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"Caution with choroidals" - choose the right one at right time.

Indian J Ophthalmol

December 2024

Department of Oculoplasty, Disha Eye Hospitals Pvt Ltd, Kolkata, West Bengal, India.

Article Synopsis
  • Choroidal detachment (CD) during retinal detachment surgery can negatively affect surgical results and vision, necessitating specific management techniques.
  • Cannula-guided choroidal drainage is essential for mitigating pre-existing CDs, especially in complex cases with hemorrhagic detachment.
  • Intraoperative sudden CD can be caused by issues like hypotony or air entry from cannula slippage, which may lead to serious complications like Venous Air Embolism (VAE); prompt action to stop air infusion is critical to prevent life-threatening outcomes.
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Background: Primary skull base chondrosarcoma (SBC) is a rare malignant central nervous system tumor, often involving the cavernous sinus. Complete excision of tumors invading this region is exceptionally challenging due to the presence of the internal carotid artery and numerous nerves within the cavernous sinus, particularly in cases with substantial tumor volume.

Case Presentation: This report describes a rare case of a massive primary SBC pushing the lateral wall of the cavernous sinus, measuring approximately 6.

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Article Synopsis
  • A 79-year-old woman was admitted to the hospital due to a month-long history of melena (bloody stools) and anemia caused by chronic gastrointestinal bleeding from cavernous hemangiomatosis in the small bowel.
  • She underwent two surgical procedures: an initial laparoscopic jejunal-ileal resection followed by a laparotomic duodenojejunal resection due to ongoing anemia.
  • Cavernous hemangiomatosis is a rare condition (7-10% of benign small bowel tumors) that often causes bleeding; diagnosis may involve various imaging techniques, and surgical resection is the preferred treatment method when feasible, considering the risks of extensive surgeries.
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When treating patients with a massive cavernous hemangioma of the liver that requires nonsurgical therapy, transcatheter arterial embolization has proven to be an effective technique. Significant advantages include the ability to obliterate the vascular supply of these lesions and the minimally invasive nature compared to surgery. A 65-year-old woman arrived at our hospital complaining primarily of stomach pain that had been there for six months.

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Article Synopsis
  • Management of wide-necked aneurysms in the cavernous ICA has improved with techniques like flow diverters and stent-assisted coiling.
  • A reported case highlighted severe complications from a laser-cut stent used in a previous aneurysm treatment, leading to regrowth and severe nosebleeding.
  • The text argues that laser-cut stents are challenging to use in complex anatomy and lack certain benefits of braided stents, prompting a discussion on better treatment strategies and learning from past mistakes.
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