ. of Copenhagen (Denmark)

    1996-03-01

    To measure blood flow and velocity in the superior sagittal sinus. MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic intracranial hypertension (IIH). Mean blood flow was 443 ml/min in healthy volunteers with a tendency towards reduced blood flow with increasing age. In NPH patients significantly lower superior sagittal sinus blood flow values were found, but this difference was no longer significant when patients and controls were matched for age. In HPH and IIH patients blood flow and velocity were within the normal range. In one patient with thrombosis of the superior sagittal sinus the blood flow was reduced to 40 ml/min. MR velocity mapping methods may be of value in the assessment of blood flow in the dural sinuses in various pathologies resulting in dural sinus occlusion, such as dural sinus thrombosis, and for following the progress of these patients while undergoing treatment. (orig.).

  14. Presentation and management of lateral sinus thrombosis following posterior fossa surgery.

    Science.gov (United States)

    Apra, Caroline; Kotbi, Owais; Turc, Guillaume; Corns, Robert; Pagès, Mélanie; Souillard-Scémama, Raphaëlle; Dezamis, Edouard; Parraga, Eduardo; Meder, Jean-François; Sauvageon, Xavier; Devaux, Bertrand; Oppenheim, Catherine; Pallud, Johan

    2017-01-01

    OBJECTIVE There are no guidelines for the management of postoperative lateral sinus thrombosis following posterior fossa surgery. Introducing treatment-dose anticoagulant therapy during the immediate postoperative period increases the risk of intracranial bleeding. This study assessed the incidence of and risk factors associated with postoperative lateral sinus thrombosis and the complications related to thrombosis and/or anticoagulation. METHODS This study was a retrospective monocentric analysis of adult patients who underwent surgical removal of a posterior fossa space-occupying lesion with available postoperative imaging. Postoperative lateral sinus thrombosis was defined as a T2* hypointensity within the venous sinus and/or a filling defect on postcontrast MRI or CT scan. RESULTS Among 180 patients, 12 (6.7%; 95% CI 3.0-10.4) were found to have lateral sinus thrombosis on postoperative imaging, none of whom were symptomatic. Unadjusted risk factors for postoperative lateral sinus thrombosis were a history of deep venous thrombosis (p = 0.016), oral contraceptive pill (p = 0.004), midline surgical approach (p = 0.035), and surgical exposure of the sinus (p postoperative lateral sinus thrombosis received immediate treatment-dose anticoagulant therapy. Lateral sinus recanalization occurred radiologically at a mean time of 272 ± 23 days in 85.7% of patients (6 of 7) undergoing treatment-dose anticoagulant therapy and in 20% of patients (1 of 5) not receiving treatment-dose anticoagulant therapy. Postoperative complications occurred in 56.2% of patients (9 of 16) who received treatment-dose curative anticoagulant therapy and in 27% of patients (45 of 164) who did not. CONCLUSIONS Incidental radiological lateral sinus thrombosis following posterior fossa surgery has an incidence of 6.7%. To further define the benefit-to-risk ratio of a treatment-dose anticoagulant therapy, a prospective trial should be considered.

  15. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M. [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B.; Draf, W. [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G. [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  16. Melanotic Neuroectodermal Tumor of Infancy with Involvement of the Superior Sagittal Sinus.

    Science.gov (United States)

    Foster, Kimberly A; Choudhri, Asim; Lingo, Ryan; Boop, Frederick

    2017-01-01

    Melanotic neuroectodermal tumor of infancy (MNTI) is a rare lesion that typically manifests in the first year of life, most commonly involving the facial bones. We present 2 infants with MNTI involving the posterior skull with associated compression of the superior sagittal sinus (SSS). A review of the anatomical locations of MNTI is offered, and the implications of SSS involvement are described. This represents the first known description of MNTI with involvement of the posterior SSS. © 2016 S. Karger AG, Basel.

  17. Sinus and venous thrombosis - a differential diagnosis of acute stroke; Die Sinus- und Venenthrombose - eine Differenzialdiagnose des akuten Schlaganfalls

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Dorenbeck, U.; Papanagiotou, P.; Reith, W. [Universitaetsklinikum des Saarlandes Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Holst, B. [Klinikum Saarbruecken gGmbH (Germany). Institut fuer Bildgebende Diagnostik und Interventionen

    2005-05-01

    Thrombosis of the cerebral veins and sinus is a rare, but important cause of stroke. The clinical picture varies. This contribution addresses the etiology, clinical picture, imaging procedures, and therapeutic options. (orig.) [German] Die Thrombose der Hirnvenen und zerebralen Sinus ist eine seltene, aber wichtige Ursache des Schlaganfalls. Das klinische Bild ist variabel. Dieser Artikel befasst sich mit der Aetiologie, dem klinischen Bild sowie der Bildgebung und den Therapieoptionen. (orig.)

  18. Bright sinus appearance on arterial spin labeling MR imaging aids to identify cerebral venous thrombosis.

    Science.gov (United States)

    Kang, Ji Hee; Yun, Tae Jin; Yoo, Roh-Eul; Yoon, Byung-Woo; Lee, A Leum; Kang, Koung Mi; Choi, Seung Hong; Kim, Ji-Hoon; Sohn, Chul-Ho; Han, Moon Hee

    2017-10-01

    Cerebral venous thrombosis is a potentially lethal disease. Early diagnosis is essential to improve its prognosis. However, its early diagnosis based on conventional imaging modalities remains a challenge in clinical settings. The purpose of this study was to evaluate whether bright sinus appearance on arterial spin-labeling perfusion-weighted image (ASL-PWI) could help identify cerebral venous thrombosis.ASL-PWI of 13 patients who were confirmed as cerebral venous thrombosis based on neurologic symptoms and computed tomography (CT) or magnetic resonance (MR) venography (with/without cerebral angiography) were retrospectively analyzed for the presence or absence of the following: bright signal in dural sinus termed "bright sinus appearance"; and hypoperfusion in brain parenchyma drained by thrombosed sinus. In addition, conventional MR findings, including susceptibility vessel sign, empty delta sign, and atypical distribution against arterial territory, were also analyzed.Bright sinus appearance on ASL-PWI was found in all (100%) 13 patients. In addition, 10 (77%) patients showed hypoperfusion in the brain parenchyma drained by thrombosed sinus on ASL-PWI. Susceptibility vessel sign and empty delta sign were revealed in 11 (85%) and 7 (54%) patients, respectively. Atypical distribution against arterial territory was seen in 5 (50%) of the 10 patients with parenchymal abnormality on conventional MR sequences. Therefore, the bright sinus appearance had higher sensitivities for identifying cerebral venous thrombosis than the susceptibility vessel sign, empty delta sign, and atypical distribution against arterial territory (with differences of 15%; P = .500, 46%; P = .031, and 50%; P = .031, respectively).Bright sinus appearance on ASL-PWI can provide important diagnostic clue for identifying cerebral venous thrombosis. Therefore, this technique may have the potential to be used as a noninvasive diagnostic tool to identify the cerebral venous thrombosis.

  19. Fatal superior sagittal sinus hemorrhage as a complication of aplasia cutis congenita: a case report and literature review.

    Science.gov (United States)

    Johnson, Rowena; Offiah, Amaka; Cohen, Marta C

    2015-06-01

    Aplasia cutis congenita (ACC) is a rare condition that occurs in around 0.01% of births. Characterized by a localized absence of skin, it affects the midline of the scalp in over 80% of cases. We describe the case of an infant born via vaginal spontaneous delivery with ACC affecting the scalp. This extended to the subcutaneous tissue and bone leaving the dura mater exposed. The patient was managed conservatively. At 4 weeks of age, she had a fatal superior sagittal sinus hemorrhage. In a review of the literature, we found ten previous cases of hemorrhage of the superior sagittal sinus complicating an ACC. Including our case, ACC complicated by hemorrhage of the superior sagittal sinus shows a 36% mortality (4/11). An analysis of these cases suggests that this tends to occur between 1 and 3 months of age, though it may occur in younger neonates.

  20. Skull fracture with effacement of the superior sagittal sinus following drone impact: a case report.

    Science.gov (United States)

    Chung, Lawrance K; Cheung, Yuri; Lagman, Carlito; Au Yong, Nicholas; McBride, Duncan Q; Yang, Isaac

    2017-09-01

    The popularity of unmanned aerial vehicles, or drones, raises safety concerns as they become increasingly common for commercial, personal, and recreational use. Collisions between drones and people may result in serious injuries. A 13-year-old male presented with a comminuted depressed skull fracture causing effacement of the superior sagittal sinus secondary to a racing drone impact. The patient experienced a brief loss of consciousness and reported lower extremity numbness and weakness after the accident. Imaging studies revealed bone fragments crossing the superior sagittal sinus with a short, focal segment of blood flow interruption. Neurosurgical intervention was deferred given the patient's improving neurological deficits, and the patient was treated conservatively. He was discharged home in stable condition. Drones may represent a hazard when operated inappropriately due to their capacity to fly at high speeds and altitudes. Impacts from drones can carry enough force to cause skull fractures and significant head injuries. The rising popularity of drones likely translates to an increased incidence of drone-related injuries. Thus, clinicians should be aware of this growing trend.

  1. Venous hypertensive encephalopathy secondary to venous sinus thrombosis and dural arteriovenous fistula.

    Science.gov (United States)

    Anand, Pria; Orru, Emanuele; Izbudak, Izlem; Zhang, Jiaying; Kheradmand, Amir

    2017-08-01

    A 52-year-old man with a history of factor V Leiden thrombophilia, persistent headaches and papilloedema presented with worsening vision and confusion. MRI and MR angiography of the brain at the time of this presentation showed findings concerning for transverse sinus thrombosis and an associated dural arteriovenous fistula. Dural venous sinus thrombosis can lead to the formation of a dural arteriovenous fistula, which must be considered in the differential diagnosis for intracranial hypertension in patients with thrombophilia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. MRI findings in a child with sigmoid sinus thrombosis following mastoiditis

    Energy Technology Data Exchange (ETDEWEB)

    Bosch, Maurice A.A.J. van den [Department of Radiology, University Medical Centre Utrecht, Room E01-132, Heidelberglaan 100, 3584 CX, Utrecht (Netherlands); Vos, Jan A. [Department of Radiology, St. Antonius Hospital, Nieuwegein (Netherlands); Letter, Marie A.C.J. de [Department of Neurology, St. Antonius Hospital, Nieuwegein (Netherlands); Ru, Jacob A. de [Department of Otolaryngology, University Medical Centre Utrecht, Utrecht (Netherlands); Diemen-Steenvoorde, Ronnie A.A.M. van; Ploetz, Frans B. [Department of Paediatrics, St. Antonius Hospital, Nieuwegein (Netherlands)

    2003-12-01

    We describe the MRI features of sigmoid sinus thrombosis following mastoiditis in a 3-year-old girl. The features consisted of increased signal from the sinus on T2-weighted images and absence of flow on MR venography. It is concluded that MRI enabled a timely diagnosis of this life-threatening disease. MRI, as a non-invasive technique that does not use ionizing radiation, should be considered the investigation of first choice, especially in young patients. (orig.)

  4. Septic Cavernous Sinus Thrombosis: Case Report and Review of the Literature

    Science.gov (United States)

    Weerasinghe, Dinushi; Lueck, Christian J.

    2016-01-01

    ABSTRACT Septic cavernous sinus thrombosis is a rare but serious complication of infection of the cavernous sinuses. There are no randomised, controlled trials of management of this condition and existing reviews of the literature are somewhat dated. The authors report a case with a favourable outcome and then present the findings of a literature review of the management of this condition. Outcome data suggest that corticosteroids are of equivocal benefit whereas antibiotics and anticoagulation are beneficial. PMID:27928417

  5. Emergency surgical management of traumatic superior sagittal sinus injury: An unusual case

    Directory of Open Access Journals (Sweden)

    Sudhansu Sekhar Mishra

    2012-01-01

    Full Text Available Head injuries following fall of heavy objects are not very uncommon in developing countries. However, compound depressed skull fracture with superior sagittal sinus (SSS laceration caused by a flying asbestos fragment in a stormy afternoon is an unusual mode of head injury. We report such an unusual case of compound depressed skull fracture by an asbestos fragment injuring the middle third of SSS and its successful surgical management in a 14-year-old child. The role of computed tomography (CT scan of head with 3D reconstruction is highlighted. Early steps taken in this case to check the profuse bleeding, which helped save the life of this boy is interesting to note.

  6. Dural arteriovenous fistula associated with neoplastic dural sinus thrombosis: two cases

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P. [Neuroradiology Department, Garcia de Orta Hospital (Portugal); Willinsky, R.; TerBrugge, K. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology

    2001-10-01

    Intracranial dural arteriovenous fistulae are direct arteriovenous shunts within the dura matter. We report two cases of arteriovenous fistulae upstream to a neoplastic dural sinus thrombosis. These cases add further support to the acquired etiology of dural arteriovenous fistulae and to the fact that venous hypertension is one of the most important precipitating factors. (orig.)

  7. Rhino-orbitocerebral mucormycosis associated with cavernous sinus thrombosis: case report

    Directory of Open Access Journals (Sweden)

    Haber, Daniel Martiniano

    2008-12-01

    Full Text Available Introduction: Mucormycosis is a rare opportunistic infection caused by Mucorales fungi, and the Rhizopus is the most common one (70% of the cases. It is an acute invasive fungal disease whose form is disseminated, cutaneous, pulmonary, gastrointestinal and rhino-orbitocerebral. The latter is the most common form and its symptoms comprise of unilateral sinusitis, fever and headache. Once established in the orbit the symptoms can be chemosis, diplopia and reduced vision. The infection can spread to the brain via the orbital apex, orbital arteries or via the cribriform plate. Mucormycosis is a medical emergency and the treatment consists of a surgery to an aggressive debridement and in the use of antifungal therapy. Despite the appropriate management, the mortality rate can reach 40% of the cases. One possible intracranial complication of Mucormycosis is the Cavernous Sinus Thrombosis which is a rare and fatal infective disease. The initial symptoms of Cavernous Sinus Thrombosis are headache, retro-orbital pain, periorbital edema, proptosis, diplopia and reduced vision. Case Report: We describe the case of 43-year-old woman with medical history of diabetes mellitus and use of immunosuppressant drugs after kidney transplantation. The patient developed Acute Bacterial Sinusitis and Rhino-orbitocerebral Mucormycosis associated with Cavernous Sinus Thrombosis.

  8. POSTSPINAL INTRACRANIAL SUBDURAL HEMATOMA AND CEREBRAL SINUS THROMBOSIS: REPORT OF A CASE

    Directory of Open Access Journals (Sweden)

    Ali ihsan Uysal

    2013-06-01

    Full Text Available Cerebral venous thrombosis is a rare but a serious complication of spinal anesthesia. It usually occurs in the presence of predisposing factors such as pregnancy, puerperium, use of oral contraceptive drugs, malignancies, thrombocytopenia and the most frequent symptom is headache. Twenty-two years of age, pregnant woman had a complaint of headache after spinal anesthesia for caesarean section and diagnosed as post-dural puncture headache, the treatment was begun. After detecting responsiveness to treatment, radiological imaging procedures were performed and subdural hematoma and transverse sinus thrombosis were detected. In this case report, it was concluded under current literatures that the subdural hematoma and transverse sinus thrombosis should be kept in mind during the diagnosis of post-dural puncture headache. [J Contemp Med 2013; 3(2.000: 116-120

  9. Cerebral sinus thrombosis in an infant with Prader-Willi syndrome and literature review

    Directory of Open Access Journals (Sweden)

    Ilias Chatziioannidis

    2013-04-01

    Full Text Available A full-term male neonate from a first pregnancy of two clinical non-consanguineous parents was born at 40 weeks of gestation with cesarean section. He was admitted at 2 hours of life to our III level Neonatal Intensive Care Unit due to generalized hypotonia, presenting at birth. Cerebral ultrasound showed a temporal bilateral aspecific alteration of the parenchimal echogenicity, whereas a magnetic resonance imaging/venography revealed an extensive cerebral sinus thrombus. Extensive diagnostic studies for prothrombotic disorders showed negative results, even if there was an alterated haemostatic screening. Persistency of hypotonia led us to investigate Prader-Willi syndrome among others. Methylation analysis confirmed the diagnosis. This is the third report associating cerebral venous thrombosis and Prader-Willi syndrome, confirming sinus thrombosis as a possible presentation of this syndrome. A review of the literature is provided in order to disclose possible similarities and differences in Prader-Willi syndrome patients with cerebral sinovenus thrombosis.

  10. Cavernous sinus thrombosis secondary to aspergillus granuloma: A case report and review of the literature.

    Science.gov (United States)

    Brenet, Esteban; Boulagnon-Rombi, Camille; N'guyen, Yohan; Litré, Claude-Fabien

    2016-10-01

    Cavernous sinus thrombosis is a rare but serious complication of sphenoid aspergillosis. The rarity of this pathology makes its diagnostic very difficult on a clinical, biological and radiological sense. The authors present a case of cavernous sinus thrombosis with ipsilateral internal carotid artery thrombosis secondary to a non-invasive sphenoid aspergillosis in an immunocompetent host, responsible of a cavernous syndrome associated to a Claude Bernard Horner syndrome. One year after surgery, the patient is still asymptomatic without recurrence. Diagnostic modalities are detailed and several management of this pathology are compared. Surgery is essential in a diagnostic and therapeutic sense. There is no evidence of the interest of adjuvant therapies such as antibiotic and anticoagulation. Concerning the antifungal treatment, the attitude towards a non-invasive sphenoid aspergillosis in an immunocompetent host is unclear. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. MR diagnosis of dural sinus thrombosis. Diagnostico por RM de las trombosis de senos durales

    Energy Technology Data Exchange (ETDEWEB)

    Rovira Caellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castao Duque, Ch.; Grive Isern, E.; Sumalla Sue, J. (Hospital General Vall d' Hebron Barcelona (Spain))

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  12. Multiple cerebral venous sinus thrombosis: Case report | Mogere ...

    African Journals Online (AJOL)

    Cerebral venous thrombosis (CVT) is an uncommon clinical problem and can be characterised by nonspecific and common symptoms of headaches and vomiting due to the intracranial hypertension. Alternate diagnoses are entertained especially when procoagulant factors are not elicited. We present a 35 year old female, ...

  13. Pediatric cavernous sinus thrombosis: A case series and review of the literature.

    Science.gov (United States)

    Smith, Douglas M; Vossough, Arastoo; Vorona, Gregory A; Beslow, Lauren A; Ichord, Rebecca N; Licht, Daniel J

    2015-09-01

    To describe clinical characteristics, imaging findings, morbidity, and mortality in a single-center cohort of 12 pediatric cavernous sinus thrombosis cases and to review all cases available in recent English literature. Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. A literature search and review was conducted, with additional cases pooled with the new cohort for an aggregate analysis. Twelve cases of cavernous sinus thrombosis in children from the Children's Hospital of Philadelphia between January 1, 2000, and December 31, 2013, were reviewed. All patients survived to discharge; 3 of 12 (25%) experienced neurologic morbidity. Contrast-enhanced MRI and contrast-enhanced head CT were 100% sensitive for detecting cavernous sinus thrombosis, while noncontrast time-of-flight magnetic resonance venography (TOF MRV) and noncontrast head CT were 0% sensitive. Literature review produced an additional 40 cases, and the aggregate mortality rate was 4 of 52 (8%) and morbidity rate was 10 of 40 (25%). Outcomes did not vary by treatment or with unilateral vs bilateral cavernous sinus involvement. There was a trend toward worse outcomes with fungal infections. Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed. © 2015 American Academy of Neurology.

  14. HELLP Syndrome and Cerebral Venous Sinus Thrombosis Associated with Factor V Leiden Mutation during Pregnancy

    Directory of Open Access Journals (Sweden)

    Zeynep Ozcan Dag

    2014-01-01

    Full Text Available Preeclampsia is a leading cause of maternal mortality and morbidity worldwide. The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality for women and their infants alike. Hormonal changes during pregnancy and the puerperium carry an increased risk of venous thromboembolism including cerebral venous sinus thrombosis (CVST. Factor 5 leiden (FVL is a procoagulant mutation associated primarily with venous thrombosis and pregnancy complications. We report a patient with FVL mutation who presented with CVST at 24th week of pregnancy and was diagnosed as HELLP syndrome at 34th week of pregnancy.

  15. Diagnosis and treatment of headache probably attributed to cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Rosario Iannacchero

    2014-12-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a rare condition whose most common and sometimes only symptom is headache. Alas, diagnosis and treatment of CVST is often delayed or overlooked because of its high clinical variability. Using guidelines advices in detecting warning signs or symptoms of secondary headaches might ease the diagnosis of CVST.The article presents the case of a woman who is in treatment for chronic migraine and assessed for secondary headache in a multidisciplinary outpatient headache program. Alert symptoms like sudden worsening headache presentation, along with anamnestic cues, prompted neuroimaging that detected left transverse sinus thrombosis whose onset was difficult to date.http://dx.doi.org/10.7175/cmi.v8i4.966 

  16. Spontaneous Bilateral Carotid-Cavernous Fistulas Secondary to Cavernous Sinus Thrombosis.

    Science.gov (United States)

    Al-Mufti, Fawaz; Amuluru, Krishna; El-Ghanem, Mohammad; Changa, Abhinav R; Singh, Inder Paul; Gandhi, Chirag D; Prestigiacomo, Charles J

    2017-04-01

    Bilateral carotid cavernous fistulas are rare entities that can cause debilitating symptoms and can lead to more severe consequences if left untreated. Therefore, the recognition and adequate treatment of these pathologies is very important. We present 2 cases of bilateral carotid cavernous fistulas that arose as a result of cavernous sinus thrombosis. We review the literature and discuss the pathophysiology, symptomatology, management, and treatment of bilateral carotid cavernous fistulas. Within our own cases, treatment of the patients was varied. The patient in case 1 was successfully treated with endovascular therapy after a failed trial of anticoagulation. The patient in case 2 demonstrated resolution of bilateral carotid cavernous fistulas after anticoagulation therapy. Case 2 highlights the fact that certain cases of bilateral carotid cavernous fistulas due to cavernous sinus thrombosis may benefit from extensive anticoagulation therapy. If anticoagulation therapy is unsuccessful, endovascular therapy may prove beneficial in resolving the fistulous shunt. Copyright © 2017 by the Congress of Neurological Surgeons.

  17. Headache Could Be Finding of Sinus Vein Thrombosis in Behcets Patients

    OpenAIRE

    Halil Sen

    2014-01-01

    Globally Behcet%u2019s disease (BD) is most frequently seen in Turkey and takes its name from the Turkish dermatologist Hulusi Behcet. Basic findings of the disease are the triad of genital ulcers, oral ulcers and uveitis. Neurological involvement in BD appears an average of 5 years after the beginning of disease, or the first appearance of the disease may be neurological findings. Sinus vein thrombosis (SVT) is among neurological involvements observed in BD. However diagnosis of SVT is diffi...

  18. Septic thrombosis of the cavernous sinus secondary to a Streptococcus milleri oral infection.

    Science.gov (United States)

    Imholz, B; Becker, M; Lombardi, T; Scolozzi, P

    2012-09-01

    Septic thrombosis of the cavernous sinus (STCS) is an uncommon and potentially lethal disease. Sphenoid and ethmoid sinusitis followed by facial cutaneous infections represents the most common aetiologies, with Staphylococcus aureus as the main responsible organism followed by the Streptococcus pneumoniae. Although all infectious foci of the head and neck area can potentially spread to the cavernous sinus, STCS from oral infection is an exceptionally rare occurrence. We report the unusual case of a patient who presented with an acute STCS secondary to a generalized Streptococcus milleri periodontitis. This case highlights the importance of systematically performing a detailed examination of the oral cavity in patients presenting with intracranial infections caused by uncommon pathogens such as the Streptococcus milleri group.

  19. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  20. The place of CT angiography in the diagnosis of cerebral sinus thrombosis; Stellenwert der Angiographie in der Diagnostik von zerebralen Sinus- und Venenthrombosen

    Energy Technology Data Exchange (ETDEWEB)

    Hagen, T. [Abt. fuer Neuroradiologie, Radiologische Klinik, Universitaet des Saarlandes, Homburg/Saar (Germany); Bartylla, K. [Abt. fuer Neuroradiologie, Radiologische Klinik, Universitaet des Saarlandes, Homburg/Saar (Germany); Waziri, A. [Abt. fuer Neuroradiologie, Radiologische Klinik, Universitaet des Saarlandes, Homburg/Saar (Germany); Schmitz, B. [Abt. fuer Neuroradiologie, Radiologische Klinik, Universitaet des Saarlandes, Homburg/Saar (Germany); Piepgras, U. [Abt. fuer Neuroradiologie, Radiologische Klinik, Universitaet des Saarlandes, Homburg/Saar (Germany)

    1996-11-01

    Dural sinus thrombosis is not uncommon. Due to the nonspecific symptomatology, as well as the manifold etiology, clinical diagnosis may be difficult. In these cases imaging procedures are frequently crucial in deciding how to proceed and how to treat. The aim of our study was to evaluate the diagnostic utility of helical CT in the detection of dural sinus thrombosis. In 20 patients with clinically supected thrombosis CT angiography was performed. In 6 patients dural sinus thrombosis was diagnosed. In order to acquire also arterial vessels, a short delay of about 22 s after the onset of the application of contrast medium was selected. By this method we found an occlusion of the MCA in two patients with clinically suspected sinus thrombosis. In all patients the transverse slices and the multiplanar reconstructions showed filling defects or an `empty delta` sign. With irregular outlines the thrombus could be depicted over the complete course of the sinus. The MIP reconstructions were particularly helpful in the evaluation of the vessel anatomy and the pathological collateral venous drainage. In three patients MR angiograms were available for comparison. The smaller veins, such as the v. vermis inferior, were less clearly depicted than in CT angiography. CT angiography is a fast and reliable method to exclude or verify a sinus thrombosis. It can be performed immediately after nonenhanced CT. According to our present experience CT angiography is sufficient for the diagnosis of a sinus thrombosis. (orig.) [Deutsch] In der Arbeit wird die Welt der CT-Angiographie zum Nachweis oder Ausschluss einer zerebralen Sinus- und Venenthrombose (SVT) dargestellt. Bei 20 Patienten mit dem klinischen Verdacht auf eine SVT wurde eine CT-Angiographie in Spiraltechnik durchgefuehrt. Bei 6 Patienten bestaetigte diese die Verdachtsdiagnose, bei 16 konnte eine Thrombose ausgeschlossen werden. Bei allen Patienten mit nachgewiesener SVT zeigten die axialen Schnitte und die multiplanaren

  1. Cerebral Venous Sinus Thrombosis following Diagnostic Curettage in a Patient with Uterine Fibroid

    Directory of Open Access Journals (Sweden)

    Xiao-Qun Zhu

    2014-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a relatively rare cerebrovascular disease, of which the risk has been documented in patients with numerous conditions. However, CVST has never been previously described in association with the use of a diagnostic curettage in patient with uterine fibroid. Herein, we described a 43-year-old woman who presented with recurrent convulsive seizures and severe and progressive headache 1 day after a diagnostic curettage of the uterus, which was confirmed to be uterine fibroid pathologically later, and her condition subsequently progressed to confusion. Brain magnetic resonance imaging (MRI revealed an acute extensive thrombosis of the left transverse and sigmoid sinus and the ipsilateral cerebellum infarction. Evaluation for primary thrombophilia revealed that an iron deficiency anemia (IDA due to the fibroid bleeding induced menorrhagia together with a diagnostic curettage might be the sole hypercoagulable risk factor identified. Treatment with anticoagulation led to full recovery of her symptoms and recanalization of the thrombosis was proven on magnetic resonance venography (MRV 2 months later. We suggest that CVST should be recognized as a potential complication related to this diagnostic technique, especially in patient with IDA. The early diagnosis and timely treatment would be of significance in improving the prognosis of this potentially lethal condition.

  2. A Case of Cerebral Sinus Venous Thrombosis Resulting in Mortality in Severe Preeclamptic Pregnant Woman

    Directory of Open Access Journals (Sweden)

    Hatice Ender Soydinc

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVST is a rarely encountered condition during pregnancy. A 21-year-old pregnant woman with labour pains was hospitalized in our clinic. Diagnosis of severe preeclampsia was made based on her clinical and laboratory findings. She suffered from convulsive episodes during postpartum period which lead to initiation of treatment for eclampsia. However neurological and radiological examinations were performed after emergence of additional neurological symptoms disclosed the diagnosis of CVST. In this paper, we aimed to present a case with CVST which diagnosis was confused with eclampsia and resulting in maternal mortality.

  3. Cerebral venous sinus thrombosis associated with essential thrombocytosis in a pediatric patient.

    Science.gov (United States)

    Jensen, Ashley W; Tefferi, Ayalew; Arndt, Carola A S

    2007-03-01

    Essential thrombocytosis (ET) is an uncommon pediatric hematologic disorder that can result in thrombotic complications, including cerebral venous sinus thrombosis (CVST). Although CVST associated with ET is exceedingly rare, it can be devastating to the patient. We here report a pediatric case of CVST associated with ET. The patient was treated with hydroxyurea and warfarin, which was later replaced by low-dose aspirin. Platelet counts were well controlled after 16 months of follow-up, and no further thrombotic events occurred. Mucositis was the main adverse effect of treatment.

  4. Dural sinus vein thrombosis in a patient with colon cancer treated with FOLFIRI/bevacizumab

    Directory of Open Access Journals (Sweden)

    Ozen Alaattin

    2009-01-01

    Full Text Available The adverse effects of regimes in cancer treatment have forced us to change to new targeted therapy options. Understanding these side effects, which can lead to discontinuation of the new therapy strategies, will allow the clinical management of these side effects and result in continuing therapies with effective medications. Bevacizumab, which is an IgG1 antibody against vascular endothelial growth factor, has side effects such as proteinuria, hypertension, venous and arterial thromboembolic events, and hemorrhage. This is the first reported case of dural sinus vein thrombosis, during the treatment with bevacizumab.

  5. Odontogenic orbital cellulitis associated with cavernous sinus thrombosis and pulmonary embolism: a case report.

    Science.gov (United States)

    Allegrini, D; Reposi, S; Nocerino, E; Pece, A

    2017-06-20

    This case illustrates the importance of prompt assessment and treatment of orbital cellulitis. In fact the ocular signs and symptoms may be associated with systemic complications which should be investigated and identified as soon as possible to avoid a poor prognosis. A 46-year-old white woman presented to our emergency room with proptosis, ophthalmoplegia, and conjunctival chemosis of her left eye. An ophthalmologist, having diagnosed orbital cellulitis in her left eye, suspected a cavernous sinus thrombosis. Hematochemical and radiological examinations confirmed the cavernous sinus thrombosis and also showed septic pulmonary embolism. A blood culture indicated Streptococcus constellatus, which is a member of the Peptostreptococcus family, a saprophyte of the oral mucosa that can be pathogenic in immunocompromised persons. The odontogenic origin was then confirmed by dental radiography which showed a maxillary abscess. Her eye signs regressed after antibiotic and anticoagulant therapy. This complex case shows the importance of a multidisciplinary approach for the management of orbital cellulitis, for the prompt diagnosis and treatment of eye injuries and possible complications, so as to avoid serious and permanent sequelae.

  6. Trombosis del seno sagital en un neonato Sagittal sinus thrombosis in a newborn

    OpenAIRE

    Lisett Hernández León; Odalys Hernández León; Omar León Vara Cuesta; Ivonne Aimé Sánchez Monterrey; Yanett Sarmiento Portal; Angelicia Crespo Campo

    2012-01-01

    La trombosis de los senos venosos durales es una rara y devastadora enfermedad. Se presenta generalmente en mujeres y ancianos, y no es frecuente en niños, aunque se reconoce ya como una causa de morbilidad y mortalidad en la población pediátrica. Se han reportado pocos casos en el mundo de neonatos afectados por esta entidad, en su mayoría fatales e insuficientemente investigados. A continuación se presenta el caso de un recién nacido con una trombosis del seno sagital que sobrevivió. Los fa...

  7. Transcranial Direct Middle Meningeal Artery Puncture for the Onyx Embolization of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus

    Science.gov (United States)

    Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2015-01-01

    A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx. PMID:25674345

  8. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  9. Safety of Pregnancy After Cerebral Venous Thrombosis: Results of the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis)-2 PREGNANCY Study.

    Science.gov (United States)

    Aguiar de Sousa, Diana; Canhão, Patrícia; Crassard, Isabelle; Coutinho, Jonathan; Arauz, Antonio; Conforto, Adriana; Béjot, Yannick; Giroud, Maurice; Ferro, José M

    2017-11-01

    Pregnancy is associated with increased risk of venous thrombotic events, including cerebral venous thrombosis. We aimed to study the complications and outcome of subsequent pregnancies in women with previous cerebral venous thrombosis. Follow-up study of women with acute cerebral venous thrombosis at childbearing age included in a previously described cohort (International Study of Cerebral Vein and Dural Sinus Thrombosis). Patients were interviewed by local neurologists to assess rate of venous thrombotic events, pregnancy outcomes, and antithrombotic prophylaxis during subsequent pregnancies. A total of 119 women were included, with a median follow-up of 14 years. Eighty-two new pregnancies occurred in 47 women. In 83% (68 of 82), some form of antithrombotic prophylaxis was given during at least 1 trimester of pregnancy or puerperium. Venous thrombotic events occurred in 3 pregnancies, including 1 recurrent cerebral venous thrombosis. Two of the 3 women were on prophylactic low-molecular-weight heparin at the time of the event. Outcomes of pregnancies were 51 full-term newborns, 9 preterm births, 2 stillbirths, and 20 abortions (14 spontaneous). In women with prior cerebral venous thrombosis, recurrent venous thrombotic events during subsequent pregnancies are infrequent. © 2017 American Heart Association, Inc.

  10. Genetic prothrombotic factors in children with otogenic lateral sinus thrombosis: five case reports.

    Science.gov (United States)

    Zangari, Paola; Messia, Virginia; Viccaro, Marika; Bottero, Sergio; Randisi, Francesco; Marsella, Pasquale; Luciani, Matteo; Locatelli, Franco

    2012-03-01

    Lateral sinus thrombosis (LST) is an uncommon, but life-threatening complication of both acute and chronic otitis media. There is some evidence that acquired or hereditary prothrombotic disorders are risk factors for LST. The aim of this work was to evaluate the role of thrombotic screening, anticoagulant therapy or prophylaxis in patients with either acute or chronic otitis media and LST. The medical records of five children hospitalized at Pediatric Hospital Bambino Gesù of Rome because of acute or chronic otitis media complicated by mastoiditis and LST were reviewed. All children underwent laboratory workup for hypercoagulability. All the five children were found to be heterozygote for the C677T MTHFR mutation and a child presented also heterozygosity for factor V Leiden mutation. They have been successfully treated with anticoagulant therapy without sequels. Children with acute or chronic otitis media may have a prothrombotic tendency that becomes clinically evident because of the inflammatory state. Patients with a family and/or personal history of thrombosis and/or thrombophilic conditions need anticoagulant prophylaxis also in the absence of clear signs of LST. Treatment with low molecular weight is successful in patients with LST.

  11. Sinusitis

    Science.gov (United States)

    Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses ... and cause pain. There are several types of sinusitis, including Acute, which lasts up to 4 weeks ...

  12. Risk factors for remote seizure development in patients with cerebral vein and dural sinus thrombosis.

    Science.gov (United States)

    Davoudi, Vahid; Keyhanian, Kiandokht; Saadatnia, Mohammad

    2014-02-01

    We aimed to define the possible risk factors for acute and remote seizures in patients with cerebral vein and sinus thrombosis (CVST). Ninety-four patients were recruited prospectively at Al-Zahra Hospital, Isfahan, Iran, between April 2007 and April 2012. To identify seizure predictors, we compared demographic, clinical and imaging factors between patients with or without acute and remote seizures. Of the 94 patients, 32 (34%) experienced at least one seizure after CVST development. Bivariate analysis showed a significant association of remote seizure with loss of consciousness at presentation (P=0.05, OR: 5.11, 95%CI: 1.07-24.30), supratentorial lesions (P=0.02, OR: 9.04, 95%CI: 1.04-78.55), lesions in the occipital lobe (P=0.00, OR: 12.75, 95%CI: 2.28-71.16), lesions in the temporal and parietal lobes, thrombophilia (P=0.03, OR: 5.87, 95%CI: 1.21-28.39), seizure in the acute phase (P=0.00, OR: 13.14, 95%CI: 2.54-201.2) and sigmoid sinus thrombosis (P=0.00, OR: 12.5, 95%CI: 2.23-69.79). Seizures in the acute phase were also more common in patients with paresis (P=0.00, OR: 4.88, 95%CI: 1.91-12.46), hemorrhagic lesions indicated by imaging (P=0.02, OR: 2.77, 95%CI: 1.08-7.10), supratentorial lesions, lesions in the frontal (P=0.01, OR: 3.81, 95%CI: 1.28-11.31) and parietal lobes (P=0.00, OR: 5.16, 95%CI: 2-13.29), thrombophilia and history of miscarriage (P=0.03, OR: 2.91, 95%CI: 1.07-7.91). No factor predicted acute or remote seizure in a multiple logistic regression analysis. Our results demonstrate that seizure development in the acute phase is the most significant factor for development of remote seizure. Parenchymal lesions in the supratentorial area were also found to be associated with both acute and remote seizures. However, no factor was predictive of acute or remote seizures in a multivariate analysis. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  13. Intracranial venous thrombosis complicating oral contraception

    Science.gov (United States)

    Dindar, F.; Platts, M. E.

    1974-01-01

    Four days after the onset of a severe headache a 22-year-old woman who had been taking oral contraceptives for less than three weeks had a convulsion, followed by right hemiparesis. Other focal neurologic signs and evidence of raised intracranial pressure appeared, and she became comatose on the seventh day. A left craniotomy revealed extensive cerebral venous thrombosis. She died the next day. On postmortem examination extensive thrombosis of the superior sagittal sinus and draining cerebral veins, and multiple areas of cerebral hemorrhage and hemorrhagic infarction were seen. Some of the superficial cerebral veins showed focal necrosis of their walls, and the lateral lacunae of the superior sagittal sinus contained proliferating endothelial cells. The adrenal veins were also thrombosed. The significance of these findings is discussed. The literature on cerebrovascular complications of oral contraception, particularly cerebral venous thrombosis, is reviewed. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4413961

  14. Headache Could Be Finding of Sinus Vein Thrombosis in Behcets Patients

    Directory of Open Access Journals (Sweden)

    Halil Sen

    2014-08-01

    Full Text Available Globally Behcet%u2019s disease (BD is most frequently seen in Turkey and takes its name from the Turkish dermatologist Hulusi Behcet. Basic findings of the disease are the triad of genital ulcers, oral ulcers and uveitis. Neurological involvement in BD appears an average of 5 years after the beginning of disease, or the first appearance of the disease may be neurological findings. Sinus vein thrombosis (SVT is among neurological involvements observed in BD. However diagnosis of SVT is difficult and it is a situation that may cause disability or mortality. Our case was a 24-year old female patient with diagnosed SVT who had a diagnosis of BD from 5 years. In spite of the patient frequently applying to health services, SVT diagnosis was delayed until 15 days after the initial symptoms. BD can cause SVT and SVT may cause disability or mortality but SVT may be diagnosed late, just as in our case. Therefore we present this case to increase awareness of this disease.

  15. Evaluation of higher brain function by MRI. Flow measurement in the superior sagittal sinus using phase contrast method

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Mototsugu [Yamada Red Cross Hospital, Misono, Mie (Japan)

    1997-01-01

    To assess the higher brain function, flow measurement in the superior sagittal sinus (SSS) was performed noninvasively using a phase contrast MRI in 76 patients with suspicious of impaired higher brain function including dementias (senile dementia of Alzheimer type; SDAT and multi-infarct dementia; MID), strokes, and others. Thirty-one normal controls were consisted of 18 healthy volunteers and 13 patients with tension headache whose higher brain function was proved be normal. Mean flow velocity was measured in the distal portion of the SSS adjoining to the occipital lobes and was multiplied by cross-sectional area of the SSS at the measuring point to obtain mean flow volume. For intellectual index, cross-cultural cognitive examination (CCCE) was applied to all cases excluding volunteers. Normal value of SSS flow volume measured by MRI was 6.92{+-}0.66 ml/s. Significant differences in both SSS flow and CCCE score from normal controls were found in SDAT group, MID group, and non-dementia group. No substantial differences between SDAT group and MID group were noted in both CCCE score and SSS flow. In normal controls, there was no correlation between SSS flow and age, whereas, significant inverse correlation of SSS flow with age was found in all cases. Between CCCE score and SSS flow, there were nearly linear relationships in all cases, SDAT group, MID group, and non-dementia group. Significant but relatively poor correlation was found in normals. (K.H.)

  16. Sinusitis

    OpenAIRE

    Gómez, Luz Eugenia; Fundación Valle de Lili

    2000-01-01

    ¿Qué son los senos para nasales?/ ¿Qué es la sinusitis?/Tipos de sinusitis/Causas de sinusitis/Factores que predisponen/La sinusitis y su relación con otras enfermedades del tracto respiratorio/Signos y síntomas/Complicaciones de la sinusitis.

  17. Sinusitis

    National Research Council Canada - National Science Library

    Morcom, Samuel; Phillips, Nicholas; Pastuszek, Andrew; Timperley, Daniel

    2016-01-01

    Background: Acute and chronic sinusitis are common primary care presentations. They are caused by mucosal inflammation, which inhibits mucociliary function of the nose and paranasal sinuses. Objective...

  18. Analysis of clinical features of ocular presentation in cranial venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Wang D

    2011-07-01

    Full Text Available Abstract Background To recognize ocular presentations in cranial venous sinus thrombosis (CVST which were easy to be misdiagnosis. Design Retrospective study. Methods Review clinical informations including general informations, general performances, and ocular presentations of 118 inpatients with CVST in the general hospital of chinese people's liberation army during 2005-2009. Main Outcome Measures The ocular symptoms as the initial onset presentations or simultaneous phenomenon among different onset type patients were analyzed. Results Of all the CVST patients, 21.2% (25/118 presented with ocular symptom as the initial presentation, 30.5% (36/118 presented with ocular symptom as well as the other symptoms, and 48.3% (57/118 presented with non-ocular symptoms as the initial onset. The CVST patients were divided into 3 groups according to the onset type. There was no marked statistical significance among groups. The most common major complaints were blurring and degeneration of acute vision, accounting for 85.9% (61/71 of all abnormal ocular chief complaints. The most common objective sign in eyes was papilloedema, accounting for 48.3% (57/118 in this group of CVST patients. About 22.4% (13/58 showed acute vision deterioration at 1-year follow-up, due to optic atrophy. Conclusions As ophthalmologists, we should master the onset characteristics and clinical manifestations of CVST. Early diagnosis and treatment is very important for the prevention of vision deterioration, especially for patients with ocular syndrome as the initial onset syndrome. For isolated agnogenic intracranial hypertension, we should consider the possibility of CVST.

  19. Sinusitis

    Science.gov (United States)

    ... 4 weeks or less. It is caused by bacteria growing in the sinuses. Chronic sinusitis is when the swelling of the sinuses is present for longer than 3 months. It may be caused by bacteria or a fungus. The following may increase the ...

  20. Assessment of CSF dynamics and venous flow in the superior sagittal sinus by MRI in idiopathic intracranial hypertension: a preliminary study

    DEFF Research Database (Denmark)

    Gideon, P; Sørensen, P S; Thomsen, C

    1994-01-01

    A velocity-sensitive magnetic resonance imaging (MRI) phase-mapping method was used for non-invasive study of cerebrospinal fluid (CSF) flow in the cerebral aqueduct, for indirect calculation of supratentorial CSF production, and for measurement of blood flow in the superior sagittal sinus (SSS......). We examined 12 patients with idiopathic intracranial hypertension (IIH; pseudotumour cerebri), and 10 healthy volunteers. The peak caudal and rostral CSF flow in the aqueduct during the cardiac cycle did not differ significantly between the patients and the volunteers. A significant correlation...

  1. Cerbral Venous Thrombosis in Ulcerative Colitis and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Hugh Chaun

    1991-01-01

    Full Text Available A 30-year-old man with an eight year history of ulcerative colitis developed left occipital headache, mental confusion, dysphasia and right-sided weakness when his bowel disease was asymptomatic. Investigations revealed thrombosis of the cerebral sagittal sinus and left transverse sinus. The literature relating to cerebrovascular complications associated with ulcerative colitis is reviewed, and the possible pathogenetic mechanisms of venous thrombosis in ulcerative colitis are discussed. The importance of recognizing that venous thrombosis may occur in association with ulcerative colitis in remission is emphasized.

  2. Cerebral vein thrombosis in a four year old with Behçet's disease.

    Science.gov (United States)

    Hacihamdioglu, Duygu Ovunc; Demiriz, Murat; Sobaci, Gungor; Kocaoglu, Murat; Demirkaya, Erkan; Gok, Faysal

    2014-01-01

    Behçet's disease (BD) is a multisystem disorder. The main pathology in BD is vasculitis that involves arteries and veins of all calibers. Central nervous system involvement occurs in 5-10% of patients. Increased morbidity and mortality is rarely observed in children. The mean age at onset in pediatric BD is approximately 7 years. Neurologic involvement in BD is usually observed after 3-6 years. We report the case of a four-year-old Turkish boy with BD with sagittal sinus thrombosis treated with infliximab. The patient presented papilledema without neurologic signs. Although long-term efficacy evaluations are needed in this case, infliximab therapy may be a good option in childhood BD with refractory sinus thrombosis. This is the youngest case of BD with sagittal sinus thrombosis reported so far. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging

    DEFF Research Database (Denmark)

    Gideon, P; Thomsen, C; Gjerris, F

    1996-01-01

    PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic...... intracranial hypertension (IIH). RESULTS: Mean blood flow was 443 ml/min in healthy volunteers with a tendency towards reduced blood flow with increasing age. In NPH patients significantly lower superior sagittal sinus blood flow values were found, but this difference was no longer significant when patients...

  4. A variant epidemic methicillin resistant Staphylococcus aureus-15 cavernous sinus thrombosis and meningitis: A rare occurrence with unusual presentation

    Directory of Open Access Journals (Sweden)

    Veena Kumari H

    2010-01-01

    Full Text Available Septic cavernous sinus thrombosis (CST is an uncommon clinical syndrome. Although Staphylococcus aureus (S aureus is the most common bacterial pathogen causing CST, it is infrequent as a cause of meningitis. We report the first case of CST and meningitis from Bengaluru, Karnataka, caused by community-acquired epidemic methicillin resistant Staphylococcus aureus-15 (EMRSA-15, in a previously healthy individual without known risk factors; the patient recovered following treatment with vancomycin. The isolate was genotyped as belonging to staphylococcal cassette chromosome mec type IV and sequence type 22 and carried the panton-valentine leucocidin gene. It is the first Indian EMRSA-15 disease isolate from a case of meningitis. EMRSA-15 has been a major problem in hospitals in UK and it is a cause for great concern in Indian hospitals too.

  5. Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging

    DEFF Research Database (Denmark)

    Gideon, P; Thomsen, C; Gjerris, F

    1996-01-01

    PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopath...

  6. Bilateral Jugular Vein and Sigmoid Sinus Thrombosis Related to an Inherited Coagulopathy: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Özge Altıntaş

    2014-01-01

    Full Text Available Internal jugular vein thrombosis (IJVT is a rare condition associated with malignancy, coagulopathy, and trauma. The optimal management of any IJVT must be individualized and depends on the condition of the patient. Case Presentation. We report the case of a 42-year-old woman with a history of a first trimester spontaneous abortion. Apart from a tension-type headache, she had no neurological symptoms. She reported an incidental diagnosis of right-sided IJVT when she was evaluated for hyperthyroidism ultrasonographically. On ultrasonography, we observed bilateral jugular vein thrombosis. The patient was started on oral warfarin. Seven months later, when she was adequately anticoagulated, she developed a second thrombosis. According to the etiological workup, she had a mutation in the homozygous methylene tetrahydrofolate reductase (MTHFR gene and reduced protein C levels and activity. Conclusion. This report illustrates an unusual presentation of a rare condition. In this case, the etiology was associated with the coagulopathy, which occurred despite adequate anticoagulation.

  7. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, Monique [APHP - Paris-Diderot University, Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, Paris (France); Crassard, Isabelle; Bousser, Marie-Germaine [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); Chabriat, Hugues [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); INSERM UMR 1161 and DHU NeuroVasc, Paris (France)

    2016-01-15

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it. (orig.)

  8. Sinuses / Sinusitis / Rhinosinusitis

    Science.gov (United States)

    ... Treatments ▸ Conditions Dictionary ▸ Sinuses|Sinusitis|Rhinosinusitis Share | Sinuses | Sinusitis | Rhinosinusitis « Back to A to Z Listing The ... into the nose. Rhinosinusitis, commonly referred to as sinusitis, occurs when the sinus openings become blocked or ...

  9. Color Doppler US of normal cerebral venous sinuses in neonates: a comparison with MR venography

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Elka [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Children' s Hospital of Eastern Ontario (CHEO), Diagnostic Imaging Department, Ottawa (Canada); Daneman, Alan; Doria, Andrea S.; Blaser, Susan; Traubici, Jeffrey; Jarrin, Jose; Shroff, Manohar [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Moineddin, Rahim [University of Toronto, Toronto (Canada); Moore, Aideen [Hospital for Sick Children, Department of Neonatology, Toronto (Canada)

    2012-09-15

    Color Doppler US (CDUS) has been used for evaluation of cerebral venous sinuses in neonates. However, there is very limited information available regarding the appearance of superficial and deep normal cerebral venous sinuses using CDUS and the specificity of the technique to rule out disease. To determine the specificity, inter-modality and inter-reader agreement of color Doppler US (CDUS). To evaluate normal cerebral venous sinuses in neonates in comparison to MR venography (MRV). Newborns undergoing a clinically indicated brain MRI were prospectively evaluated. All underwent a dedicated CDUS of the cerebral venous sinuses within 10 h (mean, 3.5 h, range, and 2-7.6 h) of the MRI study using a standard protocol. Fifty consecutive neonates participated in the study (30 males [60%]; 25-41 weeks old; mean, 37 weeks). The mean time interval between the date of birth and the CDUS study was 19.1 days. No cases showed evidence of thrombosis. Overall agreement for US reading was 97% (range, 82-100%), for MRV reading, 99% (range, 96-100%) and for intermodality, 100% (range, 96-100%). Excellent US-MRI agreement was noted for superior sagittal sinus, cerebral veins, straight sinus, torcular Herophili, sigmoid sinus, superior jugular veins (94-98%) and transverse sinuses (82-86%). In 10 cases (20%), MRV showed flow gaps whereas normal flow was demonstrated with US. Visualization of the inferior sagittal sinus was limited with both imaging techniques. Excellent reading agreement was noted for US, MRV and intermodality. CDUS is highly specific to rule out cerebral venous thrombosis in neonates and holds potential for clinical application as part of clinical-laboratory-imaging algorithms of pre/post-test probabilities of disease. (orig.)

  10. Frosted branch angiitis and cerebral venous sinus thrombosis as an initial onset of neuro-Behçet's disease: a case report and review of the literature.

    Science.gov (United States)

    Ferreira, Bruno Fortaleza de Aquino; Rodriguez, Ever Ernesto Caso; Prado, Leandro Lara do; Gonçalves, Celio Roberto; Hirata, Carlos Eduardo; Yamamoto, Joyce Hisae

    2017-04-15

    Frosted branch angiitis is a rare, severe condition. It can be either a primary or a secondary condition and is characterized by rapid deterioration of vision and fulminant retinal vasculitis that manifests as diffuse sheathing of retinal vessels, macular edema, papillitis, vitritis and anterior uveitis. We aimed to describe a case of frosted branch angiitis and cerebral venous sinus thrombosis as an initial neuro-Behçet's disease onset. Diagnosis of Behçet's disease was based on the current 2014 International Criteria for Behçet's Disease and the International consensus recommendation criteria for neuro-Behçet's disease. In addition, a literature review using search parameters of "frosted branch angiitis", "Behçet" and "neuro-Behçet" in the PubMed database is presented. A 28-year-old Brazilian pardo woman presented to our hospital with abrupt bilateral vision loss associated with recurrent aphthous oral ulcers 6 months before visual symptom onset. A fundus examination showed bilateral widespread retinal vasculitis with venous and arterial white sheathing, optic disc swelling, macular edema, and retinal hemorrhages, leading to the diagnosis of frosted branch angiitis. An extensive systemic workup for retinal vasculitis was uneventful, except for brain magnetic resonance imaging demonstrating cerebral venous sinus thrombosis and lymphocytic aseptic meningitis. A diagnosis of neuro-Behçet's disease was made, and treatment was started with methylprednisolone therapy 1 g/day for 5 consecutive days, followed by oral mycophenolate mofetil and infliximab 5 mg/kg infusion. The patient's response was rapid, with improvement of visual acuity to hand movement and counting fingers by day 7 and final visual acuity of counting fingers and 20/130. Frosted branch angiitis may be associated with infectious, noninfectious, or idiopathic causes. An extensive workup should be done to exclude systemic vasculitis such as Behçet's disease. Treatment with systemic steroids must be

  11. Pseudotumor cerebral secundário a trombose venosa dural: relato de caso pediátrico Pseudotumor cerebri secondary to dural sinus thrombosis: pediatric case report

    Directory of Open Access Journals (Sweden)

    Adriana Rocha Brito

    2005-09-01

    Full Text Available O pseudotumor cerebral é uma síndrome neurológica relativamente comum na adolescência. Na maioria dos casos, a etiologia é idiopática, mas pode haver complicações graves, como cegueira, relacionadas com a hipertensão intracraniana. O objetivo deste artigo é enfatizar o diagnóstico diferencial do pseudotumor cerebral, com atenção especial às etiologias tratáveis. Relatamos o caso de um adolescente de 12 anos que se apresentou com diplopia e cefaléia 9 dias após otite média e mastoidite à direita. A tomografia computadorizada do crânio foi normal, mas a ressonância magnética do encéfalo detectou trombose dos seios transverso e sigmóideo ipsilaterais, a qual respondeu à anticoagulação precoce. A conclusão é que a ressonância magnética do encéfalo é essencial nos pacientes com diagnóstico clínico de pseudotumor cerebral para exclusão de causas tratáveis, como a trombose venosa dural.Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.

  12. Thrombosis of venous outflows of the cavernous sinus: possible aetiology of the cortical venous reflux in case of indirect carotid-cavernous fistulas.

    Science.gov (United States)

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

    2017-05-01

    The presence of a cortical venous reflux (CVR) in a carotid-cavernous fistula (CCF) is well described and is considered to be a criterion for urgent treatment. This reflux is often associated with direct/traumatic CCF and the high-flow of the fistula alone explains the reflux. For indirect CCF, the pathophysiology of a CVR is unclear. All patients treated endovascularly for an indirect CCF with a cortical venous reflux between 2003 and 2015 were included. We retrospectively analysed data focusing on whether venous outflows of the cavernous sinus would opacify or not with the local injection of contrast, in order to locate those that could explain the venous reflux. Twenty consecutive patients (male/female ratio, 2/3) were included in this series with a mean age of 63 years. All patients presented ocular signs and no patients showed any neurological sign secondary to the CVR. We distinguished four patterns of CVR: in the superficial middle cerebral vein (75%), in the uncal vein (15%), in the superior petrosal vein (5%) and in the inferior petrosal vein (5%). Seventy percent of the cases presented a lack of opacification in more than three venous outflows of the CS involved. Each patient received an endovascular therapy by venous approach with a success rate of 76.9% per embolisation session. Two patients (10%) presented a permanent ocular paresis and two others a transient deficit. CVR is directly correlated with the thrombosis of multiple venous outflows of the CS. The "non-opacification" of at least three of the CS venous outflows is necessary for the development of CVR. Such thrombosis may be explained by the combination of haemodynamic and inflammatory changes of the venous wall.

  13. Factor V Leiden, factor V Cambridge, factor II GA20210, and methylenetetrahydrofolate reductase in cerebral venous and sinus thrombosis: A case-control study.

    Science.gov (United States)

    Saadatnia, Mohammad; Salehi, Mansour; Movahedian, Ahmad; Shariat, Seyed Ziaeddin Samsam; Salari, Mehri; Tajmirriahi, Marzieh; Asadimobarakeh, Elham; Salehi, Rasoul; Amini, Gilda; Ebrahimi, Homa; Kheradmand, Ehsan

    2015-06-01

    Factor V G1691A (FV Leiden), FII GA20210, and methylenetetrahydrofolate reductase (MTHFR) C677T mutations are the most common genetic risk factors for thromboembolism in the Western countries. However, there is rare data in Iran about cerebral venous and sinus thrombosis (CVST) patients. The aim of this study was to evaluate the frequency of common genetic thrombophilic factors in CVST patients. Forty consequently CVST patients from two University Hospital in Isfahan University of Medical Sciences aged more than 15 years from January 2009 to January 2011 were recruited. In parallel, 51 healthy subjects with the same age and race from similar population selected as controls. FV Leiden, FII GA20210, MTHFR C677T, and FV Cambridge gene mutations by polymerase chain reaction technique were evaluated in case and control groups. FV Leiden, FII GA20210, and FV Cambridge gene mutations had very low prevalence in both case (5%, 2%, 0%) and control (2.5%, 0%, 0%) and were not found any significant difference between groups. MTHFR C677T mutations was in 22 (55%) of patients in case group and 18 (35.5%) of control group (P = 0.09). This study showed that the prevalence of FV Leiden, FII GA20210, and FV Cambridge were low. Laboratory investigations of these mutations as a routine test for all patients with CVST may not be cost benefit.

  14. ROLE OF CT VENOGRAPHY AND MR VENOGRAPHY IN CEREBRAL VENOUS THROMBOSIS

    Directory of Open Access Journals (Sweden)

    Dayananda Kumar R

    2016-07-01

    Full Text Available INTRODUCTION CVT often presents with haemorrhagic infarction in areas atypical for arterial vascular distribution. Cerebral haemorrhage or focal oedema due to venous congestion or infarction is often findings at CT that lead to further imaging evaluations. Subcortical haemorrhages, while nonspecific has been reported as a common finding in CVT. AIMS AND OBJECTIVES To evaluate the imaging characteristics of cerebral venous thrombosis on CT and MR imaging, to appreciate the diagnostic pitfalls of MR venography in the diagnosis of cerebral venous thrombosis and to compare CT Venography and MR Venography in the diagnosis of cerebral venous thrombosis. MATERIAL AND METHODS This prospective study was done at Department of Radio-Diagnosis and Modern Imaging, Jaipur from September 2005 to November 2007. The study comprised of 30 patients that presented to the MR imaging with suspected untreated cortical venous thrombosis for obtaining MRV. CTV was also done in cases of dural sinus thrombosis. RESULTS The age range of patients in the study was between 19 and 58 years. The commonest age range was 20-25 Years (46%. Number of female patients was higher (83.3%. Most common risk factor in the study group was postpartum/puerperal status, followed by infection, and others. The clinical presentation in present study was acute in majority of patients. Most common sinus to be involved is superior sagittal sinus (66.6% followed by transverse sinuses (61.1% and sigmoid sinus (55.5%. CONCLUSION CT Venography is an effective, alternative imaging modality that overcomes the technical limitations of MRV and should be used in cases where technical limitations impede confident diagnosis of CVST on MRV.

  15. [Thrombosis of the cerebral venous sinuses in the differential diagnosis of idiopathic intracranial hypertension in young obese females: is it a real problem?].

    Science.gov (United States)

    Cabrera-Naranjo, Fernando; Gonzalez-Hernandez, Ayoze; Lagoa-Labrador, Iria; Fabre-Pi, Óscar

    2013-04-16

    Idiopathic intracranial hypertension (IICH) typically presents in young women with obesity or a recent weight increase. The differential diagnosis of IICH includes thrombosis of the cerebral venous sinuses (TCVS), which can also present as an isolated intracranial hypertension syndrome. We review the frequency with which patients with a typical IICH profile presented TCVS as their diagnosis. The study consisted in a retrospective review of all the admissions due to intracranial hypertension syndromes in our centre between 2000 and 2011. The cases selected were those with a normal cerebrospinal fluid study and computerised axial tomography scan of the head that presented as an isolated intracranial hypertension syndrome; those who manifested a focal neurological picture, however, were excluded. From the patients that were included, a subgroup made up of females between 16 and 35 years of age with a body mass index of above 25 were selected. A total of 37 cases were obtained. Of these, 35 (94.6%) were cases of IICH and two (5.4%) were TCVS. The time elapsed between the onset of symptoms and diagnosis was less than seven days in both cases of TCVS (100%) and in two cases (5.4%) of IICH. Up to 5.4% of patients with a typical IICH profile that present with an intracranial hypertension syndrome can present TCVS. The presence of prothrombotic factors and a high D-dimer can suggest this possibility, although there is still a need for well-established parameters that allow decisions to be made in emergencies in the absence of any chance of performing an urgent MR phlebography scan.

  16. Sinus Anatomy

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  17. Adult Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  18. Superficial vein thrombosis with hemorrhagic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Yu-wei CONG

    2016-01-01

    Full Text Available Background Cerebral superficial vein thrombosis was rare and often misdiagnosed or missed for its various etiological factors, and complicated and nonspecific clinical manifestations. This paper reported one case of superficial vein thrombosis in right fronto-parietal lobe with hemorrhagic infarction. The anatomy of superficial vein, pathophysiological points, diagnosis and treatment of superficial vein thrombosis were reviewed to help to reduce missed diagnosis or misdiagnosis. Methods and Results A 18-year-old male patient had suffered from progressive headache for 4 years and weakness of left limbs for 2 d. Head MRI showed circular space-occupying lesion in right fronto-parietal lobe. Magnetic resonance venography (MRV examination showed the front two-thirds of the superior sagittal sinus was not clear. The lesions were removed and decompressive craniectomy was conducted, showing the brain tissue was pale, partly yellow or dark red, and superficial venous engorgement. Histological observation showed pial superficial vein thrombosis and subpial encephalomalacia, and multifocal hemorrhage of cerebral cortex and local parenchymal hemorrhage. A large number of "grid cells" and vascular "cuff" phenomenan were visible in surrounding tissue, and the parenchymal blood vessel proliferation was obvious. Left hand activity of the patient was obviously limited after the operation. Conclusions Clinical diagnosis of superficial vein thrombosis with hemorrhagic infarction is difficult, and brain imaging and serological examination can provide certain help. Much attention should be paid to the multidisciplinary diagnosis and treatment to reduce misdiagnosis or missed diagnosis, and gather clinical experience. DOI: 10.3969/j.issn.1672-6731.2016.01.007

  19. Cerebral Venous Thrombosis Presented as Subarachnoid Hemorrhage and Treated with Anticoagulants

    Directory of Open Access Journals (Sweden)

    M Zare

    2005-07-01

    Full Text Available A 45-year-old woman was brought into the emergency room of Al-Zahra hospital, Isfahan, after her first generalized tonic-clonic seizure and a history of thunderclap occipital headache ten days before the first seizure. Examination revealed mild confusion and slight left hemiparesis with facial weakness and no meningeal irritation signs. CT scan showed subarachnoid hemorrhage (SAH and MRI demanstrated left lateral, sigmoid and sagittal sinus thromboses. Angiography was normal. She was treated by anticoagulants in spite of hemorraghic parenchymal lesion. Key words: Cerebral venous thrombosis, Subarachnoid hemorrhage, Anticoagulant therapy

  20. Cerebral Venous Thrombosis and Venous Infarction: Case Report of a Rare Initial Presentation of Smoker's Polycythemia.

    Science.gov (United States)

    Raval, Mihir; Paul, Anu

    2010-11-22

    INTRODUCTION: Cerebral venous thrombosis is a rare initial presentation of polycythemia. If diagnosed early, treatment can reduce mortality and morbidity significantly. Often it may present with headache as the only complaint, and thus the diagnosis is likely to be missed. CASE PRESENTATION: A medically stable 31-year-old male, a chronic smoker with a ∼17 pack-year history of smoking, was admitted to the emergency room with a 2-week history of gradually worsening, severe, throbbing headache in the occipital region sensitive to light. Initial neurological examination was positive only for some involuntary motor tics of the left leg. Initial laboratory workup showed hemoglobin of 20 g/dl and hematocrit of 56.5%. The carboxyhemoglobin level was normal, but the oxygen dissociation curve was shifted to the left. Further evaluation by MRI and MRA of the brain suggested extensive and complete thrombosis of the superior sagittal sinus, right transverse sinus and right sigmoid sinus with a small venous infarct in the right parafrontal region. Given that the patient first presented with a thrombotic event, workup for primary polycythemia and hypercoagulable disorders was carried out, including JAK2 mutation evaluation, which was negative. This left us with smoking as the only risk factor and possible cause for secondary polycythemia. He improved significantly with phlebotomy and anticoagulation treatment. CONCLUSION: This case illustrates a rare but severe complication of secondary polycythemia stressing the importance of being aware of the risk of developing cerebral thrombosis in patients with chronic smoking exposure.

  1. Perda visual bilateral grave como sinal de apresentação de trombose de seio venoso cerebral: relato de caso Severe bilateral visual loss as the presenting sign of cerebral venous sinus thrombosis: case report

    Directory of Open Access Journals (Sweden)

    Leonardo Provetti Cunha

    2005-08-01

    Full Text Available O objetivo é relatar um caso de trombose de seio venoso cerebral causando síndrome de pseudotumor, onde a principal manifestação clínica foi uma perda visual bilateral grave. Homem de 24 anos apresentando perda visual bilateral grave, obscurecimentos transitórios da visão, cefaléia, papiledema bilateral e campos visuais constrictos. Tomografia computadorizada, bem como exame neurológico, apresentavam-se normais. Punção lombar mostrou um aumento da pressão liquórica inicial e o hemograma mostrou aumento do número de plaquetas. A ressonância magnética de crânio apresentava sinais característicos de papiledema crônico e sinais sugestivos de trombose de seio sagital superior. A venorressonância magnética de crânio mostrou trombose de seios sagital superior, transversos e sigmóides. Paciente foi tratado com descompressão de bainha de nervo óptico do olho esquerdo, acetazolamida e anticoagulação. O exame oftalmológico após o tratamento mostrou redução do papiledema, mas com persistência de perda visual acentuada. O pseudotumor cerebral com perda visual severa pode ser um sinal de apresentação de trombose venosa cerebral secundária a doença hematológica grave.Our purpose is to report a case of cranial venous thrombosis causing pseudotumor syndrome, where the principal clinical manifestation was severe bilateral vision loss. A 24-year-old man presented with severe bilateral vision loss, transient obscuration of vision, headache, bilateral papilledema and constricted visual fields. Computed tomography as well as neurologic examination was unrevealing. A lumbar puncture disclosed an increased cerebrospinal fluid opening pressure and complete blood count (CBC showed increased numbers of platelets. A brain magnetic resonance imaging disclosed characteristic sings of chronic papilledema and suggestive signs of superior sagital sinus thrombosis. A cranial magnetic resonance venography disclosed thrombosis of superior

  2. Cerebral Venous Thrombosis and Venous Infarction: Case Report of a Rare Initial Presentation of Smoker’s Polycythemia

    Directory of Open Access Journals (Sweden)

    Mihir Raval

    2010-11-01

    Full Text Available Introduction: Cerebral venous thrombosis is a rare initial presentation of polycythemia. If diagnosed early, treatment can reduce mortality and morbidity significantly. Often it may present with headache as the only complaint, and thus the diagnosis is likely to be missed. Case Presentation: A medically stable 31-year-old male, a chronic smoker with a ∼17 pack-year history of smoking, was admitted to the emergency room with a 2-week history of gradually worsening, severe, throbbing headache in the occipital region sensitive to light. Initial neurological examination was positive only for some involuntary motor tics of the left leg. Initial laboratory workup showed hemoglobin of 20 g/dl and hematocrit of 56.5%. The carboxyhemoglobin level was normal, but the oxygen dissociation curve was shifted to the left. Further evaluation by MRI and MRA of the brain suggested extensive and complete thrombosis of the superior sagittal sinus, right transverse sinus and right sigmoid sinus with a small venous infarct in the right parafrontal region. Given that the patient first presented with a thrombotic event, workup for primary polycythemia and hypercoagulable disorders was carried out, including JAK2 mutation evaluation, which was negative. This left us with smoking as the only risk factor and possible cause for secondary polycythemia. He improved significantly with phlebotomy and anticoagulation treatment. Conclusion: This case illustrates a rare but severe complication of secondary polycythemia stressing the importance of being aware of the risk of developing cerebral thrombosis in patients with chronic smoking exposure.

  3. Sinus Headaches

    Science.gov (United States)

    ... Evaluation and management of "sinus headache" in the otolaryngology practice. Otolaryngology Clinics of North America. 2014;47:269. Sinusitis. ... et al. Why the confusion about sinus headache? Otolaryngology Clinics of North America. 2014;47:169. Sinus ...

  4. 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 ...

  5. Multiplanar sinus CT: a systematic approach to imaging before functional endoscopic sinus surgery.

    Science.gov (United States)

    Hoang, Jenny K; Eastwood, James D; Tebbit, Christopher L; Glastonbury, Christine M

    2010-06-01

    The purpose of this essay is to present a systematic approach to the use of coronal, axial, and sagittal images for CT evaluation of the sinuses before functional endoscopic sinus surgery (FESS). We present a systematic approach to the use of coronal, axial, and sagittal images in CT evaluation before FESS. Each imaging plane is valuable for displaying anatomic variants, which can predispose a patient to recurrent disease and affect the surgical approach, and critical variants, which can make surgery hazardous.

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

    African Journals Online (AJOL)

    Dr. NWaorgu

    Abstract. Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain ...

  7. Coexistance of cerebral sinovenous thrombosis and Dandy Walker malformation in newborn.

    Science.gov (United States)

    Gverić-Ahmetasević, Snjezana; Colić, Ana; Gverić, Tugomir; Gasparović, Vesna Elvedi; Pavlisa, Goran; Ozretić, David

    2011-01-01

    Cerebral sinovenous thrombosis in neonatal period may cause neurological impairment, epilepsy, and lead to stroke. It is caused primarily by coagulopathy of numerous reasons, occasionally perinatal asphyxia, traumatic delivery and hyperhomocysteinemia. Dandy-Walker malformation is characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa. Dandy-Walker malformation, variant, and mega cisterna magna represent a spectrum of developmental anomalies. Insults to developing cerebellar hemispheres and the fourth ventricle are believed to be the cause of malformation. Our patient was born from noncomplicated pregnancy, noncomplicated nontraumatic vaginal delivery at term, excellent Apgar scores, without peculiarities in clinical status. She was brest-fed by the 42nd hour of life when she had rightsided seizures during sleep that repeated for five times in next 24 hours. Brain Ultrasound (US) revealed clot in left lateral ventricle, slight dilatation of left ventricle, both sided periventricular echodensity, ischemia, slight enlargement of forth ventricle and a bit smaller cerebellum. There was no visible flow through left transverse, superior sagittal and straight sinus. Magnetic Resonance (MRI) confirmed the finding and showed thrombosis of left and right transverse venous sinuses and confluence of sinuses. Electroencephalogram (EEG) showed leftsided focal changes. The newborn was treated with phenobarbiton for 8 days and had no convulsions during that period. All coagulation parameters, homocistein, lipoproteins (a) and D-dimers were normal. There were no mutations on FV R506Q, PT 20210A, MTHFR 677C/T. No antiphospholipides were found. Heart US showed no structural anomalies. No other patology or risk factors were present at the time. Before discharge, US showed hydrocephalus. Flow in affected sinuses was visible with color Doppler. MRI showed recanalization of affected sinuses, also

  8. Endoscopic Sinus Surgery

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    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  9. Expectations of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  10. Complications of Sinusitis

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  11. Complications of Sinus Surgery

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  12. Sinusitis Q and A

    Science.gov (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult Sinusitis Pediatric Sinusitis Fungal Sinusitis Sinusitis & Asthma Empty Nose Syndrome Cystic Fibrosis Sinusitis Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ...

  13. [Fungal sinusitis].

    Science.gov (United States)

    Riechelmann, H

    2011-06-01

    The incidence of fungal sinusitis is subjected to significant geographical variation. Basically, invasive and non-invasive fungal sinusitis is distinguished. Invasive fungal sinusitis is observed mainly in immunocompromised hosts. The diagnopsis is based on positive fungus detection combined with characteristic clinical features. The treatment of invasive fungal sinusitis is based on surgical debridement and systemic antifungal therapy. Non-invasive fungal sinusitis is either treated with surgery alone or surgery combined with systemic steroid therapy. The majority of studies showed no benefit of postoperative antimycotic medical treatment in patients with non-invasive fungal sinusitis. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Multiple cerebral venous sinus thrombosis: Case report

    African Journals Online (AJOL)

    weeks gestation who presented with headache, vomiting, photophobia and neck stiffness. The diagnostic workup and ... Ninety percent of patients report a headache,. 50% have some type of neurological deficit and convulsions occur .... Principles of Pediatric. Neurosurgery, vol 4. Berlin: Springer. 1994. 7. Adams W.M., Laitt ...

  15. Core curriculum illustration: dural venous sinus thrombosis.

    Science.gov (United States)

    Rajendran, Sibi; Pereira, Alex; Eckerd, Morgan; Pawley, Barbara

    2017-08-01

    This is the 25th installment of a series that will highlight one case per publication issue from the bank of cases available online as a part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for study online at http://www.aseronline.org/curriculum/toc.htm .

  16. Orbital cellulitis complicating sinusitis: a 15-year review | Nwaorgu ...

    African Journals Online (AJOL)

    Background: Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess.

  17. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies.

    Science.gov (United States)

    Byju, N; Jose, James; Saifudheen, K; Gafoor, V Abdul; Jithendranath, P

    2012-10-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9(th), 10(th), and 12(th) cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.

  18. Sinus x-ray

    Science.gov (United States)

    ... an infection and inflammation of the sinuses called sinusitis . A sinus x-ray is ordered when you have any of the following: Symptoms of sinusitis Other sinus disorders, such as a deviated septum ( ...

  19. A STUDY OF CLINICAL AND INVESTIGATIVE PROFILE OF CORTICAL VENOUS THROMBOSIS

    Directory of Open Access Journals (Sweden)

    Dwijal Patel

    2017-08-01

    Full Text Available BACKGROUND In 1825, Ribes, a French physician, described the foremost detailed explanation of Cerebral Venous Sinus Thrombosis (CVST. Infective causes, thrombophilic abnormalities, oral contraceptives, antithrombin III, protein C and protein S defects, antiphospholipid syndrome, high plasma concentrations of homocysteine, low plasma folate level are common causes of CVT. The prognosis after CVT during pregnancy and puerperium is probably better than after CVT from other causes. During the past decade, increased awareness of the diagnosis improved neuroimaging techniques and more effective treatment have improved the prognosis. MATERIALS AND METHODS 32 patients admitted to SSG Hospital from November 2012 to November 2013 with a confirmed diagnosis of cerebral venous thrombosis by imaging of brain (MR Veno were included. Meticulous history, clinical examination and laboratory investigations were carried out in all cases. Haemorrhagic thromboembolic stroke and metabolic encephalopathy were excluded from study. RESULTS The puerperal CVT group consisted of 17 women (53.125% and the non-puerperal group consisted of 25 patients (78.125% of which 10 were women and 15 were men. The present study showed 42.875% of patients presented within 10 days. Headache was the most common symptom in the present study accounting for 85% of patients. In the present study, 50% of cases had seizures, 31.25% of patients had focal deficit, 53.125% of patients had altered level of consciousness and 25% of patients had papilloedema. The most common finding in the present study is haemorrhagic infarction present in 59.375% of cases. The transverse sinus is most commonly involved accounting for 65.625% followed by sigmoid sinus with 59.375% and superior sagittal sinus with 56.25%. In our study, all the 32 patients were treated with anticoagulants. All patients were subjected to LMWH and then switched on to warfarin therapy maintaining the INR value 1.5 to 2 times normal

  20. Acute Sinusitis

    Science.gov (United States)

    ... Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days. In ... sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops. Risk factors You may ...

  1. [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.

  2. Parenchymal abnormalities in cerebral venous thrombosis: findings of magnetic resonance imaging and magnetic resonance angiography; Alteracoes parenquimatosas na trombose venosa cerebral: aspectos da ressonancia magnetica e da angiorressonancia

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Clecia Santos; Pellini, Marcos [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: csferreira@superig.com.br; Boasquevisque, Edson [Universidade do Estado do Rio de Janeiro, (UERJ), RJ (Brazil). Faculdade de Medicina. Dept. de Patologia; Souza, Luis Alberto M. de [Hospital da Beneficencia Portuguesa do Rio de Janeiro, RJ (Brazil). Servico de Imagem. Setor de Ressonancia Magnetica

    2006-09-15

    Objective: to determine the frequency and localization of parenchymal abnormalities in cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography as well as their correlation with the territory and affected venous drainage. Materials and methods: retrospective analysis (1996 to 2004) of 21 patients (3 male and 18 female) age range between 3 and 82 years (mean 40 years, median 36 years) with clinical and radiological diagnosis of cerebral venous thrombosis on magnetic resonance imaging and magnetic resonance angiography in 2D PC, 3D PC and contrast-enhanced 3D TOF sequences. The statistical analysis was performed with the qui-square test. Four patients had follow-up exams and three patients underwent digital subtraction angiography. Results: main predisposing factors were: infection, use of oral contraceptives, hormone replacement therapy and collagenosis. Predominant symptoms included: focal deficit, headache, alteration of consciousness level and seizures. Most frequent parenchymal manifestations were: cortical/subcortical edema or infarct, venous congestion and collateral circulation, meningeal enhancement and thalamic and basal ganglia edema or infarct. Occlusion occurred mainly in superior sagittal, left transverse, left sigmoid and straight sinuses. Cavernous sinus and cortical veins thrombosis are uncommon events. Conclusion: cerebral venous thrombosis is an uncommon cause of stroke, with favorable prognosis because of its reversibility. Diagnosis is highly dependent on the radiologist capacity to recognize the presentations of this disease, principally in cases where the diagnosis is suggested by parenchymal abnormalities rather than necessarily by visualization of the thrombus itself. An accurate and rapid diagnosis allows an immediate treatment, reducing the morbidity and mortality rates. (author)

  3. Sinus Headaches

    Science.gov (United States)

    ... choose any aerobic exercise you enjoy, including walking, swimming and cycling. Warm up slowly, however, because sudden, ... dosages for you. References Patel ZM, et al. Evaluation and management of "sinus headache" in the otolaryngology ...

  4. Chronic Sinusitis

    Science.gov (United States)

    ... weeks, despite treatment attempts. Also known as chronic rhinosinusitis, this condition interferes with drainage and causes mucus ... Regular exposure to pollutants such as cigarette smoke Complications Chronic sinusitis complications include: Meningitis. This infection causes ...

  5. 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.

  6. Thrombosis incancer

    Directory of Open Access Journals (Sweden)

    Tomasz Chojnacki

    2015-03-01

    Full Text Available Malignant tumours are among the strongest risk factors for venous thromboembolism. The probability scores for deep vein thrombosis and pulmonary embolism, which we use in our everyday practice, have not yet been validated in patients with cancer, which is why they should be used with caution. Prevention of thrombosis should always be implemented in patients undergoing surgery and most patients treated conservatively, which results from the application of appropriate probability scores assessing the risk of thrombosis in these patients. The prevention method should be adjusted individually depending on the characteristics of the patient and the existence of contraindications to the use of given methods, bearing in mind their availability, cost and ability to monitor the anticoagulant effect. Treatment of venous thromboembolism in patients with cancer is different from treating it in patients with no concomitant tumour. These differences relate to both the type of treatment (anticoagulant drug selection and dosage and its duration. Low-molecular-weight heparin is the preferred form of both initial and long-term treatment, which should last at least 6 months. Both oncologists and other health care professionals working in cancer teams should make sure at each time that the patient has at least minimal knowledge about the symptoms ensuring early detection of thrombosis. Good communication with the patient considerably facilitates effective prevention and treatment.

  7. Case Presentation of Sagittal Balance.

    Science.gov (United States)

    Kim, Paul K

    2016-04-01

    Sagittal balance is an important concept in spinal coronal and kyphotic deformity correction. Sagittal alignment/lumbar lordosis is increasingly recognized and discussed in terms of surgical outcomes. Positive sagittal balance can lead to development of iatrogenic kyphosis, flatback syndrome, adjacent level degeneration, and junctional kyphosis. This concept is no longer associated only with deformity. Spine surgeons have learned that sagittal alignment/lumbar lordosis is very important even in 1-level or 2-level interbody fusion procedures, and that it can be attained, maintained, or lost during any procedure, resulting in complications.

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

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

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are obstructed and the best imaging modality for sinusitis. Tell your doctor if there’s a possibility you ... the sinuses is primarily used to: help diagnose sinusitis . evaluate sinuses that are filled with fluid or ...

  10. Sinus MRI scan

    Science.gov (United States)

    ... tissues surrounding the eye (orbital cellulitis) Nasal polyps Sinusitis -- acute Sinusitis -- chronic Talk to your provider if you have ... therefore is not typically used for suspected acute sinusitis. Alternative Names MRI of the sinuses; Magnetic resonance ...

  11. Pediatric sagittal alignment.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Labelle, Hubert; Roussouly, Pierre

    2011-09-01

    There is a wide variation in the regional parameters used to describe the spine and sacro-pelvis in children and adolescents. There is a slight tendency for thoracic kyphosis and lumbar lordosis to increase with age. Pelvic incidence and pelvic tilt also tend to increase during growth, while sacral slope remains relatively stable. Strong knowledge of the close relationships between adjacent anatomical regions of the spine and sacro-pelvis is the key when evaluating and interpreting sagittal spino-pelvic alignment. The scheme of correlations between adjacent regional parameters needs to be preserved in order to maintain a balanced posture. The net resultant from these relationships between adjacent anatomical regions is best represented by parameters of sagittal global balance. C7 plumbline tends to move backwards from childhood to adulthood, where it stabilizes or slightly moves forward secondary to degenerative changes. C7 plumbline in front of both hip axis and center of the upper sacral endplate occurs in 29% of subjects aged 3-10 years, 12% of subjects aged between 10 and 18 years, and 14% of subjects aged 18 years or older. Therefore, although most normal subjects stand with a C7 plumbline behind the hip axis, a C7 plumbline in front of both hip axis and sacrum can be seen in normal individuals. However, progressive forward displacement of C7 plumbline should raise a suspicion for the risk of developing spinal pathology.

  12. Endoscopic Sinus Surgery for Chronic Sinusitis

    OpenAIRE

    篠, 昭男; 吉原, 俊雄; Akio, SHINO; Toshio, YOSHIHARA

    2004-01-01

    Endoscopic sinus surgery (ESS) has became basic surgical treatment for chronic sinusitis instead of the Caldwell-Luc procedure. This technique is aimed at improvement of ventilation and excretion with endoscopic approach between nasal cavity and each sinus. The mucosa preservation of sinus is recognized to important as the surgery for inflammatory disease. The ostiomeatal complex (OMC) plays a significant role in the pathogenesis of sinusitis. Obstruction here predisposes to chronic sinusitis...

  13. Sinusitis: Overview

    Science.gov (United States)

    ... congestion. Your doctor may suggest a decongestant nasal spray to treat swelling. Do not use this for more than 3 days. It can worsen the swelling in your sinuses once you stop using the medicine.A process called nasal irrigation can provide relief. A saline solution through a ...

  14. Sinusitis (acute)

    Science.gov (United States)

    2008-01-01

    Introduction Acute sinusitis is defined pathologically, by transient inflammation of the mucosal lining of the paranasal sinuses lasting less than 4 weeks. Clinically, it is characterised by nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and, if more severe, additional malaise and fever. It affects 1−5% of the adult population each year in Europe. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments in people with clinically diagnosed acute sinusitis, and with radiologically or bacteriologically confirmed acute sinusitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics (amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides, different doses [amoxicillin, co-amoxiclav, doxycycline, cephalosporins, macrolides], long-course regimens), antihistamines, cephalosporins or macrolides, decongestants (xylometazoline, phenylephrine, pseudoephedrine), doxycycline, saline nasal washes, steam inhalation, and topical corticosteroids (intra-nasal). PMID:19450327

  15. Quality control of reconstructed sagittal balance for sagittal imbalance.

    Science.gov (United States)

    Chang, Kao-Wha; Leng, Xiangyang; Zhao, Wenhai; Ching-Wei, Cheng; Chen, Tsung-Chein; Chang, Ku-I; Chen, Yin-Yu

    2011-02-01

    Prospective radiographic study. To investigate the feasibility of controlling quality of reconstructed sagittal balance for sagittal imbalance. Patients with sagittal imbalance cannot walk or stand erect without overwork of musculature because of compromised biomechanical advantage. The result is muscle fatigue and activity-related pain. During reconstructive surgery, restoration of optimal sagittal balance is crucial for obtaining satisfactory clinical results. However, there is no way to control quality of reconstructed sagittal balance before or during surgery. A method was developed to determine the lumbosacral curve in a way that theoretically would bring sagittal balance to an ideal state by calculation and simulation for each patient before surgery and then template rods of the curve and a blueprint were made accordingly for operative procedures. Ninety-four consecutive patients with sagittal imbalance due to lumbar kyphosis were treated for intractable pain and then followed up for a mean of 4.3 years. Radiographs were analyzed before surgery, 2 months after surgery, and at most recent follow-up. The mean estimated values of L1-S1 lordosis, sacral inclination angle, sacrofemoral distance, and distribution of L1-S1 lordosis at the closing-opening wedge osteotomy site and L4-S1 segments were 30.8°, 24.6°, 0 mm, 16.1% (-5°), and 62% (-19°), respectively. The mean reconstructed values were 41.1°, 23.3°, 3.9 mm, 41% (-17°), and 46% (-19°), respectively. There were significant differences between estimated and reconstructed values of L1-S1 lordosis and the percentage of distributions; however, there was no significant difference between the estimated and reconstructed magnitude of L4-S1 lordosis, sacral inclination angle, and sacrofemoral distance. A properly oriented pelvis can be brought nearly directly above the hip axis. The mean sagittal global balance, represented by the distance between the vertical line through the hip axis and sacral promontory

  16. Cerebral sinovenous thrombosis associated with iron deficiency anemia secondary to severe menorrhagia: a case report.

    Science.gov (United States)

    Corrales-Medina, Fernando F; Grant, Leon; Egas-Bejar, Daniela; Valdivia-Ascuna, Zoila; Rodriguez, Nidra; Mancias, Pedro

    2014-09-01

    Cerebral sinovenous thrombosis is a rare condition presenting with a wide spectrum of nonspecific symptoms that can make early diagnosis difficult. Cerebral sinovenous thrombosis has been associated with various etiologies. Iron deficiency anemia associated with cerebral sinovenous thrombosis in teenagers is rare. We present a teenage patient with complete thrombosis of the vein of Galen, straight sinus, and left internal cerebral vein associated with iron deficiency anemia due to severe menorrhagia. Mechanisms that can explain the association between iron deficiency anemia and thrombosis are discussed. © The Author(s) 2013.

  17. [Thrombophlebitis of venous sinuses in otitis media].

    Science.gov (United States)

    Kuczkowski, Jerzy

    2007-01-01

    Thrombophlebitis of dura venous sinuses is a rare intracranial complication of otitis media, which may be sometimes accompanied by symptoms or sepsis. Anatomical conditions and early diagnosis of this vascular complication determine the treatment modality. Aim of this study was the assessment of diagnostics and treatment of venous sinuses thrombophlebitis in acute and chronic otitis media considering anatomy and the venous sinuses and status of coagulation system. Otogenic thrombophlebitis may occur in lateral, transverse, upper and lower petrosal sinuses, and rarely in cavernous. In some cases thrombophlebitis proces may expand into brain or emissary mastoid veins. Lateral sinus thrombophlebitis in chronic otitis media usually appears clinically as septic fever, earache, and increasing neurologic signs. In acute otitis media when thrombophlebitis develops the patient complains about headache, high fever and visual acquity. Diagnosis of venous sinus thrombophlebitis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Contrast enhanced CT scan shows "delta sign". Septic thrombophlebitis sinus sigmoidei is caused by mixed bacterial flora. Surgical treatment in cases with septic thrombus consists of radical modiffied ear operation and lateral sinus exposure. Thrombectomy and jugular vein ligation is performed when sepsis or thrombus is present. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given taking into consideration parameters of coagulation system and the type of thrombus. Treatment results of venous sinuses thrombophlebitis are good if they are not accompanied by other intracranial complications.

  18. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  19. Adult Spinal Deformity: Sagittal Imbalance

    Directory of Open Access Journals (Sweden)

    Cavanilles-Walker JM

    2014-10-01

    Full Text Available Spinal sagittal imbalance, deformity of the spine in the sagittal plane, is nowadays a major cause of pain and disability among patients presenting to the spine clinic in daily practice. Normal sagittal spinal balance is a result of mutual articulation of the pelvis and the spine in the sagittal plane. Sagittal imbalance of the spine could be related to many spinal pathologies interesting primarily the spine or could appear after an instrumentation spinal surgery. Variations in the spine sagittal alignment can be compensated by compensatory mechanisms occurring in the spine, pelvis and lower limb areas. The main objective of these mechanisms is to allow the patient to keep an erect position within the cone of economy in an energy-efficient way. Once a spinal deformity surpasses these compensatory mechanisms surgical intervention is often requested. In this paper the Authors performed comprehensive a critical analysis of the rigidity of the deformity, including the spinal and pelvic parameters. The compensatory mechanisms are paramount in order to be able to offer a tailored solution to these patients. Since conservative measures fail in most patients, successful management of these patients requires achieving fusion of a balanced spine. Appropriate preoperative optimization as well as appropriate surgical preoperative planning are critical in order to avoid potential complications. Selecting the appropriate surgical technique to achieve spinal balance is crucial to success.

  20. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  1. 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 ...

  2. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  3. Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

    Science.gov (United States)

    Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

    2018-01-01

    Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and

  4. Unusual Case of Cerebral Venous Thrombosis in Patient with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Inha Kim

    2015-05-01

    Full Text Available The development of cerebral venous thrombosis (CVT as a secondary complication of Crohn's disease (CD seems to be rare, but it is generally accepted that the disease activity of CD contributes to the establishment of a hypercoagulable state. Here, we describe a case of CVT that developed outside the active phase of CD. A 17-year-old male visited the emergency room because of a sudden onset of right-sided weakness and right-sided hypesthesia. He had been diagnosed with CD 1 year before and was on a maintenance regimen of mesalazine and azathioprine. He did not exhibit any symptoms indicating a CD flare-up (bloody stools, abdominal pain, complications, or weight loss. A brain MRI scan revealed an acute infarction of the left frontal cortex and a cortical subarachnoid hemorrhage. Additionally, a magnetic resonance venography revealed a segmental filling defect in the superior sagittal sinus and also the non-visualizability of some bilateral cortical veins. The characteristics of the present case suggest that the risk of CVT is most likely related to CD per se rather than disease activity associated with CD.

  5. Plain Language Summary: Adult Sinusitis (Sinus Infection).

    Science.gov (United States)

    Caspersen, Leslie A; Walter, Lindsey M; Walsh, Sandra A; Rosenfeld, Richard M; Piccirillo, Jay F

    2015-08-01

    This plain language summary serves as an overview in explaining sinusitis (pronounced sign-you-side-tis). The purpose of this plain language summary is to provide patients with standard language explaining their condition in an easy-to-read format. This summary applies to those 18 years of age or older with sinusitis. The summary is featured as an FAQ (frequently asked question) format. The summary addresses how to manage and treat sinusitis symptoms. Adult sinusitis is often called a sinus infection. A healthcare provider may refer to a sinus infection as rhinosinusitis (pronounced rhi-no-sign-you-side-tis). This includes the nose as well as the sinuses in the name. A sinus infection is the swelling of the sinuses and nasal cavity.The summary is based on the published 2015 "Clinical Practice Guideline: Adult Sinusitis." The evidence-based guideline includes research to support more effective diagnosis and treatment of adult sinus infections. The guideline was developed as a quality improvement opportunity for managing sinus infections by creating clear recommendations to use in medical practice. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  6. Life-threatening Cerebral Venous Thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Daniel Agustin Godoy

    2016-06-01

    Full Text Available Cerebral venous sinus thrombosis (CVT can compromise dural sinus, cerebral veins or both. It is an uncommon condition and it is more prevalent in young women. Several prothrombotic states are the principal predisposing factors. Clinical spectrum of presentation is wide, so this entity requires a high suspect index for correct and prompt diagnosis. CVT may develop serious complications that can be life-threatening such as hemorrhagic venous infarctions, cerebral edema, and intracranial hypertension. This report describes the case of a woman who was in treatment for unspecific vaginal bleeding with oral contraceptives. Suddenly she deteriorated to coma with severe respiratory compromise. Neuroimaging showed thrombosis of multiple venous sinus. Physiological neuroprotection, osmotherapy, mechanical ventilation and anticoagulation therapy were the keystones of treatment. In a few months, the patient has recovered a good functional status, while maintaining a motor deficit on the right hand.

  7. Sinusitis (For Parents)

    Science.gov (United States)

    ... Special Needs Factsheet School Violence and the News Sinusitis KidsHealth > For Parents > Sinusitis Print A A A What's in this article? Causes Symptoms Prevention Treatment en español Sinusitis Sinuses are moist air spaces within the bones ...

  8. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    CONCLUSION: Deep Venous Thrombosis is a common disease with fatal and serious long term burdensome complications. ... WAJM 2009; 28(2): 77–82. Keywords: Deep Vein Thrombosis, Venous Thrombosis,. Phlebothrombosis. ... phlebitic syndrome, ulcers and varicose veins. In surgical patients with malignant disease ...

  9. clinical features and patterns of imaging in cerebral venous sinus

    African Journals Online (AJOL)

    2013-09-01

    Sep 1, 2013 ... patients with CVST is headache, followed by seizures, neck pain, neurological deficits and visual disturbance. Infective cause is much more common in our population and other developed countries compared to the developed world. INTRODUCTION. Cerebral venous sinus thrombosis is a relatively.

  10. Cerebral venous thrombosis.

    Science.gov (United States)

    Ferro, José Manuel; Canhão, Patrícia; Aguiar de Sousa, Diana

    2016-12-01

    Cerebral venous thrombosis (CVT) has an incidence of 1.32/100,000/years in high-income countries, and higher in middle- and low-income countries. CVT is more frequent in infants and children young adults and females, especially during pregnancy/puerperium. CVT are now being diagnosed with increasing frequency because of the increased awareness and higher use of magnetic resonance imaging (MR) for investigating patients with acute and subacute headaches and new onset seizures. CVT rarely present as a stroke syndrome. Their most frequent presentations are isolated headache, intracranial hypertension syndrome, seizures, a lobar syndrome and encephalopathy. The confirmation of the diagnosis of CVT relies on the demonstration of thrombi in the cerebral veins and/or sinuses by MR/MR venography or veno CT. The more frequent risk factors/associated conditions for CVT are genetic prothrombotic conditions, antiphospholipid syndrome and other acquired prothrombotic diseases, including cancer, oral contraceptives, puerperium and pregnancy, infections and trauma. The prognosis of CVT is in general favorable, as acute death rate is below 5% and only 15% of the patients remain dependent or die. Treatment in the acute phase includes management of the associated condition, anticoagulation with either low molecular weight or unfractionated heparin, treatment of intracranial hypertension, prevention of recurrent seizures and headache relief. In patients in severe condition on admission or who deteriorate despite anticoagulation, local thrombolysis or thrombectomy is an option. Decompressive surgery is lifesaving in patients with large venous infarcts or hemorrhage with impending herniation. After the acute phase, patients should anticoagulated for a variable period of time, depending on their inherent thrombotic risk. CVT patients may experience recurrent seizures. Prophylaxis with anti-epileptic drugs is recommended after the first seizure, in those with hemispheric lesions. There

  11. Allergic Fungal Sinusitis

    OpenAIRE

    Correll, Daniel P.; Luzi, Scott A.; Nelson, Brenda L.

    2014-01-01

    A 42 year old male presents with worsening pain and an increase in thick chronic drainage of the left sinus. Image studies show complete opacification of the left frontal sinus, left sphenoid sinus, and the left maxillary sinus. The patient was taken to the operating room and tissue for microscopic evaluation was obtained. The microscopic findings were classic for allergic fungal sinusitis: areas of alternating mucinous material and inflammatory cell debris and abundant Charcot–Leyden crystal...

  12. Cortical venous thrombosis following exogenous androgen use for bodybuilding.

    Science.gov (United States)

    Sveinsson, Olafur; Herrman, Lars

    2013-02-05

    There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic-clonic seizure. At admission, he was drowsy, not fully orientated, had sensory inattention, pronation drift and a positive extensor response, all on the left side. The patient had been using anabolic steroids (dainabol 20 mg/day) for the last month for bodybuilding. CT angiography showed a right cortical venous thrombosis. Anticoagulation therapy was started with intravenous heparin for 11 days and oral anticoagulation (warfarin) thereafter. A control CT angiography 4 months later showed resolution of the thrombosis. He recovered fully.

  13. Cerebral Venous Thrombosis Presenting with Subracnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Esra Eruyar

    2015-08-01

    Full Text Available Subarachnoid hemorrhage (SAH associated with cerebral venous thrombosis (CVT is rarely reported. In our case, the initial CT shows with suspected lesions that SAH. After the initial diagnosis of SVT with history and neurological examination findings MRV taken and consistend with thrombus signal change. Dural sinus thrombosis with secondary venous hypertension may lead to SAH into the subarachnoid space due to the rupture of fragile, thin-walled cortical veins. Patients with non-traumatic, non-aneurysmal and non-perimesencephalic subaracnoid hemorrhage tend to have clots circumscribed along the cortical convexity, a condition referred as acute cortical SAH. CVT is a potential cause of cortical SAH. This case; SAH may be the first sign of SVT and especially SVT must do in etiologic research without the involvement of the basal sisterna in cases of SAH.

  14. Relation between intraocular pressure and size of transverse sinuses

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. 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 ...

  16. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  17. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed ... nasal cavity by small openings. top of page What are some common uses of the procedure? CT ...

  18. [Maxillary sinus hypoplasia].

    Science.gov (United States)

    Plaza, G; Ferrando, J; Martel, J; Toledano, A; de los Santos, G

    2001-03-01

    Maxillary sinus hypoplasia is rare, with an estimated prevalence of 1-5%. Out of the CT scans performed in sinusal patients between March 1998 and June 1999, we report on 4 isolated maxillary sinus hypoplasia, 4 maxillary sinus hypoplasia associated to concha bullosa, and 10 isolated conchae bullosas. All cases were evaluated by nasosinusal endoscopy and CT scan. Size, location and uni/bilateral presentation of concha bullosa is correlated to maxillary sinus hypoplasia presence, specially with regards to uncinate process presence, medial or lateral retraction. The pathogenesis of maxillary sinus hypoplasia is reviewed, and its relation to concha bullosa, evaluating how this could explain some cases of the so called chronic maxillary sinus atelectasia, as an acquired and progressive variant of maxillary sinus hypoplasia in adults.

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... a patient's paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity , a system of air channels connecting the nose with the ...

  20. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... determining if the sinuses are obstructed and the best imaging modality for sinusitis. Tell your doctor if ... over time. Follow-up examinations are sometimes the best way to see if treatment is working or ...

  1. Computed Tomography (CT) -- Sinuses

    Medline Plus

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

  2. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... view of the body's interior. Refinements in detector technology allow nearly all CT scanners to obtain multiple ... modality for sinusitis. CT of the sinuses is now widely available and is performed in a relatively ...

  3. A rare cause of cerebral venous thrombosis: cryptococcal meningoencephalitis.

    Science.gov (United States)

    Senadim, Songul; Alpaydin Baslo, Sezin; Tekin Güveli, Betül; Dedei Daryan, Metin; Kantaroglu, Elif; Ozturk, Oya; Atakli, Dilek

    2016-07-01

    Cryptococcal meningoencephalitis (CM) is a serious central nervous system infection caused by Cryptococcus neoformans, seen mostly in immunocompromised hosts and less in immunocompetent patients. The vast majority of cryptococcosis cases are seen as human immunodeficiency virus infections with advanced immunosuppression. Meningitis and meningoencephalitis are the most common clinical manifestations. Nevertheless, immunocompetent patients with CM are rarely reported. Cerebral venous sinus thrombosis is a rare complication of CM. Here, we report an immunocompetent patient with CM from a non-endemic area, who presented with an acute onset and atypical symptoms associated with cerebral venous thrombosis.

  4. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... top of page What are some common uses of the procedure? CT of the sinuses is primarily ...

  5. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses 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 ...

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

    Science.gov (United States)

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

    2014-01-01

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

  7. Allergic Fungal Sinusitis.

    Science.gov (United States)

    Correll, Daniel P; Luzi, Scott A; Nelson, Brenda L

    2015-12-01

    A 42 year old male presents with worsening pain and an increase in thick chronic drainage of the left sinus. Image studies show complete opacification of the left frontal sinus, left sphenoid sinus, and the left maxillary sinus. The patient was taken to the operating room and tissue for microscopic evaluation was obtained. The microscopic findings were classic for allergic fungal sinusitis: areas of alternating mucinous material and inflammatory cell debris and abundant Charcot-Leyden crystals. Cultures were performed and the patient began steroid therapy and desensitization therapy.

  8. Lifestyle and venous thrombosis

    NARCIS (Netherlands)

    Pomp, Elisabeth Rebekka

    2008-01-01

    In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA study), a large population-based case-control study, we investigated lifestyle factors as risk factors for venous thrombosis. Overweight, smoking and alcohol consumption were addressed and pregnancy and

  9. [Sagittal balance of the spine].

    Science.gov (United States)

    Mangione, P; Sénégas, J

    1997-01-01

    The authors examined the modifications of sagittal shape and muscular functions in different vertebral diseases in order to investigate their correlations and to specify the role of hip extension in standing posture. We included 57 patients presenting various diseases, among which lumbar kyphosis, spondylosis and spondylolisthesis, backache and lumbar stenosis. We measured joint mobility (hip extension, lumbar flexion), muscular retractions (ilio-psoas, hamstrings, rectus femoris), and muscular strength (spine flexors and extensors, hamstrings, quadriceps femoris). On standing lateral x-rays, measurements were made of various spinal and pelvic parameters, among which the "pelvi-femoral angle", proposed by the authors for hip extension evaluation. There was a significant correlation between pelvi-femoral angle and pelvic backward tilting (r = 0.8037 p tilt-up arise compensating the anterior displacement of the center of gravity, while in spondylolisthesis, anterior displacement is secondary to sacral obliquity. It is very important to evaluate the pelvis position in sagittal spinal diseases, in order to understand postural deterioration mechanisms. Lumbar kyphosis and spondylolisthesis are two examples of failure of upright posture.

  10. [Pott's puffy tumor: a rare complication of frontal sinusitis].

    Science.gov (United States)

    Aínsa Laguna, D; Pons Morales, S; Muñoz Tormo-Figueres, A; Vega Senra, M I; Otero Reigada, M C

    2014-05-01

    Pott's puffy tumor is a rare complication of frontal sinusitis characterized by swelling and edema in the brow due to a subperiosteal abscess associated with frontal osteomyelitis. Added complications are cellulitis by extension to the orbit and intracranial infection by posterior extension, with high risk of meningitis, intracranial abscess, and venous sinus thrombosis. Early diagnosis and aggressive medical or surgical treatment are essential for optimal recovery of affected patients. In the antibiotic age it is extremely rare, with very few cases described in the recent literature. A case is presented of a Pott inflammatory tumor in a 7 year-old boy, as a complication of acute pansinusitis who presented with front preseptal swelling and intracranial involvement with thrombosis of ophthalmic and superior orbital veins and frontal epidural abscess extending to the subarachnoid space. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  11. Tuberculosis of paranasal sinuses

    OpenAIRE

    Sanehi, S.; Dravid, Chandrashekhar; Chaudhary, Neena; Venkatachalam, V. P.

    2008-01-01

    Nasal tuberculosis is very rare but much rarer is tuberculosis of paranasal sinuses. It involves especially the maxillary sinus and is usually unilateral. We report an unusual case of tuberculosis of frontal and maxillary sinus in a 68 years old male, who presented with a swelling above left medial canthus, with no other eye or nasal complaints. Clinical and radiological findings on our initial evaluation suggested that the patient had left frontal mucocoele with bilateral maxillary haziness....

  12. Mycetoma sans sinuses

    Directory of Open Access Journals (Sweden)

    Saha Sudipta

    2006-01-01

    Full Text Available Mycetoma is a chronic suppurative infection involving the skin, subcutaneous tissue and bone. The hallmark of mycetoma is tumefaction, draining sinuses and the presence of microcolonies called grains. Sinuses develop in all patients with mycetoma within a year of the appearance of the lesion. The following case is reported as no sinuses had developed despite the presence of the lesion for 9 years, posing a diagnostic dilemma.

  13. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers

    OpenAIRE

    Yang, Mingyuan; Yang, Changwei; Ni, Haijian; Zhao, Yuechao; Li, Ming

    2016-01-01

    T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal ...

  14. Neonatal Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT were studied in 42 children, using neurology clinic records (1986-2005 at Indiana University School of Medicine.

  15. Pilonidal Sinus of the Penis

    Directory of Open Access Journals (Sweden)

    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.

  16. Thrombosis in vasculitis.

    Science.gov (United States)

    Springer, Jason; Villa-Forte, Alexandra

    2013-01-01

    To review the association of thrombosis and vasculitis and discuss some of the proposed causal mechanisms. It is becoming increasingly evident that various systemic inflammatory diseases such as vasculitis are associated with an increased risk of both venous and arterial thrombosis. Increasing evidence supports the use of immunosuppression in the management of venous thrombosis in Behçet's disease. An increased incidence of thromboembolic disease in antineutrophil cytoplasmic antibody-associated vasculitis has been recognized, especially during periods of active disease. In addition, a higher risk of ischemic heart disease in these patients has also been observed. As in giant cell arteritis, recent evidence supports the role of aspirin in the prevention of ischemic events in Takayasu's disease. Thromboembolic disease is an important complication of several forms of systemic vasculitis, and it may result in significant morbidity and mortality. Many questions such as the role for screening of asymptomatic patients, prevention of thrombosis, and duration of anticoagulation in patients with vasculitis remain unanswered. Future studies exploring the mechanisms of thrombosis and its link to inflammation may provide insights in predicting patients at a higher risk for thrombosis and improve outcomes.

  17. [Deep vein thrombosis prophylaxis.

    Science.gov (United States)

    Sandoval-Chagoya, Gloria Alejandra; Laniado-Laborín, Rafael

    2013-01-01

    Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk for thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy. Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini's checklist for thrombosis risk assessment in adult patients. Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001). Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines.

  18. 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, ... is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside ...

  19. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... are the limitations of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of ...

  20. Odontogene sinusitis maxillaris

    NARCIS (Netherlands)

    Weijerman, J.E.

    1972-01-01

    Een oroantrale fistel blijkt in 51,7% der gevallen geleid te hebben tot een chronische en slechts in 29,2% tot een acute sinusitis (tabel 7 blz.72). Een verklaring hiervoor is vermoedelijk de goede drainagemogelijkheid van de sinus doordat het ostium meestal open is en bovendien afvoer van de pus

  1. Topographic anatomy of the fetal inferior vena cava, coronary sinus, and pulmonary veins: Variations in Chiari's network.

    Science.gov (United States)

    Naito, Michiko; Yu, Hee Chul; Kim, Ji Hyun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2015-07-01

    To understand anomalies in Chiari's network better, we assessed the topographical anatomy of the fetal inferior vena cava (IVC), coronary sinus, and atria. We examined sagittal serial paraffin sections of 15 human fetuses of crown-rump length 24-36 mm, corresponding to a gestational age of 8 weeks. Although their outflow tract morphologies were similar, these 15 specimens could be classified into two groups. In eight specimens, the left common cardinal vein reached the body wall, whereas in the other seven the vein was obliterated near the left pulmonary vein. Irrespective of the group in which the specimen was included, the anteroposterior arrangement of the coronary sinus, the sinus septum (septum), and the right sinus valve (right valve) could be classified into three types: the right valve-septum-coronary sinus arrangement in seven specimens; the right valve-coronary sinus-septum arrangement in five; and the coronary sinus-right valve-septum arrangement in three. Depending on differences in topographical anatomy, the sinus septum separated the coronary sinus opening from either the right or the left atrium. Likewise, the coronary sinus opening was either adjacent to or distant from the IVC terminal. Rather than the counter-side position of the right valve being at the IVC terminal, the left sinus valve protruded leftward, forming an incomplete interatrial septum. Fetal variations seemed to be closely connected with individual variations and a high frequency of Chiari's network anomalies in adults. © 2014 Wiley Periodicals, Inc.

  2. Brain structure in sagittal craniosynostosis

    Science.gov (United States)

    Paniagua, Beatriz; Kim, Sunghyung; Moustapha, Mahmoud; Styner, Martin; Cody-Hazlett, Heather; Gimple-Smith, Rachel; Rumple, Ashley; Piven, Joseph; Gilmore, John; Skolnick, Gary; Patel, Kamlesh

    2017-03-01

    Craniosynostosis, the premature fusion of one or more cranial sutures, leads to grossly abnormal head shapes and pressure elevations within the brain caused by these deformities. To date, accepted treatments for craniosynostosis involve improving surgical skull shape aesthetics. However, the relationship between improved head shape and brain structure after surgery has not been yet established. Typically, clinical standard care involves the collection of diagnostic medical computed tomography (CT) imaging to evaluate the fused sutures and plan the surgical treatment. CT is known to provide very good reconstructions of the hard tissues in the skull but it fails to acquire good soft brain tissue contrast. This study intends to use magnetic resonance imaging to evaluate brain structure in a small dataset of sagittal craniosynostosis patients and thus quantify the effects of surgical intervention in overall brain structure. Very importantly, these effects are to be contrasted with normative shape, volume and brain structure databases. The work presented here wants to address gaps in clinical knowledge in craniosynostosis focusing on understanding the changes in brain volume and shape secondary to surgery, and compare those with normally developing children. This initial pilot study has the potential to add significant quality to the surgical care of a vulnerable patient population in whom we currently have limited understanding of brain developmental outcomes.

  3. Mutation in the Prothrombin Gene G20210A as a Cause of Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Jorge A. Arroyave

    2012-01-01

    Full Text Available Introduction. Cerebral venous sinus thrombosis (CVST is a rare form of cerebrovascular disease, which may manifest clinically by a wide variety of signs and symptoms. It has been associated with multiple risk factors including genetic or acquired blood disorders, infections, and trauma. Case Report. Man of 17 years who presented with 10 days of intense global headache with nausea and vomiting and subsequent onset of mild hemiparesis and hypoesthesia in right hemibody. Studies show venous thrombosis of the superior longitudinal sinus. It was identified a gene mutation in prothrombin G20210A as a probable cause of the thrombosis. Conclusions. Substitution of guanine for adenine at nucleotide 20210 in the coding region of the prothrombin gene is the second most common primary thrombophilia. Multiple cases of CVST have been associated with this mutation. In the presence of CVST must be considered the primary studies for thrombophilia gene mutations, including prothrombin G20210A.

  4. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, /sup 125/I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references.

  5. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  6. Portal Vein Thrombosis: Recent Advance.

    Science.gov (United States)

    Qi, Xingshun

    2017-01-01

    Portal vein thrombosis is a life-threatening vascular disorder of the liver. In this chapter, I will review the recent advance regarding the epidemiology, etiology, management, and prognosis of portal vein thrombosis.

  7. Analysis of sagittal spinopelvic parameters in achondroplasia.

    Science.gov (United States)

    Hong, Jae-Young; Suh, Seung-Woo; Modi, Hitesh N; Park, Jong-Woong; Park, Jung-Ho

    2011-08-15

    Prospective radiological analysis of patients with achondroplasia. To analyze sagittal spinal alignment and pelvic orientation in achondroplasia patients. Knowledge of sagittal spinopelvic parameters is important for the treatment of achondroplasia, because they differ from those of the normal population and can induce pain. The study and control groups were composed of 32 achondroplasia patients and 24 healthy volunteers, respectively. All underwent lateral radiography of the whole spine including hip joints. The radiographic parameters examined were sacral slope (SS), pelvic tilt, pelvic incidence (PI), S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis (LL1, LL2), and sagittal balance. Statistical analysis was performed to identify significant differences between the two groups. In addition, correlations between parameters and symptoms were sought. Sagittal spinopelvic parameters, namely, pelvic tilt, pelvic incidence, S1 overhang, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis 1 and sagittal balance were found to be significantly different in the patient and control groups (P achondroplasia patients and normal healthy controls. The present study shows that sagittal spinal and pelvic parameters can assist the treatment of spinal disorders in achondroplasia patients.

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity. CT scanning is painless, noninvasive and accurate. It’s ...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... allows the body parts to be distinguished from one another on an x-ray film or CT ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ...

  10. Sinusitis in adults - aftercare

    Science.gov (United States)

    ... still have symptoms after taking all of your antibiotics properly. You have any changes in your vision. You notice small growths in your nose. Alternative Names Sinus infection - self-care; Rhinosinusitis - self-care ...

  11. Sinusitis (For Teens)

    Science.gov (United States)

    ... When the nasal congestion (stuffiness) associated with the common cold or allergies doesn't allow the sinuses to ... have dry coughs and find it hard to sleep. Others have upset stomachs or feel nauseous. Although ...

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... of the nasal cavity and sinuses. plan for surgery by defining anatomy. top of page How should ... CT scanning may eliminate the need for exploratory surgery and surgical biopsy. No radiation remains in a ...

  13. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  14. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... and accurate. It’s also the most reliable imaging technique for determining if the sinuses are obstructed and ... to obtain images. For children, the CT scanner technique will be adjusted to their size and the ...

  15. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... presence of inflammatory diseases. provide additional information about tumors of the nasal cavity and sinuses. plan for ... Risks There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit ...

  16. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  17. Pediatric cerebral sinovenous thrombosis following cranial surgery.

    Science.gov (United States)

    Petrov, Dmitriy; Uohara, Michael Y; Ichord, Rebecca; Ali, Zarina; Jastrzab, Laura; Lang, Shih-Shan; Billinghurst, Lori

    2017-03-01

    Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014. Thirteen subjects were retrospectively analyzed for clinical presentation, surgical details, radiographic characteristics, laboratory study results, treatment, and outcome. Diagnostic testing and treatment adhered to a consensus-based institutional stroke protocol. Cranial vault reconstruction, subdural empyema evacuation, and tumor resection were each observed in three subjects. Eleven (85%) subjects had sinus exposure during surgery, and eight (73%) developed thrombus in a sinus within or adjacent to the operative field. Two (15%) had documented iatrogenic sinus injury. On post-operative testing, ten (77%) subjects had prothrombotic abnormalities. Seven (54%) were treated with anti-coagulation therapy (ACT) starting on a median of post-operative day (POD) 3 (IQR 1-3) for a median of 2.9 months (IQR 2.4-5.4). Median time to imaging evidence of partial or complete recanalization was 2.4 months (IQR 0.7-5.1). No symptomatic hemorrhagic complications were encountered. Pediatric CSVT may be encountered after cranial surgery, and decisions related to anti-coagulation are challenging. The risk of CSVT should be considered in pre-surgical planning and post-operative evaluation of cases with known risk factors. In our study, judicious use of ACT was safe in the post-operative period.

  18. Anatomy of maxillary sinus and its ostium: A radiological study using computed tomography

    Directory of Open Access Journals (Sweden)

    Anne D Souza

    2016-01-01

    Full Text Available Background: Interventions involving the middle meatus are commonly performed because the majority of the paranasal sinuses open into the osteomeatal complex. Therefore, the aim of the present study was to locate the level of maxillary sinus ostium (MSO, to measure the distances between MSO and different anatomical landmarks, to measure the different dimensions of maxillary sinus and to compare the morphology of maxillary sinus between the right and the left sides. Materials and Methods: The study involved 50 computed tomography (CT images of normal paranasal sinus anatomy in coronal and sagittal planes from the Department of Radiodiagnosis. The location of the sinus ostium (upper, middle, or lower third was observed. Perpendicular distance from the sinus ostium to the lower border of inferior turbinate and hard palate were measured. The maximum vertical, transverse, and antero-posterior diameters of the maxillary sinus were measured. Results: Of 50 CT images, the MSO was located in the upper third in 40 cases while in 10 it was located in the middle third. The most common location of MSO was in the upper third. The dimensions of the maxillary sinus indicated bilateral symmetry. Conclusion: The dimensions of the maxillary sinus indicated bilateral symmetry, and there were no significant gender differences when compared. However, the distances of the MSO from the major anatomical landmarks were significantly different between males and females which are seldom reported earlier. This knowledge about the variations in the lateral wall of the nasal cavity is crucial during the endoscopic interventions and for functional endoscopic sinus surgeries.

  19. [Deep venous cerebral thrombosis. Report of one case].

    Science.gov (United States)

    Bravo, M; Ferrer, S

    1998-10-01

    We report a 39 years old female presenting with headache, progressive clouding of sensorium and long pathway deficit signs. Brain CAT scan showed a process involving basal ganglia, thalami and Herophilus press. A thrombosis of this vessel was suspected. The first magnetic resonance imaging was informed as a diffuse inflammatory process compatible with an encephalitis. The patient aggravated and a second magnetic resonance imaging demonstrated a partial thrombosis of sinus rectus, Galenus vein, Herophilus press and both internal cerebral veins. Intravenous heparin was started with a progressive recovery of the patient. Two months later she had an almost complete recovery with a persistent mild right brachial paresis and a memory deficit for recent events.

  20. Multivessel coronary artery thrombosis.

    Science.gov (United States)

    Kanei, Yumiko; Janardhanan, Rajesh; Fox, John T; Gowda, Ramesh M

    2009-02-01

    Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). We describe a 37-year-old male present with inferior wall STEMI who was found to have large thrombi in both the right coronary artery (RCA) and the left anterior descending artery (LAD). We reviewed 23 patients with multivessel thrombosis in acute myocardial infarction in the literature. The mean age of patients was 53 +/- 14 years (32-82 years); 74% were males, and most patients had multiple risk factors for coronary artery disease. The LAD (78%) and RCA (87%) were the arteries involved for most patients. Aspiration thrombectomy was used in 3 cases. Though it is rare, STEMI with multiple culprit arteries can occur, and it is crucial to recognize this condition to determine the proper treatment, since most of these patients are critically ill.

  1. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers.

    Science.gov (United States)

    Yang, Mingyuan; Yang, Changwei; Ni, Haijian; Zhao, Yuechao; Li, Ming

    2016-01-01

    T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, Psagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK-0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not be thoroughly replaced for SVA. maxTK was the primary contributor to T1 sagittal angle. According to this equation, we could restore sagittal balance by surgically changing thoracic kyphosis and lumbar lordosis, which could serve as a guideline for osteotomy.

  2. Superior ophthalmic vein thrombosis developed after orbital cellulitis.

    Science.gov (United States)

    Cumurcu, Tongabay; Demirel, Soner; Keser, Sinem; Bulut, Taner; Cavdar, Mufide; Doğan, Metin; Saraç, Kaya

    2013-03-01

    A 65-year-old female patient presented with eye pain, swelling and blurred vision in the left eye. Routine biochemistry and microbiological analyzes were conducted. Orbital tomography (CT), magnetic resonance imaging (MRI) findings, and cerebral angiography were performed. Orbital cellulitis due to a complication of ethmoidal sinusitis was diagnosed with thrombosis of the SOV in the patient. Systemic broad-spectrum antibiotic and anticoagulant therapy was started on the patient. The patient's symptoms were recorded at the end of two weeks of the treatment.

  3. Portal Vein Thrombosis

    Science.gov (United States)

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  4. Tuberculosis of paranasal sinuses.

    Science.gov (United States)

    Sanehi, S; Dravid, Chandrashekhar; Chaudhary, Neena; Venkatachalam, V P

    2008-03-01

    Nasal tuberculosis is very rare but much rarer is tuberculosis of paranasal sinuses. It involves especially the maxillary sinus and is usually unilateral. We report an unusual case of tuberculosis of frontal and maxillary sinus in a 68 years old male, who presented with a swelling above left medial canthus, with no other eye or nasal complaints. Clinical and radiological findings on our initial evaluation suggested that the patient had left frontal mucocoele with bilateral maxillary haziness. Diagnosis was established on FNAC report and subsequent Ziehl - Neelsen staining of nasal swabs and tuberculin skin test. Later chest x-ray examination was suggestive of pulmonary tuberculosis, which was the primary cause. Patient responded well to antituberculosis drug therapy.

  5. Maxillary sinus augmentation

    Directory of Open Access Journals (Sweden)

    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.

  6. Cutaneous odontogenic sinus.

    Science.gov (United States)

    Scott, M J; Scott, M J

    1980-06-01

    A case report and discussion of cutaneous odontogenic sinus tracts, frequently encountered but often misdiagnosed and mistreated, are presented. Awareness that periapical dental abscesses are the most common etiologic factor of cutaneous sinus tracts involving the face and neck will facilitate their early diagnosis and prevent needless treatment or anxiety for the patient. These lesions are often misinterpreted as chronic, resistant to therapy, pyogenic nodules, or granulomas. A high degree of suspicion is required for making the correct diagnosis, and dental roentgenographic studies should routinely be obtained in all such lesions. Permanent healing cannot be achieved unless the original site of infection is located and eradicated.

  7. Red blood cells in thrombosis.

    Science.gov (United States)

    Byrnes, James R; Wolberg, Alisa S

    2017-10-19

    Red blood cells (RBCs) have historically been considered passive bystanders in thrombosis. However, clinical and epidemiological studies have associated quantitative and qualitative abnormalities in RBCs, including altered hematocrit, sickle cell disease, thalassemia, hemolytic anemias, and malaria, with both arterial and venous thrombosis. A growing body of mechanistic studies suggests that RBCs can promote thrombus formation and enhance thrombus stability. These findings suggest that RBCs may contribute to thrombosis pathophysiology and reveal potential strategies for therapeutically targeting RBCs to reduce thrombosis. © 2017 by The American Society of Hematology.

  8. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... or thickened sinus membranes . detect the presence of inflammatory diseases. provide additional information about tumors of the nasal ... reduce the risk of an allergic reaction. These medications generally need ... of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any ...

  10. CURRENT APPROACH TO SINUSITIS

    African Journals Online (AJOL)

    Enrique

    scopic or external spheno-eth- moidectomy. Complications of ABRS. Orbital complications are the most common complication of sinusitis. The Chandler classification gives a clinical approach to orbital inflamma- tion: • inflammatory oedema (lid oedema). • orbital cellulitis (diffuse oedema). • subperiosteal abscess (displace-.

  11. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses ...

  12. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... quality for accurate interpretation. The actual CT scan takes less than a minute and the entire process ... tissue as well as the lungs, bones, and blood vessels. CT examinations are fast and ... is usually the first test ordered when a sinus tumor is suspected. If ...

  13. Numerical simulations of thrombosis

    Directory of Open Access Journals (Sweden)

    Naveen Kumar G Ramunigari

    2013-01-01

    Full Text Available Background: Mathematical approaches for biological events have gained significant importance in development of biomedical research. Deep vein thrombosis (DVT is caused by blood clot in veins deeply rooted in the body, resulting in loss of blood, pain, and numbness of the body part associated with that vein. This situation can get complicated and can be fatal, when the blood clot travels to other parts of the body which may result in pulmonary embolism (PE. PE causes approximately 300,000 deaths annually in the United States alone. Materials and Methods: We are trying to propose a computational approach for understanding venous thrombosis using the theory of fluid mechanics. In our study, we are trying to establish a computational model that mimics the venous blood flow containing unidirectional venous valves and will be depicting the blood flow in the veins. We analyzed the flow patterns in veins, which are included with lump like substances. This lump like substances can be clots, tissue debris, collagen or even cholesterol. Our study will facilitate better understanding of the biophysical process in case of thrombosis. Results: The predicted model analyzes the consequences that occur due to the clot formations in veins. Knowledge of Navier-Stokes equations in fluid dynamics along with the computational model of a complex biological system would help in diagnosis of the problem at much faster rate of time. Valves of the deep veins are damaged as a result of DVT, with no valves to prevent deep system reflux, the hydrostatic venous pressure in the lower extremity increases dramatically. Conclusion: Our model is used to determine the effects of an interrupted blood flow as a result of thrombin formation, which might result in disturbed systemic circulation. Our results indicated a positive inverse correlation exists between clots and the flow velocity. This would support medical practitioners to recommend faster curing measures.

  14. Neurological Sequelae in Uncorrected Tetralogy of Fallot

    African Journals Online (AJOL)

    4 years of age is thrombosis of intracranial dural sinuses or cerebral veins usually in association with iron‑deficiency anemia. Superior sagittal sinus, transverse sinus, great vein of. Galen, and meningeal veins are the common sites of thrombosis in decreasing order of precedence. Intracranial hypertension may be the only ...

  15. Evolution of Sagittal Imbalance Following Corrective Surgery for Sagittal Plane Deformity.

    Science.gov (United States)

    McDowell, Michael M; Tempel, Zachary J; Gandhoke, Gurpreet S; Khattar, Nicholas K; Hamilton, D Kojo; Kanter, Adam S; Okonkwo, David O

    2017-07-01

    Sagittal balance in adult spinal deformity is a major predictor of quality of life. A temporary loss of paraspinal muscle force and somatic pain following spine surgery may limit a patient's ability to maintain posture. To assess the evolution of sagittal balance and clinical outcomes during recovery from adult spinal deformity surgery. Retrospective review of a prospective observational database identified a consecutive series of patients with sagittal vertical axis (SVA) > 40 mm undergoing adult deformity surgery. Radiographic parameters and clinical outcomes were measured out to 2 yr after surgery. A total of 113 consecutive patients met inclusion criteria. Mean preoperative SVA was 90.3 mm, increased to 104.6 mm in the first week, then gradually reduced at each follow-up interval to 59.2 mm at 6 wk, 45.0 mm at 3 mo, 38.6 mm at 6 mo, and 34.1 mm at 1 yr (all P sagittal alignment did not fully reflect surgical correction of sagittal balance until 6 mo after adult deformity surgery. Sagittal balance initially worsened then steadily improved at each interval over the first year postoperatively. At 1 yr, all clinical and radiographic measures outcomes were significantly improved.

  16. Sagittal Balance in Adolescent Idiopathic Scoliosis

    Science.gov (United States)

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-01-01

    Abstract The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have

  17. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Bilateral intraorbital abscesses and cavernous sinus thromboses secondary to Streptococcus milleri with a favorable outcome.

    Science.gov (United States)

    Udaondo, Patricia; Garcia-Delpech, Salvador; Díaz-Llopis, Manuel; Salom, David; Garcia-Pous, Maria; Strottmann, James M

    2008-01-01

    A 51-year-old woman with left proptosis, diplopia, headache, and nausea was found to have bilateral intraorbital abscesses, left superior ophthalmic vein thrombosis, bilateral cavernous sinus thromboses, and a left temporal lobe intracerebral abscess. Because the paranasal sinuses were unaffected, a dental origin was suspected and confirmed. The causative organism was Streptococcus milleri. Aggressive surgical intervention included bilateral orbital abscess drainage and dental extraction, and medical therapy included intravenous metronidazole, ceftriaxone, heparin, and methylprednisolone. A left sixth cranial nerve paresis was the only long-term sequela.

  20. Ellis-van Creveld Syndrome with Sagittal Craniosynostosis.

    Science.gov (United States)

    Fischer, Andrew S; Weathers, William M; Wolfswinkel, Erik M; Bollo, Robert J; Hollier, Larry H; Buchanan, Edward P

    2015-06-01

    Ellis-van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail.

  1. 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...... and radiographic variables potentially influencing the risk of sinus membrane perforation were evaluated and divided into patient-related factors (age, sex, smoking habit); surgery-related factors (type of surgical approach, side, units, sites, and technique of osteotomy); and maxillary sinus-related factors...

  2. Treatment results of functional endoscopic sinus surgery in chronic sinusitis

    Directory of Open Access Journals (Sweden)

    Naraghi M

    2002-07-01

    Full Text Available Background: Endoscopic sinus surgery has been used for diagnosis and treatment of chronic inflammatory diseases of paranasal sinuses since recent years. Materials and Methods: In this study 104 patients with chronic sinusitis (with or without polyps which were managed with endoscopic sinus surgery (ESS were followed for 6 to 24 months after surgery (24 patients refused to continue follow up and the recovery rate of symptoms were evaluated. Results: The effectiveness of this therapy is statistically approved and the most important symptom which diminished was nasal obstruction (from 95 percent to 18.5 percent, the least important symptom which diminished was anosmia (from 57 percent to 21 percent. Conclusion: This study confirmed the efficacy of functional endoscopic sinus surgery in improvement of chronic sinusitis symptoms.

  3. 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

  4. Morphological segmentation for sagittal plane image analysis.

    Science.gov (United States)

    Bezerra, F N; Paula, I C; Medeiros, F S; Ushizima, D M; Cintra, L S

    2010-01-01

    This paper introduces a morphological image segmentation method by applying watershed transform with markers to scale-space smoothed images and furthermore provides images for clinical monitoring and analysis of patients. The database comprises sagittal plane images taken from a digital camera of patients submitted to Global Postural Reeducation (GPR) physiotherapy treatment. Orthopaedic specialists can use these segmented images to diagnose posture problems, assess physiotherapy treatment evolution and thus reduce diagnostic errors due to subjective analysis.

  5. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Jansen, Olav [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuroradiology, Kiel (Germany); Baalen, Andreas van [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuropediatrics, Kiel (Germany); Bartsch, Thorsten [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurology, Kiel (Germany); Doerner, Lutz [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurosurgery, Kiel (Germany)

    2012-01-15

    The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH). Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls. Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls. Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed. (orig.)

  6. OPTIMIZATION OF SECRETOLYTIC TREATMENT OF ACUTE SINUSITIS

    OpenAIRE

    S.V. Makarevich

    2008-01-01

    Efficiency of sinupret in children with acute sinusitis as a drug with serolytic action, is studied. it is established that secretolytic therapy in case of acute sinusitis, aimed at the improvement of drainage and ventilation function of paranasal sinuses, is one of the potentially productive directions of nonbinvasive methods of treatment of acute sinusitis.Key words: children, acute sinusitis, secretolytic treatment.

  7. Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses

    Energy Technology Data Exchange (ETDEWEB)

    Sirikci, Akif; Bayram, Metin [Department of Radiology, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey); Bayazit, Y.A.; Kanlikama, Muzaffer [Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Gaziantep University, Kolejtepe, 27310, Gaziantep (Turkey)

    2004-02-01

    We assessed the morphological and radiological characteristics of ethmomaxillary sinus (EMS), which is an enlarged posterior ethmoidal air cell occupying the superior portion of the maxillary sinus while draining into superior meatus. This study is based on 1450 patients submitted to CT examination of the paranasal sinuses between 1998 and 2002. Sequential CT scans were obtained in the coronal plane in all the patients with 2.5- to 5-mm section thickness and were evaluated for EMS. The diagnosis of EMS was made when there was a posterior ethmoidal cell occupying the superior part of the maxillary sinus while draining to the superior meatus. When EMS was diagnosed, the morphology of the septum between the and maxillary sinus, and width of the superior meatus, were noted. The EMS was found in 10 of 1450 (0.7%) patients. The coexisting anatomic variations were concha bullosa (50%), upper concha pneumatization (20%), maxillary sinus hypoplasia (20%), uncinate bulla (10%), hypertrophied inferior concha (10%), paradoxic middle concha (10%), and septate maxillary sinus (10%). There was no relation between EMS and sinus disease. The EMS is a rare anatomic variation and does not appear to be associated with sinusitis. The EMS is not a well-studied anatomic variation, and the literature is lacking adequate information about this anatomic variation. This study performed in a large series of patients will possibly contribute to better understanding of this particular anomaly. (orig.)

  8. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers.

    Directory of Open Access Journals (Sweden)

    Mingyuan Yang

    Full Text Available T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, P<0.001, maxLL with weak significance (r = 0.206, P = 0.024, SS with weak significance (r = 0.237, P = 0.009, PI with very weak significance (r = 0.189, P = 0.039, SVA with moderate significance (r = 0.445, P<0.001, TPA with weak significance (r = 0.207, P = 0.023, and T1SPI with weak significance (r = 0.309, P = 0.001. The result of multiple regression analysis showed that T1 sagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK-0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not

  9. Analysis of sagittal balance of ankylosing spondylitis using spinopelvic parameters.

    Science.gov (United States)

    Lee, Jung Sub; Suh, Kuen Tak; Kim, Jeung Il; Goh, Tae Sik

    2014-05-01

    Prospective study. To analyze sagittal spinopelvic parameters in ankylosing spondylitis (AS) patients. There are little data on the relationship between the sagittal spinopelvic parameters and AS. The study and control groups comprised 90 AS patients and 40 controls. Participants were classified into 3 groups: normal (n=40), sagittal balance (n=58), and sagittal imbalance (n=32) groups. All underwent lateral radiograph of the whole spine including hip joints. The radiographic parameters were sacral slope, pelvic tilting, pelvic incidence, overhang of S1, thoracic kyphosis, lumbar lordosis, and C7 plumbline. Statistical analysis was performed to identify significant differences between the 2 groups. Correlations between radiological parameters and symptoms were sought. AS patients and controls were found to be significantly different in terms of sagittal balance, sacral slope, pelvic tilt, pelvic incidence, S1 overhang, and lumbar lordosis. However, no significant difference was observed between these 2 groups for thoracic kyphosis (P>0.05). Of the 90 AS patients, 32 patients (5 women and 27 men) were assigned to the sagittal imbalance group and 58 (12 women and 46 men) to the sagittal balance group. There was a significant difference in all sagittal parameters and visual analogue scale (VAS) score between these 2 groups. Correlation analysis revealed significant relationships between sagittal parameters in AS. However, there was no association between sacral slope and S1 overhang, and between pelvic incidence and VAS score. Stepwise logistic regression analysis revealed that pelvic tilt contributed significantly to sagittal balance. AS patients and normal controls were found to be significantly different in terms of sagittal spinopelvic parameters. Significant relationships were found between sagittal spinopelvic parameters in AS patients. Pelvic tilt was a significant parameter in determination of sagittal balance in AS patient. Furthermore, VAS scores were

  10. [Estrogens and vascular thrombosis].

    Science.gov (United States)

    Colmou, A

    1982-09-01

    The incidence of thromboses among young women has increased with widespread use of oral contraceptives (OCs) due to the significant thromboembolic risk of estrogen. Estrogens intervene at the vascular, platelet, and plasma levels as a function of hormonal variations in the menstrual cycle, increasing the aggregability of the platelets and thrombocytes, accelerating the formation of clots, and decreasing the amount of antithrombin III. Estrogens are used in medicine to treat breast and prostate cancers and in gynecology to treat dysmenorrhea, during the menopause, and in contraception. Smoking, cardiovascular disease and hypertension, hypercholesterolemia, and diabetes are contraindicators to estrogen use. Thrombosis refers to blockage of a blood vessel by a clot or thrombus. Before estrogens are prescribed, a history of phlebitis, obesity, hyperlipidemia, or significant varicosities should be ruled out. A history of venous thrombosis, hyperlipoproteinemia, breast nodules, serious liver condition, allergies to progesterone, and some ocular diseases of vascular origin definitively rule out treatment with estrogens. A family history of infarct, embolism, diabetes, cancer, or vascular accidents at a young age signals a need for greater patient surveillance. All patients receiving estrogens should be carefully observed for signs of hypertension, hypercholesterolemia, hypercoagulability, or diabetes. Nurses have a role to play in carefully eliciting the patient's history of smoking, personal and family medical problems, and previous and current laboratory results, as well as in informing the patients of the risks and possible side effects of OCs, especially for those who smoke. Nurses should educate patients receiving estrogens, especially those with histories of circulatory problems, to avoid standing in 1 position for prolonged periods, avoid heat which is a vasodilator, avoid obesity, excercise regularly, wear appropriate footgear, and follow other good health

  11. [Orbital complications of sinusitis].

    Science.gov (United States)

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  12. Understanding Biofilms in Chronic Sinusitis.

    Science.gov (United States)

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation.

  13. 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.)

  14. Intracranial Complications of Pediatric Sinusitis.

    Science.gov (United States)

    Wiersma, Alexandria J; Vu, Tien

    2017-06-13

    "Headache and fever" is a common presentation to the urgent care and emergency department setting and can have many etiologies. We present a case of a 10-year-old girl who presented with headache and fever and was found to have intracranial extension of sinusitis despite lack of typical sinus or chronic upper respiratory tract infection symptoms. This case illustrates the need in the emergency department or urgent care to keep a broad differential diagnosis for pediatric headache, especially when initial interventions are unsuccessful. We also review the epidemiology of pediatric sinusitis, age at sinus development, and associated intracranial complications.

  15. The Sagittal Pelvic Thickness: A Determining Parameter for the Regulation of the Sagittal Spinopelvic Balance

    OpenAIRE

    Jean, Legaye

    2013-01-01

    Objective. To propose and validate a dimensional parameter, the sagittal pelvic thickness (SPT) (distance between the middle point of the upper sacral plate and the femoral heads axis, expressed as a ratio with the length of the upper plate of S1: (SPT/S1) for the analysis of the sagittal balance of the pelvispinal unit. Methods. The parameters were analysed on standing radiographic imaging and compared for normal, low back pain, children, and spondylolysis cases. Results. Values of SPT/S1 we...

  16. Sinus Infection and Toothache: Any Connection?

    Science.gov (United States)

    ... sinus infection cause a toothache? Answers from Alan Carr, D.M.D. Yes, a sinus infection (sinusitis) ... problem is contributing to the toothache. With Alan Carr, D.M.D. References Longo DL, et al., ...

  17. Thrombosis and Hemostasis in Surgery

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Larsen, Julie Brogaard; Pasalic, Leonardo

    2017-01-01

    The present issue of Seminars in Thrombosis & Hemostasis focuses on challenges related to hemostatic and thromboembolic complications in surgery or trauma. Multiple factors contribute to perioperative bleeding or thromboembolic risk. These factors might be related to the individual patient (e...

  18. The use of the T1 sagittal angle in predicting overall sagittal balance of the spine.

    Science.gov (United States)

    Knott, Patrick T; Mardjetko, Steven M; Techy, Fernando

    2010-11-01

    A balanced sagittal alignment of the spine has been shown to strongly correlate with less pain, less disability, and greater health status scores. To restore proper sagittal balance, one must assess the position of the occiput relative to the sacrum. The assessment of spinal balance preoperatively can be challenging, whereas predicting postoperative balance is even more difficult. This study was designed to evaluate and quantify multiple factors that influence sagittal balance. Retrospective analysis of existing spinal radiographs. A retrospective review of 52 adult spine patient records was performed. All patients had full-column digital radiographs that showed all the important skeletal landmarks necessary for accurate measurement. The average age of the patient was 53 years. Both genders were equally represented. The radiographs were measured using standard techniques to obtain the following parameters: scoliosis in the coronal plane; lordosis or kyphosis of the cervical, thoracic, and lumbar spine; the T1 sagittal angle (angle between a horizontal line and the superior end plate of T1); the angle of the dens in the sagittal plane; the angle of the dens in relation to the occiput; the sacral slope; the pelvic incidence; the femoral-sacral angle; and finally, the sagittal vertical axis (SVA) measured from both the dens of C2 and from C7. It was found that the SVA when measured from the dens was on average 16 mm farther forward than the SVA measured from C7 (psagittal angle was found to have a moderate positive correlation (r=0.65) with SVA(dens), psagittal T1 tilt can be used as a good predictor of overall sagittal balance. When examining the other variables, it was found that cervical lordosis had a weak correlation (r=0.37) with SVA(dens) that was unexpected, given that cervical lordosis determines head position. Thoracic kyphosis also had a weak correlation (r=0.26) with SVA(C1), which was equally surprising. Lumbar lordosis had a slightly higher correlation

  19. Acute bacterial sinusitis in children.

    Science.gov (United States)

    DeMuri, Gregory; Wald, Ellen R

    2013-10-01

    On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

  20. Managing acute invasive fungal sinusitis.

    Science.gov (United States)

    Dwyhalo, Kristina M; Donald, Carrlene; Mendez, Anthony; Hoxworth, Joseph

    2016-01-01

    Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis and can be fatal, especially in patients who are immunosuppressed. Early diagnosis and intervention are crucial and potentially lifesaving, so primary care providers must maintain a high index of suspicion for this disease. Patients may need to be admitted to the hospital for IV antifungal therapy and surgical debridement.

  1. [A case of cerebral venous thrombosis with reversible brain parenchymal lesions: usefulness of diffusion weighted imaging and measurement of apparent diffusion coefficient].

    Science.gov (United States)

    Kuwahara, S; Abe, T; Kawada, M; Uga, S; Shimizu, K

    2001-01-01

    A 47-year-old man with a history of thrombophlebitis of his left leg for several years presented with a mild left hemiparesis and ipsilateral hypesthesia. Magnetic resonance imaging showed subacute thrombosis of the superior sagittal sinus and a cortical vein of the right cerebral hemisphere. A linear hyperintense area was found in the white matter of the right postcentral gyrus on T 2- and diffusion weighted axial imagings on the 7 days after the onset. The patient was treated conservatively, and his clinical course was uneventful. His neurological dysfunctions recovered within approximately three weeks after the onset. The white matter lesion in the right postcentral gyrus also disappeared one month later. The apparent diffusion coefficients (ADCs) in the white matter of the pre- and postcentral gyrus were measured bilaterally on the ADC mapping imaging. In the subacute stage, the ADC values in the white matter of the right pre- and postcentral gyrus were 0.50 x 10(-3) mm2/sec and 0.91 x 10(-3) mm2/sec, respectively. The %ADC indicating the ratio of ADC value of the lesion to that of the contralateral brain tissue was calculated. The %ADCs in the white matter of the pre- and postcentral gyrus were 64.9% and 124.5% respectively. In the chronic stage, the ADC values in the white matter of the right pre- and postcentral gyrus were 0.96 x 10(-3) mm2/sec and 0.99 x 10(-3) mm2/sec, and the %ADCs improved to 106.7% and 106.5% respectively. The lesions in the white matter of the right pre- and postcentral gyrus were reversible. The former was thought to be mainly ascribed to cellular edema and the latter was vasogenic edema. The present case showed when %ADC of the ischemic lesion in cerebral venous thrombosis was higher than 60%-70%, conservative therapy alone is sufficient effective for the improvement of neurological deficits.

  2. Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    Rebecca Ichord

    2017-07-01

    Full Text Available Cerebral sinovenous thrombosis (CSVT is a rare but serious cerebrovascular disorder affecting children from the newborn period through childhood and adolescence. The incidence is estimated at 0.6/100,000/year, with 30–50% occurring in newborns. Causes are diverse and are highly age dependent. Acute systemic illness is the dominant risk factor among newborns. In childhood CSVT, acute infections of the head and neck such as mastoiditis are most common, followed by chronic underlying diseases such as nephrotic syndrome, cancer, and inflammatory bowel disease. Signs and symptoms are also age related. Seizures and altered mental status are the commonest manifestations in newborns. Headache, vomiting, and lethargy, sometimes with 6th nerve palsy, are the most common symptoms in children and adolescents. Recent multicenter cohort studies from North America and Europe have provided updated information on risk factors, clinical presentations, treatment practices, and outcomes. While systemic anticoagulation is the most common specific treatment used, there are wide variations and many uncertainties even among experts concerning best practice. The treatment dilemma is especially pronounced for neonatal CSVT. This is due in part to the higher prevalence of intracranial hemorrhage among newborns on the one hand, and the clear evidence that newborns suffer greater long-term neurologic morbidity on the other hand. With the advent of widespread availability and acceptance of acute endovascular therapy for arterial ischemic stroke, there is renewed interest in this therapy for children with CSVT. Limited published evidence exists regarding the benefits and risks of these invasive therapies. Therefore, the authors of current guidelines advise reserving this therapy for children with progressive and severe disease who have failed optimal medical management. As research focused on childhood cerebrovascular disease continues to grow rapidly, the future prospects

  3. Tumor cerebri: Metastatic renal cell carcinoma with dural venous sinus compression leading to intracranial hypertension; a case report

    OpenAIRE

    Marvin, Eric; Synkowski, Jordan; Benko, Michael

    2017-01-01

    Background: Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension (IIH), is a condition associated with increased intracranial pressure (ICP) in the absence of radiographic findings such as mass lesions or cerebral edema. Case Description: We describe a case of progressive headache and visual disturbances attributed to PTC that resulted from subacute superior sagittal sinus (SSS) stenosis by a metastatic tumor. Conclusions: Venous outflow obstruction often presents wit...

  4. A Rare Cause of Headache: Aspergillus Sinusitis

    OpenAIRE

    Şehnaz Arıcı; Özge Özen Gökmuharremoğlu; Behiye Özer

    2015-01-01

    Fungal sinusitis are mostly seen in immunosuppressive individuals and somtimes which can be mortal. Most frequently species of Aspergillus were isolated from, clinical forms of mycotic sinonasal disease.Surgical debridement,sinus ventilation and medical therapy in treatment of fungal sinusitis, are recommended. In this article, a case of healthy immune patient with fungal sinusitis who peresent with headache was repoted.

  5. [Maxillary sinus myxoma].

    Science.gov (United States)

    Niedzielski, Artur; Partycka-Pietrzyk, Kornela; Brodzisz, Agnieszka; Walczyna, Beata; Mielnik-Niedzielska, Grażyna

    2016-07-29

    Myxoma is a slow growing, benign neoplasm, which pathogenesis still remains disputed. The lesion has well-defined borders but a true capsule is absent. Because of that myxoma can be locally invasive causing bone destruction. A change is mainly observed among persons between 20-30 years of age and is very uncommon in the pediatric population. Most myxomas are observed in myocardium, but rarely may also manifest in the head and neck region. In the paper we describe an unusual case of myxoma of maxillary sinus in a female infant. Diagnostic challenges, treatment, outcome, post-operative follow-up are discussed as well as a review of the literature in order to present many features of this rare pathology. © 2016 MEDPRESS.

  6. Maxillary sinusitis with pulmonary tuberculosis.

    Science.gov (United States)

    Upadhyay, Rashmi; Prakash, Ved; Singh, Abhishek Bahadur; Saheer, S

    2014-08-01

    Tubercular infection of the nasal cavity is an infrequently encountered condition. More so, after the discovery of relevant antibiotics, nasal sinus tuberculosis is not commonly seen. Few cases have reported tuberculosis of the paranasal sinuses, nasopharynx and larynx. With the increasing incidence of HIV, these rare forms of infection have started re-emerging. We present a case of a middle aged man presenting with nasal cavity lesion along with pulmonary tuberculosis, which came to light only after the diagnosis of maxillary sinus tuberculosis. 2014 BMJ Publishing Group Ltd.

  7. Aggressiv fibromatose i sinus frontalis

    DEFF Research Database (Denmark)

    Godballe, Christian; Jensen, Søren Gade; Krogdahl, Annelise

    2009-01-01

    Aggressive fibromatosis (AF) is a benign tumour with expansive and locally invasive growth. It is very rarely seen in the head and neck area. We present a 52-year-old female patient with AF localized to the left frontal sinus. The condition was initially mistaken for chronic sinusitis however...... computed tomography indicated tumour. A biopsy showed AF and the patient received surgical treatment. Symptoms, signs and treatment are discussed. It is concluded that AF in the sino-nasal tract is a rare, but potentially life threatening condition which might be mistaken for a simple sinusitis...

  8. CEREBRAL VENOUS THROMBOSIS IN THE MEDITERRANEAN AREA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    A Lotan

    2011-01-01

    Full Text Available

    Cerebral venous sinus (sinovenous thrombosis (CSVT is a serious and rare disorder,  increasingly recognized and diagnosed in pediatric patients. The etiology and pathophisiology has not yet been completely clarified, and unlike adults with CSVT,  management in children and neonates remains controversial. However, morbidity and mortality are significant, highlighting the continued need for high-quality studies within this field. The following review will highlight aspects of CSVT in the mediteranian area in children

  9. Importance of T2*-weighted gradient-echo MRI for diagnosis of cortical vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Fellner, Franz A. [Institut fuer Radiologie, Landes-Nervenklinik Wagner Jauregg, Linz (Austria) and Zentrales Radiologie Institut, Allgemeines Krankenhaus der Stadt Linz, Krankenhausstr. 9, 4020 Linz (Austria)]. E-mail: franz.fellner@akh.linz.at; Fellner, Claudia [Institut fuer Radiologie, Landes-Nervenklinik Wagner Jauregg, Linz (Austria); Aichner, Franz T. [Abteilung fuer Neurologie, Landes-Nervenklinik Wagner-Jauregg, Linz (Austria); Moelzer, Guenther [Institut fuer Radiologie, Landes-Nervenklinik Wagner Jauregg, Linz (Austria)

    2005-11-01

    We examined six patients with isolated venous thrombosis (n = 2), or venous thrombosis combined with sinus thrombosis (n = 4) (CVT). The clinical symptoms were non-specific (acute cephalea, paresis, epileptic seizure, progressive speech disorder). All examinations were performed on a 1.5 T system (Magnetom Symphony, Siemens, Erlangen, Germany), maximum gradient field strength 30 mT/m, minimal gradient rise time 450 {mu}s, according to the following protocol: Transverse T2-weighted turbo spin-echo (TSE), fluid attenuated inversion recovery (FLAIR), T1-weighted spin-echo (SE), before and after administration of contrast medium, T2*-weighted conventional gradient-echo (GRE), T2*-weighted spin-echo echo planar imaging (SE EPI), both without and with diffusion weighting as well as two-dimensional (2D) venous time-of-flight (TOF) MRA. The venous thromboses were best detectable in the T2*-weighted conventional GRE sequence in all patients. In two patients, the CVT was discernible only in this sequence. The sinus thrombosis was well discernible only in the T2*-weighted GRE sequence in only one case; in the remaining cases it was detectable only with difficulty. For these cases, other sequences such as SE, diffusion-weighted, or 2D-TOF-MRA sequence were superior. The T2*-weighted conventional GRE sequence was superior to the T2*-weighted SE EPI sequence in all patients. To sum up, it can be concluded, that T2*-weighted conventional GRE sequences are possibly the best method of detection of acute cortical vein thromboses. Therefore, it seems to be of benefit to integrate a T2*-weighted conventional GRE sequence into the MR-protocol for the diagnosis of isolated cortical vein thrombosis.

  10. Intracardiac and intracerebral thrombosis associated with ...

    African Journals Online (AJOL)

    Intracardiac and intracerebral thrombosis associated with methylenetetrahydrofolate reductase A1298C homozygote mutation in paediatric steroidresistant ... The patient was found to have a homozygote mutation in the methylenetetrahydrofolate reductase (MTHFR) gene as an additional risk factor for recurrent thrombosis.

  11. Radiology in diagnostics of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya М.L

    2013-09-01

    Full Text Available The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinogenous sinusitis has been revealed. The work provides information about the effectiveness of various radiation techniques in the diagnosis of odontogenic sinusitis. Conclusion. For suspected odontogenic sinusitis, treatment of choice includes the combined use of X-ray of the paranasal sinuses in the mentoanterior projection and contact intraoral radiographs of «causal teeth». Computer tomography is the most informative additional method to clarify the diagnosis of odontogenic sinusitis.

  12. Ellis–van Creveld Syndrome with Sagittal Craniosynostosis

    Science.gov (United States)

    Fischer, Andrew S.; Weathers, William M.; Wolfswinkel, Erik M.; Bollo, Robert J.; Hollier, Larry H.; Buchanan, Edward P.

    2014-01-01

    Ellis–van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail. PMID:26000085

  13. Paranasal sinus obliteration in Wegener granulomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Paling, M.R.; Roberts, R.L.; Fauci, A.S.

    1982-08-01

    The authors report 14 cases of Wegener granulomatosis in which one or more paranasal sinuses were obliterated by bone. The maxillary antra were involved in all cases, with the other sinuses being affected less frequently. These changes are thought to result from chronic bacterial sinusitis superimposed on the granulomatous vasculitic process. Computed tomography dramatically demonstrated the bone changes, consisting of a combination of sinus wall thickening and trabeculated new bone formation within the sinuses.

  14. OPTIMIZATION OF SECRETOLYTIC TREATMENT OF ACUTE SINUSITIS

    Directory of Open Access Journals (Sweden)

    S.V. Makarevich

    2008-01-01

    Full Text Available Efficiency of sinupret in children with acute sinusitis as a drug with serolytic action, is studied. it is established that secretolytic therapy in case of acute sinusitis, aimed at the improvement of drainage and ventilation function of paranasal sinuses, is one of the potentially productive directions of nonbinvasive methods of treatment of acute sinusitis.Key words: children, acute sinusitis, secretolytic treatment.

  15. Magnetic Resonance Imaging Findings in Cerebral Venous Thrombosis due to Behcet's Disease and the Importance of Susceptibility-Weighted Imaging: Case Report

    Directory of Open Access Journals (Sweden)

    Mehmet Deniz Bulut

    2015-12-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon disorder that can lead to an unfavorable prognosis and even be fatal in some cases.CVT is seen mainly in females, especially those between the ages of 20 and 35 years. The disorder has many etiologic factors. This report presents the case of a 34-year-old male patient with Behçet’s disease admitted with complaints of headache and vomiting. The major venous vascular structures that were visible in cranial magnetic resonance imaging (MRI and MR venography were found to be filled with thrombosis. The patient’s susceptibility-weighted imaging (SWI revealed marked hypointensities consistent with thrombosis in the transverse sinus, sigmoid sinus, and in the venous vascular structures of the posterior fossa. Thus, it was found that cerebral venous thrombosis due to Behçet disease could clearly be determined by the SWI sequence; in addition, thrombosis by the venous vascularity in veins of the posterior fossa were more visible than via the other MR sequences. The conclusion was made that SWI can promptly demonstrate cerebral venous thrombosis, contribute to the diagnosis, and provide useful additional information.

  16. Venous and arterial thrombosis in dialysis patients

    NARCIS (Netherlands)

    Ocak, Gurbey; Vossen, Carla Y.; Rotmans, Joris I.; Lijfering, Willem M.; Rosendaal, Frits R.; Parlevliet, Karien J.; Krediet, Ray T.; Boeschoten, Els W.; Dekker, Friedo W.; Verduijn, Marion

    2011-01-01

    Whether the risk of both venous and arterial thrombosis is increased in dialysis patients as compared to the general population is unknown. In addition, it is unknown which subgroups are at highest risk. Furthermore, it is unknown whether having a history of venous thrombosis or arterial thrombosis

  17. Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study

    Science.gov (United States)

    Dragan, Eliza; Guillaume, Odri A.; Haba, Danisia; Olszewski, Raphael

    2015-01-01

    Background The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. Material/Methods One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. Results All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. Conclusions In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation. PMID:26363865

  18. When Sinuses Attack! (For Kids)

    Science.gov (United States)

    ... People, Places & Things That Help Feelings Q&A Movies & More Quizzes Kids' Dictionary of Medical Words En ... nose, the sinuses are lined with a moist, thin layer of tissue called a mucous membrane (say: ...

  19. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... are the most effective. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 3); MEDLINE (1950 to May 2007) and EMBASE (1974 to June 2007). SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing antibiotics with placebo...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...

  20. Complications of pediatric paranasal sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Janet R. [The Children' s Hospital, The Cleveland Clinic, Pediatric Radiology, Cleveland, OH (United States)

    2004-12-01

    Acute paranasal sinus infection in children is often diagnosed clinically without the need for radiographic confirmation. Most cases have a favorable outcome following appropriate antibiotic therapy. A small percentage of cases where symptoms and signs are persistent or severe will require emergent imaging to rule out complications related to local spread of disease intraorbitally or intracranially. A strong index of suspicion is required in such cases, and cross-sectional imaging evaluation with CT and MRI should include axial and coronal images of the paranasal sinuses and, where appropriate, the orbits and brain (with attention to the cavernous sinus). There is no role for plain radiography in the evaluation of the complications of acute sinusitis in the pediatric patient. (orig.)

  1. Maxillary sinusitis with pulmonary tuberculosis

    OpenAIRE

    Upadhyay, Rashmi; Prakash, Ved; Singh, Abhishek Bahadur; Saheer, S

    2014-01-01

    Tubercular infection of the nasal cavity is an infrequently encountered condition. More so, after the discovery of relevant antibiotics, nasal sinus tuberculosis is not commonly seen. Few cases have reported tuberculosis of the paranasal sinuses, nasopharynx and larynx. With the increasing incidence of HIV, these rare forms of infection have started re-emerging. We present a case of a middle aged man presenting with nasal cavity lesion along with pulmonary tuberculosis, which came to light on...

  2. Computed tomography and magnetic resonance for the advanced imaging of the normal nasal cavity and paranasal sinuses of the koala (Phascolarctos cinereus).

    Science.gov (United States)

    Bercier, Marjorie; Alexander, Kate; Gorow, April; Pye, Geoffrey W

    2014-12-01

    The objective of this study is to describe computed tomography (CT) and magnetic resonance (MR) for the cross-sectional imaging of the normal anatomy of the nasal cavity and paranasal sinuses of the koala (Phascolarctos cinereus), to provide reference figures for gross anatomy with corresponding CT and MR images and to compare the features of the nasal cavity and paranasal sinuses of the normal koala with that reported in other domestic species. Advanced imaging can be used to aid in diagnosis, to plan surgical intervention, and to monitor therapeutic responses to diseases of the nasal passages in koalas. One clinically normal koala was anesthetized twice for the separate acquisition of dorsal CT scan images and transverse, dorsal, and sagittal MR images of its nasal cavity and paranasal sinuses. Sagittal and transverse CT planes were reformatted. Three fresh koala skulls were also transected in one of each transverse, sagittal, and dorsal planes and photographed. The CT and MR images obtained were matched with corresponding gross anatomic images and the normal bone, tissues and airway passages were identified. All anatomic structures were readily identifiable on CT, magnetic resonance imaging (MRI), and gross images. CT and MRI are both valuable diagnostic tools for imaging the nasal cavities and paranasal sinuses of koalas. Images obtained from this project can be used as baseline references for future comparison with diseased koalas to help with diagnosis, surgical intervention, and response to therapy.

  3. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao

    2016-01-01

    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  4. Preeclampsia, Hypoxia, Thrombosis, and Inflammation

    Directory of Open Access Journals (Sweden)

    Amir A. Shamshirsaz

    2012-01-01

    Full Text Available Reductions in uteroplacental flow initiate a cascade of molecular effects leading to hypoxia, thrombosis, inflammation, and endothelial cell dysfunction resulting in untoward pregnancy outcomes. In this review, we detail these effects and their relationship to preeclampsia (PE and intrauterine growth restriction (IUGR.

  5. Hormonal contraception, thrombosis and age

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind

    2014-01-01

    INTRODUCTION: This paper reviews the risk of thrombosis with use of different types of hormonal contraception in women of different ages. AREAS COVERED: Combined hormonal contraceptives with desogestrel, gestodene, drospirenone or cyproterone acetate (high-risk products) confer a sixfold increased...

  6. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a

  7. Lower-limb venous thrombosis

    African Journals Online (AJOL)

    307. Lower-limb venous thrombosis. July 2009 Vol.27 No.7 CME. Most DVTs arise in calf muscle veins, particularly within the gastrocnemius and soleus muscles (calf vein DVT). Many of these remain localised to the muscle and will not cause any clinical problem. If, however, the circumstances that initially caused the.

  8. Bilateral cavernous sinus thromboses and intraorbital abscesses secondary to Streptococcus milleri.

    Science.gov (United States)

    Watkins, Lynnette M; Pasternack, Mark S; Banks, Michelle; Kousoubris, Philip; Rubin, Peter A D

    2003-03-01

    To report the first case of bilateral cavernous sinus thromboses and bilateral intraorbital abscesses secondary to Streptococcus milleri. Single interventional case report. The findings of the ophthalmic evaluation, radiographic imaging, medical and surgical intervention, specimen cultures, and clinical course were analyzed. A 17-year-old female had bilateral proptosis, decreased vision in the left eye, and altered mental status at presentation. An orbital compartment syndrome developed in the left eye and purulent material was present after lateral canthotomy, suggestive of an intraorbital abscess. Magnetic resonance imaging (MRI) scans revealed bilateral cavernous sinus thromboses, and subsequent computed tomographic (CT) scans revealed bilateral intraorbital abscesses in the setting of acute ethmoid and sphenoid sinusitis. Antibiotic treatment and surgical drainage of the orbital abscess and sinuses was performed, and specimen cultures revealed S. milleri. After surgery, the patient experienced hearing loss and a right internal capsule infarct, in addition to complete vision loss in the left eye. A second intraorbital abscess developed in the right eye and was drained surgically. The vision remained 20/20. Streptococcus milleri is a virulent organism with a propensity to form abscesses in multiple areas of the body and should be considered as a possible etiologic agent in abscess formation of the orbit and cavernous sinus thrombosis.

  9. FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS

    Directory of Open Access Journals (Sweden)

    Luis Muñiz Luna

    2016-03-01

    Full Text Available ABSTRACT Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

  10. The usefulness of sagittal reformation for diagnosis of sternal fracture

    Energy Technology Data Exchange (ETDEWEB)

    Im, Dong Jin; Hahn, Seok; Kim, Young Ju [Dept. of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2014-01-15

    The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

  11. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis.

    Science.gov (United States)

    Blizzard, Daniel J; Gallizzi, Michael A; Sheets, Charles; Smith, Benjamin T; Isaacs, Robert E; Eure, Megan; Brown, Christopher R

    2016-01-01

    Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this study meets criteria for an IRB waiver.

  12. Pediatric subperiosteal orbital abscess secondary to acute sinusitis: a 5-year review.

    Science.gov (United States)

    Soon, Vincent Tan Eng

    2011-01-01

    Subperiosteal orbital abscesses (SPOAs) secondary to acute sinusitis are rare occurrences in the pediatric age group, more so in the neonatal period. Here, a rare case of SPOA in a 38-day-old newborn later drained via endoscopic sinus surgery is included also. This review describes the demographic data, clinical history, treatment, microbiology results, complications, and outcome. The admission records for all the patients who were admitted to the Pediatric Surgical Ward in Sarawak General Hospital, Kuching, Malaysia, between January 2004 and May 2009 were retrospectively reviewed. Records of patients who presented with preseptal cellulitis, orbital cellulitis, subperiosteal abscess (extraconal), orbital abscess (intraconal), and cavernous sinus thrombosis were closely studied. Ophthalmology consultations were obtained in all these cases. Ultimately, 3 patients having SPOA secondary to acute sinusitis were selected for this review. All patients were male with rapid onset of periorbital signs, absence of purulent rhinorrhea, and presence of significant thrombocytosis (exceeding 500 × 10(9)/L). The 38-day-old newborn had mixed infection of methicillin-resistant coagulase-negative Staphylococcus bacteremia and local Acinetobacter eye infection with Staphylococcus aureus in the SPOA. All had medially located SPOA that was adequately drained via endoscopic sinus surgery, resulting in full recovery. Newborns with preexisting risk factors and immature immunity are at risk of severe and rare infections. Contrast-enhanced paranasal sinus computed tomographic scan is mandatory and reliable to differentiate preseptal and postseptal orbital infection, as both conditions can present similarly and rapidly deteriorate. In the contrast-enhanced computed tomography-demonstrable SPOA, endoscopic sinus surgery drainage of the abscess proved to be safe and reliable as the main treatment modality. All patients recovered well without complications. Copyright © 2011 Elsevier Inc. All

  13. Sagittal Abdominal Diameter: Application in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Thaís Da Silva-Ferreira

    2014-05-01

    Full Text Available Excess visceral fat is associated with cardiovascular risk factors. Sagittal abdominal diameter (SAD has recently been highlighted as an indicator of abdominal obesity, and also may be useful in predicting cardiovascular risk. The purpose of the present study was to review the scientific literature on the use of SAD in adult nutritional assessment. A search was conducted for scientific articles in the following electronic databases: SciELO , MEDLINE (PubMed and Virtual Health Library. SAD is more associated with abdominal fat (especially visceral, and with different cardiovascular risk factors, such as, insulin resistance, blood pressure, and serum lipoproteins than the traditional methods of estimating adiposity, such as body mass index and waist-to-hip ratio. SAD can also be used in association with other anthropometric measures. There are still no cut-off limits established to classify SAD as yet. SAD can be an alternative measure to estimate visceral adiposity. However, the few studies on this diameter, and the lack of consensus on the anatomical site to measure SAD, are obstacles to establish cut-off limits to classify it.

  14. Role of magnetic resonance venography in evaluation of cerebral ...

    African Journals Online (AJOL)

    Eman Abd-El Latif Abd-Elaziz El Damarawy

    2011-12-14

    Dec 14, 2011 ... Abbreviations: MRI, magnetic resonance imaging; MRV, magnetic resonance venography; SSS, superior sagittal sinus; CVO, cerebral venous occlusion; CVT, cerebral venous thrombosis; DSA, digital subtraction angiography; CT, computed tomography; CTV, computed tomography venography; CVST ...

  15. Walking sagittal balance correction by pedicle subtraction osteotomy in adults with fixed sagittal imbalance.

    Science.gov (United States)

    Yagi, Mitsuru; Kaneko, Shinjiro; Yato, Yoshiyuki; Asazuma, Takashi; Machida, Masafumi

    2016-08-01

    Pedicle subtraction osteotomy (PSO) is widely used to treat severe fixed sagittal imbalance. However, the effect of PSO on balance has not been fully documented. The aim of this study was to assess dynamic walking balance after PSO to treat fixed sagittal imbalance. Gait and balance were assessed in 15 consecutive adult female patients who had been treated by PSO for a fixed sagittal imbalance and compare patients' preop and postop dynamic walking balance with that of 15 age- and gender-matched healthy volunteers (HV). Each patient's chart, X-rays, pre and postop SRS22 outcome scores, and ODI were reviewed. Means were compared by Mann-Whitney U test and Chi-square test. The mean age was 66.3 years (51-74 years). The mean follow-up was 2.7 years (2-3.5 years). The C7PL and GL, measured on the force platform, were both improved from 24.2 ± 7.3 cm and 27.6 ± 9.4 to 5.4 ± 2.6 cm and 7.2 ± 3.4 cm, respectively. The baseline hip ROM was significantly smaller in patients compared to HV, whereas no significant difference was observed in the knee or ankle ROM. The pelvic tilt (preop -0.4° ± 1.4°, postop 8.9° ± 1.0°), and maximum hip-extension angle (preop -1.2° ± 14.2°, postop -11.2° ± 7.2°) were also improved after surgery. Cadence (116 s/min), stance-swing ratio (stance 63.2 % vs. swing 36.8 %), and stride (98.0 cm) were all increased after surgery. On the other hand, gait velocity was significantly slower in the PSO group at both pre and postop than in HV (PSO 53.3 m/min at preop and 58.8 m/min at postop vs. HV 71.1 m/min, p = 0.04). Despite a mild residual spinal-pelvic malalignment, PSO restored sagittal alignment and balance satisfactorily and has improved the gait pattern.

  16. An extracardiac unruptured right sinus of valsalva aneurysm complicated with atherothrombosis

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    2016-04-01

    Full Text Available We present quite a rare case of extracardiac unruptured right sinus of valsalva aneurysm (SVA complicated with atherothrombosis in a young adult man. A 35-year-old male with a giant unruptured SVA arising from the right coronary sinus (RCS with extracardiac protrusion was diagnosed by echocardiography. Contrast-enhanced computed tomography (CT revealed a huge calcified aneurysm with mural thrombi originating from the aortic root, and about 80% stenosis at the initial segment of the right coronary artery (RCA. Intraoperative exploration demonstrated a giant unruptured aneurysm arising from the RCS. Different from other SVAs reported before, this aneurismal wall appeared thick and atheromatous-like. In this aneurysm, there was a small localized intima tearing and mural thrombosis, and the orifice of the RCA was almost blocked. This patient underwent surgical patch repair to prevent aneurysm rupture and coronary artery bypass grafting for RCA revascularization. In conclusion, the pathological examination demonstrated marked foam cells, inflammatory cells, and thrombosis in the aneurismal wall. Learning points: • Echocardiographic characteristics of sinus of valsalva aneurysm (SVA. • Diagnostic evaluation of extracardiac unruptured SVA. • Pathology of rare SVA.

  17. Concomitant Deep Venous Thrombosis, Femoral Artery Thrombosis, and Pulmonary Embolism after Air Travel

    Directory of Open Access Journals (Sweden)

    Salim Abunnaja

    2014-01-01

    Full Text Available The association between air travel and deep venous thrombosis and/or pulmonary embolism “economy-class syndrome” is well described. However, this syndrome does not describe any association between long duration travel and arterial thrombosis or coexistence of venous and arterial thrombosis. We present a case of concomitant deep venous thrombosis, acute femoral artery thrombosis, and bilateral pulmonary embolisms in a patient following commercial air travel. Echocardiogram did not reveal an intracardiac shunt that may have contributed to the acute arterial occlusion from a paradoxical embolus. To our knowledge, this is the first report in the literature that associates air traveling with both arterial and venous thrombosis.

  18. Clinical and angiographic characteristics of cavernous sinus dural arteriovenous fistulas manifesting as venous infarction and/or intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Naoko; Naito, Isao; Takatama, Shin; Shimizu, Tatsuya; Iwai, Tomoyuki [Geriatrics Research Institute and Hospital, Department of Neurosurgery, Maebashi (Japan); Shimaguchi, Hidetoshi [Gunma University Graduate School of Medicine, Department of Neurosurgery, Maebashi (Japan)

    2009-01-15

    Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) rarely cause venous infarction (VI) and/or intracranial hemorrhage (ICH) despite the presence of cortical venous drainage (CVD). The present study investigated the characteristics of CS DAVFs manifesting as VI/ICH. Fifty-four patients treated for CS DAVFs were retrospectively studied. Six patients presented with VI/ICH. Two of the three patients presenting with ICH had CVD only to the superficial sylvian vein (SSV) or the deep sylvian vein (DSV). Three patients presenting with VI had multiple drainages, and angiography of these patients showed a varix on the SSV, drainage into the DSV with agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the distal petrosal vein. CS DAVF with CVD only carries higher risk of VI/ICH than multiple drainages. Many CS DAVFs presenting with VI, especially those with drainage into the petrosal vein, have multiple drainages in the early stage. Thrombosis of the inferior and superior petrosal sinuses and superior orbital vein gradually increases pressure of the CVD, and then, VI may occur. In contrast, CS DAVFs with CVD only from the beginning, common in the patients with drainage into the SSVs and DSVs, are likely to cause ICH. Angiographic risk factors causing VI/ICH are CVD only, varix formation, agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the superior orbital vein, lateral half of the superior petrosal sinus, and distal CVD. (orig.)

  19. Outcome of primary posterior sagittal anorectoplasty of high ...

    African Journals Online (AJOL)

    2013-01-29

    Jan 29, 2013 ... Background: Conventional posterior sagittal anorectoplasty (PSARP) for high anorectal malformation (ARM) involves initial colostomy creation with ... associated multiple congenital anomalies and high risk of overwhelming sepsis .... muscle complex, and mark the position for the neoanus. Inclusion criteria.

  20. Posterior sagittal rectopexy in the treatment of recurrent rectal ...

    African Journals Online (AJOL)

    Pediatric Surgery. Annals of Pediatric Surgery 2011, 7:101–104. Keywords: children, complications, posterior sagittal rectopexy, rectal prolapse, recurrent. Department of ... Correspondence to Amel Abd Eltwab Hashish, Department of Pediatric Surgery,. Faculty of ... without constipation, prolonged diarrhea, malnutrition,.

  1. Evaluation of Global Sagittal Balance in Koreans Adults.

    Science.gov (United States)

    Cho, Yongjae

    2017-09-01

    The global sagittal postural patterns as characterized by Roussouly classification have been previously described in various ethnicities, there were no studies investigated in Koreans. To analyze the distribution of the global sagittal postural patterns in Korean adults using Roussouly classification, the author prospectively studied. 252 asymptomatic Korean adults was recruited. Data was obtained by reviewing the films for each subject. Spinopelvic parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. We compared the data across different ethnicities from our study and a previous study to further characterize Korean sagittal postures. The subject included 151 males and 101 females, with mean age of 33.2±8.2 years. The average descriptive results were as below: thoracic kyphosis 28.6±7.7°, lumbar lordosis 48.3±10.2°, sacral slope 37.8±5.8°, pelvic incidence 45.1±7.5°, pelvic tilt 9.4±6.7°, spinosacral angle 130.1±5.4°, and sagittal vertical axis 16.25±22.5 mm. 125 subjects among 252 (49.6%) belonged to Roussouly type 3 (namely neutral). There were also 58 (23%), 33 (13.1%), and 36 (14.3) subjects in type 1, 2, and 4 (namely non-neutral), respectively. Enrolling 252 asymptomatic Korean adults, this prospective study found that 49.6% of asymptomatic Korean adults possessed a sagittal posture of Roussouly type 3. All radiologic parameters follows general concept of spinal sagittal balance pattern. Overall, this study might be a basis for further investigation of spinal sagittal balance.

  2. Early Post-Operative Coronary Thrombosis Following Repair of a Proximal Coronary Artery Fistula.

    Science.gov (United States)

    Chugh, Yashasvi; Lau, Bryan; Taub, Cynthia C

    2016-12-01

    Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively.

  3. Clinical Features and Treatments of Odontogenic Sinusitis

    National Research Council Canada - National Science Library

    Lee, Kyung Chul; Lee, Sung Jin

    2010-01-01

    The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis...

  4. 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

  5. Endoscopic transorbital route to the cavernous sinus through the meningo-orbital band: a descriptive anatomical study.

    Science.gov (United States)

    Dallan, Iacopo; Di Somma, Alberto; Prats-Galino, Alberto; Solari, Domenico; Alobid, Isam; Turri-Zanoni, Mario; Fiacchini, Giacomo; Castelnuovo, Paolo; Catapano, Giuseppe; de Notaris, Matteo

    2017-09-01

    OBJECTIVE Exposure of the cavernous sinus is technically challenging. The most common surgical approaches use well-known variations of the standard frontotemporal craniotomy. In this paper the authors describe a novel ventral route that enters the lateral wall of the cavernous sinus through an interdural corridor that includes the removal of the greater sphenoid wing via a purely endoscopic transorbital pathway. METHODS Five human cadaveric heads (10 sides) were dissected at the Laboratory of Surgical NeuroAnatomy of the University of Barcelona. To expose the lateral wall of the cavernous sinus, a superior eyelid endoscopic transorbital approach was performed and the anterior portion of the greater sphenoid wing was removed. The meningo-orbital band was exposed as the key starting point for revealing the cavernous sinus and its contents in a minimally invasive interdural fashion. RESULTS This endoscopic transorbital approach, with partial removal of the greater sphenoid wing followed by a "natural" ventral interdural dissection of the meningo-orbital band, allowed exposure of the entire lateral wall of the cavernous sinus up to the plexiform portion of the trigeminal root and the petrous bone posteriorly and the foramen spinosum, with the middle meningeal artery, laterally. CONCLUSIONS The purely endoscopic transorbital approach through the meningo-orbital band provides a direct view of the cavernous sinus through a simple and rapid means of access. Indeed, this interdural pathway lies in the same sagittal plane as the lateral wall of the cavernous sinus. Advantages include a favorable angle of attack, minimal brain retraction, and the possibility for dissection through the interdural space without entering the neurovascular compartment of the cavernous sinus. Surgical series are needed to demonstrate any clinical advantages and disadvantages of this novel route.

  6. Mid-sagittal plane and mid-sagittal surface optimization in brain MRI using a local symmetry measure

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Skoglund, Karl; Ryberg, Charlotte

    2005-01-01

    This paper describes methods for automatic localization of the mid-sagittal plane (MSP) and mid-sagittal surface (MSS). The data used is a subset of the Leukoaraiosis And DISability (LADIS) study consisting of three-dimensional magnetic resonance brain data from 62 elderly subjects (age 66 to 84...... years). Traditionally, the mid-sagittal plane is localized by global measures. However, this approach fails when the partitioning plane between the brain hemispheres does not coincide with the symmetry plane of the head. We instead propose to use a sparse set of profiles in the plane normal direction......, the mid-sagittal plane is not always planar, but a curved surface resulting in poor partitioning of the brain hemispheres. To account for this, this paper also investigates an optimization strategy which fits a thin-plate spline surface to the brain data using a robust least median of squares estimator...

  7. Thrombosis in pregnancy and maternal outcomes.

    Science.gov (United States)

    James, Andra H

    2015-09-01

    Pregnancy increases the risk of thrombosis four- to five-fold. Seventy-five to eighty percent of pregnancy-related thrombotic events are venous and twenty to -twenty-five percent are arterial. The main reason for the increased risk is hypercoagulability. Women are hypercoagulable because they have evolved so that they are protected against the bleeding challenges of pregnancy, miscarriage, or childbirth. Both genetic and acquired risk factors can further increase the risk of thrombosis. The maternal consequences of thrombosis of pregnancy include permanent vascular damage, disability, and death. While the maternal outcomes of thrombosis can be modified by anticoagulation therapy, management of thrombosis during pregnancy is the subject of another paper in this issue (see paper by B. Konkle). This review will focus on the epidemiology, pathophysiology, risk factors, and maternal consequences of thrombosis in pregnancy. © 2015 Wiley Periodicals, Inc.

  8. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

    Meyer-Olesen, Christine L; Nielsen, Sune F; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease in the ge......BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease...... in the general population. METHODS: We included 54628 participants from the Copenhagen City Heart Study (1981-83) and the Copenhagen General Population Study (2004-12), all with a measured concentration of IgM rheumatoid factor and without autoimmune rheumatic disease or venous thromboembolism. The main outcome...... was incident deep venous thrombosis. There were no losses to follow-up. RESULTS: During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs

  9. Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula.

    Science.gov (United States)

    Zenteno, Marco; Jorge, Santos-Franco; Rafael, Moscote-Salazar Luis; Raphael, AlvisMiranda Hernando; Gabriel, Alcala-Cerra; Ángel, Lee

    2015-01-01

    carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Caotid-cavernous fistula wes diagnosed, for the technical difficulty inherent in the case was made a contralateral transvenous approach and embolization with 360° GDG coils, with successful evolution of the patient. The endovascular management of these lesions is currently possible with excellent results.

  10. Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula

    Science.gov (United States)

    Zenteno, Marco; Jorge, Santos-Franco; Rafael, Moscote-Salazar Luis; Raphael, AlvisMiranda Hernando; Gabriel, Alcala-Cerra; Ángel, Lee

    2015-01-01

    carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Caotid-cavernous fistula wes diagnosed, for the technical difficulty inherent in the case was made a contralateral transvenous approach and embolization with 360° GDG coils, with successful evolution of the patient. The endovascular management of these lesions is currently possible with excellent results. PMID:25767589

  11. Cervical spine alignment, sagittal deformity, and clinical implications: a review.

    Science.gov (United States)

    Scheer, Justin K; Tang, Jessica A; Smith, Justin S; Acosta, Frank L; Protopsaltis, Themistocles S; Blondel, Benjamin; Bess, Shay; Shaffrey, Christopher I; Deviren, Vedat; Lafage, Virginie; Schwab, Frank; Ames, Christopher P

    2013-08-01

    This paper is a narrative review of normal cervical alignment, methods for quantifying alignment, and how alignment is associated with cervical deformity, myelopathy, and adjacent-segment disease (ASD), with discussions of health-related quality of life (HRQOL). Popular methods currently used to quantify cervical alignment are discussed including cervical lordosis, sagittal vertical axis, and horizontal gaze with the chin-brow to vertical angle. Cervical deformity is examined in detail as deformities localized to the cervical spine affect, and are affected by, other parameters of the spine in preserving global sagittal alignment. An evolving trend is defining cervical sagittal alignment. Evidence from a few recent studies suggests correlations between radiographic parameters in the cervical spine and HRQOL. Analysis of the cervical regional alignment with respect to overall spinal pelvic alignment is critical. The article details mechanisms by which cervical kyphotic deformity potentially leads to ASD and discusses previous studies that suggest how postoperative sagittal malalignment may promote ASD. Further clinical studies are needed to explore the relationship of cervical malalignment and the development of ASD. Sagittal alignment of the cervical spine may play a substantial role in the development of cervical myelopathy as cervical deformity can lead to spinal cord compression and cord tension. Surgical correction of cervical myelopathy should always take into consideration cervical sagittal alignment, as decompression alone may not decrease cord tension induced by kyphosis. Awareness of the development of postlaminectomy kyphosis is critical as it relates to cervical myelopathy. The future direction of cervical deformity correction should include a comprehensive approach in assessing global cervicalpelvic relationships. Just as understanding pelvic incidence as it relates to lumbar lordosis was crucial in building our knowledge of thoracolumbar deformities, T

  12. Sagittal spino-pelvic alignment in chronic low back pain.

    Science.gov (United States)

    Chaléat-Valayer, Emmanuelle; Mac-Thiong, Jean-Marc; Paquet, Jérôme; Berthonnaud, Eric; Siani, Fabienne; Roussouly, Pierre

    2011-09-01

    The differences in sagittal spino-pelvic alignment between adults with chronic low back pain (LBP) and the normal population are still poorly understood. In particular, it is still unknown if particular patterns of sagittal spino-pelvic alignment are more prevalent in chronic LBP. The current study helps to better understand the relationship between sagittal alignment and low back pain. To compare the sagittal spino-pelvic alignment of patients with chronic LBP with a cohort of asymptomatic adults. Sagittal spino-pelvic alignment was evaluated in prospective cohorts of 198 patients with chronic LBP and 709 normal subjects. The two cohorts were compared with respect to the sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), lumbar tilt (LT), lordotic levels, thoracic kyphosis (TK), thoracic tilt (TT), kyphotic levels, and lumbosacral joint angle (LSA). Correlations between parameters were also assessed. Sagittal spino-pelvic alignment is significantly different in chronic LBP with respect to SS, PI, LT, lordotic levels, TK, TT and LSA, but not PT, LL, and kyphotic levels. Correlations between parameters were similar for the two cohorts. As compared to normal adults, a greater proportion of patients with LBP presented low SS and LL associated with a small PI, while a greater proportion of normal subjects presented normal or high SS associated with normal or high PI. Sagittal spino-pelvic alignment was different between patients with chronic LBP and controls. In particular, there was a greater proportion of chronic LBP patients with low SS, low LL and small PI, suggesting the relationship between this specific pattern and the presence of chronic LBP.

  13. Sinus Histiocytosis with Massive Lymphadenopathy

    African Journals Online (AJOL)

    1974-03-09

    Mar 9, 1974 ... REPORT OF TWO ADDITIONAL CASES WITH ULTRASTRUCTURAL. OBSERVATIONS c. C. SUNCLAIR~NUTH. L. B. KAHN. C. J. UYS. SUMMARY. Two cases of a recently described entity, 'sinus histio- cytosis with massive lymphadenopathy,' occurring in Black males, are reported. Prominent cervical ...

  14. Systemic corticosteroids for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Hayward, G.; Heneghan, C.J.; Mar, C.B. Del; Perera, R.; Glasziou, P.P.; Rovers, M.M.

    2014-01-01

    BACKGROUND: Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal

  15. Silent sinus syndrome: An imploding antrum syndrome

    Directory of Open Access Journals (Sweden)

    Sneha H Choudhary

    2016-01-01

    Full Text Available Silent sinus syndrome (SSS is a rare entity that is associated with spontaneous, painless, unilateral enophthalmos and hypoglobus resulting from downward bowing of the orbital floor in the absence of any symptomatic sinonasal disease. The diagnosis is suspected clinically, but it is confirmed radiologically by its characteristic imaging features that include maxillary sinus outlet obstruction, sinus opacification and sinus volume loss caused by inward retraction of the sinus walls. The purpose of this article is to acquaint the reader with the clinical and imaging features of the SSS, along with a brief discussion about its pathogenesis and treatment, which is relatively unknown among oral and maxillofacial radiologists.

  16. Mucocoele of the maxillary sinus

    Directory of Open Access Journals (Sweden)

    Perić Aleksandar

    2007-01-01

    Full Text Available Background. Mucocoele is histopathologically benign, cystic change of paranasal sinuses filled with mucoid contents, which with its growth is pressuring and destroying local bone walls. In only 3% of the cases it can be localized in maxillary sinuses. Etiology is unknown. Pyocoele develops by secondary infection. Case report. The male patient was 21 years old. His symptoms were runny nose with thick contents and heavy breathing on the right side of the nose, headaches, as well as the swelling of the right cheek. During clinical examination, the expansive change was found. It was completely closing the right side of the nose cavity. Computerized tomography (CT of paranasal cavities showed excessive expansion of the right maxillary sinus, with very thinned walls, while the cavity was filled with liquid. After antibiotics therapy, the radical operation of the right maxillary sinus was performed, based on Caldwell Luc method. The frontal wall was found to be extremely convex and thinned, while the medial wall was with dehiscention. The cystic change was extirpated. Mucocoele was proved by pathohistologic findings. Its wall was about 2 mm thick and it showed squamous metaplasia in the large part of the mucocoela epithel. In the submucosa fibrosis and inflammatory infiltrate was present. Postoperative follow-up was under control. Clinically and radiographycaly, six months after therapy, the patient does not have troubles. Conclusion. The rare localization of the mucocoeles in maxillary sinus can be explained with the width of the maxillary ostia. Infected mucocoeles, expanded to the local anatomical structures, should be operated on with classic radical surgical operation. .

  17. Ambient air pollution and thrombosis.

    Science.gov (United States)

    Robertson, Sarah; Miller, Mark R

    2018-01-03

    Air pollution is a growing public health concern of global significance. Acute and chronic exposure is known to impair cardiovascular function, exacerbate disease and increase cardiovascular mortality. Several plausible biological mechanisms have been proposed for these associations, however, at present, the pathways are incomplete. A seminal review by the American Heart Association (2010) concluded that the thrombotic effects of particulate air pollution likely contributed to their effects on cardiovascular mortality and morbidity. The aim of the current review is to appraise the newly accumulated scientific evidence (2009-2016) on contribution of haemostasis and thrombosis towards cardiovascular disease induced by exposure to both particulate and gaseous pollutants.Seventy four publications were reviewed in-depth. The weight of evidence suggests that acute exposure to fine particulate matter (PM 2.5 ) induces a shift in the haemostatic balance towards a pro-thrombotic/pro-coagulative state. Insufficient data was available to ascertain if a similar relationship exists for gaseous pollutants, and very few studies have addressed long-term exposure to ambient air pollution. Platelet activation, oxidative stress, interplay between interleukin-6 and tissue factor, all appear to be potentially important mechanisms in pollution-mediated thrombosis, together with an emerging role for circulating microvesicles and epigenetic changes.Overall, the recent literature supports, and arguably strengthens, the contention that air pollution contributes to cardiovascular morbidity by promoting haemostasis. The volume and diversity of the evidence highlights the complexity of the pathophysiologic mechanisms by which air pollution promotes thrombosis; multiple pathways are plausible and it is most likely they act in concert. Future research should address the role gaseous pollutants play in the cardiovascular effects of air pollution mixture and direct comparison of potentially

  18. Allergic fungal sinusitis causing nasolacrimal duct obstruction.

    Science.gov (United States)

    Kim, Charles; Kacker, Ashutosh; Chee, Ru-Ik; Lelli, Gary J

    2013-04-01

    Allergic fungal sinusitis is thought to represent a chronic autoimmune reaction directed against fungal elements within the sinuses, and is commonly seen in individuals with a history of chronic sinusitis that is refractory to medical therapy. The authors present a case of allergic fungal sinusitis involving the lacrimal drainage system. A 54-year-old woman initially presented with recurrent erythema and induration of the left nasolacrimal sac due to dacryocystitis, which was unresponsive to treatment with topical and systemic antibiotics. Radiological evaluation demonstrated the presence of multiple soft tissue masses along the medial canthi. During subsequent endoscopic dacryocystorhinostomy, significant amounts of allergic mucin were found within the sinuses and marked eosinophilia was present within tissue obtained from the lacrimal sac, findings highly suggestive of allergic fungal sinusitis. A diagnosis of allergic fungal sinusitis should be considered in patients presenting with epiphora in the appropriate clinical context. However, involvement of the lacrimal drainage system is an exceedingly unusual presentation.

  19. Analysis of Global Sagittal Postural Patterns in Asymptomatic Chinese Adults.

    Science.gov (United States)

    Hu, Panpan; Yu, Miao; Sun, Zhuoran; Li, Weishi; Jiang, Liang; Wei, Feng; Liu, Xiaoguang; Chen, Zhongqiang; Liu, Zhongjun

    2016-04-01

    A prospective imaging study. To characterize the distribution of the global sagittal postural patterns in asymptomatic Chinese adults using Roussouly classification. The norms of sagittal parameters in asymptomatic Chinese population have been previously described, but no report described their global sagittal postural patterns as characterized by Roussouly classification. A cohort of 272 asymptomatic Chinese adults was recruited. Data was assimilated by reviewing the films for each subject. Sagittal parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. The pattern distributions were compared across genders within the study cohort. We also compared the data across different ethnicities from our study and a previous study to further characterize Chinese sagittal postures. The cohort included 161 males and 111 females, with mean age of 23.2±4.4 years. The average descriptive results were as below: pelvic incidence (PI) 46.4°±9.6°, thoracic kyphosis (TK) 24.2°±9.0°, lumbar lordosis (LL) 50.6°±10.6°, sacral slope (SS) 37.2°±7.6°, pelvic tilt (PT) 9.4°±6.8°, spinosacral angle (SSA) 131.1°±7.5° and sagittal vertical axis (SVA) 17.24±32.36 mm. Despite a significant difference between two genders in LL, PI, SSA, and SVA, no difference was found in the distribution of Roussouly types among them. 47.8% of our cohort belonged to Roussouly type 3, while type 1, 2 and 4 comprised 23.2%, 14.0% and 15.1% of the subjects, respectively. Roussouly classification was capable of categorizing sagittal parameters except for the PT. This study also found that 4.4% of the recruited subjects belonged to the C7-anterior subgroup. From a characterization of the sagittal postural patterns of asymptomatic Chinese adults using Roussouly classification, the distribution was similar between Chinese males and females; however, from a cross-study comparison, it was different between asymptomatic Chinese and Caucasian

  20. Change in sagittal balance with placement of an interspinous spacer.

    Science.gov (United States)

    Schulte, Leah M; O'Brien, Joseph R; Matteini, Lauren E; Yu, Warren D

    2011-09-15

    A prospective case series. To determine the effect of X-STOP implantation on sagittal spinal balance using 36-inch films. Interspinous process spacers have been shown as an effective treatment of neurogenic claudication. The devices block the last few degrees of extension at the stenotic level, thus preventing compression of the nerve roots. These devices have been criticized because they may push the patient's spine into a kyphotic position. However, opening the stenotic level may allow a patient to stand more upright, thereby improving sagittal balance. Institutional review board's approval was obtained. A prospective study of 20 patients who were undergoing an X-STOP insertion was utilized. Their spines were x-rayed preoperatively and postoperatively with 36-inch films. Preoperative and postoperative sagittal balance was measured with a C7 body plum line on both films and the difference was measured. Lumbar lordosis was also compared using Cobb angles. Measurements taken from lateral full-length spine radio-graphs showed an average improvement in sagittal balance of 2.0 cm (range -3.7 to 6.1 cm). The average change in lordosis was -1.1°. Although previous studies of interspinous process distraction have examined segmental lordosis, disc angles, and other parameters, this study is the first to examine overall spinal balance on full-length films. Interspinous distraction does not seem to be detrimental to sagittal balance, and may improve it.

  1. Dentoalveolar Heights in Vertical and Sagittal Facial Patterns.

    Science.gov (United States)

    Islam, Zafar Ul; Shaikh, Attiya Jawaid; Fida, Mubassar

    2016-09-01

    To determine and compare the mean dentoalveolar heights (mm) in different vertical and sagittal facial patterns. Cross-sectional study. Orthodontics Clinic, The Aga Khan University Hospital, Karachi, from September to November 2013. Subjects, aged 15 - 20 years, having fully erupted first permanent molars and central incisors were included in the study from orthodontic records. The pretreatment cephalographs of subjects were traced manually over an illuminator. The various parameters like angles and dentoalveolar heights were measured and recorded on data collection form. Mean value ± SD for the variables were generated. ANOVAwas used to compare the means of dentoalveolar heights among the vertical and sagittal facial patterns. Post Hoc Bonferroni test was applied to show difference among the three vertical and three sagittal facial patterns. P-value equal to or less than 0.05 was taken as statistically significant. The mean age of subjects was 15.8 ±3.2 years in vertical group and 16.3 ±2.9 years in sagittal group. There was statistically significant difference (p=0.008) for the upper anterior dentoalveolar height (UADH) among vertical groups, with statistically significant difference for UADH between hyperdivergent and normodivergent (p=0.04) and hyperdivergent and hypodivergent (p=0.01) facial patterns. The UADH were significantly greater in the hyperdivergent group as compared to both the normodivergent and hypodivergent groups. The sagittal groups showed no statistically significant difference for dentoalveolar heights.

  2. Ex vivo comparative study on three sinus lift tools for transcrestal detaching maxillary sinus mucosa.

    Science.gov (United States)

    Li, Yanfeng; Hu, Pin; Han, Yishi; Fan, Jiadong; Dong, Xinming; Ren, Huan; Yang, Chunhao; Shi, Tingting; Xia, Dong

    2017-07-04

    The objective of this study was to comparatively evaluate 3 different sinus lift tools, namely umbrella-shaped sinus lift curette YSL-04, our recently designed probe-improved sinus lift curettes, and our newly invented elevator 014, using our previous developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time. Goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time were generated according to our previously developed protocol. The effectiveness for each tool was evaluated through the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions. The results showed that all 3 sinus lift tools could transcrestally detach the maxillary sinus mucosa and create extra space under the elevated sinus floor on the goat ex vivo sinus models. Moreover, our newly invented elevator 014 had advantages over the other 2 in term of the capability to detach the sinus mucosa. Our newly invented elevator 014 might be a promising tool for detaching maxillary sinus mucosa in transcrestal maxillary sinus floor elevation.

  3. Anatomical aspects of sinus floor elevations.

    Science.gov (United States)

    van den Bergh, J P; ten Bruggenkate, C M; Disch, F J; Tuinzing, D B

    2000-06-01

    Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a

  4. Cerebral Arterial Thrombosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Giovanni Casella

    2013-01-01

    Full Text Available Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD. We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  5. Cerebral arterial thrombosis in ulcerative colitis.

    Science.gov (United States)

    Casella, Giovanni; Cortelezzi, Claudio Camillo; Marialuisa, Delodovici; Cariddi Lucia, Princiotta; Elena Pinuccia, Verrengia; Baldini, Vittorio; Segato, Sergio

    2013-01-01

    Thrombosis, mainly venous, is a rare and well-recognized extraintestinal manifestation of inflammatory bowel disease (IBD). We describe a 25-year-old Caucasian man affected by ulcerative colitis and sclerosing cholangitis with an episode of right middle cerebral arterial thrombosis resolved by intraarterial thrombolysis. We perform a brief review of the International Literature.

  6. Successful Thrombolysis of Aortic Prosthetic Valve Thrombosis ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    She delivered a normal baby uneventfully in follow up at full term of pregnancy with no complications. Fibrinolytic therapy for mechanical valve thrombosis is a reasonable alternative to surgery in first trimester of pregnancy. KEY WORDS: Prosthetic valve thrombosis; Echocardiography; Streptokinase;. Thrombolysis; Fetus.

  7. Sex-specific aspects of venous thrombosis

    NARCIS (Netherlands)

    Roach, Rachel Elizabeth Jo

    2014-01-01

    Venous thrombosis is a disease that occurs in 1-2 per 1000 people per year. At the time of their first venous thrombosis, approximately 50% of women are exposed to reproductive risk factors (oral contraception, postmenopausal hormone therapy, pregnancy and the puerperium). In this thesis, we showed

  8. Deep vein thrombosis and pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R.

    2016-01-01

    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer

  9. Thromboelastography in patients with cerebral venous thrombosis

    NARCIS (Netherlands)

    Koopman, Karen; Uyttenboogaart, Maarten; Hendriks, Herman G. D.; Luijckx, Gert-Jan; Cramwinckel, Ivo R.; Vroomen, Patrick C.; De Keyser, Jacques; van der Meer, Jan

    Introduction: Cerebral venous thrombosis (CVT) is a rare presentation of venous thrombosis and has been associated with many conditions. In about 20% no risk factor is identified. The aim of this study was to assess the clot formation by thromboelastography (TEG) in patients with a history of CVT

  10. Intranasal steroids for acute sinusitis.

    Science.gov (United States)

    Zalmanovici Trestioreanu, Anca; Yaphe, John

    2013-12-02

    Acute sinusitis is a common reason for primary care visits. It causes significant symptoms and often results in time off work and school. We examined whether intranasal corticosteroids (INCS) are effective in relieving symptoms of acute sinusitis in adults and children. We searched CENTRAL 2013, Issue 4, MEDLINE (January 1966 to May week 2, 2013), EMBASE (1990 to May 2013) and bibliographies of included studies. Randomised controlled trials (RCTs) comparing INCS treatment to placebo or no intervention in adults and children with acute sinusitis. Acute sinusitis was defined by clinical diagnosis and confirmed by radiological evidence or by nasal endoscopy. The primary outcome was the proportion of participants with either resolution or improvement of symptoms. Secondary outcomes were any adverse events that required discontinuation of treatment, drop-outs before the end of the study, rates of relapse, complications and return to school or work. Two review authors independently extracted data, assessed trial quality and resolved discrepancies by consensus. No new trials were found for inclusion in this update. Four studies involving 1943 participants with acute sinusitis met our inclusion criteria. The trials were well-designed and double-blind and studied INCS versus placebo or no intervention for 15 or 21 days. The rates of loss to follow-up were 7%, 11%, 41% and 10%. When we combined the results from the three trials included in the meta-analysis, participants receiving INCS were more likely to experience resolution or improvement in symptoms than those receiving placebo (73% versus 66.4%; risk ratio (RR) 1.11; 95% confidence interval (CI) 1.04 to 1.18). Higher doses of INCS had a stronger effect on improvement of symptoms or complete relief: for mometasone furoate 400 µg versus 200 µg (RR 1.10; 95% CI 1.02 to 1.18 versus RR 1.04; 95% CI 0.98 to 1.11). No significant adverse events were reported and there was no significant difference in the drop-out and

  11. Microparticles in Hemostasis and Thrombosis

    Science.gov (United States)

    Owens, A. Phillip; Mackman, Nigel

    2011-01-01

    Blood contains microparticles (MPs) derived from a variety of cell types, including platelets, monocytes and endothelial cells. In addition, tumors release MPs into the circulation. MPs are formed from membrane blebs that are released from the cell surface by proteolytic cleavage of the cytoskeleton. All MPs are procoagulant because they provide a membrane surface for the assembly of components of the coagulation protease cascade. Importantly, the procoagulant activity is increased by the presence of anionic phospholipids, particularly phosphatidylserine (PS), and the procoagulant protein tissue factor (TF), which is the major cellular activator of the clotting cascade. High levels of platelet-derived PS+ MPs are present in healthy individuals, whereas the number of TF+,PS+ MPs is undetectable or very low. However, levels of PS+, TF+ MPs are readily detected in a variety of diseases and monocytes appear to be the primary cellular source. In cancer, PS+, TF+ are derived from tumors and may serve as a useful biomarker to identify patients at risk for venous thrombosis. This review will summarize our current knowledge on the role of procoagulant MPs in hemostasis and thrombosis. PMID:21566224

  12. CT of the paranasal sinuses is not a valid indicator for sinus surgery in CF patients

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Aanæs, Kasper; Norling, Rikke

    2012-01-01

    BACKGROUND: No guidelines comprise when or to what extent sinus surgery should be done in patients with cystic fibrosis (CF) or how a CT scan of the paranasal sinuses should influence the decision. Symptoms of rhinosinusitis and/or eradication of pathogenic bacteria from the sinuses are reasons...... for sinus surgery. METHODS: In this observational cross sectional study, 55 CF cases had their preoperative CT scans scored according to the Lund Mackay- and the Nair-system. Correlations between the CT scans, symptoms, surgical findings and cultures obtained during sinus surgery were made. RESULTS...... is not a valid criterion for sinus surgery in CF patients....

  13. High spatial resolution magnetic resonance imaging of experimental cerebral venous thrombosis with a blood pool contrast agent.

    Science.gov (United States)

    Spuentrup, E; Wiethoff, A J; Parsons, E C; Spangenberg, P; Stracke, C P

    2010-06-01

    The purpose of this study was to investigate the feasibility of clot visualization in small sinus and cortical veins with contrast enhanced MRA in a cerebral venous thrombosis animal model using a blood pool contrast agent, Gadofosveset, and high spatial resolution imaging. For induction of cerebral venous thrombosis a recently developed combined interventional and microsurgical model was used. Cerebral sinus and cortical vein thrombosis was induced in six pigs. Two further pigs died during the procedure. Standard structural, time-of-flight- and phase contrast-angiograms were followed by fast time resolved high resolution 3D MRA (4D MRA) and subsequent high spatial resolution 3D MRA in the equilibrium phase with and without addition of parallel imaging. Visualization of the clots using the different sequences was subjectively compared and contrast-to-noise ratio (CNR) was assessed. In the remaining six animals the procedure and MR-imaging protocol including administration of Gadofosveset was successfully completed. The 3D high resolution MRA in the equilibrium phase without the addition of parallel imaging was superior to all the other applied MR measurement techniques in terms of visualization of the clots. Only applying this sequence bridging vein thromboses were also seen as a small filling defect with a high CNR of >18. Only the non-accelerated high spatial resolution 3D MRA in the equilibrium in conjunction with the blood pool agent Gadofosveset allows for high-contrast visualization of very small clots in the cerebral sinus and cortical veins. STATEMENT CLINICAL IMPACT: Detection of cortical vein thrombosis is of high clinical impact. Conventional MRI sequences often fail to visualize the clot. We could demonstrate that, in contrast to conventional sequences, with high spatial resolution 3D MRA in the equilibrium in conjunction with the blood pool agent Gadofosveset very small clots in the cerebral sinus and cortical veins could be successfully visualized. We

  14. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    OpenAIRE

    Crovetto Martínez, Rafael; Martin Arregui, Francisco Javier; Zabala López de Maturana, Aitor; Tudela Cabello, Kiara; Crovetto de la Torre, Miguel Angel

    2014-01-01

    Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study Design: This is a retrospective cohort study performed on 55 patients diagn...

  15. Computerized Tomographic Study on the Paranasal Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sun Kyung; Lim, Sug Young; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    1999-08-15

    The purpose of this study was to evaluate the computed tomographic (CT) images of the paranasal sinusitis(PNS). The author examined the extent and the recurring patterns of the paranasal sinusitis and some important anatomic landmarks. The author analyzed PNS images retrospectively in 500 patients who visited Chonbuk National University Hospital between January 1996 and December 1997. The most frequently affected sinus was maxillary sinus (82.9%), followed by anterior ethmoid sinus (67.9%), posterior ethmoid sinus (48.9%), frontal sinus (42.0%) and sphenoid sinus (41.4%). The characteristic features of CT images of the sinusitis were sinus opacification (22.4%), mucoperiosteal thickening (34.3%), and polyposis (2.0%). Sinonasal inflammatory diseases were categorized into 5 patterns according to Babbel's classification. They were 1) infundibular (13.0%), 2) ostiomeatal unit (67.4%), 3)sphenoethmoidal recess (13.0%), 4) sinonasal polyposis (9.6%) and 5) unclassifiable patterns (18.0%). The incidences of contact between sinus and optic nerve were as follows ; the incidences of contact with posterior ethmoid sinus, sphenoid sinus, both posterior sinuses were 11.4%, 66.8%, 6.3%, respectively. The incidences of contact between sphenoid sinus and maxillary nerve, vidian nerve, internal carotid artery were 74.5%, 79.2%, 45.1% respectively. The incidences of pneumatization of the posterior ethmoid sinus were as follows; normal 70.6% and overriding type 29.4%. The incidences of sphenoid sinus pneumatization were as follows; normal 56.9% , rudimentary 12.5%, pterygoid recess 22.7%, anterior clinoid recess 2.7%, and both pterygoid and anterior clinoid recess 5.2%. The inflammatory sinonasal diseases were classified into five patterns using the CT of PNS, which was proven to be an excellent imaging modality providing detailed information about mucosal abnormality, pathologic patterns and the proximity of the important structures to the posterior paranasal sinuses. This

  16. Objective classification system for sagittal craniosynostosis based on suture segmentation

    Science.gov (United States)

    Qian, Xiaohua; Tan, Hua; Zhang, Jian; Zhuang, Xiahai; Branch, Leslie; Sanger, Chaire; Thompson, Allison; Zhao, Weiling; Li, King Chuen; David, Lisa; Zhou, Xiaobo

    2015-01-01

    Purpose: Spring-assisted surgery is an effective and minimally invasive treatment for sagittal craniosynostosis (CSO). The principal barrier to the advancement of spring-assisted surgery is the patient-specific spring selection. The selection of spring force depends on the suture involved, subtypes of sagittal CSO, and age of the infant, among other factors. Clinically, physicians manually judge the subtype of sagittal CSO patients based on their CT image data, which may cause bias from different clinicians. An objective system would be helpful to stratify the sagittal CSO patients and make spring choice less subjective. Methods: The authors developed a novel informatics system to automatically segment and characterize sutures and classify sagittal CSO. The proposed system is composed of three phases: preprocessing, sutures segmentation, and classification. First, the three-dimensional (3D) skull was extracted from the CT images and aligned with the symmetry of the cranial vault. Second, a “hemispherical projection” algorithm was developed to transform 3D surface of the skull to a polar two-dimensional plane. Through the transformation, an “effective” projected region can be obtained to enable easy segmentation of sutures. Then, the different types of sutures, such as coronal sutures, lambdoid sutures, sagittal suture, and metopic suture, obtained from the segmented sutures were further identified by a dual-projection technique of the midline of the sutures. Finally, 108 quantified features of sutures were extracted and selected by a proposed multiclass feature scoring system. The sagittal CSO patients were classified into four subtypes: anterior, central, posterior, and complex with the support vector machine approach. Fivefold cross validation (CV) was employed to evaluate the capability of selected features in discriminating the four subtypes in 33 sagittal CSO patients. Receiver operating characteristics (ROC) curves were used to assess the robustness

  17. Sagittal alignment of cervical spine in adult idiopathic scoliosis.

    Science.gov (United States)

    Aykac, Bilal; Ayhan, Selim; Yuksel, Selcen; Guler, Umit Ozgur; Pellise, Ferran; Alanay, Ahmet; Perez-Grueso, Francisco Javier Sanchez; Acaroglu, Emre

    2015-06-01

    Alignment of the cervical spine (CS) in adolescent idiopathic scoliosis (IS) as well as in asymptomatic adult populations has recently been studied and described as being less lordotic in the adolescent IS population. However, few studies have examined the sagittal alignment of the CS in adult IS or its association with other radiological variables and clinical relevance. The aim of this study is to analyse the sagittal alignment of CS in adult IS and its association with age, alignment of the thoracic, lumbar and global spinal column as well as health-related quality of life (HRQOL) parameters. A retrospective review of prospectively collected data from a multicenter database was performed. Of 468 consecutive adult IS patients, 213 were included in the study; the remainder were excluded due to poor quality X-rays where the CS was not properly visible, or previous surgery. X-rays were measured for the following CS parameters: [Cranial base-C2 (C0-C2) lordosis, C2-C7 lordosis, thoracic (T1) slope, thoracic inlet angle (TIA) and odontoid (Od)-T1 offset using a measurement software]. These measurements were then evaluated for possible associations with patient age and with pre-existing alignment parameters and HRQOL scores using Pearson correlation tests. The average and standard deviations for CS alignment parameters were 32.3° ± 10.2° for C0-C2; 5.7° ± 14.1° for C2-C7; 23.9° ± 11.3° for T1 slope, 70.5° ± 14.7° for TIA and 20.8° ± 16.5° for Od-T1 offset. CS alignment showed a significant (p < 0.05) correlation with age, T kyphosis and several other sagittal alignment parameters such as sagittal vertical axis (SVA), global tilt and T1 sagittal tilt, but not with the HRQOL parameters. The sagittal alignment of the CS in adult IS is less lordotic than the normal average while less kyphotic than that of IS of a younger age. It correlates with age, thoracic kyphosis and some global sagittal alignment parameters. These findings suggest that CS alignment is

  18. Sagittal synostosis: I. Preoperative morphology of the skull

    DEFF Research Database (Denmark)

    Guimaraes-Ferreira, J.; Gewalli, F.; David, L.

    2006-01-01

    The aim of this study was to characterise the preoperative morphology of the skull in sagittal synostosis in an objective and quantified way. The shapes of the skulls of 105 patients with isolated premature synostosis of the sagittal suture ( SS group) were studied and compared with those...... of a control group of 72 children with unilateral incomplete cleft lip (UICL). A standardised radiocephalometric technique was used to obtain the images. A modification of a method developed by Kreiborg was used to analyse the radiocephalograms, which included the digitisation of 88 landmarks in the calvaria...

  19. Cerebral venous thrombosis: treatment with local fibrinolysis plus alteplase; Trombosis venosa cerebral. Tratamiento mediante fibrinolisis local con alteplasa

    Energy Technology Data Exchange (ETDEWEB)

    Asis Bravo, F. de; Delgado, F.; Cano, A.; Bautista, D.

    2002-07-01

    Cerebral venous thrombosis is a rare entity with widely variable clinical signs: thus, a high degree of suspicion is required for diagnosis. It affects the dural sinuses and may or may not invade cerebral veins. The diagnosis has usually been based on an angiographic study although, at the present time, new noninvasive imaging techniques, such as computed tomography, magnetic resonance and magnetic resonance angiography are being employed in a growing number of cases. Treatment should involve symptomatic and etiologic therapy. Although anti coagulation would appear to be a reasonable option in these patients, it remains controversial. As in other processes such as pulmonary embolism and coronary thrombosis, the introduction of novel and increasingly safe fibrinolytic drugs, together with technical innovations in the field of interventional neuroradiology, is changing the perspectives for the management of these patients. We present the case of a 43-year-old woman with right sinus thrombosis who was treated with local thrombolysis plus alteplase (tissue plasminogen activator). The authors describe the technique employed and review the literature. (Author) 16 refs.

  20. Sphenoid sinus adenoid cystic carcinoma

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2008-12-01

    Full Text Available Introduction: The sphenoid adenoid cystic carcinoma is a rare malign neoplasm, in the head and neck and when located in the paranasal sinuses, it is formed in the minor salivary glands. It grows slowly and is characterized by a large invasion of the adjacent tissues, and also has a large capacity of metastasis. The surgery associated with post-operative radiotherapy is used as treatment. Objective: To describe a case of sphenoid sinus adenoid cystic carcinoma in a male, black, 62 year patient. Case Report: N.L.B., 62 years of age, male, had bloody rhinorrhea for 6 months associated with bilateral nasal obstruction. The nasofibroscopy showed lesion of polypoid aspect in the left nasal cavity. He was submitted to biopsy and the anatomopathological exam showed adenoid cystic carcinoma and the patient was forwarded to oncology. Conclusions: The importance of conducting the differential diagnosis between chronic nasosinusal infection and nasosinusal tumors.

  1. Incidental findings in paranasal sinuses and mastoid cells. A cross-sectional magnetic resonance imaging (MRI) study in a pediatric radiology department

    Energy Technology Data Exchange (ETDEWEB)

    Kalle, T. von; Fabig-Moritz, C.; Winkler, P. [Olgahospital Klinikum, Stuttgart (Germany). Radiologie; Heumann, H. [Olgahospital Klinikum, Stuttgart (Germany). Paediatrische HNO-Heilkunde und Otologie

    2012-07-15

    Purpose: Misdiagnosis of 'sinusitis' is still frequent in children, although mucosal swelling in the paranasal sinuses of children has been reported as a common incidental finding. Recent radiological publications on the problem are rare. We prospectively evaluated the mucosal thickening in the paranasal sinuses and mastoid cells of children who underwent MRI of the head for reasons other than sinusitis or mastoiditis. Materials and Methods: 147 patients, 0.2 - 22.7 years, median 8.9. Axial and sagittal T2 TSE images were evaluated by two experienced pediatric radiologists. Categories for the degree of mucosal swelling were for the maxillary, frontal and sphenoid sinuses: no swelling, minor: < 5 mm, or major: {>=} 5 mm; for ethmoid cells and mastoid cells: not present, minor: {<=} 50 % of cells, or major: > 50 %. Results: 61 % of children had one or more salient findings in their paranasal sinuses or mastoid cells. 48 % had mucosal swelling in their paranasal cavities, 25 % in their mastoid cells. The prevalence was higher among children less than 10 years of age (60 % and 42 %) and among children with current upper respiratory tract infection (71 % and 35 %). There was no correlation to a history of headache, snoring, asthma and allergies, or to gender or place of residence. Conclusion: Mucosal swelling in paranasal sinuses and in mastoid cells is a frequent incidental finding in children. Even major mucosal swelling in a paranasal sinus is not necessarily a sign of infection. In radiological reports the terms 'sinusitis' and 'mastoiditis' should therefore be used with great caution. The initiation of treatment should be based on clinical symptoms and not on radiological abnormalities alone. (orig.)

  2. Global sagittal axis: a step toward full-body assessment of sagittal plane deformity in the human body.

    Science.gov (United States)

    Diebo, Bassel G; Oren, Jonathan H; Challier, Vincent; Lafage, Renaud; Ferrero, Emmanuelle; Liu, Shian; Vira, Shaleen; Spiegel, Matthew Adam; Harris, Bradley Yates; Liabaud, Barthelemy; Henry, Jensen K; Errico, Thomas J; Schwab, Frank J; Lafage, Virginie

    2016-10-01

    OBJECTIVE Sagittal malalignment requires higher energy expenditure to maintain an erect posture. Because the clinical impact of sagittal alignment is affected by both the severity of the deformity and recruitment of compensatory mechanisms, it is important to investigate new parameters that reflect both disability level and compensatory mechanisms for all patients. This study investigated the clinical relevance of the global sagittal axis (GSA), a novel measure to evaluate the standing axis of the human body. METHODS This is a retrospective review of patients who underwent full-body radiographs and completed health-related quality of life (HRQOL) questionnaires: Oswestry Disability Index (ODI), Scoliosis Research Society-22, EuroQol-5D (EQ-5D), and the visual analog scale for back and leg pain. The GSA was defined as the angle formed by a line from the midpoint of the femoral condyles to the center of C-7, and a line from the midpoint between the femoral condyles to the posterior superior corner of the S-1 sacral endplate. After evaluating the correlation of GSA/HRQOL with sagittal parameters, linear regression models were generated to investigate how ODI and GSA related to radiographic parameters (T-1 pelvic angle, pelvic retroversion, knee flexion, and pelvic posterior translation). RESULTS One hundred forty-three patients (mean age 44 years) were included. The GSA correlated significantly with all HRQOL (up to r = 0.6 with EQ-5D) and radiographic parameters (up to r = 0.962 with sagittal vertical axis). Regression between ODI and sagittal radiographic parameters identified the GSA as an independent predictor (r = 0.517, r2 = 0.267; p Analysis of standardized coefficients revealed that when controlling for deformity, the GSA increased with a concurrent decrease in pelvic retroversion (-0.837) and increases in knee flexion (+0.287) and pelvic posterior translation (+0.193). CONCLUSIONS The GSA is a simple, novel measure to assess the standing axis of the human

  3. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation.

    Science.gov (United States)

    Harvey, Richard J; Goddard, John C; Wise, Sarah K; Schlosser, Rodney J

    2008-07-01

    Assess paranasal sinus distribution of topical solutions following endoscopic sinus surgery (ESS) using various delivery devices. Experimental prospective study. Ten cadaver sinus systems were irrigated with Gastroview before surgery, after ESS, and after medial maxillectomy. Delivery was via pressurized spray (NasaMist), neti pot (NasaFlo), and squeeze bottle (Sinus Rinse). Scans were performed before and after each delivery with a portable CT machine (Xoran xCAT), and blinded assessments were made for distribution to individual sinuses. Total sinus distribution was greater post-ESS (P squeeze bottle > pressurized spray (P spray solutions in un-operated sinuses provide little more than nasal cavity distribution. Use of squeeze bottle/neti pot post-ESS offers a greatly enhanced ability to deliver solutions to the paranasal sinuses.

  4. Late recovery from foreign body sinusitis after maxillary sinus floor augmentation

    Science.gov (United States)

    Felisati, Giovanni; Saibene, Alberto Maria; Lenzi, Riccardo; Pipolo, Carlotta

    2012-01-01

    A 55-year-old male patient was referred to our clinic with signs and symptoms of recurring sinusitis after a right maxillary sinus floor augmentation for implantological purposes. Investigations showed an antibiotic-resistant ethmoidomaxillary sinusitis resulting from bone graft infection and displacement of previously inserted xenograft material into the maxillary sinus. The patient thus underwent a surgical procedure combining nasal endoscopy and oral surgery in order to remove the infected graft and restore sinusal drainage. The procedure was apparently successful but sinusitis relapsed after surgery and persisted despite 2 weeks of antibiotic therapy and local medications. A CT scan showed persistence of grafting fragments in the maxillary sinus. A new surgical procedure was scheduled while a more accurate endoscopic local medication was performed. Six hours after the treatment, the patient spontaneously expelled the fragments and promptly recovered. The patient successfully underwent another maxillary sinus floor augmentation procedure 6 months later. PMID:23234824

  5. Comprehensive review on endonasal endoscopic sinus surgery

    Science.gov (United States)

    Weber, Rainer K.; Hosemann, Werner

    2015-01-01

    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  6. Acute renal artery thrombosis after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Murat Özban

    2014-12-01

    Full Text Available Early kidney transplant loss as a result of acute thrombosis of the renal artery remains a constant and devastating complication, with an incidence of 0.2-7.5%. While uncommon, arterial obstruction in the early postoperative period is a surgical emergency and must be ruled out if previously established diuresis ceases suddenly. Arterial thrombosis may occur as a result of injury to a diseased artery, problems with anastomoses, hypercoagulability or malpositioning of the allograft. In this study, we analyzed data on a group of 105 renal transplant recipients who presented with acute postoperative graft dysfunction between January 2006 and May 2012, to identify cases of acute renal artery thrombosis. We report on our experience of immediate re-transplantation following early kidney transplant thrombosis. Overall, two (1.9% patients suffered early (within 48 hours of surgery allograft renal artery thrombosis. In both patients, transplantation had not been complicated by atherosclerotic lesions or other thrombophilic states and postoperative diuresis had been successfully achieved, but diuresis ceased abruptly during the early postoperative period. Emergent duplex ultrasound scans were performed and acute renal artery thrombosis was detected in both patients. The patients were operated immediately and retransplantation procedures were conducted. We have reported our experience of immediate retransplantation following early primary graft dysfunction due to renal artery thrombosis. In conclusion, close monitoring of postoperative diuresis and, if necessary, immediate retransplantation in this situation can prove to be a successful treatment for preventing graft loss.

  7. [Cerebral artery thrombosis in pregnancy].

    Science.gov (United States)

    Charco Roca, L M; Ortiz Sanchez, V E; Hernandez Gutierrez-Manchon, O; Quesada Villar, J; Bonmatí García, L; Rubio Postigo, G

    2015-11-01

    A 28 year old woman, ASA I, who, in the final stages of her pregnancy presented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Florid tuberculosis of the paranasal sinuses].

    Science.gov (United States)

    Andratschke, M; Nerlich, A G; Hagedorn, H

    2009-11-01

    Infections due to the Mycobacterium tuberculosis of the head and neck region mainly affect the cervical lymph nodes. We report a rare case of paranasal sinus tuberculosis. The patient presented as an emergency with right-sided headache and epiphora. Clinical, radiological and laboratory results yielded a diagnosis of acute exacerbated chronic sinusitis with meningeal affection resulting from transmigration. Histological and molecular investigations confirmed mycobacterial infection of the paranasal sinuses.

  9. Systemic corticosteroid therapy for acute sinusitis.

    Science.gov (United States)

    Venekamp, Roderick P; Thompson, Matthew J; Rovers, Maroeska M

    Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? Oral corticosteroids combined with antibiotics may be associated with modest benefit for short-term relief of symptoms in adults with severe symptoms of acute sinusitis compared with antibiotics alone. Oral corticosteroids as monotherapy are not associated with improved clinical outcomes in adults with clinically diagnosed acute sinusitis.

  10. Teratoma of the cavernous sinus: case report.

    Science.gov (United States)

    Pikus, H J; Holmes, B; Harbaugh, R E

    1995-05-01

    We report the case of an infant with a mature teratoma of the lateral wall of the cavernous sinus. A complete excision of the tumor was achieved. There was no evidence of recurrence at 1-year follow-up examination. Intracranial teratomas and the anatomy of the lateral wall of the cavernous sinus are briefly reviewed. To our knowledge, this is the first case of a teratoma confined to the cavernous sinus.

  11. Odontogenic sinusitis: an ancient but under-appreciated cause of maxillary sinusitis.

    Science.gov (United States)

    Patel, Nimish A; Ferguson, Berrylin J

    2012-02-01

    For well over 100 years, it has been appreciated that maxillary dental infections can cause sinusitis. This insight has been largely overlooked with the advent of functional endoscopic sinus surgery (ESS) and its emphasis on the osteomeatal complex. We review several recent case series and reviews of odontogenic sinusitis that characterize and discuss emerging diagnostic modalities in odontogenic sinusitis. In recent publications on odontogenic sinusitis, up to 40% of chronic bacterial maxillary sinus infections are attributed to a dental source, which is far higher than the previously reported incidence of 10%. Plain dental films and dental evaluations frequently fail to detect maxillary dental infection that can be causing odontogenic sinusitis. However, sinus computed tomography (CT) or Cone Beam Volumetric CT (CBVCT) are far more successful in identifying dental disease causing sinusitis. The microbial pathogens of odontogenic sinusitis remain unchanged from earlier reviews; however, the clinical findings in odontogenic sinusitis are better described in recent reviews. Successful treatment of odontogenic sinusitis requires management of the odontogenic source and may require concomitant or subsequent sinus surgery. Odontogenic sinusitis is frequently recalcitrant to medical therapy and usually requires treatment of the dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent ESS is required. Evaluation of all patients with persistent chronic rhinosinusitis (CRS) should include inspection of the maxillary teeth on CT scan for evidence of periapical lucencies. Unilateral recalcitrant disease associated with foul smelling drainage is especially characteristic of odontogenic sinusitis. High-resolution CT scans and CBVCT can assist in identifying dental disease.

  12. Systemic corticosteroids for acute sinusitis.

    Science.gov (United States)

    Venekamp, Roderick P; Thompson, Matthew J; Hayward, Gail; Heneghan, Carl J; Del Mar, Chris B; Perera, Rafael; Glasziou, Paul P; Rovers, Maroeska M

    2014-03-25

    Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal congestion. To assess the effects of systemic corticosteroids on clinical response rates and to determine adverse effects and relapse rates of systemic corticosteroids compared to placebo or standard clinical care in children and adults with acute sinusitis. We searched CENTRAL (2014, Issue 1), MEDLINE (1966 to February week 1, 2014) and EMBASE (January 2009 to February 2014). Randomised controlled trials (RCTs) comparing systemic corticosteroids to placebo or standard clinical care for patients with acute sinusitis. Two review authors independently assessed the methodological quality of the trials and extracted data. Five RCTs with a total of 1193 adult participants met our inclusion criteria. We judged methodological quality to be moderate in four trials and high in one trial. Acute sinusitis was defined clinically in all trials. However, the three trials performed in ear, nose and throat (ENT) outpatient clinics also used radiological assessment as part of their inclusion criteria. All participants were assigned to either oral corticosteroids (prednisone 24 mg to 80 mg daily or betamethasone 1 mg daily) or the control treatment (placebo in four trials and non-steroidal anti-inflammatory drugs (NSAIDs) in one trial). In four trials antibiotics were prescribed in addition to oral corticosteroids or control treatment, while one trial investigated the effects of oral corticosteroids as a monotherapy.When combining data from the five trials, participants treated with oral corticosteroids were more likely to have short-term resolution or improvement of symptoms than those receiving the control treatment: at days three to seven (risk ratio (RR) 1.3, 95% confidence interval (CI) 1.1 to 1

  13. Influence of tonsil size on sagittal cephalometric measurements.

    Science.gov (United States)

    Diouf, Joseph Samba; Ngom, Papa Ibrahima; Fadiga, Mohamed Siddick; Badiane, Alpha; Diop-Ba, Khady; Sonko, Ousmane; Diagne, Falou

    2015-06-01

    The role of tonsils in the origin of sagittal skeletodental abnormalities has been widely discussed in the literature but remains controversial. Data on the probable relationship between enlarged tonsils and the presence of these abnormalities were subjective. The aim of this study was to quantify the relationship between the space occupied by the palatine tonsils and sagittal cephalometric measurements. A cross-sectional study was performed on a group of children divided into 5 subgroups according to the standardized tonsillar hypertrophy grading scale. Cephalometric measurements were recorded for each child. Data were analyzed using SPSS 20.0 for Windows. The strength of the association between tonsil grades and quantitative variables was assessed using Spearman's rank correlation coefficient (Rho). The level of significance was fixed at P=0.05. Lengths SN, t2-p3, h-Gn and Xi-pm, and angles I/F, I/SN, i/M, SNB, SNPog and SNGn were significantly and negatively correlated with grades. The ANB angle, the sagittal position of the pogonion and the angle of facial convexity were significantly and positively correlated with grades. Early evaluation of tonsil size can prevent certain skeletodental abnormalities in the sagittal plane caused by upper airway obstruction. Thus, more aggressive late treatments, which are not always as effective as when they are performed during childhood, can be avoided. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

  14. Bilateral sagittal split osteotomy versus distraction osteogenesis for mandibular advancements

    NARCIS (Netherlands)

    Baas, E.M.

    2015-01-01

    The aim of this thesis was to compare the treatment modality of distraction osteogenesis (DO) with the gold standard for mandibular advancement surgery. In fact we compare distraction osteogenesis with the standard of care, which is a conventional bilateral sagittal split osteotomy as described by

  15. CHANGES IN THE SAGITTAL BALANCE IN CONGENITAL SCOLIOSIS CORRECTION SURGERY

    Directory of Open Access Journals (Sweden)

    José Antonio Mancuso Filho

    Full Text Available ABSTRACT Objective: This study aimed to determine whether surgery leads to changes in sagittal balance in patients with congenital scoliosis. Methods: We retrospectively reviewed all cases of scoliosis operated in a tertiary hospital between January 2009 and January 2013. In all cases the deformity in the coronal and sagittal planes, kyphosis, and lordosis were measured, using the Cobb method, and spinopelvic parameters: pelvic incidence (PI, sacral slope (SS, and pelvic tilt (PT. Results A hundred and eleven medical records were analyzed, but the sample resulted in 10 patients, six of whom were females (60%. The average age was 13.4 years. In the comparative analysis between pre and postoperative, only the coronal deformity (12.37; CI 95% [7.88-16.86]; p<0.001, the sagittal deformity (12.71; CI 95% [4.21-21.22]; p=0.011, and the lumbar lordosis (9.9; CI 95% [0.38-19.42]; p=0.043 showed significant change. Conclusion: There was no change in the spinopelvic parameters of patients with congenital scoliosis undergoing surgery at IOF-FMUSP between 2009 and 2013; however, it was observed decrease in lumbar lordosis, and deformity angle in the sagittal and coronal planes.

  16. Lenke 1 and 5: changes in sagittal balance

    Directory of Open Access Journals (Sweden)

    Delson Valdemir Pessin

    2014-09-01

    Full Text Available OBJECTIVE: To assess in a cross-sectional study whether there are changes in sagittal balance in patients with adolescent idiopathic scoliosis Lenke types 1 and 5 compared with patients without pathology of the spine and compare the values of the parameters of normal subjects with the parameters found in the literature. METHODS: We measured the values of the parameters of sagittal balance of 21 patients with scoliosis and 14 patients without scoliosis in panoramic radiographs or simply collected data previously measured from the medical records. We compared the mean values of normal subjects, the mean values found in the literature, and the means between normal subjects and patients with scoliosis. For this, we used the Student t test. RESULTS: Using a confidence interval of 5% (p < 0.05 and the Student t test we obtained statistical significance in the comparison of two parameters of sagittal balance between normal subjects and patients with scoliosis. We observed similarities in the measurements of the average parameters of normal subjects with regard to the work already published. CONCLUSIONS: The adolescent idiopathic scoliosis causes changes in two parameters of sagittal balance with statistical significance but suggests changes in all other parameters. As for comparison with previously published work, the results were similar.

  17. Intra-operative complications in sagittal and vertical ramus osteotomies

    NARCIS (Netherlands)

    van Merkesteyn, J. P.; Groot, R. H.; van Leeuwaarden, R.; Kroon, F. H.

    1987-01-01

    In orthognatic surgery of the mandibular ramus, intra-operative complications as a lesion of the inferior alveolar nerve, fractures of the osteotomised segments, incomplete sectioning, malpositioning of segments and haemorrhage may occur. In this report, intra-operative complications in 124 sagittal

  18. Giant osteoma of the ethmoidal sinus

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2009-06-01

    Full Text Available Introduction: The osteomas are osseous lesions with slow and asymptomatic growth that most of the times is a finding in radiological exams requested for other reason. It's the most common benign neoplasm of the paranasal sinuses. The osteomas are located mainly in the frontal sinus (57% to 80%, followed by the ethmoidal sinuses (20%, maxillary sinuses and rarely in the sphenoid sinus. It has a discreet predominance in the male sex 1.5 and its incidence is higher in the 3rd and 4th decades of life. The treatment is surgical no matter the size. Objective: To describe a case of giant osteoma of the ethmoidal sinus including a brief literature review. Case Report: JDA, male, 33 years old, presented with a right constant nasal obstruction for 01 year. Upon exam, he presented with facial asymmetry with lateralization of the right ocular globe. The computed tomography of the paranasal sinuses showed a lesion with density of soft parts occupying partially the right nasal cavity, ethmoid sinus and right maxillary. The patient was submitted to surgery with full exeresis of the lesion. The anatomopathological exam confirmed osteoma. The patient evolved without evidences of the lesion recurrence. Final Comments: The osteomas in the ethmoidal sinus, irrespectively of the size and due to the risk of complications, must be operated.

  19. Treatment of chronic sinusitis in a horse with systemic and intra-sinus antimicrobials.

    Science.gov (United States)

    Gordon, Danielle L; Radtke, Catherine L

    2017-03-01

    A 12-year-old Norwegian Fjord gelding was diagnosed with paranasal sinusitis as a post-operative complication of tooth repulsion surgery. The infection with inspissated purulent material persisted despite sinus trephination and lavage, and systemic antimicrobial therapy. Resolution occurred following infusion of a gelatin/penicillin mixture into the right rostral and caudal maxillary sinus.

  20. Compensatory mechanisms contributing to keep the sagittal balance of the spine

    National Research Council Canada - National Science Library

    Barrey, Cédric; Roussouly, Pierre; Le Huec, Jean-Charles; D’Acunzi, Gennaro; Perrin, Gilles

    2013-01-01

    .... For the two last stages, the compensatory mechanisms permit to limit the consequences of loss of lumbar lordosis on global sagittal alignment and therefore contribute to keep the sagittal balance...

  1. Sagittal plane biomechanics cannot injure the ACL during sidestep cutting.

    Science.gov (United States)

    McLean, Scott G; Huang, Xuemei; Su, Anne; Van Den Bogert, Antonie J

    2004-10-01

    Knee joint sagittal plane forces are a proposed mechanism of anterior cruciate ligament injury during sport movements such as sidestep cutting. Ligament force magnitudes for these movements however, remain unknown. The need to examine injury-causing events suggests elucidation via model-based investigations is possible. Using this approach, the current study determined whether sagittal plane knee loading during sidestep cutting could in isolation injure the anterior cruciate ligament. Experiments were performed on subject-specific forward dynamic musculoskeletal models, generated from data obtained from 10 male and 10 female athletes. Models were optimized to simulate subject-specific cutting movements. Random perturbations (n=5000) were applied to initial contact conditions and quadriceps/hamstrings activation levels to simulate their effect on peak 3D knee loads. Injury via the sagittal plane mechanism was based on the criterion of an anterior drawer force greater than 2000 N. Realistic neuromuscular perturbations produced significant increases in external knee anterior force and valgus and internal rotation moments. Peak anterior drawer force never exceeded 2000 N in any model, and thus failed to cause anterior cruciate ligament injuries. Valgus loads reached values that were high enough to rupture the ligament, occurring more frequently in females than in males. Sagittal plane knee joint forces cannot rupture the anterior cruciate ligament during sidestep cutting. The interaction between muscle and joint mechanics and external ground reaction forces in this plane, places a ceiling on ligament loads. Valgus loading is a more likely injury mechanism, especially in females. Modifying sagittal plane biomechanics will thus unlikely contribute to the prevention of anterior cruciate ligament injuries.

  2. Developing a System for Efficient Analysis of Lumbosacral Sagittal Balance

    Directory of Open Access Journals (Sweden)

    D. M. Zhuk

    2015-01-01

    Full Text Available Lumbosacral sagittal balance is the neutral vertical alignment in the sagittal plane to provide decreasing stress loading on muscular-ligamentous structures. The achieving sagittal balance is a basis to provide successful surgical treatment and minimize further complications. As of today, there is no standard quantitative evaluation method of sagittal lumbo-sacral balance, which allows conducting its effective analysis and planning surgical treatment taking into consideration the preservation of normal biomechanics of lumbosacral spine. The goal of the study is to develop a diagnostic system for individual correction of lumbo-sacral sagittal balance by the author’s method with automatic counting and optimized matching of data values based on a specified number of terms using medical visualization data. This study has been conducted with RMAPE’s Department of Traumatology and Orthopedic Surgery. To solve the problem, a random searching algorithm has been exploited. The stop condition of the algorithm was to achieve the objective function value in adjusted interval, initial points of which are the calculated (angular values. The interaction of the angular values, used in the proposed method has been investigated, and their proportional change has been proved. Moreover, the mathematical dependence among geometrical and anatomical parameters of lumbosacral spine has been determined. Based on conducted study, a number of algorithms enabling the automation of the individual determination of optimal lumbosacral balance’s parameters at preoperative planning stage for patients with vertebral column diseases have been created. This allows us to raise physician’s efficiency, minimize mid- and long-term risk of postoperative complications, and avoid reoperations, and prognosticate long-term complications already performed surgery.

  3. Bilateral orbital abscesses with subdural empyema and cavernous sinus thrombosis due to melioidosis in a child

    Directory of Open Access Journals (Sweden)

    Jayaraman Kogilavaani

    2014-09-01

    Full Text Available Orbital cellulitis is an emergency situation in children. Rapid diagnosis and appropriate management are mandatory to save both vision and life. In contrast, melioidosis infection causing orbital cellulitis with intracranial infection is a rare situation in children, and requires an aggressive management. Poor response or worsening of clinical condition despite appropriate management of paediatric orbital cellulitis should alert the physician of this devastating infection, especially when it occurs in those living in endemic areas.

  4. Treating Sinusitis: Don't Rush to Antibiotics

    Science.gov (United States)

    ... AAAAI) Treating Sinusitis (AAAAI) Don’t rush to antibiotics DOWNLOAD PDF The sinuses are small, hollow spaces ... or teeth. Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually ...

  5. Arterial thrombosis in the antiphospholipid syndrome

    NARCIS (Netherlands)

    Urbanus, R.T|info:eu-repo/dai/nl/304818402

    2008-01-01

    The antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease that mainly affects young women. The syndrome is characterized by recurrent thrombosis or pregnancy morbidity in association with the persistent serological presence of antiphospholipid antibodies. Antiphospholipid

  6. Successful Thrombolysis of Aortic Prosthetic Valve Thrombosis ...

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    threatening. Standard surgical treatment using cardiopulmonary bypass carries high maternal and fetal complications. Here we report a case of an antenatal female in first trimester with aortic prosthetic valve thrombosis (PVT), who was successfully ...

  7. Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Vidal, Christophe; Ilharreborde, Brice; Azoulay, Robin; Sebag, Guy; Mazda, Keyvan

    2013-06-01

    Radiological reproducibility study. To assess intra and interobserver reliability of radiographic measurements for global sagittal balance parameters and sagittal spine curves, including cervical spine. Sagittal spine balance in adolescent idiopathic scoliosis (AIS) is a main issue and many studies have been reported, showing that coronal and sagittal deformities often involve sagittal cervical unbalance. Global sagittal balance aims to obtain a horizontal gaze and gravity line at top of hips when subject is in a static position, involving adjustment of each spine curvature in the sagittal plane. To our knowledge, no study did use a methodologically validated imaging analysis tool able to appreciate sagittal spine contours and distances in AIS and especially in the cervical region. Lateral full-spine low-dose EOS radiographs were performed in 75 patients divided in three groups (control subjects, AIS, operated AIS). Three observers digitally analyzed twice each radiograph and 11 sagittal measures were collected for each image. Reliability was assessed calculating intraobserver Pearson's r correlation coefficient, interobserver intra-class correlation coefficient (ICC) completed with a two-by-two Bland-Altman plot analysis. This measurement method has shown excellent intra and interobserver reliability in all parameters, sagittal curvatures, pelvic parameters and global sagittal balance. This study validated a simple and efficient tool in AIS sagittal contour analysis. It defined new relevant landmarks allowing to characterize cervical segmental curvatures and cervical involvement in global balance.

  8. Lupus anticoagulant, factor V Leiden, and methylenetetrahydrofolate reductase gene mutation in a lupus patient with cerebral venous thrombosis.

    Science.gov (United States)

    Uthman, Imad; Khalil, Ismail; Sawaya, Raja; Taher, Ali

    2004-08-01

    We describe the case of a young Lebanese woman with systemic lupus erythematosus (SLE) and a positive lupus anticoagulant (LAC) who developed right internal jugular vein and sigmoid sinus thrombosis. Coagulation studies showed that in addition to the LAC the patient was heterozygous for the factor V (FV) Leiden mutation, and C677T mutation of the methylenetetrahydrofolate reductase gene. The high prevalence of FV Leiden in the eastern Mediterranean region suggests that we should probably screen our SLE patients in this area, especially those with anticardiolipin antibodies and/or LAC who have no history of thrombosis, for this and other thrombophilia markers. The detection of such abnormalities may have major practical consequences for the long-term management of these patients to prevent further thrombotic episodes.

  9. Allergic fungal sinusitis in children.

    Science.gov (United States)

    Thorp, Brian D; McKinney, Kibwei A; Rose, Austin S; Ebert, Charles S

    2012-06-01

    Allergic fungal sinusitis (AFS) is a subtype of eosinophilic chronic rhinosinusitis (CRS) characterized by type I hypersensitivity, nasal polyposis, characteristic computed tomography scan findings, eosinophilic mucus, and the presence of fungus on surgical specimens without evidence of tissue invasion. This refractory subtype of CRS is of the great interest in the pediatric population, given the relatively early age of onset and the difficulty in managing AFS through commercially available medical regimens. Almost universally, a diagnosis of AFS requires operative intervention. Postoperative adjuvant medical therapy is a mainstay in the treatment paradigm of pediatric AFS. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Aneurismatisk knoglecyste i sinus maxillaris

    DEFF Research Database (Denmark)

    Danielsen, Annegrete Aalkjær; Jensen, Margarat Malgorzata; Iyer, Victor Vishwanath

    2017-01-01

    This case report describes a primary aneurysmal bone cyst in the maxillary sinus of a 50-year-old woman. She had nonspecific symptoms through four years of tearing, muscle tension in the face and neck as well as a sense of altered sound of speech. A magnetic resonance imaging of the facial skeleton...... showed multiple cystic processes with liquid mirror in nearly all large cysts. Histology confirmed the diagnosis of a rare aneurysmal bone cyst, and the operation was done by endoscopic resection. At the one-month post-operative control there was no recurrence....

  11. Recent Advances in Computational Modeling of Thrombosis

    OpenAIRE

    Yesudasan, Sumith; Averett, Rodney D.

    2018-01-01

    The study of thrombosis is crucial to understand and develop new therapies for diseases like deep vein thrombosis, diabetes related strokes, pulmonary embolism etc. The last two decades have seen an exponential growth in studies related to the blood clot formation using computational tools and through experiments. Despite of this growth, the complete mechanism behind thrombus formation and hemostasis is not known yet. The computational models and methods used in this context are diversified i...

  12. Mesenteric venous thrombosis: multidisciplinary therapeutic approach

    Directory of Open Access Journals (Sweden)

    Stefano Pieri

    2007-08-01

    Full Text Available Mesenteric venous thrombosis is a particular form of intestinal ischemia related to high mortality. The lack of a characteristic clinical picture often leads to a difficult diagnostic and therapeutic classification. We report the case of a young woman, using estrogenic and progestinic oral therapy, affected by a severe form of mesenteric thrombosis and complicated by segmental post ischemic stenosis of small intestine.

  13. Prothrombotic Fibrin Clot Phenotype in Patients with Deep Vein Thrombosis and Pulmonary Embolism: A New Risk Factor for Recurrence

    Directory of Open Access Journals (Sweden)

    Anetta Undas

    2017-01-01

    Full Text Available Prothrombotic fibrin clot phenotype, involving faster formation of dense meshwork composed of thinner and highly branched fibers that are relatively resistant to plasmin-induced lysis, has been reported in patients with not only myocardial infarction or stroke, but also venous thromboembolism (VTE, encompassing deep vein thrombosis (DVT, and/or pulmonary embolism (PE. Prothrombotic fibrin clot phenotype, in particular prolonged clot lysis time, is considered a novel risk factor for VTE as well as venous thrombosis at unusual location, for example, cerebral sinus venous thrombosis, retinal vein obstruction, and Budd-Chiari syndrome. Growing evidence from observational studies indicates that abnormal fibrin clot properties can predict recurrent DVT and PE and they are involved in serious complications of VTE, for example, thromboembolic pulmonary hypertension and postthrombotic syndrome. The purpose of this article is to review our current understanding of the role of fibrin clot structure and function in venous thrombosis with emphasis on clinical issues ranging from prognosis to therapy.

  14. Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation.

    Science.gov (United States)

    Drăgan, Eliza; Rusa, Oana; Nemţoi, A; Melian, G; Mihai, C; Haba, Danisia

    2014-01-01

    An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation. 120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT. Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05). The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.

  15. The role of the uncinate process in sinusitis aetiology: isolated agenesis versus maxillary sinus hypoplasia.

    Science.gov (United States)

    Uluyol, S; Arslan, İ B; Demir, A; Mercan, G C; Dogan, O; Çukurova, İ

    2015-05-01

    This study aimed to evaluate the clinical significance of maxillary sinus hypoplasia and isolated agenesis of the uncinate process in sinusitis aetiology. Three patients with isolated agenesis of the uncinate process and 27 patients with 43 maxillary sinus hypoplasia variations were recruited. The frequencies of sinusitis episodes and radiological findings were compared between patient subgroups. In all, 23 type I maxillary sinus hypoplasia, 13 type II maxillary sinus hypoplasia and 7 type III maxillary sinus hypoplasia variations were detected. Patients with isolated agenesis of the uncinate process underwent antibiotic treatment an average of 7 times per year, whereas those with types I, II and III maxillary sinus hypoplasia were treated 1.57, 3.22, and 5.75 times per year, respectively, over a 5-year period. The antibiotic treatment frequency for patients with isolated agenesis of the uncinate process was significantly higher than for those with types I and II maxillary sinus hypoplasia. Isolated agenesis of the uncinate process seems to play a stronger role than types I and II maxillary sinus hypoplasia in the pathophysiology of chronic sinusitis.

  16. 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

  17. GENETIC PREDICTORS OF IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    A. A. Chernova

    2012-01-01

    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  18. carcinome a petites cellules du sinus piriforme

    African Journals Online (AJOL)

    Les auteurs rapportent un cas de localisation au sinus piriforme d'un carcinome à petites cellules. Ce type histologique a été souvent décrit dans la pathologie tumorale pulmonaire. Sa localisation au sinus piriforme étant exceptionnelle. Nous présentons dans ce document les aspects endoscopiques, radiologiques, ...

  19. Pseudocystic CT pattern of renal sinus lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Downey, E.F. Jr.; Friedman, A.C.; Hartman, D.S.; Pyatt, R.S.; Thane, T.T.; Warnock, G.R.

    1982-09-01

    Previous reports of renal sinus lipomatosis (RSL) have emphasized the CT finding of increased fat around the renal pelvis. The authors present a case in which the CT density of the renal sinus was the same as water. This density appears to depend on the relative amounts of fat and fibrous tissue present.

  20. Mucocele formation after frontal sinus obliteration

    NARCIS (Netherlands)

    Hansen, F. S.; van der Poel, N. A.; Freling, N. J. M.; Fokkens, W. J.

    2018-01-01

    A possible complication of frontal sinus obliteration with fat is the formation of mucoceles. We studied the prevalence of mucoceles as well as and the need for revision surgery. Retrospective case review of forty consecutive patients undergoing frontal sinus obliteration from September 1995 to

  1. Chronic Cutaneous Draining Sinus of Dental Origin

    African Journals Online (AJOL)

    surgery. It can also result from infection or inflammation. The root canal of a necrotic tooth is a source of predominantly anaerobic microbes. The tooth may present without any symptoms, except a cutaneous draining sinus.[1] Due to the extra-oral location of the sinus, patients tend to seek medical care first. These cutaneous.

  2. Sinus floor bone failures in maxillary sinus floor augmentation: a case-control study.

    Science.gov (United States)

    Cortes, Arthur Rodriguez Gonzalez; Pinheiro, Lucas Rodrigues; Cavalcanti, Marcelo Gusmão Paraíso; Arita, Emiko Saito; Tamimi, Faleh

    2015-04-01

    Extreme bone resorption in posterior maxilla may lead to absence of part of the sinus floor. This phenomenon has been termed sinus floor bone failure, and may compromise sinus floor augmentation. The present article aims to evaluate risk factors related to sinus floor bone failures and to evaluate the influence of these failures in sinus floor augmentation outcomes in patients with severely atrophic posterior maxilla. In this case-control study, patients were selected among those referred for sinus floor augmentation. Only patients presenting a ridge bone height of less than 3 mm were included. Cases were defined as presenting sinus floor bone failure, whereas controls did not present any interruption in the sinus floor bone. Information collected included clinical dental records and computed tomographic assessment of sinus width, septa, and schneiderian membrane. Risk estimates for sinus floor bone failures were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression analyses. A p value under 0.05 was considered statistically significant. In addition, sinus floor augmentation outcomes of both groups were also assessed. In all, 23 cases and 58 controls were included in the study. Sinus floor bone failures were significantly associated with the number of missing posterior teeth (AOR 3.67; 95% CI 0.86 to 15.63; p = .046) and a history of periodontitis (AOR 6.39; 95% CI 1.86 to 21.95; p = .002). Of the total, 15 cases and 27 controls underwent sinus floor augmentation. Schneiderian membrane perforation occurred during the surgery of two cases and of one control. No implants were lost during a mean postsurgical follow-up of 20 months. The number of missing posterior teeth and a history of periodontitis may be considered as risk factors for sinus floor bone failures. © 2013 Wiley Periodicals, Inc.

  3. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    Science.gov (United States)

    Crovetto-Martínez, Rafael; Martin-Arregui, Francisco J.; Zabala-López-de-Maturana, Aitor; Tudela-Cabello, Kiara

    2014-01-01

    Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study Design: This is a retrospective cohort study performed on 55 patients diagnosed of odontogenic sinusitis and treated surgically by functional endoscopic sinus surgery. Results: This study showed that 52.7% of odontogenic maxillary sinusitis spreads to anterior ethmoid, causing added anterior ethmoid sinusitis. We found that 92.3% of the odontogenic maxillary sinusitis (who underwent middle meatal antrostomy) and 96.5% of the odontogenic maxillary sinusitis extended to the anterior ethmoid (treated with middle meatal antrostomy and anterior ethmoidectomy) were cured. Conclusions: Ethmoid involvement is frequent in maxillary odontogenic sinusitis. The ethmoid involvement does not worsen the results of “functional endoscopic sinus surgery” applied to the odontogenic sinusitis. Key words:Odontogenic maxillary sinusitis, ethmoiditis, functional endoscopic sinus surgery. PMID:24608208

  4. Pilonidal sinus – challenges and solutions

    Directory of Open Access Journals (Sweden)

    Guner A

    2015-09-01

    Full Text Available Ali Guner, Arif Burak Cekic Department of General Surgery, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey Abstract: Although it is clinically asymptomatic in some cases, pilonidal sinus disease may also present as a complicated disease, characterized by multiple sinus tracts, leading to severe impairment of patient quality of life. Although clinical studies of pilonidal sinus have been conducted for approximately a century, the gold standard for treatment is undefined. The ideal treatment requires a shorter hospital stay, requires less wound care, results in rapid recovery, maintains quality of life, and has low recurrence rates. In this review, we aim to discuss the challenges and possible solutions for the management of pilonidal sinus disease. Keywords: pilonidal sinus disease, surgery, management, complications, recurrence

  5. Bilateral inferior petrosal sinus sampling.

    Science.gov (United States)

    Zampetti, Benedetta; Grossrubatscher, Erika; Dalino Ciaramella, Paolo; Boccardi, Edoardo; Loli, Paola

    2016-07-01

    Simultaneous bilateral inferior petrosal sinus sampling (BIPSS) plays a crucial role in the diagnostic work-up of Cushing's syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88-100% and 67-100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50-70%) makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres. © 2016 The authors.

  6. Bilateral inferior petrosal sinus sampling

    Directory of Open Access Journals (Sweden)

    Benedetta Zampetti

    2016-08-01

    Full Text Available Simultaneous bilateral inferior petrosal sinus sampling (BIPSS plays a crucial role in the diagnostic work-up of Cushing’s syndrome. It is the most accurate procedure in the differential diagnosis of hypercortisolism of pituitary or ectopic origin, as compared with clinical, biochemical and imaging analyses, with a sensitivity and specificity of 88–100% and 67–100%, respectively. In the setting of hypercortisolemia, ACTH levels obtained from venous drainage of the pituitary are expected to be higher than the levels of peripheral blood, thus suggesting pituitary ACTH excess as the cause of hypercortisolism. Direct stimulation of the pituitary corticotroph with corticotrophin-releasing hormone enhances the sensitivity of the procedure. The procedure must be undertaken in the presence of hypercortisolemia, which suppresses both the basal and stimulated secretory activity of normal corticotrophic cells: ACTH measured in the sinus is, therefore, the result of the secretory activity of the tumor tissue. The poor accuracy in lateralization of BIPSS (positive predictive value of 50–70% makes interpetrosal ACTH gradient alone not sufficient for the localization of the tumor. An accurate exploration of the gland is recommended if a tumor is not found in the predicted area. Despite the fact that BIPSS is an invasive procedure, the occurrence of adverse events is extremely rare, particularly if it is performed by experienced operators in referral centres.

  7. Transorbital Cavernous Sinus Direct Puncture : Alternative to treat dural arteriovenous fistula.

    Science.gov (United States)

    Trivelato, Felipe Padovani; Manzato, Luciano Bambini; Filho, Paulo Moacir Mesquita; Ulhôa, Alexandre Cordeiro; Vanzin, José Ricardo; Abud, Daniel Giansante; Rezende, Marco Túlio Salles

    2016-08-09

    The authors present a retrospective series of their clinical experience in the treatment of cavernous dural arteriovenous fistulas (DAVF) by direct transorbital puncture of the cavernous sinus as an alternative to the endovascular approach. Between October 2012 and September 2014, eight patients harboring cavernous DAVF underwent percutaneous treatment by direct transorbital puncture of the cavernous sinus at three institutions. All patients presented with ocular symptoms. Standard endovascular approaches, including transvenous and transarterial routes, were primarily attempted without success in all cases. Direct puncture was performed through two different approaches, namely inferolateral and superomedial. The entry point was the inferior and superior eyelid, respectively. Embolization was performed with coils or Onyx (Covidien, Irvine, CA). Immediate and late angiographies were used to evaluate the occlusion of the fistula. Of the patients seven had complete occlusion of the cavernous DAVFs noted on the immediate and follow-up angiograms and one patient had residual filling but reduction of the shunt resulted in clinical improvement. None of the patients had worsening of neurological function. One case was complicated by inadvertent internal carotid puncture but without clinical manifestations. One patient experienced postoperative superior ophthalmic vein thrombosis. In very specific cases, when endovascular access is not possible or fails to occlude cavernous DAVF, direct transorbital puncture of the cavernous sinus was shown to be feasible, safe and very effective.

  8. Clinical Features and Treatments of Odontogenic Sinusitis

    Science.gov (United States)

    Lee, Sung Jin

    2010-01-01

    Purpose The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis. Also, this study was designed to find methods for reducing the incidence of odontogenic sinusitis. Materials and Methods A retrospective chart analysis was completed on twenty-seven patients with odontogenic sinusitis. They were all treated at Kangbuk Samsung Hospital between February 2006 and August 2008. The study protocol and informed consent forms were approved by the institutional review boards for human beings at Kangbuk Samsung Hospital. Results Ten patients (37.0%) had dental implant related complications and 8 (29.6%) had dental extraction related complications. Unilateral purulent nasal discharge was the most common symptom (66.7%). The therapeutic modality included transnasal endoscopic sinus surgery in 19 (70.4%) patients, and a Caldwell-Luc operation in two (7.4%) patients. Conclusion In our study, there was no significant difference in the incidence between genders. The average age of the patients was 42.9 years. The incidence was highest in the fourth decade. There were no significant differences between the symptoms of odontogenic sinusitis and that of other types of sinusitis. However, almost all of the patients with odontogenic sinusitis had unilateral symptoms. Iatrogenic causes, which include dental implants and dental extractions, were the most common etiologic factors related to the development of odontogenic sinusitis. Therefore, a preoperative consultation between a rhinologist and a dentist prior to the dental procedure should be able to reduce the incidence of odontogenic sinusitis. PMID:20879062

  9. Temporomandibular joint computed tomography: development of a direct sagittal technique

    Energy Technology Data Exchange (ETDEWEB)

    van der Kuijl, B.; Vencken, L.M.; de Bont, L.G.; Boering, G. (Univ. of Groningen, (Netherlands))

    1990-12-01

    Radiology plays an important role in the diagnosis of temporomandibular disorders. Different techniques are used with computed tomography offering simultaneous imaging of bone and soft tissues. It is therefore suited for visualization of the articular disk and may be used in patients with suspected internal derangements and other disorders of the temporomandibular joint. Previous research suggests advantages to direct sagittal scanning, which requires special positioning of the patient and a sophisticated scanning technique. This study describes the development of a new technique of direct sagittal computed tomographic imaging of the temporomandibular joint using a specially designed patient table and internal light visor positioning. No structures other than the patient's head are involved in the imaging process, and misleading artifacts from the arm or the shoulder are eliminated. The use of the scanogram allows precise correction of the condylar axis and selection of exact slice level.

  10. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review

    NARCIS (Netherlands)

    Wichers, Iris M.; Di Nisio, Marcello; Büller, Harry R.; Middeldorp, Saskia

    2005-01-01

    The aim of this systematic review was to summarize the evidence from randomized controlled trials (RCT) concerning the efficacy and safety of medical or surgical treatments of superficial vein thrombosis (SVT) for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE). A

  11. Interleukin 8 and venous thrombosis: evidence for a role of inflammation in thrombosis

    NARCIS (Netherlands)

    van Aken, Benien E.; Reitsma, Pieter H.; Rosendaal, Frits R.

    2002-01-01

    Elevated plasma levels of interleukin 8 (IL-8) were previously shown to be associated with recurrent venous thrombosis. To assess the risk of venous thrombosis, IL-8 plasma concentrations were measured in patients and control subjects of the Leiden Thrombophilia Study (LETS). This population based

  12. Posterior sagittal pararectal approach with rectal mobilization for repair of rectourethral fistula: an alternative approach.

    Science.gov (United States)

    Abdalla, Medhat Ahmed

    2009-05-01

    To present this clinical series to report our initial experience with our technique as an alternative approach for treatment of rectourethral fistulas (RUFs). RUFS are a devastating complication of the urinary tract. The most appropriate approach remains controversial. From March 2002 to August 2007, 8 patients with RUF were referred to our institution. The etiology of the RUF was a fractured pelvis in 2, radical prostatectomy in 1, transurethral resection of the prostate in 1, anterior bowel resection in 1, and a pull-through operation in 3. Of the 8 patients, 5 had undergone urinary diversion and 3 had undergone a previous repair that had failed. They were evaluated and treated using the posterior sagittal approach with rectal mobilization. The fistulas were excised, and both the urethra and rectum were repaired. The inferior half of the gluteus maximus muscle was used as barrier in 5 of the 8 patients. The operative and immediate and late postoperative complications were recorded. The clinical outcome was defined as success when the patients experienced no fecaluria or pneumaturia. All 8 patients, with a mean age of 38.7 years, were completely cured of their RUF. The mean operative time was 290 minutes, and the mean blood loss was 637.5 mL. The median hospital stay was 18 days. Early postoperative complications included wound infection in 1 and deep vein thrombosis in 1 patient. One patient developed a late complication of urinary incontinence. Our approach is safe, provides excellent exposure, and allows for dissection under direct vision. The gluteus maximus flap is a good, nearby flap that can be used with minimal host morbidity.

  13. Sagittal plane deformity: an overview of interpretation and management.

    Science.gov (United States)

    Roussouly, Pierre; Nnadi, Colin

    2010-11-01

    The impact of sagittal plane alignment on the treatment of spinal disorders is of critical importance. A failure to recognise malalignment in this plane can have significant consequences for the patient not only in terms of pain and deformity, but also social interaction due to deficient forward gaze. A good understanding of the principles of sagittal balance is vital to achieve optimum outcomes when treating spinal disorders. Even when addressing problems in the coronal plane, an awareness of sagittal balance is necessary to avoid future complications. The normal spine has lordotic curves in the cephalad and caudal regions with a kyphotic curve in between. Overall, there is a positive correlation between thoracic kyphosis and lumbar lordosis. There are variations on the degree of normal curvature but nevertheless this shape allows equal distribution of forces across the spinal column. It is the disruption of this equilibrium by pathological processes or, as in most cases, ageing that results in deformity. This leads to adaptive changes in the pelvis and lower limbs. The effects of limb alignment on spinal posture are well documented. We now also know that changes in pelvic posture also affect spinal alignment. Sagittal malalignment presents as an exaggeration or deficiency of normal lordosis or kyphosis. Most cases seen in clinical practise are due to kyphotic deformity secondary to inflammatory, degenerative or post-traumatic disorders. They may also be secondary to infection or tumours. There is usually pain and functional disability along with concerns about self-image and social interaction due to inability to maintain a horizontal gaze. The resultant pelvic and lower limb posture is an attempt to restore normal alignment. Addressing this complex problem requires detailed expertise and awareness of the potential pitfalls surrounding its treatment.

  14. Sagittal spinopelvic balance in normal children and adolescents.

    Science.gov (United States)

    Mac-Thiong, Jean-Marc; Labelle, Hubert; Berthonnaud, Eric; Betz, Randal R; Roussouly, Pierre

    2007-02-01

    The sagittal spinopelvic balance is poorly documented in normal pediatric subjects. The purpose of this study is to characterize the sagittal spinopelvic balance in the pediatric population and to evaluate the correlations between spinopelvic parameters. Seven parameters were evaluated from the lateral standing radiographs of 341 normal subjects aged 3-18 years old: thoracic kyphosis (TK), thoracic tilt (TT), lumbar lordosis (LL), lumbar tilt (LT), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI). The mean values for the pelvic parameters were 49.1+/-11.0, 7.7+/-8.0 and 41.4+/-8.2 degrees for PI, PT and SS, respectively. The mean values for the spinal parameters were 48.0+/-11.7, 44.0+/-10.9, -7.3+/-5.2 and -3.1+/-5.2 degrees for LL, TK, LT and TT, respectively. The spinopelvic parameters were different from those reported in normal adults, but the correlations between the parameters were similar. PI was significantly related to SS and PT. Significant correlations were found between the parameters of adjacent anatomical regions. Pelvic morphology (PI) regulates sagittal sacro-pelvic orientation (SS and PT). Sacral orientation (SS) is correlated with the shape (LL) and orientation (LT) of the lumbar spine. Adjacent anatomical regions of the spine and pelvis are interdependent, and their relationships result in a stable and compensated posture, presumably to minimize energy expenditure. Results from this study could be used as an aid for the planning of surgery in pediatric patients with spinal deformity in order to restore a relatively normal sagittal spinopelvic balance.

  15. Classification of normal sagittal spine alignment: refounding the Roussouly classification.

    Science.gov (United States)

    Laouissat, Féthi; Sebaaly, Amer; Gehrchen, Martin; Roussouly, Pierre

    2017-04-28

    Although the Roussouly classification of common variants in spinal sagittal alignment is well accepted, no studies have implemented it in an asymptomatic adult population. In addition, no study investigated the radiographic features of asymptomatic patients with an anteverted pelvis. The aim of this prospective radiographic study of 296 asymptomatic adults without spinal pathology was to investigate how the Roussouly classification could include the anteverted pelvis concept. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and the lumbar parameters lumbar lordosis (Global LL), lordosis tilt angle (LTA), total number of lordotic vertebra (LL verteb), and C7 plumbline/sacrofemoral distance ratio (C7PL ratio) were evaluated in 296 healthy volunteers (126 males, 170 females; mean age, 27 years; range 18-48 years). Comparison between the five types of the Roussouly classification used Student, ANOVA, and Tukey tests for quantitative variables and χ (2), Fischer, and Holm tests for qualitative variables. Mean PI and PT were, respectively, (39°, 10°) for type 1, (41°, 10°) for type 2, (53°, 13°) for type 3, and (62°, 12°) for type 4 (p  35°. PT was low or negative (mean 4° ± 3°). C7PL ratio was >1 (in front of the hip axis) in 13% of all cases, and between 0 and 1 (between sacrum and hip axis) in 49%. Although asymptomatic adults stood with stable global balance, the sagittal spinal alignment of healthy subjects, newly divided in 5 sagittal types, varied significantly. Type 3 AP appears as a new and unusual sagittal shape with low-grade PI, very low or negative PT, and hyperlordosis. Whereas most asymptomatic adults stood with C7PL behind the hip axis, a sizeable portion had C7 in front of the hip axis. This could be a new controversial aspect of ideal spinal balance.

  16. Sagittal plane deformity: an overview of interpretation and management

    Science.gov (United States)

    Roussouly, Pierre

    2010-01-01

    The impact of sagittal plane alignment on the treatment of spinal disorders is of critical importance. A failure to recognise malalignment in this plane can have significant consequences for the patient not only in terms of pain and deformity, but also social interaction due to deficient forward gaze. A good understanding of the principles of sagittal balance is vital to achieve optimum outcomes when treating spinal disorders. Even when addressing problems in the coronal plane, an awareness of sagittal balance is necessary to avoid future complications. The normal spine has lordotic curves in the cephalad and caudal regions with a kyphotic curve in between. Overall, there is a positive correlation between thoracic kyphosis and lumbar lordosis. There are variations on the degree of normal curvature but nevertheless this shape allows equal distribution of forces across the spinal column. It is the disruption of this equilibrium by pathological processes or, as in most cases, ageing that results in deformity. This leads to adaptive changes in the pelvis and lower limbs. The effects of limb alignment on spinal posture are well documented. We now also know that changes in pelvic posture also affect spinal alignment. Sagittal malalignment presents as an exaggeration or deficiency of normal lordosis or kyphosis. Most cases seen in clinical practise are due to kyphotic deformity secondary to inflammatory, degenerative or post-traumatic disorders. They may also be secondary to infection or tumours. There is usually pain and functional disability along with concerns about self-image and social interaction due to inability to maintain a horizontal gaze. The resultant pelvic and lower limb posture is an attempt to restore normal alignment. Addressing this complex problem requires detailed expertise and awareness of the potential pitfalls surrounding its treatment. PMID:20567858

  17. Variability in Minimally Invasive Surgery for Sagittal Craniosynostosis.

    Science.gov (United States)

    Garland, Catharine B; Camison, Liliana; Dong, Shirley M; Mai, Rick S; Losee, Joseph E; Goldstein, Jesse A

    2018-01-01

    Minimally invasive approaches to the surgical correction of sagittal craniosynostosis are gaining favor as an alternative to open cranial vault remodeling. In this systematic review, the reviewers evaluate the variability in described surgical techniques for minimally invasive correction of sagittal craniosynostosis. Articles were selected based on predetermined inclusion and exclusion criteria from an online literature search through PubMed, EMBASE, and the Cochrane library. Extracted data included the incisions, method of dissection, osteotomies performed, and type of force therapy utilized.A total of 28 articles from 15 author groups were included in the final analysis. Of the 28 articles, 17 distinct techniques were identified. Significant variation existed in both the technique and the terminology used to describe it. Access to the cranium varied between a standard bicoronal incision (n = 2), a "lazy S" incision (n = 2), and multiple short incisions along the fused sagittal suture (n = 13). Additional variations were found in the size and design of the osteotomy, the usage (and duration, if applicable) of force therapy, and the age of the patient at the time of surgical intervention.This systematic review demonstrates that minimally invasive approaches to sagittal craniosynostosis vary widely in technique with respect to the incisions, osteotomies, and force therapy used. Additionally, the terminology employed in describing minimally invasive approaches is inconsistent across centers. This discrepancy between technique and terminology presents challenges for reporting and interpreting the increasing body of literature on this subject. We recommend standard terminology be used for future publications on minimally invasive techniques.

  18. Isolated sagittal craniosynostosis: definition, classification, and surgical indications.

    Science.gov (United States)

    Massimi, Luca; Caldarelli, Massimo; Tamburrini, Gianpiero; Paternoster, Giovanna; Di Rocco, Concezio

    2012-09-01

    Sagittal craniosynostosis (SC) remains the most common type of synostosis, accounting for about a half of all forms. It would result from a mesenchymal disorder involving the intramembranous ossification of the sagittal suture and leading to its early fusion. No specific data on the etiologic factors are currently available. The premature ossification of the sagittal suture can result in three main types of SC, according to the different segment prevalently involved: anterior, posterior, and complete SC. The diagnosis is easily obtained by clinical examination. However, a radiological work up (3D CT scan) may be necessary to rule out hidden venous or cranial anomalies possibly associated with most severe cases, or for the surgical planning. The most common indication for surgery is the improvement of the cosmetic appearance of the skull, since a cranial deformation may have a significant psychological impact on affected subjects. To relieve from raised intracranial pressure is a further indication to surgery. Although an increased intracranial pressure can be demonstrated in a minority of affected children at diagnosis, indeed, it can present later (usually after the second/third year of life) with chronic symptoms. The role of surgery in the preservation of cognitive functions in scaphocephalic patients does not seem to be relevant, since minor anomalies of the cerebral development associated with SC would occur independently from the cranial shape. On the other hand, the surgical correction may show a protective effect on some visual skills, like the ability to fix and follow, and the fixation shift.

  19. International Society on Thrombosis and Haemostasis core curriculum project: core competencies in clinical thrombosis and hemostasis.

    Science.gov (United States)

    McLintock, C; Pabinger, I; Bauer, K A; Laffan, M; Angchaisuksiri, P; Rezende, S M; Middeldorp, S; Ross, M

    2016-01-01

    Essentials The priority of ISTH was to establish a global core curriculum in thrombosis and hemostasis. International survey to determine competencies required for clinical specialists was carried out in the field. Competency framework provides a reference point for mapping and developing regional curricula. Core curriculum informs and links to a variety of ISTH educational materials. Background The International Society on Thrombosis and Haemostasis (ISTH) identified the need for an international core curriculum on thrombosis and hemostasis for its society members and the larger thrombosis and hemostasis community. Aims The current research sought consensus on the core competencies required by medical doctors who are ready to practise as independent clinical specialists in thrombosis and hemostasis with the aim of developing a core clinical curriculum for specialists in the field. Method A draft list of competencies was developed by the Working Group and formed the basis of an online survey. ISTH members and the larger thrombosis and hemostasis community were asked to rate the importance of each competency, on a Likert scale, for clinical specialists in thrombosis and hemostasis. Results There were a total of 644 responses to the online survey with broad geographical representation. There was general agreement on what level of competency would be required for clinical specialists in thrombosis and hemostasis at the specified level of training. Conclusions Using the survey to gain consensus on the level of competency required by clinical specialists in the field of thrombosis and hemostasis enabled the development of a core clinical curriculum that has been endorsed by the ISTH Council. The curriculum will offer a framework and international reference that will be used by the society, by national and regional organizations, and for further research. © 2015 International Society on Thrombosis and Haemostasis.

  20. Anatomic (positional) variation of maxillary wisdom teeth with special regard to the maxillary sinus.

    Science.gov (United States)

    Lanzer, Martin; Pejicic, Rada; Kruse, Astrid L; Schneider, Thomas; Grätz, Klaus W; Lübbers, Heinz-Theo

    2015-01-01

    The removal of wisdom teeth is one of the most common interventions in oral surgery. In order to avoid complications, a profound knowledge of the anatomy of teeth and adjacent tissues is crucial. In the case of maxillary wisdom teeth, their relationship to the maxillary sinus, to the pterygoid fossa, to the maxillary tuber and the adjacent venous plexus is particularly important. Three-dimensional (3D) imaging, for example by means of cone beam computed tomography (CBCT), is increasingly utilized in practice. However, the necessity of CBCT imaging is still a matter of intensive debate. The aim of this study was to describe the anatomic (positional) variation of maxillary wisdom teeth and, based on these findings, to elucidate the additional benefit of such imaging. A retrospective case study was performed using patients examined by means of CBCT imaging in the Department of Dento-Maxillofacial Radiology during the period from 2008 to 2013. Primary study variables comprised the spatial relationship of the teeth to the maxillary sinus, the degree of retention and root development, the covering of the root with bone and mucosa, the root configuration, and the developmental stage of the tooth. In addition, the association of the inclination of teeth in the transversal and sagittal plane with the above variables was evaluated. Descriptive statistical parameters were calculated for all results of the examination. In total, CBCT recordings of 713 maxillary wisdom teeth from 430 patients were evaluated. Their mean age was 29.8 years, and the proportion of male patients slightly prevailed (54.4%). Most teeth exhibited fully developed roots (64.1%). Overall 22.9% of third molars were impacted, 32.3% were retained, and 6.5% were erupting. In more than a third of the patients, wisdom teeth were in occlusion. The inclination of the third molars both in the transversal and sagittal plane was significantly associated with the distance of the root from the maxillary sinus as well

  1. Minimally Invasive Sinus Augmentation Procedure Using a Dedicated Hydraulic Sinus Lift Implant Device: A Prospective Case Series Study on Clinical, Radiologic, and Patient-Centered Outcomes.

    Science.gov (United States)

    Tallarico, Marco; Meloni, Silvio Mario; Xhanari, Erta; Pisano, Milena; Cochran, David L

    The aim of this study was to evaluate clinical and radiologic outcomes of a novel device that allows simultaneous hydraulic sinus membrane elevation, bone grafting, and implant placement. A sample of 18 consecutive participants with severe atrophy of the posterior maxilla underwent transcrestal elevation of the sinus membrane and implant placement. At the 6-month follow-up, the following parameters were assessed: implant success, any complications, marginal bone loss (MBL), three-dimensional (3D) graft measurements, implant stability quotient (ISQ), and graft density. No implants failed during follow-up (10.8 ± 2.8 months; range: 7-14 months). No membrane tears or other adverse events were observed. Mean residual alveolar ridge height was 4.78 ± 0.88 mm. Six months after the procedure, the mean MBL was 0.18 mm. The mean sinus membrane elevation was 12.78 ± 2.18 mm (range: 10.7-14.23). Along the basic 3D reference planes, the dimensions of grafted bone measured around implants were as follows: axial area = 239.7 ± 57.68 mm(2); sagittal area = 257.0 ± 60.83 mm(2); coronal area = 143.3 ± 29.46 mm(2). The mean volume of the graft was 2.38 ± 0.26 mL at baseline and 2.05 ± 0.24 mL 6 months after graft maturation (difference: 0.33 ± 0.29 mL, P = .0090). Graft density (in Hounsfield units [HU]), improved during healing from 322.0 ± 100.42 HU to 1,062.0 ± 293.7 HU; difference 740.0 ± 295.35 HU (P = .0001). The mean ISQ value was 65.5 at implant placement, and it increased to 74.1 at the 6-month examination (P = .0014). Of 18 patients, 12 experienced no pain (66.6%) and 10 experienced no swelling (55.5%). No severe pain or swelling was reported in any of the cases. The mean number of analgesic tablets consumed was 0.78 ± 0.67. Mean surgical time was 24.0 ± 4.07 minutes. The iRaise Sinus Lift System may provide a new option for minimally invasive transcrestal sinus surgery with minimal patient discomfort. A physiologic contraction of 13.9% of its original volume

  2. Effect of Preoperative Sagittal Balance on Cervical Laminoplasty Outcomes.

    Science.gov (United States)

    Oshima, Yasushi; Takeshita, Katsushi; Taniguchi, Yuki; Matsubayashi, Yoshitaka; Doi, Toru; Ohya, Junichi; Soma, Kazuhito; Kato, So; Oka, Hiroyuki; Chikuda, Hirotaka; Tanaka, Sakae

    2016-11-01

    Retrospective case series. To clarify how preoperative global sagittal imbalance influences outcomes in patients with cervical compression myelopathy undergoing cervical laminoplasty. The influence of sagittal balance on outcomes of cervical laminoplasty remains uncertain. The authors retrospectively reviewed data of 106 patients who underwent double-door cervical laminoplasty between 2004 and 2011 and investigated the influence of the C7 sagittal vertical axis (SVA) on outcome scores. Primary outcomes used were Japanese Orthopedic Association (JOA) scores, Numerical Rating Scale for neck or arm pain, the Short Form 36 Health Survey (physical and mental component summary scores ), and the Neck Disability Index (NDI). Ninety-two patients with complete data were eligible for inclusion. The preoperative C7 SVA was ≤5 cm in 64 patients (69.6%) and > 5 cm in 28 (30.4%). We compared each parameter by the magnitude of spinal sagittal balance (preoperative C7 SVA > 5 cm vs. C7 SVA ≤ 5 cm) after adjusting for age via the least square mean analysis because the average age was significantly higher in patients with C7 SVA > 5 cm. As for the radiographic parameters, both C2-7 SVA and C7 SVA were larger in patients when the C7 SVA was > 5 cm. Numerical Rating Scale for postoperative arm pain, postoperative JOA scores, and both pre- and postoperative physical component summary and NDI were worse in patients with C7 SVA > 5 cm; however, the JOA score recovery rate and changes in physical component summary and NDI were not significantly different. Postoperative functional outcome scores were significantly lower in patients with C7 SVA > 5 cm, although the improvement after cervical laminoplasty was not greatly affected. The involvement of global sagittal balance and cervical regional alignment should be considered in evaluating surgical outcomes for patients undergoing cervical laminoplasty. 4.

  3. [Maxillary sinusitis of odontogenic origin: surgical treatment].

    Science.gov (United States)

    Chemli, H; Mnejja, M; Dhouib, M; Karray, F; Ghorbel, A; Abdelmoula, M

    2012-04-01

    The frequency of maxillary sinusitis of dental origin (MSDO) is under estimated. The medical and surgical treatment has improved thanks to endoscopic guidance. We report our experience and strategy in the treatment of MSDO. Twenty-two patients presenting with MSDO were treated between 1998 and 2008. The results were evaluated on clinical, functional, sinusal, and odontologic signs. MSDO accounted for 16% of surgically managed sinusitis. CT was performed in 95% of cases. The etiologies were apical leakage in seven patients, migration of a tooth or root during extraction, or presence of ectopic tooth in the sinus in nine patients, a cyst in three patients, and oroantral communication in three patients. Surgery was performed after antibiotic and NSAID treatment. The first surgical step was the treatment of the odontogenic source. The second step was sinus drainage by endoscopic treatment in 64%, Caldwell-Luc in 23%, and drainage by oroantral communication enlarged then closed in the same operative time in 13%. The follow up ranged from 3 months to 10 years. Early postoperative superinfection was observed in two patients. Two patients presented with recurrent sinusitis. The postoperative sequels were hyposmia in three patients, dental pulpotomy, and trigeminal neuralgia in five patients treated by Caldwell-Luc surgery. Nasal endoscopy has improved the surgical management of MSDO. It makes curettage and exclusion of sinus cavities obsolete. It is reliable and has a low rate of complications. The best treatment remains prevention. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Current concepts on complications associated with sinus augmentation procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation

  5. Current Concepts on Complications Associated With Sinus Augmentation Procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation

  6. Association between maxillary sinus pathologies and healthy teeth

    Directory of Open Access Journals (Sweden)

    Gina D. Roque-Torres

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE: To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS: Three radiologists analyzed 109 cone beam computed tomography (CBCT images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies ( p = 0.01. RESULTS: Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference ( p = 0.006 between the tooth roots in diseased maxillary sinuses (6.09% and those in normal sinuses (3.43%. The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses ( p < 0.0001. Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION: Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

  7. [Conservative therapy of chronic sinusitis].

    Science.gov (United States)

    Reiss, Michael; Reiss, Gilfe

    2012-01-01

    The chronic rhinosinusitis is defined as chronic inflammation of the nose and nasal sinuses, with or without nasal polyps. Patients suffering from chronic rhinosinusitis report about nasal obstruction and secretion, olfactory impairment, head and facial pain. These symptoms cause also considerable impact on quality of life. Therefore, an adequate rhinological diagnostics as well as therapies are essential. This paper reviews the pharmacologic and non-pharmacologic therapy of chronic rhinosinusitis. First choice of therapy should be topical glucocorticoids. The application of glucocorticoids causes anti-inflammatory and certain curative effects. Hypertonic salt solutions improve nasal symptoms. Long-term therapy with oral macrolides might improve median to severe symptoms of chronic rhinosinusitis without nasal polyps. An additional therapy with antihistamines is possible in patients with an allergy. Adaptive desensitization in patients suffering from analgesic-intolerance associating among other with nasal polyps is currently the single causal therapy. Therefore, frequency of endonasal revision surgery is reduced after desensitization.

  8. A Rational Approach to Sinus Augmentation: The Low Window Sinus Lift

    Directory of Open Access Journals (Sweden)

    Terry Zaniol

    2017-01-01

    Full Text Available Sinus augmentation is a well-known approach to treating alveolar bone ridge atrophy in the posterior maxilla. The preparation of the lateral window is crucial. Its size, design, and position in the vestibular sinus wall may affect the intra- and postsurgical complication rates and affect the intrasurgical activity of both surgeons and assistants. The present paper describes a rational technique that also exploits the guided surgery approach for design and preparation of a lateral window for sinus augmentation, the Low Window Sinus Lift. To illustrate the use of this approach, a case is presented in which the 50-year-old patient had the left maxillary first molar extracted, followed two months later by sinus augmentation and placement of three implants. One year after delivery of the definitive prosthesis, all three implants were successful, and the prosthesis was fully functional. Controlled studies should be undertaken to assess whether this technique provides significant advantages compared to other sinus augmentation approaches.

  9. 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.

  10. Goat Model for Direct Visualizing the Effectiveness of Detaching Sinus Mucosa in Real Time During Crestal Maxillary Sinus Floor Elevation.

    Science.gov (United States)

    Fan, Jiadong; Hu, Pin; Li, Yanfeng; Wang, Fuli; Dong, Xinming; Liu, Bin; Liu, Le; Zhang, Yue; Gu, Xiangmin

    2017-08-01

    The procedure of crestal maxillary sinus floor elevation presents a great challenge to the field of implant dentistry. Due to the limited visualization in this procedure, the effectiveness of detaching sinus mucosa could not be assessed in real time. We recently developed an ex vivo goat sinus model by cutting the goat residual skulls along four lines determined from computerized tomography (CT) scans, extracting the maxillary premolar or molar teeth, and preparing implant socket in the maxilla. The generated ex vivo goat sinus models exposed the maxilla and the whole maxillary sinus mucosa, thus enabling real-time observation of detaching maxillary sinus mucosa via directly visualizing the working situation of sinus lift tool in the models and directly measuring the length of detached mucosa and space volume generated under the elevated sinus mucosa. One commercially available umbrella-shaped sinus lift curette was used to detach the maxillary sinus mucosa to evaluate the effectiveness of the ex vivo goat sinus models. The results showed that this curette could detach the sinus mucosa 3.75 mm in length in the mesiodistal direction and 2.81 mm in the buccal-palatal direction. Moreover, a space volume of 52.7 μl could be created under the elevated sinus mucosa in the goat ex vivo models. All the experimental results suggested that this ex vivo goat sinus model might be useful in the evaluation of improved or newly designed sinus lift tools for elevating the maxillary sinus mucosa via the crestal approach.

  11. The effect of sinus surgery with intensive follow-up on pathogenic sinus bacteria in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Aanaes, Kasper; von Buchwald, Christian; Hjuler, Thomas

    2013-01-01

    Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce...... pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment....

  12. Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; Hiltunen, Sini; Tatlisumak, Turgut; Peters, Guusje M.; Silvis, Suzanne M.; Haapaniemi, Elena; Kruyt, Nyika D.; Putaala, Jukka; Coutinho, Jonathan M.

    2016-01-01

    Background and Purpose-Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis. Methods-Consecutive adult patients with cerebral venous thrombosis were included

  13. Very late bare-metal stent thrombosis, rare but stormy!

    LENUS (Irish Health Repository)

    Ali, Mohammed

    2011-08-01

    Recurrent in-stent thrombosis is rarely reported, with catastrophic clinical consequences of either acute coronary syndrome or death. We present a case of recurrent in-stent thrombosis with its outcome and a concise literature review.

  14. Clinical features and diagnosis of venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Hirsh, J.; Hull, R.D.; Raskob, G.E.

    1986-12-01

    The clinical diagnosis of venous thrombosis is inaccurate because the clinical findings are both insensitive and nonspecific. The sensitivity of clinical diagnosis is low because many potentially dangerous venous thrombi are clinically silent. The specificity of clinical diagnosis is low because the symptoms or signs of venous thrombosis all can be caused by nonthrombotic disorders. A current approach to the diagnosis of clinically suspected venous thrombosis favors the use of impedance plethysmography over Doppler ultrasonography as the main test for this disorder. This is because impedance plethysmography is precise and objective, whereas the interpretation of Doppler ultrasonography is subjective and requires considerable skill and experience to form reliable diagnoses. The use of serial impedance plethysmography has been evaluated recently in a prospective study. The rationale of repeated impedance plethysmography evaluation is based on the premise that calf vein thrombi are only clinically important when they extend into the proximal veins, at which point detection with impedance plethysmography is possible. Therefore, by performing repeated examinations with impedance plethysmography in patients with clinically suspected venous thrombosis, it is possible to identify patients with extending calf vein thrombosis who can be treated appropriately. Impedance plethysmography is performed immediately on referral; if it is positive in the absence of clinical conditions that are known to produce falsely positive results, the diagnosis of venous thrombosis is established, and the patient is treated accordingly. If the result of the initial impedance plethysmography evaluation is negative, anticoagulant therapy is withheld, and impedance plethysmography is repeated the following day, again on day 5 to 7 and on day 10 to 14. 87 references.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Characteristics and dimensions of the sinus membrane in patients referred for single-implant treatment in the posterior maxilla: a cone beam computed tomographic analysis.

    Science.gov (United States)

    Schneider, Adrienne C; Bragger, Urs; Sendi, Pedram; Caversaccio, Marco D; Buser, Daniel; Bornstein, Michael M

    2013-01-01

    The purpose of the present study was to evaluate the thickness and anatomic characteristics of the sinus membrane using cone beam computed tomography (CBCT) in patients evaluated for implant surgery in the posterior maxilla. The study included 131 consecutive patients referred for dental implant placement in the posterior maxilla. A total of 138 CBCT images was obtained using fields of view of 4 × 4 cm, 6 × 6 cm, or 8 × 8 cm. Reformatted sagittal CBCT slices were analyzed with regard to the thickness and characteristics of the sinus membrane at single-tooth gaps in the posterior maxilla. Factors that might influence the dimensions of the sinus membrane, such as age, sex, endodontic status, and the season, were analyzed. The mean thickness of the maxillary sinus mucosa varied between 2.1 and 2.69 mm in the three locations analyzed. Fewer than half of the evaluated sinuses exhibited a healthy mucosa (49 of 138, or 35.51%). Most of the pathologic findings were flat, shallow thickenings (63 of 138, or 45.65%). Sex did not influence the thickness of the sinus membrane at the root tips of the premolars or at single-tooth gaps, but there was a statistically significant correlation in the region of the maxillary molars. No other evaluated factors had a statistically significant effect on the dimensions of the antral mucosa. In the present study, sex was the only factor influencing the dimension of the sinus membrane, whereas patient age, season, and the endodontic status of neighboring teeth had no significant effect on the thickness of the antral mucosa. Future studies should address which types of mucosal thickening require interdisciplinary therapy.

  17. Difference between Sinusitis and a Cold

    Science.gov (United States)

    ... Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth ... has bacterial sinusitis after examining your child and hearing about the progression of symptoms. In older children, ...

  18. Sphenoid Sinusitis and Migraine-Type Headache

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2002-02-01

    Full Text Available Three case histories of children (ages 10, 12, and 14 years with isolated sphenoid sinusitis who presented with acute, subacute, and chronic headache symptoms resembling migraine are reported from the University of Texas-Houston Medical School.

  19. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest

  20. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Rovers, M.M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibiotics may be associated with modest

  1. Maxillary sinus perforation by orthodontic anchor screws

    National Research Council Canada - National Science Library

    Motoyoshi, Mitsuru; Sanuki-Suzuki, Rina; Uchida, Yasuki; Saiki, Akari; Shimizu, Noriyoshi

    2015-01-01

    .... The placement torque and screw mobility of each implant were determined using a torque tester and a Periotest device, and variability in these values in relation to sinus perforation was evaluated...

  2. Osteoma of the skull base and sinuses

    NARCIS (Netherlands)

    Georgalas, Christos; Goudakos, John; Fokkens, Wytske J.

    2011-01-01

    Osteomata of the frontal and ethmoid sinuses have traditionally been surgically removed via external approaches. However, endoscopic techniques have increasingly been used for the surgical management of selected cases. Advances in visualization and instrumentation, as well as the excellent access

  3. Analysis of computed tomography features of fungal sinusitis and their correlation with nasal endoscopy and histopathology findings.

    Science.gov (United States)

    Gupta, Kamini; Saggar, Kavita

    2014-01-01

    The purpose of this study was to analyze the computed tomography (CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings. Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at our hospital and had evidence of definite sinonasal disease on clinical evaluation. Multidetector CT was carried out on Somatom definition AS + 128 slice CT Machine by Siemens Germany Ltd. Axial sections were performed with the plane of data acquisition parallel to the hard palate and slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA S, 120 KV and tube rotation time of 0.5 s. Provisional CT diagnosis was made in all cases and correlated with nasal endoscopy and histopathological findings. Out of total 16 patients, 12 showed immunocompromised status and had infection with mucormycosis. Out of 12, 9 patients (75%) showed extension of disease beyond the sinonasal cavities and 4 (33.3%) showed evidence of bone destruction. All patients with candidiasis showed soft-tissue attenuation with hyperdense areas on CT scan. Nearly, 66.6% patients with aspergillosis showed soft-tissue attenuation with hyperdense areas and expansion of sinonasal cavities. Fifteen patients (93%) were proved to be of fungal sinusitis on histopathology. One patient of non-specific granulomatous infection showed bone destruction and mimicked fungal sinusitis on CT. In the present study, fungal sinusitis could be correctly diagnosed on CT with high accuracy. Thus, understanding the different CT findings of fungal sinusitis allows the radiologist to play a crucial role in the diagnosis and prompt treatment.

  4. Presentation and diagnosis of allergic fungal sinusitis.

    Science.gov (United States)

    Zakirullah; Nawaz, Ghareeb; Sattar, Syed Fazle

    2010-01-01

    Allergic fungal sinusitis (AFS) is a form of fungal disease that has recently been considered a distinct clinicopathologic entity. Other forms of fungal sinusitis include acute-fulminant (invasive), chronic indolent (invasive) and mycetoma (non-invasive). Objectives were to assess the presentation and to describe the diagnostic techniques for allergic fungal sinusitis in our setup. Descriptive study was conducted in the Department of ENT and Head & Neck Surgery, Khyber Medical College and Khyber Teaching Hospital, Peshawar from January 2002 to April 2008. Twenty-three cases of allergic fungal sinusitis (ASF) were selected for the study. Data like, name, age, sex, address, clinical features, labs (Eosinophil count) and imaging studies (CT and/or MRI) were recorded, including the pre- and postoperative treatment, operative findings and postoperative results, recurrence of disease were also recorded. Surgical procedures were performed on all cases followed by medical treatment. Study revealed that AFS is a disease of younger age, mainly occurring in 2nd & 3rd decade of life, with male to female ratio 1:1.3. Allergic rhinitis (91%) and nasal polyposis (91%) were important associated factors. Nasal obstruction (96%), nasal discharge (91%), post-nasal discharge (87%) and unilateral multi sinus extension were important clinical features. Increased eosinophil count and increased IgE level was found in 78% cases. Histopathological analysis showed fungal hyphae in all cases and aspergillus was predominant organism on culture. Orbital erosion was seen in 78% and skull base erosion was observed in 9%. Recurrence of disease was seen in nine cases. Allergic fungal sinusitis (AFS) is a disease of young immunocompetent adults. Nasal obstruction, nasal discharge, nasal allergy and proptosis were the most common presentations. Initial diagnosis of allergic fungal sinusitis requires high index of suspicion in patients presenting with chronic rhinosinusitis, such cases should be

  5. Systemic corticosteroid therapy for acute sinusitis

    OpenAIRE

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest benefit for short-term relief of symptoms in adults with severe symptoms of acute sinusitis compared with antibiotics alone. Oral corticosteroids as monotherapy are not associated with improved clinical...

  6. Comparative assessment of sagittal skeletal discrepancy: a cephalometric study.

    Science.gov (United States)

    Aparna, P; Kumar, Dilip N; Prasad, Mandav; Shamnur, Naveen; G, Arun Kumar; K R, Sridhar; B R, Gopal Krishna; Gupta, Neeraj

    2015-04-01

    Evaluating the sagittal apical base relationship during orthodontic diagnosis and treatment planning is an important step. This study was aimed at comparison of Beta angle, ANB angle and Wit's appraisal for assessment of sagittal skeletal discrepancy. Eighty six young adults (43 female and 43 male) were selected from the patient's reporting to Department of Orthodontics, College of Dental Sciences, Davangere, India. Family lineage was studied to know the nativity of Davangere. The standardized pre-treatment lateral cephalogram of the chosen sample was traced. The sample was divided into three skeletal pattern groups: Class I, Class II and Class III, based on the ANB angle and profile, Beta angle was assessed in each group. The data was subjected to statistical analysis student's t-test, ANOVA test and correlation and regression analysis, using the software namely SPSS Software version 13. Microsoft word and Excel were used to generate graphs and tables. In the local Davangere population, Class I skeletal pattern group exhibited Beta angle between 26°-34°, Beta angle less than 27° was found in Class II skeletal pattern, and Beta angle greater than 32° was seen Class III skeletal pattern. The coefficient of variation of Beta angle in all the three groups was significantly homogenous compared to ANB angle and Wits appraisal. The correlation and regression analysis of the total sample indicated a highly significant correlation between Beta angle and ANB angle (pskeletal patterns. The Correlation and regression analysis for the total sample suggests a highly significant relation between Beta angle and ANB angle and, between Beta angle and Wits appraisal. It can be more reliably used to assess sagittal jaw discrepancies than ANB angle and Wits appraisal.

  7. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis.

    Science.gov (United States)

    Debarge, Romain; Demey, Guillaume; Roussouly, Pierre

    2011-09-01

    This is a radiographic study of ankylosing spondylitis patients with severe fixed kyphotic deformity who underwent pedicle subtraction osteotomy. Our goal was to measure and validate new angle to assess global kyphosis and to evaluate the sagittal balance after surgery. This is the first report which describes new angle to assess global kyphosis (T1-S1). Pre and postoperative controls were compared according to the Pelvic Incidence. The sagittal parameters ankylosing spondylitis patients were compared with 154 asymptomatic patients. In addition to the pelvic parameters and the C7 tilt, we used the spino-sacral angle. Pelvic incidence in ankylosing spondylitis patients was higher than asymptomatic population (61° vs. 51°). For a same tilt of C7 for both groups, the low pelvic incidence group had a lower sacral slope and pelvic tilt and a higher global kyphosis (spino-sacral angle = 90°) than the high pelvic incidence group (spino-sacral angle = 98°). In the adult volunteers, the C7 tilt and spino-sacral angle measured, respectively, 95° and 135°. The preoperative C7 tilt measured 73° and increased to 83° (p = 0.0025). The preoperative spino-sacral angle measured 96° and increased to 113.3° (p = 0.003). A low pelvic incidence pelvis has a lower sacral slope than in high pelvic incidence and can support a bigger kyphosis. All the parameters were improved by the pedicle subtraction osteotomy, but the average spinosacral angle remained lower than the control group. When C7 tilt was useful to assess the improvement of the sagittal balance, SSA allowed a better evaluation of the correction of kyphosis itself.

  8. Sagittal morphology and equilibrium of pelvis and spine.

    Science.gov (United States)

    Vaz, G; Roussouly, P; Berthonnaud, E; Dimnet, J

    2002-02-01

    A prospective analysis of the sagittal profile of 100 healthy young adult volunteers was carried out in order to evaluate the relationship between the shape of the pelvis and lumbar lordosis and to create a databank of the morphologic and positional parameters of the pelvis and spine in a normal healthy population. Inclusion criteria were as follows: no previous spinal surgery, no low back pain, no lower limb length inequality, no scoliotic deviation. For each subject, a 30 x 90-cm sagittal radiograph including spine, pelvis and proximal femurs in standing position on a force plate was performed. The global axis of gravity was determined with the force plate. Each radiograph was digitized using dedicated software. The spinal parameters registered were values for thoracic kyphosis and lumbar lordosis. The pelvic angles measured were: pelvic incidence, sacral slope and pelvic tilt. The global axis of gravity was on average 9 mm anterior of the center of the femoral heads. The anatomic parameter of pelvic incidence angle varied from 33 degrees to 85 degrees (mean: 51.7 degrees, SD: 11 degrees). The average lumbar lordosis was 46.5 degrees. The average thoracic kyphosis was 47 degrees. We found a statistical correlation between incidence angle and lumbar lordosis (r=0.69, P<0.001) and between sacral slope angle and lumbar lordosis (r=0.75, P<0.001). Spine and pelvis balance around the hip axis in order to position the gravity line over the femoral heads. We propose a scheme of sagittal balance of the standing human body.

  9. SAGITTAL SPINAL MORPHOLOGY IN HIGHLY TRAINED ADOLESCENT TENNIS PLAYERS

    Directory of Open Access Journals (Sweden)

    José M. Muyor

    2013-09-01

    Full Text Available Sports with a predominance of forward-bending and extension postures have been associated with alterations in the sagittal spinal curvatures and greater risk of spinal injury. Because, the tennis players adopt these postures, the aims of this study were: 1 to describe spinal curvatures and pelvic tilt in male and female highly trained adolescent tennis players during relaxed standing posture and with thoracic spine corrected (in prone lying on the floor; and 2 to determine the frequency of thoracic hyperkyphosis and lumbar hypo/hyper lordosis in these postures. Forty adolescent tennis players (24 male and 16 female aged 13-18 years, participated voluntarily in this study. The Spinal Mouse system was used to measure sagittal spinal curvatures and pelvic tilt. The mean values in the relaxed standing posture were 43.83° ± 7.87° (thoracic kyphosis, - 27.58° ± 7.01° (lumbar lordosis, and 13.38° ± 5.57° (pelvic tilt for male tennis players, respectively; and 36.13° ± 6.69° (thoracic kyphosis, - 32.69° ± 5.06° (lumbar lordosis, 20.94° ± 5.36° (pelvic tilt for female tennis players (p < 0.05 between genders in all spinal parameters. The male and female tennis players showed a frequency of 62.5% and 93.8% (p = 0.032 for neutral thoracic kyphosis, and 83.3% and 93.8% (p = 0.062 in neutral lumbar lordosis, respectively. In conclusion, due to the high percentage of neutral spinal curvatures in both male and female tennis players, to practice tennis in these levels does not alter sagittal spinal morphology in the relaxed standing posture in adolescent highly trained tennis players

  10. Use of engineered bone for sinus augmentation.

    Science.gov (United States)

    Beaumont, Christian; Schmidt, Roswitha J; Tatakis, Dimitris N; Zafiropoulos, Gregory-George

    2008-03-01

    Tissue-engineered bone grafts represent an appealing alternative for maxillary sinus augmentation because they eliminate the significant drawbacks associated with extra- and intraoral bone-harvesting procedures. In the present case series, we document the outcomes of sinus augmentation surgery using tissue-engineered bone grafts. Three patients requiring bilateral sinus augmentation received tissue-engineered bone grafts combined with xenograft prior to implant placement. Implants were placed and loaded 6 and 12 months postaugmentation, respectively. Radiographs were taken and clinical examinations were performed preoperatively and at 4, 6, 12, and 18 months postaugmentation. Biopsies were obtained at 4 and 6 months postaugmentation. Standardized orthopantomograms were used to measure the posterior maxilla bone height. None of the patients experienced untoward complications during or following the therapeutic procedures. Ten implants were inserted into the augmented sinuses and loaded. Biopsies revealed a lack of inflammation or pathology; newly formed fibrous bone with osteoblastic activity and xenograft particles was evident. Compared to 4 months postaugmentation, augmented tissue was more mature at 6 months. The postoperative (18 months) bone height in augmented areas was significantly greater than the preoperative height (P bone height. Sinus augmentation using tissue-engineered bone grafts was successful in all three cases, permitting the subsequent insertion and loading of dental implants. The present cases demonstrated the feasibility of using engineered bone for sinus augmentation. Controlled clinical trials will be required to evaluate this new and evolving treatment modality.

  11. Silent sinus syndrome: A traumatic case.

    Science.gov (United States)

    Février, E; Vandersteen, C; Castillo, L; Savoldelli, C

    2017-06-01

    Silent sinus syndrome is an unusual cause of progressive enophthalmos and hypoglobus due to atelectasia of the maxillary sinus associated with osteolysis of the orbital floor. This syndrome is classically idiopathic, but the term is also used to describe traumatic or iatrogenic (surgical orbital decompression) cases. We report the case of a 33-year-old man who presented with a left orbital trauma without functional disorder. Computed tomography (CT) scan revealed a nondisplaced fracture of the left orbital floor. No surgical indication was made. Three months later, the patient presented with progressive enophthalmos. CT revealed a complete lysis of the left orbital floor and a left maxillary sinus atelectasia. The original nondisplaced fracture of the orbital floor was not responsible for enophthalmos but the associated fracture of the left uncinate process that induced the closure of the left maxillary sinus infundibulum. This induced in turn hypoventilation of the sinus and a left orbital floor lysis. Treatment consisted in surgical opening of the maxillary sinus ostium and reconstruction of the orbital floor. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. [Sagittal balance of the spine: a therapeutic revolution].

    Science.gov (United States)

    Faundez, A; Roussouly, P; Le Huec, J C

    2011-12-21

    In humans, the erect position and bipedal walk is possible because of a balance between pelvic and spinal parameters. The most important pelvic parameter is the pelvic incidence which represents the base on which the spine lies. With aging, thoracic kyphosis increases, lumbar lordosis decreases, compromising the spino-pelvic balance. Compensatory phenomenons are possible, but rely mostly on the amplitude of pelvic incidence. Analysis of spino-pelvic parameters and detection of a compensated or uncompensated sagittal imbalance are mandatory before any therapeutic action is undertaken for a degenerative pathology of the spine.

  13. ANALYSIS AND PLANNING OF HINDFOOT DEFORMITY CORRECTION IN SAGITTAL PLANE

    Directory of Open Access Journals (Sweden)

    L. N. Solomin

    2017-01-01

    Full Text Available Background. The disadvantage of the known methods of analysis and planning of hindfoot deformities in the sagittal plaBackground. Long bone deformity planning is well established. However, there are not well described methods of analysis and planning of hindfoot deformities in the sagittal plane. Such planning is made even more difficult with concomitant deformation of the midfoot and/or ankle contracture or malpositioned arthrodesis. The aim of our study was to develop a universal method of analysis and planning of the calcaneus correction, based on the normally derived reference lines and angles.Methods. We analyzed 65 standing lateral foot films in normal adults, 23-54 years old were analyzed. We drew the talus joint line (points “a” and “b” – Line 1. We drew a second line, (Line 2 the calcaneal line, which starts at the back of the calcaneal tuberosity (point “d”, drawn perpendicular to a line from top to bottom of the calcaneal tuberosity. The intersection of the calcaneal line and the talar joint line form point (c anteriorly. We measured lines ab, ac and cd, and their ratios: ac/ab, and cd/ab.Results. Talar joint line (Line 1 and calcaneal line (Line 2 intersect at a point (c, forming an angle 15.2° (±3.4°. The ratio ac/ab = 2.56 (± 1.1. The ratio cd/ab = 4.59 (±1.0. These ratios are constants for calculating the idealized joint lines for deformity planning. For deformity cases, draw Line 1, the talar joint line ab. Extend that line anteriorly to (c, which is a distance ab×2.56 from point (a. From (c, draw an idealized calcaneal line, Line-2, at an angle 15° to Line 1. Place (d on this line, at a distance ab×4.59 from point (c. Next, draw the deformed calcaneal line (Line 3 and point (d1 where it exits the calcaneal tuberosity. Use the same technique and landmarks as for drawing the normal calcaneal line. The intersection of Lines 2 and 3 is the apex of the deformity. Rotate the piece containing Line 3 around this

  14. The role of minimally invasive lateral lumbar interbody fusion in sagittal balance correction and spinal deformity.

    Science.gov (United States)

    Costanzo, Giuseppe; Zoccali, Carmine; Maykowski, Philip; Walter, Christina M; Skoch, Jesse; Baaj, Ali A

    2014-10-01

    The recent proliferation of minimally invasive lateral lumbar interbody fusion (LLIF) techniques has drawn attention to potential for these techniques to control or correct sagittal misalignment in adult spinal deformity. We systemically reviewed published studies related to LLIF use in adult spinal deformity treatment with emphasis on radiographic assessment of sagittal balance. A literature review was conducted to examine studies focusing on sagittal balance restoration in adult degenerative scoliosis with the LLIF approach. Fourteen publications, 12 retrospective and 2 prospective, reported data regarding lumbar lordosis correction (1,266 levels in 476 patients) but only two measured global sagittal alignment. LLIF appears to be especially effective when the lumbar lordosis and sagittal balance correction goals are less than 10° and 5 cm, respectively. However, the review demonstrated a lack of consistent reporting on sagittal balance restoration with the MIS LLIF techniques.

  15. [Sagittal Balance of the Spine--Clinical Importance and Radiographic Assessment].

    Science.gov (United States)

    Decker, S; Müller, C W; Omar, M; Krettek, C; Schwab, F; Trobisch, P D

    2016-04-01

    Sagittal deformities of the spine frequently result in back pain, as patients have to expend much energy in compensation. The sagittal alignment of the spine is defined by its curvatures (lordosis and kyphosis) relative to the position of the pelvis. Diagnostic assessment is based on full spine a. p. and lateral X-rays. The sagittal balance is primarily described by different angles that can be measured, e.g. lumbar lordosis, pelvic incidence, pelvic tilt and thoracic kyphosis. The quality of life can best be estimated by subtracting lumbar lordosis from the pelvic incidence. However, initial evaluation of the sagittal balance can also be based on the sagittal vertical axis. The severity of imbalance can be described by the sagittal vertical axis and the pelvic tilt, but surgical therapy necessitates a more profound analysis, which can be based on the SRS-Schwab classification. Georg Thieme Verlag KG Stuttgart · New York.

  16. Analysis of the relationship between coronal and sagittal deformities in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Hu, Panpan; Yu, Miao; Liu, Xiao; Zhu, Bin; Liu, Xiaoguang; Liu, Zhongjun

    2016-02-01

    To characterize the sagittal alignment of each Lenke type and investigate the relationship between coronal and sagittal deformities in adolescent idiopathic scoliotic (AIS) patients. A cohort of 184 subjects with AIS was retrospectively recruited. Radiographic data were measured and collected, including the Lenke types, Cobb angles of structural curves, and sagittal spino-pelvic parameters. Subjects were grouped according to their genders, Lenke curve types, lumbar modifiers and the amount of coronal structural curves. The sagittal alignment was then compared between the different groups, and correlation analysis was also taken between coronal and sagittal parameters. Besides, each subject's Roussouly type was decided and its distribution was compared among different Lenke types. The cohort included 59 males and 125 females, averagely aged at 15.5 ± 3.3 years old. Most sagittal parameters except thoracic kyphosis (TK) and pelvic tilt (PT) were similar among different Lenke types, while all the sagittal parameters were similar between males and females. The groups with different lumbar modifiers had similar sagittal parameters except TK, which was also true for the groups with different amounts of coronal curves. 42.4 % of the cohort belonged to Roussouly type 3, and the distribution of Roussouly types was comparable among all Lenke types. All sagittal parameters except C7 translation ratio were significantly different among Roussouly types (P < 0.05). Correlation analysis showed that main thoracic (MT) was negatively correlated with lumbar lordosis (LL, r = -0.324), sacral slope (r = -0.321) and spino-sacral angle (r = -0.363). Partial correlation analysis found that thoracolumbar/lumbar was negatively correlated with TK (r = -0.464) and LL (r = -0.422) when MT was controlled. The influence of coronal deformity on sagittal parameters was limited and mainly reflected in the deviation of TK. Most coronal and sagittal parameters were not significantly correlated, and

  17. Prediction of sagittal balance in patients with osteoporosis using spinopelvic parameters.

    Science.gov (United States)

    Lee, Jung Sub; Lee, Hong Seok; Shin, Jong Ki; Goh, Tae Sik; Son, Seung Min

    2013-05-01

    Little data is available on the relationships between sagittal balance and spinopelvic parameters in osteoporosis. We analyzed sagittal spinopelvic parameters in osteoporotic patients. In this prospective study, the patient and control groups comprised 124 osteoporotic patients and 40 controls. Average age was 72.4 ± 6.8 in the osteoporosis group and 42.7 ± 12.5 in the control group, which was significantly different (P sagittal vertical axis, namely, a sagittal balance group (n = 56) and a sagittal imbalance group (n = 68). All 164 study subjects underwent whole spine lateral radiography, which included hip joints. The radiographic parameters investigated were sacral slope, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. Statistical analysis was performed to identify significant differences between the two groups. Osteoporotic patients and controls were found to be significantly different in terms of sagittal vertical axis, sacral slope, pelvic tilt, lumbar lordosis, and thoracic kyphosis. However, no significant difference was observed between patients and controls in terms of pelvic incidence (P > 0.05). Significant differences were found between the balance and imbalance groups in terms of age, lumbar spine bone mineral density (LSBMD), femoral neck BMD (FNBMD), visual analogue scale (VAS) score, sacral slope, and pelvic incidence. Correlation analysis revealed significant relationships between sagittal parameters and osteoporosis. Stepwise logistic regression analysis revealed that FNBMD and pelvic incidence contributed significantly to sagittal balance. Sagittal spinopelvic parameters were found to be significantly different in patients and normal controls. Significant relationships were found between sagittal spinopelvic parameters in osteoporotic patients. In particular, low FNBMD and high pelvic incidence were significant parameters in determination of sagittal balance in osteoporotic patients.

  18. Incidence and predictors of coronary stent thrombosis

    DEFF Research Database (Denmark)

    D'Ascenzo, Fabrizio; Bollati, Mario; Clementi, Fabrizio

    2013-01-01

    Stent thrombosis remains among the most feared complications of percutaneous coronary intervention (PCI) with stenting. However, data on its incidence and predictors are sparse and conflicting. We thus aimed to perform a collaborative systematic review on incidence and predictors of stent thrombo...

  19. Effort thrombosis: A case study and discussion

    African Journals Online (AJOL)

    secondary thrombosis, and are older, and have concurrent systemic illness. 3. The anatomical relations of the subclavian vein in the thoracic outlet are: • superior and anterior: the clavicle, subclavius muscle and costoclavicular ligament. • inferior: first rib. • posterior: anterior scalene muscle.1,3,8. Other structures which are ...

  20. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)

    2010-01-01

    textabstractExtrahepatic portal vein thrombosis (EPVT) is the most common cause of portal hypertension in non- cirrhotic patients. EPVT has been defined as an obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal veins. Although the portal vein accounts

  1. Travel and venous thrombosis: a systematic review

    NARCIS (Netherlands)

    Kuipers, S.; Schreijer, A. J. M.; Cannegieter, S. C.; Bueller, H. R.; Rosendaal, F. R.; Middeldorp, S.

    2007-01-01

    In the past decade, numerous publications on the association between venous thrombosis (VT) and travel have been published. Relative and absolute risks of VT after travel, and particularly after travel by air, have been studied in case-control and observational follow-up studies, whereas the effect

  2. Portal vein thrombosis complicating appendicitis | Ayantunde | West ...

    African Journals Online (AJOL)

    Appendicitis is still the most common acute surgical abdomen all over the world and its complications may be grave. We report an adult case of acute appendicitis complicated by Portal Vein Thrombosis (PVT) and ascending portomesenteric phlebitis treated successfully with antibiotics and anticoagulation with no residual ...

  3. vein thrombosis in elective hip replacement

    African Journals Online (AJOL)

    With the decision tree and these costs, the cost of the various modalities of prophylaxis was then detennined. Results. The probability, detennined by the forum, of developing a deep-vein thrombosis (DYD when no prophylaxis is used was 0.5, with a mortality rate of 2.1 %. The cost of this decision was R875. No prophylaxis ...

  4. Circadian Variation in Coronary Stent Thrombosis

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Lennon, Ryan J.; Ting, Henry H.; Rihal, Charanjit S.; Holmes, David R.

    Objectives We sought to determine the circadian, weekly, and seasonal variation of coronary stent thrombosis. Background Other adverse cardiovascular events such as acute myocardial infarction are known to have higher incidences during the early morning hours, Mondays, and winter months. Methods The

  5. Portal vein thrombosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    von Köckritz, Leona; De Gottardi, Andrea; Trebicka, Jonel

    2017-01-01

    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty...

  6. Bilateral thalamic infarction that is secondary thrombosis to the deep venous structures: report of two cases

    Directory of Open Access Journals (Sweden)

    Serdar Oruc

    2016-12-01

    Full Text Available Deep cerebral venous thrombosis cases are the %6 of the cerebral venous thrombosis (CVT cases. The recognition of these patients is difficult since this disease is rarely observed and its clinical presentation is nonspecific and variable. In its etiology, the most frequently observed reasons are hypercoagulopathy, oral contraceptive use, pregnancy, puerperium, dehydration, and head trauma. Less frequently observed reasons are vasculitis, inflammatory bowel disease, malignancies, anemia, and tumor invasion through venous sinuses. In this report, were presented two cases who were admitted to the hospital with headache complaint and cognitive changes.According to the advanced magnetic resonance imaging, acute infarction was detected in bilateral thalamus. We observed CVT with adversely affected deep cerebral venous system structures. CVT development was associated with the use of oral contraceptives in the first case and it was associated with anemia in the second case. Both patients were discharged from the hospital upon healing with anticoagulant therapy. In this study, it has been emphasized by representing these two patients that CVT should be thought in the etiology of bilateral thalamic ischemia. Furthermore, it is also crucial to known that these patients can be fully improved clinically and radiologically in case appropriate medical treatment is applied.

  7. Venous thrombosis: the history of knowledge.

    Science.gov (United States)

    Mannucci, P M

    2002-01-01

    Venous thrombosis is a frequent disease. It is surprising, therefore, that no case truly compatible with a diagnosis of venous thrombosis was apparently reported in the antiquity. There is no case that could be reasonably attributed to a venous thrombus in the writings of Hippocrates, Galenus, Celius Aurelianus, Ibn an-Nafiz, Avicenna and others. Venous thrombosis is not among the many diseases mentioned in the Bible. The term "leucophlegmasia", first used by Hippocrates and then by Celius Aurelianus, refers to cases of bilateral leg edema, most likely due to conditions such as heart failure, liver cirrhosis and renal insufficiency. Nothing compatible with a diagnosis of venous thrombosis can be found in pieces of art from ancient Egypt, Greece, Rome, Persia and South America. While in these sources there are sometimes representations of varicose veins and ulcers, unilateral leg edema or other pictures compatible with venous thrombosis are not featured. The first well documented case of venous thrombosis is depicted in a beautifully illustrated manuscript written in the 13th century and currently preserved in Paris at the Bibliothèque Nationale (MS Fr 2829, Folio 87). The manuscript describes the case of a young man from Normandy named Raoul who at the age of twenty developed unilateral edema in the right ankle that subsequently extended up to the thigh, with no obvious symptoms in the contralateral leg. Raoul was advised to visit the tomb of Saint Louis who was buried in the church of Saint Denis, where the patient spent several days confessing his sins and praying the saint. Afterwards he chose to collect the dust accumulating below the stone that covered the tomb and to apply it on the fistulae and ulcers of his foot. The openings stopped running and were filled with flesh. He was first obliged to use crutches but subsequently he could walk with a cane, to be eventually able to dispose of all devices, even though his foot throbbed a little. Raoul was cured as

  8. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis

    National Research Council Canada - National Science Library

    Harroud, Adil; Labelle, Hubert; Joncas, Julie; Mac-Thiong, Jean-Marc

    2013-01-01

    Global sagittal alignment is considered as an important aspect in the management of spinal disorders, but the evidence establishing its clinical impact in lumbosacral spondylolisthesis is still poor...

  9. Cranialization of the frontal sinus-the final remedy for refractory chronic frontal sinusitis

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Wagemakers, Michiel; Korsten-Meijer, Astrid G. W.; Buiter, C. T. Kees; van der Laan, Bernard F. A. M.; Mooij, Jan Jakob A.

    Object. Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed

  10. Distribution of sagittal occlusal relationships in different stages of dentition

    Directory of Open Access Journals (Sweden)

    Emine KAYGISIZ

    2015-01-01

    Full Text Available The aim of this study was to assess the distribution of sagittal occlusal relationships in different dentition periods in a Turkish sample group. In total, 1,110 patients (561 females, 549 males aged 4.6-23 years were randomly chosen after intraoral clinical examination. The subjects were classified according to their sagittal occlusal relationships and four dentition stages –deciduous, early mixed, late mixed, and permanent dentition. The statistical significance of the occurrence of malocclusion types in dentition stages was evaluated by Chi-square and Fischer’s exact tests. Class I malocclusion was observed at the highest rate in all dentition stages. Class III malocclusion was observed at the highest rate in the permanent dentition, whereas Class II malocclusion was observed at the highest rate in the late mixed dentition. The rates of Class I, II, and III malocclusions were similar in males and females. Our study reveals that the prevalence of malocclusion and need for orthodontic treatment has increased in the population towards the permanent dentition.

  11. Analysis of sagittal condyl inclination in subjects with temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Dodić Slobodan

    2010-01-01

    Full Text Available Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD. The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examineers with signs (symptoms of TMD, and the control group also included 30 persons without any signs (symptoms of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo. The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagittal condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.

  12. Acute cytomegalovirus infection complicated by venous thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Parola Philippe

    2005-08-01

    Full Text Available Abstract Background CMV-induced vasculopathy and thrombosis have been reported, but they are rare conditions usually encountered in immunocompromised patients. However more and more complications of CMV infections are recognized in immunocompetent patients. Case presentation We present a case report of a previously healthy adult with cytomegalovirus infection that was complicated by tibiopopliteal deep venous thrombosis and in whom Factor V Leiden heterozygous mutation was found. Conclusion This new case report emphasizes the involvement of cytomegalovirus in induction of vascular thrombosis in patients with predisposing risk factors for thrombosis. It is necessary to screen for CMV infection in patients with spontaneous thrombosis and an history of fever.

  13. Acute cytomegalovirus infection complicated by venous thrombosis: a case report

    Science.gov (United States)

    Rovery, Clarisse; Granel, Brigitte; Parola, Philippe; Foucault, Cédric; Brouqui, Philippe

    2005-01-01

    Background CMV-induced vasculopathy and thrombosis have been reported, but they are rare conditions usually encountered in immunocompromised patients. However more and more complications of CMV infections are recognized in immunocompetent patients. Case presentation We present a case report of a previously healthy adult with cytomegalovirus infection that was complicated by tibiopopliteal deep venous thrombosis and in whom Factor V Leiden heterozygous mutation was found. Conclusion This new case report emphasizes the involvement of cytomegalovirus in induction of vascular thrombosis in patients with predisposing risk factors for thrombosis. It is necessary to screen for CMV infection in patients with spontaneous thrombosis and an history of fever. PMID:16098229

  14. Bioprinted thrombosis-on-a-chip.

    Science.gov (United States)

    Zhang, Yu Shrike; Davoudi, Farideh; Walch, Philipp; Manbachi, Amir; Luo, Xuan; Dell'Erba, Valeria; Miri, Amir K; Albadawi, Hassan; Arneri, Andrea; Li, Xiaoyun; Wang, Xiaoying; Dokmeci, Mehmet Remzi; Khademhosseini, Ali; Oklu, Rahmi

    2016-10-18

    Pathologic thrombosis kills more people than cancer and trauma combined; it is associated with significant disability and morbidity, and represents a major healthcare burden. Despite advancements in medical therapies and imaging, there is often incomplete resolution of the thrombus. The residual thrombus can undergo fibrotic changes over time through infiltration of fibroblasts from the surrounding tissues and eventually transform into a permanent clot often associated with post-thrombotic syndrome. In order to understand the importance of cellular interactions and the impact of potential therapeutics to treat thrombosis, an in vitro platform using human cells and blood components would be beneficial. Towards achieving this aim, there have been studies utilizing the capabilities of microdevices to study the hemodynamics associated with thrombosis. In this work, we further exploited the utilization of 3D bioprinting technology, for the construction of a highly biomimetic thrombosis-on-a-chip model. The model consisted of microchannels coated with a layer of confluent human endothelium embedded in a gelatin methacryloyl (GelMA) hydrogel, where human whole blood was infused and induced to form thrombi. Continuous perfusion with tissue plasmin activator led to dissolution of non-fibrotic clots, revealing clinical relevance of the model. Further encapsulating fibroblasts in the GelMA matrix demonstrated the potential migration of these cells into the clot and subsequent deposition of collagen type I over time, facilitating fibrosis remodeling that resembled the in vivo scenario. Our study suggests that in vitro 3D bioprinted blood coagulation models can be used to study the pathology of fibrosis, and particularly, in thrombosis. This versatile platform may be conveniently extended to other vascularized fibrotic disease models.

  15. Genetic risk factors for thrombosis in systemic lupus erythematosus.

    Science.gov (United States)

    Kaiser, Rachel; Li, Yonghong; Chang, Monica; Catanese, Joseph; Begovich, Ann B; Brown, Elizabeth E; Edberg, Jeffrey C; McGwin, Gerald; Alarcón, Graciela S; Ramsey-Goldman, Rosalind; Reveille, John D; Vilá, Luis M; Petri, Michelle A; Kimberly, Robert P; Taylor, Kimberly E; Criswell, Lindsey A

    2012-08-01

    Thrombosis is a serious complication of systemic lupus erythematosus (SLE). We investigated whether genetic variants implicated in thrombosis pathways are associated with thrombosis among 2 ethnically diverse SLE cohorts. Our discovery cohort consisted of 1698 patients with SLE enrolled in the University of California, San Francisco, Lupus Genetics Project and our replication cohort included 1361 patients with SLE enrolled in the PROFILE cohort. Patients fulfilled American College of Rheumatology SLE criteria, and data relevant to thrombosis were available. Thirty-three single nucleotide polymorphisms (SNP) previously shown to be associated with risk of deep venous thrombosis in the general population or implicated in thrombosis pathways were genotyped and tested for association with thrombosis in bivariate allelic analyses. SNP with p FGG) rs2066865 (OR 1.91, p = 0.01) in Hispanic Americans. SNP in these genes showed association with venous thrombosis risk in whites: MTHFR rs1801131 (OR 1.51, p = 0.01), MTHFR rs1801133 (OR 0.70, p = 0.04), FVL rs6025 (OR 2.69, p = 0.002), and FGG rs2066865 (OR 1.49, p = 0.02) in whites. A SNP in FGG rs2066865 (OR 2.19, p = 0.003) demonstrated association with arterial thrombosis risk in Hispanics. Our results implicate specific genetic risk factors for thrombosis in patients with SLE and suggest that genetic risk for thrombosis differs across ethnic groups.

  16. Prevalence of incidental paranasal sinus opacification in dental paediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo [Department of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2008-12-15

    The purpose of this study was to determine the prevalence of sinus opacification among dental paediatric patients. Two hundred and eight Cone Beam Computed Tomography (CBCT) scans of dental patients under the age of 18 were reviewed for sinus opacification. Patients with any sinus-related signs or symptoms were excluded. The overall prevalence of sinus opacification was 48.1%. The ethmoid (28.4%) and maxillary (27.8%) sinuses were most frequently affected. There were no statistically significant differences for both age and gender. The high prevalence of sinus opacification in asymptomatic children emphasizes the necessity of clinical correlation.

  17. [Diagnosis and treatment of fungal ball rhino-sinusitis].

    Science.gov (United States)

    Nie, Jun; Liu, Fenfang; Zhang, Hanwu; Li, Li

    2013-07-01

    To explore the diagnosis and treatment of the fungal ball rhino-sinusitis. The clinical data of 128 cases with the fungal ball rhino-sinusitis in our hospital between September 2005 and January 2012 were retrospectively analyzed. All patients were accepted nasal endoscopic surgery and followed up after surgery. The diagnosis were confirmed by postoperative pathological examination. The sinus of all patients epithelialized after the surgery from fourth to ninth weeks, one case recurred eight months later. Sinus CT scan and nasal endoscopy were very important to the diagnosis of the fungal ball rhino-sinusitis, and nasal endoscopic surgery is the most important treatment method to fungal ball rhino-sinusitis.

  18. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.

    Science.gov (United States)

    Cleary, Daniel R; Siler, Dominic A; Whitney, Nathaniel; Selden, Nathan R

    2017-06-02

    OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation

  19. Improvement of psychiatric symptoms in youth following resolution of sinusitis.

    Science.gov (United States)

    Mahony, Talia; Sidell, Douglas; Gans, Hayley; Brown, Kayla; Farhadian, Bahare; Gustafson, Melissa; Sherr, Janell; Thienemann, Margo; Frankovich, Jennifer

    2017-01-01

    Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines. Sinusitis treatments, sinonasal imaging, and neuropsychiatric symptoms before, during, and after sinusitis onset were noted. Patients were included in the final review if they had a clear diagnosis of isolated sinusitis (without concurrent illness and/or immunodeficiency), and were evaluated during an episode of sinusitis. 10/150 (6.6%) patients had isolated sinusitis at the time of their neuropsychiatric deterioration. Eight patients received antibiotics to treat sinusitis, three of whom also received sinus surgery. Neuropsychiatric symptoms improved in all eight patients concurrent with resolution of sinusitis per parent report and clinician assessment. One patient did not follow through with recommended sinus surgery or antibiotics and her psychiatric symptoms persisted. One patient was lost to follow-up. Improvement of psychiatric symptoms correlated with resolution of sinus disease in this retrospective study. Identification, treatment, and resolution of underlying infections, including sinusitis, may have the potential to change the trajectory of some neuropsychiatric illnesses. Randomized clinical trials are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. [Treatment of low-dose erythromycin and sinus displacement on sinusitis in patients with nasopharyngeal carcinoma after radiotherapy].

    Science.gov (United States)

    Wei, Zhenghong; Han, Guang; Li, Bennong

    2011-11-01

    To study the effect of low-dose erythromycin combined with sinus displacement therapy on treating sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. The sinus displacement were used with mixed liquid of metronidazole, protease and dexamethasone, and meantime roxithromycin was orally administered. Effective rate was 97.1% in 35 nasopharyngeal carcinoma patients with sinusitis after radiotherapy. Low-dose erythromycin combined with sinus displacement therapy is effective to treat sinusitis in patients with nasopharyngeal carcinoma after radiotherapy. Its advantages are safe, effective, and easy to do.

  1. Evolution of sinusal and non-sinusal spleens of Mammals

    Directory of Open Access Journals (Sweden)

    Ion Udroiu

    2006-09-01

    Full Text Available Abstract Mammals present different types of spleen. In the past, attempts have been made to define characteristics for a classification of this organ, but the evolutionary process that has led to the splenic types of modern mammals has been poorly investigated. This review categorizes all mammalian spleens studied so far, synthesizing several earlier classification principles and updating them in the light of recent research. The main qualitative features are the type of circulation (closed, open or both and the nature of the venous vessels in the splenic cords (venules or sinuses. The main quantitative feature is the proportion between red and white pulp. Moreover, a phylogeny of this organ is proposed: from a ‘primitive type’ with closed circulation (characteristic of monotremes, insectivores and tree shrews, the spleen has evolved into an ‘archetypal type’ with open circulation (peculiar to mice, gerbils, bats and marsupials. It has subsequently diversified into different models: blood-storing spleens (ungulates and carnivores and defensive spleens (Old World monkeys and the majority of rodents. Riassunto Evoluzione delle milze sinusale e non-sinusale dei mammiferi I mammiferi presentano diversi tipi di milza. Nel passato, sono stati fatti dei tentativi per definire le caratteristiche utili alla classificazione di quest’organo, ma il processo evolutivo che ha portato ai tipi di milza dei mammiferi moderni è stato poco studiato. Questa review classifica tutte le milze dei mammiferi studiate finora, facendo una sintesi dei criteri di classificazione precedenti ed aggiornandoli alla luce delle più recenti ricerche. I principali caratteri qualitativi sono il tipo di circolazione (chiusa, aperta o entrambe e la natura dei vasi venosi nei cordoni splenici (venule o seni. Il principale carattere quantitativo è la proporzione tra la polpa rossa e quella bianca. Inoltre, viene

  2. Subtotal cranial vault remodelling in anterior sagittal suture closure: impact of age on surgical outcome

    NARCIS (Netherlands)

    Engel, M.; Hoffmann, J.; Muhling, J.; Castrillon-Oberndorfer, G.; Seeberger, R.; Freudlsperger, C.

    2012-01-01

    Isolated fusion of the sagittal suture is usually treated before 1 year of age, but some patients present at a later age. The aim of this study was to evaluate the impact of children's age on the surgical outcome. The authors investigated 46 patients with isolated nonsyndromic sagittal

  3. Extensor Tendon Instability Due to Sagittal Band Injury in a Martial Arts Athlete: A Case Report.

    Science.gov (United States)

    Kochevar, Andrew; Rayan, Ghazi

    2017-03-01

    A Taekwondo participant sustained a hand injury from punching an opponent that resulted in painful instability of the ring finger extensor digitorum communis tendon due to sagittal band damage. His symptoms resolved after reconstructive surgery on the sagittal band (SB) with stabilization of the extensor tendon over the metacarpophalangeal joint.

  4. 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 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/dehiscence and transverse sinus stenosis in

  5. [Surgery of the nose and paranasal sinuses].

    Science.gov (United States)

    Hofer, M; Dacho, A; Dietz, A

    2016-01-01

    A compromised overview of surgical techniques regarding the nose (functional) and para nasal sinus inflammation surgical treatment is exposed in this article. The nasal septum is within the focus for function, form and stability for the nasal structure (especially for tip and back of the nose) and for success of a rhinoplasty. An important role play the lower nasal turbinates regulating nasal air flow and thus having a great effect after turbinate surgery (submucosal resection and lateral fracturing).The endonasal endoscopy is of utmost importance for diagnosis, therapy and detection of recurrence. In severe cases of nasal polyps, functional endoscopic sinus surgery (FESS) remains the ultimate therapy. However, the indication to operate will be carried out after exhaustion of medical treatment. The most important recurrent prophylaxis for rhino sinusitis and nasal polyps is an appropriate post operative nasal care. © Georg Thieme Verlag KG Stuttgart · New York.

  6. [The normative combined therapy for recurrent sinusitis].

    Science.gov (United States)

    Peng, Bengang; Sun, Yiqing; Miao, Xutao; Wang, Xin; Li, Wenjun

    2014-06-01

    To assess the treatment outcome after endoscopic sinus surgery (ESS) in patients with recurrent sinusitis and to research which factors could influence the clinical outcome. Endoscopic sinus surgery was performed in 55 patients. The clinical outcome and epithelization of mucosa after ESS were evaluated by Chinese ENT Association criteria. The total cure rate was 81.82%, effective rate was 92.73%. The mean period of epithelization after operation was 13.2 weeks. No serious complication occurred. The treatment efficacy can be greatly improved by the normative combined therapy which include the standard and orderly perioperative treatment ,the overall shape and nasalization of nasal cavity, postoperative follow-up and clearing cav ity after ESS.

  7. Miller Fisher syndrome with sinus arrest

    Directory of Open Access Journals (Sweden)

    Nobuko Shiraiwa

    2017-08-01

    Full Text Available Dysautonomia in Guillain-Barre syndrome (GBS rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

  8. MR-guided endoscopic sinus surgery.

    Science.gov (United States)

    Hsu, L; Fried, M P; Jolesz, F A

    1998-08-01

    We describe an interactive, intraoperative imaging-guided method for performing endoscopic sinus surgery (ESS) within a vertically open MR system. The procedure was performed with intraoperative imaging using a 0.5-T magnet with a 56-cm vertical gap. Interactive control of imaging planes was accomplished by optical tracking with two infrared light-emitting diodes mounted on an aspirator probe. The probe's position defined the location of the orthogonal imaging planes. Twelve patients with varying degrees of sinus disease underwent ESS with MR imaging guidance. Patients had acute and chronic sinusitis, nasal polyposis causing airway obstruction, or tumor requiring tissue biopsy. All procedures were performed with the patients under general anesthesia. The integration of endoscopy with optical tracking and intraoperative interactive imaging allowed localization of anatomic landmarks during ESS. No complications were encountered.

  9. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis: diagnostic criteria.

    Science.gov (United States)

    Uri, N; Ronen, O; Marshak, T; Parpara, O; Nashashibi, M; Gruber, M

    2013-09-01

    Chronic sinusitis is one of the most common otolaryngological diagnoses. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed and treated as chronic sinusitis, causing continuing harm. To better identify and characterise these two subgroups of patients, who may suffer from a systemic disease requiring multidisciplinary treatment and prolonged follow up. A retrospective, longitudinal study of all patients diagnosed with allergic fungal sinusitis or eosinophilic mucin rhinosinusitis within one otolaryngology department over a 15-year period. Thirty-four patients were identified, 26 with eosinophilic mucin rhinosinusitis and 8 with allergic fungal sinusitis. Orbital involvement at diagnosis was commoner in allergic fungal sinusitis patients (50 per cent) than eosinophilic mucin rhinosinusitis patients (7.7 per cent; p sinusitis patients. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis have the same clinical presentation but different clinical courses. The role of fungus and the ability to confirm its presence are still problematic issues, and additional studies are required.

  10. An unusual foreign body in the maxillary sinus: Dental impression ...

    African Journals Online (AJOL)

    2015-03-06

    12] The present report presents a case of dental impression material that passed through an oro‑antral fistula while in its plastic form, solidified inside the maxillary sinus, and caused a maxillary sinus infection. Case Report.

  11. Severe bleeding after sinus floor elevation using the transcrestal technique

    DEFF Research Database (Denmark)

    Jensen, Simon Storgard; Eriksen, Jacob; Schiodt, Morten

    2012-01-01

    To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique.......To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique....

  12. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    Science.gov (United States)

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Degenerative retrolisthesis: is it a compensatory mechanism for sagittal imbalance?

    Science.gov (United States)

    Jeon, C-H; Park, J-U; Chung, N-S; Son, K-H; Lee, Y-S; Kim, J-J

    2013-09-01

    We investigated the spinopelvic morphology and global sagittal balance of patients with a degenerative retrolisthesis or anterolisthesis. A total of 269 consecutive patients with a degenerative spondylolisthesis were included in this study. There were 95 men and 174 women with a mean age of 64.3 years (sd 10.5; 40 to 88). A total of 106 patients had a pure retrolisthesis (R group), 130 had a pure anterolisthesis (A group), and 33 had both (R+A group). A backward slip was found in the upper lumbar levels (mostly L2 or L3) with an almost equal gender distribution in both the R and R+A groups. The pelvic incidence and sacral slope of the R group were significantly lower than those of the A (both p anterolisthesis and high pelvic incidence.

  14. Sagittal spinopelvic parameters in 2-level lumbar degenerative spondylolisthesis

    Science.gov (United States)

    Wang, Tao; Wang, Hui; Liu, Huan; Ma, Lei; Liu, Feng-Yu; Ding, Wen-Yuan

    2016-01-01

    Abstract The purpose of our study is to evaluate sagittal parameters in 2-level lumbar degenerative spondylolisthesis (DS) (TLDS). A total of 15 patients with TLDS, 40 patients with single-level DS (SLDS), and 30 normal volunteers as control were included in our study. All subjects performed on full spine X-ray. Two categorized data were analyzed: patient characteristics—age, sex, body mass index, radiographic parameters-pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), sacral slope (SS), PI–LL, Cobb between the fifth thoracic vertebral and 12th thoracic vertebral (T5–T12), sagittal vertical axis (SVA) Cobb angle of spondylolisthesis level (CSL), ratio of PT to SS (PT/SS), CSL/LL, variation trend of SS over PI, and LL over PI. The PI (73.1° vs 52.9°), SS (50.8° vs 32.2°), LL (53.1° vs 46.9°), SVA (66.1 vs 22.0 mm), PI–LL (20.0° vs 6.0°), and CSL (23.6° vs 20.0°) in TLDS were significantly larger than these in SLDS. The PI (73.1° vs 40.6°), PT (22.3° vs 17.1°), SS (50.8° vs 23.5°), LL (53.1° vs 32.5°), PI–LL (20.0° vs 8.1°), and SVA (66.1 vs 17.0 mm) in TLDS were significantly larger than those in the normal group (NG). The PI (52.9° vs 40.6°), PT (21.0° vs 17.1°), SS (32.2° vs 23.5°), LL (46.9° vs 32.5°), and SVA (22.0 vs 17.0 mm) in SLDS were significantly higher than those in NG. However, PT/SS (44.0%), LL over PI (y = 0.39x + 24.25), SS over PI (y = 10.79 + 0.55x) were lower in TLDS than these in SLDS (63.8%, y = 0.41x + 25, y = 0.65x − 2.09, respectively), and the similar tend between SLDS and NG (74.0%, y = 0.49x + 13.09, y = 0.67x − 3.9, respectively). Our results showed that 2-level lumbar DS, which was caused by multiple-factors, has a severe sagittal imbalance, but single-level has not any. When we plan for surgical selection for 2-level lumbar DS, global sagittal balance must be considered. PMID:27977581

  15. Application of 3-Dimensional Computerized Tomography Angiography for Defining Cavernous Sinus Aneurysms and Intradural Aneurysms Involving the Internal Carotid Artery Around the Anterior Clinoid Process.

    Science.gov (United States)

    Cheng, Quan; Huang, Chun-Bo; Wang, Jun-Yu; Jiang, Bing; Zhang, Long-Bo; Zeng, Ming; Chen, Yuan-Bing; Zhang, Hong-Fu; Chen, Feng-Hua

    2017-10-01

    This study aimed to investigate the application of 3-dimensional computed tomography angiography (3D-CTA) for defining cavernous sinus aneurysms and intradural aneurysms involving the internal carotid artery around the anterior clinoid process. Results from 42 patients with an aneurysm of the internal carotid artery around the anterior clinoid process who underwent 3D-CTA were reviewed and compared with those of observed clinical operations. Among the 42 patients, there was a total of 45 aneurysms of the internal carotid artery around the anterior clinoid process. After surgery, 33 of the 45 aneurysms were confirmed as intradural aneurysms, and the other 12 were confirmed as aneurysms in the cavernous sinus. 3D-CTA imaging of the medial sagittal plane showed that 31 out of 31 (100%) intradural aneurysms of the internal carotid artery were above the virtual line between the inferior border of the anterior clinoid process and the tuberculum sellae, and 12 out of 14 (86%) cavernous sinus aneurysms were below the virtual line (P cavernous sinus aneurysms from intradural aneurysms involving the internal carotid artery around the anterior clinoid process. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Systemic complications of functional endoscopic sinus surgery in patients with chronic rhinosinusitis].

    Science.gov (United States)

    Wang, Hongtian; Jiang, Wen; Xu, Cong; Qiu, Xin

    2014-10-01

    To analyses the causes and prevention of systemic complications of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis. Three typical cases were reported including their medical history, preoperative diagnosis, medications during preoperational period, complications and treatment. The causes and preventive measures of systemic complications were analyzed. Three patients were all suffered from chronic rhinosinusitis with nasal polyps (CRSwNP). After FESS, 1 case was complicated with coma and hyponatremia, 1 case with acute myocardial infarction, and 1 case with lower extremity deep venous thrombosis. The patient with coma and hyponatremia was soon waked after intravenous infusion of 10% sodium chloride. Two patients with acute myocardial infarction and lower extremity deep venous thrombosis were soon completely rehabilitated after emergency thrombolytic therapy and endovascular intervention. Three patients were completed recovered from their systemic complications without any severe sequela. Systemic hemostatic drugs should be banned in patients with hypercoagulable state in perioperation period of FESS in order to avoid severe systemic complications. Timely vascular interventional treatment can prevent severe sequels.

  17. Influence of World Thrombosis Day on digital information seeking on venous thrombosis: a Google Trends study.

    Science.gov (United States)

    Scheres, L J J; Lijfering, W M; Middeldorp, S; Cannegieter, S C

    2016-12-01

    Essentials In 2014, World Thrombosis Day (WTD) was initiated to increase global awareness of thrombosis. Google Trends can be used freely to monitor digital information seeking behavior. We used Google Trends data to assess the impact of WTD on internet searches on venous thrombosis. The WTD period was associated with more searches on thrombosis compared to control periods. Background World Thrombosis Day (WTD) was launched in 2014 and is to be held every year to increase global awareness of venous thrombosis. Measuring the impact of health awareness days is challenging; however, use of internet-based data seems promising. Methods Google Trends data were used to quantify digital searches for 'venous thrombosis' worldwide and 'trombose' in the Netherlands. The relative search volume (RSV), which is the proportion of the term of interest amongst all Google searches for a specific region and timeframe was used. Mean differences for 4 weeks surrounding WTD (period of interest) and the remaining weeks of the year (control period) were estimated with 95% confidence intervals (95% CI). This was done for 2014, 2015 and 2009-2013 (control years). Results and discussion Mean differences in RSV for worldwide searches were 2.9 (95% CI, -8.2, 14.1) in 2014 and 10.5 (95% CI, 0.4, 20.5) in 2015. These figures were 15.3 (95% CI, 4.7, 25.8) and 15.9 (95% CI, 7.8, 24.1) for the Netherlands, respectively. Relatively, this corresponds to an increase in RSV of 3.9% and 13.9% for 2014 and 2015 worldwide and a 21.9% and 23.3% increase for 2014 and 2015 in the Netherlands. There was one control year with an increase in RSV in the WTD period. Conclusion In 2014 and 2015 WTD was associated with an increase in digital information seeking on venous thrombosis worldwide. This association was more pronounced in 2015 than in 2014. © 2016 International Society on Thrombosis and Haemostasis.

  18. Assessment of spring cranioplasty biomechanics in sagittal craniosynostosis patients.

    Science.gov (United States)

    Borghi, Alessandro; Schievano, Silvia; Rodriguez Florez, Naiara; McNicholas, Roisin; Rodgers, Will; Ponniah, Allan; James, Greg; Hayward, Richard; Dunaway, David; Jeelani, N U Owase

    2017-11-01

    OBJECTIVE Scaphocephaly secondary to sagittal craniosynostosis has been treated in recent years with spring-assisted cranioplasty, an innovative approach that leverages the use of metallic spring distractors to reshape the patient skull. In this study, a population of patients who had undergone spring cranioplasty for the correction of scaphocephaly at the Great Ormond Street Hospital for Children was retrospectively analyzed to systematically assess spring biomechanical performance and kinematics in relation to spring model, patient age, and outcomes over time. METHODS Data from 60 patients (49 males, mean age at surgery 5.2 ± 0.9 months) who had received 2 springs for the treatment of isolated sagittal craniosynostosis were analyzed. The opening distance of the springs at the time of insertion and removal was retrieved from the surgical notes and, during the implantation period, from planar radiographs obtained at 1 day postoperatively and at the 3-week follow-up. The force exerted by the spring to the patient skull at each time point was derived after mechanical testing of each spring model-3 devices with the same geometry but different wire thicknesses. Changes in the cephalic index between preoperatively and the 3-week follow-up were recorded. RESULTS Stiffer springs were implanted in older patients (p springs were used (p spring models, however, the devices all plateaued. Indeed, regardless of patient age or spring model, after 10 days from insertion, all the devices were open. CONCLUSIONS Results in this study provide biomechanical insights into spring-assisted cranioplasty and could help to improve spring design and follow-up strategy in the future.

  19. Spatiotemporal complexity of the aortic sinus vortex

    Science.gov (United States)

    Moore, Brandon; Dasi, Lakshmi Prasad

    2014-07-01

    The aortic sinus vortex is a classical flow structure of significant importance to aortic valve dynamics and the initiation and progression of calcific aortic valve disease. We characterize the spatiotemporal characteristics of aortic sinus vortex dynamics in relation to the viscosity of blood analog solution as well as heart rate. High-resolution time-resolved (2 kHz) particle image velocimetry was conducted to capture 2D particle streak videos and 2D instantaneous velocity and streamlines along the sinus midplane using a physiological but rigid aorta model fitted with a porcine bioprosthetic heart valve. Blood analog fluids used include a water-glycerin mixture and saline to elucidate the sensitivity of vortex dynamics to viscosity. Experiments were conducted to record 10 heart beats for each combination of blood analog and heart rate condition. Results show that the topological characteristics of the velocity field vary in timescales as revealed using time bin-averaged vectors and corresponding instantaneous streamlines. There exist small timescale vortices and a large timescale main vortex. A key flow structure observed is the counter vortex at the upstream end of the sinus adjacent to the base (lower half) of the leaflet. The spatiotemporal complexity of vortex dynamics is shown to be profoundly influenced by strong leaflet flutter during systole with a peak frequency of 200 Hz and peak amplitude of 4 mm observed in the saline case. While fluid viscosity influences the length and timescales as well as the introduction of leaflet flutter, heart rate influences the formation of counter vortex at the upstream end of the sinus. Higher heart rates are shown to reduce the strength of the counter vortex that can greatly influence the directionality and strength of shear stresses along the base of the leaflet. This study demonstrates the impact of heart rate and blood analog viscosity on aortic sinus hemodynamics.

  20. Heparin-induced thrombocytopenia and thrombosis.

    Science.gov (United States)

    Patel, Vipul P; Bong, Matthew; Di Cesare, Paul E

    2007-05-01

    Heparin-induced thrombocytopenia (HIT) and heparin induced thrombocytopenia with thrombosis (HITT) ar rare complications associated with use of unfractionate heparin (UFH) or low-molecular-weight heparin (LMWH) HIT is a benign clinical condition characterized by a mil drop in platelet count with no clinical significance. HIT is an immune-mediated reaction associated with a wide spread "hypercoagulable" state resulting in arterial an venous thrombosis. There is a higher incidence of HIT with UFH use than with LMWH use. Orthopedic surger patients are at higher risk for developing HITT than are patients who receive prophylactic heparin for cardiovascular surgery or medical reasons. Therapy for patients suspected of having HITT should begin with immedi ate discontinuation of heparin in any form followed by pharmacologic inhibition with thrombin (e.g., recombinant hirudin [lepirudin], argatroban, danaparoid sodium).

  1. Rock climbing-related subclavian vein thrombosis.

    Science.gov (United States)

    Lutter, Christoph; Monasterio, Erik; Schöffl, Volker

    2015-10-01

    Paget-Schroetter syndrome, also known as upper extremity deep venous thrombosis (UEDVT), is a rare condition, characterised by a (sub-) total occlusion of the axillary-subclavian venous system due to thrombosis. UEDVT is the most common vascular condition among athletes so far; although the general incidence is low, this problem will become more frequent as a result of increased participation in climbing sports. The purpose of this report is to illustrate two cases in rock climbers where UEDVT developed during rock climbing or bouldering. Fortunately, both patients were diagnosed relatively early after the symptoms began, despite the ambiguity of UEDVT symptoms. This relatively unfamiliar condition may become more highly recognised as a potentially serious differential diagnosis of unspecific pain of the shoulder. Rock climbers are disposed to develop UEDVT due to frequent stress on the upper extremities during training or competition. 2015 BMJ Publishing Group Ltd.

  2. C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment.

    Science.gov (United States)

    Matsubayashi, Yoshitaka; Chikuda, Hirotaka; Oshima, Yasushi; Taniguchi, Yuki; Fujimoto, Yoh; Shimizu, Takachika; Tanaka, Sakae

    2017-05-01

    Previous studies have indicated that the T1 slope correlates with cervical lordosis. In contrast, the specific impact of the C7 sagittal vertical axis (C7SVA) on cervical lordosis remains unknown. This study aimed to investigate the specific role of C7SVA in cervical lordosis. This was a retrospective radiographic study. Forty-eight consecutive patients who underwent lateral standing radiography of the entire spine were retrospectively reviewed. Radiographic parameters included occipito (Oc)-C7, Oc-C2, C2-C7, C2-C4, and C5-C7 angles; T1 slope; C7SVA; T1 pelvic angle (TPA); pelvic incidence; pelvic tilt; and sacral slope. The radiographs of 96 consecutive patients who underwent lateral standing radiography of the entire spine in June 2015 in our hospital were retrospectively reviewed. Patients having cervical deformities, having undergone cervical fusion, and under 18 years of age were excluded. A total of 48 Asian patients (14 men and 34 women; mean age, 54.6 years) were eligible. Pathologies included scoliosis, myelopathy, thoracolumbar deformity, and spondylosis. Spearman rank correlation coefficients were used to examine correlations between the parameters. The relationship between C5-C7 lordosis and the radiographic parameters was calculated using the forward stepwise multivariate regression analysis. The authors do not have financial associations relevant to this article. C7SVA correlated with the Oc-C7 (r=0.42) and C2-C7 (r=0.50) angles. However, the correlation coefficient was smaller than that between the T1 slope and Oc-C7 (r=0.83) or C2-C7 (r=0.76) angles. When the C2-C7 angle was divided into C2-C4 and C5-C7 angles, C7SVA correlated with the C5-C7 (r=0.63) angle but not with the C2-C4 angle. The correlation coefficient between the C5-C7 angle and C7SVA was higher than that between the C5-C7 angle and T1 slope (r=0.53) or the C5-C7 angle and TPA (r=0.60). Using radiographic parameters and age, multiple regression analysis revealed that only C7SVA affected

  3. Evolution of the paranasal sinuses' anatomy through the ages

    Science.gov (United States)

    Mavrodi, Alexandra

    2013-01-01

    Previously, anatomists considered paranasal sinuses as a mysterious region of the human skull. Historically, paranasal sinuses were first identified by ancient Egyptians and later, by Greek physicians. After a long period of no remarkable improvement in the understanding of anatomy during the Middle Ages, anatomists of the Renaissance period-Leonardo da Vinci and Vesalius-made their own contribution. Nathaniel Highmore's name is also associated with the anatomy of paranasal sinuses as he was first to describe the maxillary sinus. PMID:24386595

  4. A Rare Diabetic Autonomic Neuropathy: Carotid Sinus Hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ahmet Kaya

    2016-03-01

    Full Text Available Carotid sinus hypersensitivity is a common cause of fainting and falls in the elderly, and can be diagnosed by carotid sinus massage. We present a 67-year-old diabetic man who was admitted with hyperglycemia. During thyroid examination, clouding of consciousness occurred with unilateral palpation. Asystole was documented for 4.8 seconds and suspected for 7 seconds upon carotid sinus massage. A cardioverter defibrillator was implanted. Carotid sinus hypersensitivity should be kept in mind when examining diabetic patients.

  5. Incidental sinusitis in a pediatric intensive care unit

    Science.gov (United States)

    Moore, Brooke M.; Kurachek, Stephen C.; Blumberg, Karen; Laguna, Theresa A.; Liu, Meixia; Olson, Erin E.

    2013-01-01

    Objective Intubation is a risk factor for nosocomial sinusitis in adult intensive care patients. Sinusitis in intubated adults can be an occult cause of fever. In children nasal intubation may be associated with a greater risk of sinusitis. No pediatric study has determined the incidence of nosocomial sinusitis in the pediatric intensive care unit (PICU) setting. We hypothesized that within a subset of patients who had head CT imaging: (1) the incidence of sinusitis in PICU patients exceeds the incidence in non-PICU patients; (2) the incidence of sinusitis is greater in PICU patients with a tube (nasotracheal, nasogastric, orotracheal, or orogastric); and (3) nasal tubes confer an increased risk for sinusitis compared to oral tubes. Design Retrospective chart review Setting Independent not-for-profit pediatric healthcare system Patients PICU and non-PICU (inpatients hospitalized on medical-surgical wards) patients referred for head CT Interventions None Measurements and Main Results CT images were evaluated for the presence of a tube and sinusitis. Images were scored using the Lund-MacKay (LM) staging system. Sinusitis was defined as a LM score >3.5. 596 patients were studied; 395 (66.3%) PICU. 197 (50%) PICU versus 69 (34.3%) non-PICU patients had sinusitis (p sinusitis versus 88/248 (35.9%) of those without a tube present (p sinusitis based on tube location (p=0.218). Younger age or the presence of a tube increased the probability of sinusitis (p sinus disease had evidence of sinusitis. This finding raises the concern that sinusitis in PICU patients is common and likely should be considered in the differential diagnosis of fever in PICU patients. PMID:21283043

  6. Mechanisms in adverse reactions to food. The sinuses

    DEFF Research Database (Denmark)

    Høst, A

    1995-01-01

    Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract.......Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract....

  7. The imaging of conditions affecting the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Y., E-mail: yenzhitang@doctors.net.u [Royal Free Hospital, Pond Street London NW32QG (United Kingdom); Booth, T.; Steward, M.; Solbach, T.; Wilhelm, T. [Royal Free Hospital, Pond Street London NW32QG (United Kingdom)

    2010-11-15

    The cavernous sinus can be affected by a wide range of conditions including tumours, infection, inflammation, and trauma. Disease in the cavernous sinus can produce characteristic signs and symptoms, which relate to the numerous crucial structures traversing and surrounding the cavernous sinus. Imaging, with the use of different techniques, plays a crucial role in diagnosis and management. The anatomy and imaging of the different disease entities in the cavernous sinus will be reviewed.

  8. Clinical significance of factor V leiden and prothrombin G20210A-mutations in cerebral venous thrombosis - comparison with arterial ischemic stroke.

    Science.gov (United States)

    Beye, Aida; Pindur, Gerhard

    2017-08-28

    Cerebrovascular diseases are considered in a different way concerning their etiology with regard to arterial and venous occlusion. The role of thrombophilia in this context remains undetermined. For this reason, a case-control study was conducted including a total of 202 patients (154 females, 48 males) aged from 18 to 76 years (mean: 39.8 years) suffering either from cerebral sinus venous thrombosis (n = 101) or from arterial ischemic stroke (n = 101). Study groups were evaluated on the basis of age- and gender-matched pairs. Gene mutations of factor V-1691 (factor V Leiden) and prothrombin-20210 being considered as the most common thrombophilia markers were analyzed in this study. Factor V Leiden-mutations were found in 16.8% of patients with cerebral sinus venous thrombosis (CVT) and in 17.8% of patients with arterial ischemic stroke (AIS), which was significantly more frequent than in controls at a rate of 4.95% (ORs: 3.89 and 4.16). Prothrombin-mutations were significantly more frequent in CVT at a rate of 14.9% versus 2.97% in controls (OR: 5.70). This does not apply for AIS showing a rate of 4.95% prothrombin-mutations. Rates of factor V Leiden-mutations are not different in CVT compared with AIS. In contrast, however, prothrombin-mutations were significantly more frequent in CVT than in AIS with a rate of 14.9% versus 4.95% (OR 3.35). Furthermore, 3 cases with combined heterozygosity of factor V Leiden- and prothrombin-mutation have been identified in CVT, but not in AIS or controls. All of the above mentioned mutations were exclusively heterozygous. We conclude from these data that thrombophilia in terms of factor V Leiden genotype is a risk factor for both CVT and AIS in equal measure. In contrast, prothrombin-20210-mutations were different playing a significant role in the pathogenesis of cerebral sinus vein- thrombosis, but not in arterial ischemic stroke. Also, the combined occurrence of heterozygous prothrombin- and factor V Leiden

  9. Percutaneous management of prosthetic valve thrombosis.

    Science.gov (United States)

    Hariram, Vuppaladadhiam

    2014-01-01

    Thrombosis of a prosthetic valve is a serious complication in patients with prosthetic heart valves. Thrombolysis is the initial choice of treatment. Patients who do not respond to thrombolysis are subjected to surgery which carries a high risk. We report a case series of 5 patients with prosthetic mitral valve thrombosis who did not respond to thrombolysis and were subjected to percutaneous manipulation of the prosthetic valves successfully and improved. Five patients who were diagnosed to have prosthetic mitral valve thrombosis and failed to respond to a minimum of 36 h of thrombolysis (persistent symptoms with increased gradients, abnormal findings on fluoroscopy),were subjected to percutaneous treatment after receiving proper consent. None of them had a visible thrombus on transthoracic echocardiogram. All patients underwent transseptal puncture following which a 6F JR4 guiding catheter was passed into the left atrium. The valve leaflets were repeatedly hit gently under fluoroscopic guidance till they regained their normal mobility. Mean age was 38.8 years. Average peak and mean gradients prior to the procedure were 38 and 25 and after the procedure were 12 and 6 mm of Hg respectively. All patients had successful recovery of valve motion on fluoroscopy with normalization of gradients and complete resolution of symptoms. None of the patients had any focal neurological deficits, embolic manifestations or bleeding complications. Percutaneous manipulation of prosthetic valves in selected patients with prosthetic valve thrombosis who do not respond to thrombolytic therapy is feasible and can be used as an alternative to surgery. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  10. Deep Vein Thrombosis after Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Vivek Singh Guleria

    2015-01-01

    Full Text Available Deep vein thrombosis (DVT is a rare but potentially serious complication of coronary angiography (CAG, incidence being just 0.05%. Only a few clinical cases of DVT after diagnostic transfemoral catheterization have been reported. Here, we describe the case of a 54-year-old woman who developed significant DVT after CAG without venous thromboembolism (VTE and, which was treated with anticoagulants.

  11. Atypical ultrasonographic presentation of ovarian vein thrombosis.

    Science.gov (United States)

    Graupera, B; Pascual, M A; Garcia, P; Di Paola, R; Ubeda, B; Tresserra, F

    2011-01-01

    Ovarian vein trombosis (OVT) is a pathologic entity classically considered as a postpartum complication and only rarely associated with other diseases. Due to its vague symptoms, it is usually underdiagnosed. However its consequences can be fatal. We report a case of an incidental finding of ovarian thrombosis in an asymptomatic 45-year-old woman who underwent surgery due to the ultrasonographic finding of a para-ovarian cyst.

  12. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  13. A Genetical approach to deep venous thrombosis

    OpenAIRE

    Yavuz, Celal

    2012-01-01

    Deep venous thrombosis (DVT) is a common disorder that frequently occurs after surgical procedures and trauma and in the presence of cancer or immobilization conditions. However, it can also develop without any of these predisposing factors. This condition directs the researcher's enquiry to investigating the basis of organismal thrombotic predisposition. The common prothrombotic genetic mutations include factor V Leiden, factor II G20210 A, plasminogen activator inhibitor-1, prot...

  14. A genetical approach to deep venous thrombosis

    OpenAIRE

    Celal Yavuz

    2012-01-01

    Deep venous thrombosis (DVT) is a common disorderthat frequently occurs after surgical procedures andtrauma and in the presence of cancer or immobilizationconditions. However, it can also develop without any ofthese predisposing factors. This condition directs theresearcher’s enquiry to investigating the basis of organismalthrombotic predisposition. The common prothromboticgenetic mutations include factor V Leiden, factor IIG20210 A, plasminogen activator inhibitor-1, prothrombinA20210, and f...

  15. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-01-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  16. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-03-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  17. Rhinoplasty and Functional Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    George L. Murrell

    2011-01-01

    Full Text Available An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by the author. Combined rhinoplasty and FESS can be performed with good results (functional and cosmetic and minimal complications. Advances in sinus surgery technique and equipment have made the procedure safer, faster, more precise, and more comfortable.

  18. Rhinoplasty and functional endoscopic sinus surgery.

    Science.gov (United States)

    Murrell, George L

    2011-01-01

    An increasing number of patients are opting for combining sinus surgery and cosmetic rhinoplasty. The author has been performing rhinoplasty with FESS since April of 1990. The technique and equipment used in early cases is much different than that used in more recent surgeries. Specific advances include high definition monitor, intraoperative navigation system, and powered dissecting instruments. The benefits of these advances are illustrated by a review of the more recent cases performed by the author. Combined rhinoplasty and FESS can be performed with good results (functional and cosmetic) and minimal complications. Advances in sinus surgery technique and equipment have made the procedure safer, faster, more precise, and more comfortable.

  19. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  20. Large radicular cyst in the maxillary sinus.

    Science.gov (United States)

    Sagit, Mustafa; Guler, Sabri; Tasdemir, Arzu; Akf Somdas, Mehmet

    2011-11-01

    Radicular cysts (RCs) are the most common inflammatory jaw cystic lesions that occur infected and necrotic in teeth pulps. They account for more than 50% of all odontogenic cysts. Radicular cysts cause slowly progressive painless swelling. There are no symptoms until they become large. Enucleating the cyst is recommended with primary treatment. Here we describe a patient with a large RC with maxillary sinus involvement who underwent an endonasal endoscopic approach for complete resection. In conclusion, the endonasal endoscopic approach should be kept in mind for the resection of RC with maxillary sinus involvement because of its minimally invasive characteristics.