In order to assess the value of MR in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a period of 2 years. The aim of this study was: 1) to assess the score of MR in the detection of cranial nerves III to XII; 2) to determine accurate landmarks allowing for easy detection of those cranial nerves. Cranial nerves III, V, VII, VIII are well seen (70 to 100%), very often in both axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes [81 and 83%), but it is difficult to distinguish between the vagal nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, fourth and sixth nerves are rarely visualized. The more important landmarks are the chiasma, the colliculi, the Meckel's cave, the internal auditory canal, the jugular foramen, the hypoglossal canal and the different brainstem structures. We suggest the following scanning protocol: short spin echo sequences (TR = 600 ms, TE = 20 msec), 3 to 5 continuous sections, 16 to 20 cm field of vue with respectively 4 or 2 excitations, 256 x 256 matrix, with at least one acquisition plane (axial), but preferably two or three planes. Thus MR is sensitive exam in the recognition of cranial nerves, and it must be the first step exam in patients presenting with cranial nerve disease.
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January 2025
Département d'Anesthésie, Hôpital Antoine Béclère, APHP.Université Paris-Saclay, Clamart, France.
We describe a patient with severe Arnold Chiari Malformation and syringomyelia who underwent gynecological laparoscopy in an emergency context; no brain imaging was available. We here report the successful use of optic nerve sheath diameter (ONSD) and middle cerebral artery (MCA) velocity measurements as surrogate monitoring for cerebral blood flow and intracranial pressure, respectively. MCA velocity was low when assessed after peritoneal insufflation and ONSD increased to 6.
View Article and Find Full Text PDFJ Vis Exp
January 2025
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine;
Electroacupuncture (EA) is one of the most commonly used methods in acupuncture and has a good effect on pain, depression, sensory movement disorders, and other diseases. The effectiveness of EA is influenced by many factors, such as the accuracy of acupoint selection, the duration and course of EA treatment, and EA parameters. However, it has rarely been discussed whether the positive and negative electrodes of the EA instrument with acupoints at different locations and distances have an effect on the curative effect.
View Article and Find Full Text PDFCureus
December 2024
Department of Microbiology, Fırat University School of Medicine, Elazig, TUR.
Coronavirus disease (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that primarily affects the respiratory system but can also lead to neurological complications such as Guillain-Barré syndrome (GBS). This case report describes an eight-year-old boy with COVID-19-associated GBS involving multiple cranial nerves (third, seventh, and ninth) without pulmonary symptoms. The patient initially presented with flu-like symptoms along with right facial paralysis, which progressed to bilateral facial paralysis, limb weakness, and sensory loss.
View Article and Find Full Text PDFJ Pak Med Assoc
January 2025
Department of Ophthalmology and Visual Sciences, Dow University of Health Sciences, Karachi, Pakistan.
Tolosa-Hunt Syndrome (THS) is an exceptionally rare disorder characterised by recurrent episodes of excruciating ophthalmoplegia, commonly affecting one side of the face and involving the third, fourth, sixth, and fifth cranial nerves. This syndrome results from non-specific inflammation affecting the cavernous sinus, superior orbital fissure (SOF), and/or orbital apex. In this case report, we present the clinical features, diagnostic evaluation, and management of a 46-year-old female with THS.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Department of Pain, The Third Xiangya Hospital and Institute of Pain Medicine, Central South University, Changsha, China.
Background: Interventional therapy of trigeminal neuropathic pain has been well documented; however, intraoperative monitoring and management of pain hypersensitivity remains barely reported, which may pose a great challenge for pain physicians as well as anesthesiologists.
Case Presentation: A 77-year-old Han Chinese male, who suffered from severe craniofacial postherpetic neuralgia, underwent pulsed radiofrequency of trigeminal ganglion in the authors' department twice. The authors successfully placed a radiofrequency needle through the foramen ovale during the first procedure with local anesthesia and intravenous sedation (dexmedetomidine).
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