This Video 1 presents the surgical management of a 36-year-old woman who presented with progressive weakness in her right arm associated with a pins-and-needles sensation. Magnetic resonance imaging of the cervical spine revealed a likely hemorrhagic cavernous malformation of the spinal cord at the C3-4 level. The lesion was wholly intramedullary with no presentation to the surface of the spinal cord. It was located in the spinal cord centrally with some right-side predominance. Treatment options were presented to the patient, who agreed to surgery. A resection was performed after a hemilaminotomy at C3 and C4 levels. A biportal technique was used, demonstrating resection of the malformation through 2 small myelotomies made between the entering rootlets at the dorsal root entry zone. This was intended to preserve all roots at the entry zone while enabling visualization of the entire cavernous malformation and its cavity from 2 different portals of entry, essentially providing the same field of access while preserving all roots. After successful resection, the cavity was carefully inspected and closure of the dura was performed, followed by fixation of the osteotomy sites of the laminae at C3 and C4. The patient awoke with no new neurologic deficits and has had no evidence of lesion recurrence or symptoms in 3-year follow-up. The patient provided consent for publication.
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http://dx.doi.org/10.1016/j.wneu.2020.02.181 | DOI Listing |
Gastroenterology
December 2024
Division of Gastroenterology and Hepatology, Department of Medicine, Endeavor Health, Chicago, Illinois.
Description: Portal vein thromboses (PVTs) are common in patients with cirrhosis and are associated with advanced portal hypertension and mortality. The treatment of PVTs remains a clinical challenge due to limited evidence and competing risks of PVT-associated complications vs bleeding risk of anticoagulation. Significant heterogeneity in PVT phenotype based on anatomic, host, and disease characteristics, and an emerging spectrum of therapeutic options further complicate PVT management.
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea.
Background And Purpose: The dorsolateral portion of the caudal pons contains the vestibular nucleus (VN) and inferior cerebellar peduncle (ICP) that play important roles in conveying and processing vestibular and ocular motor signals. This study aimed to characterize ocular motor abnormalities along with their anatomical correlations in dorsolateral pons (DLP) lesions.
Methods: We analyzed clinical features, and results of neuro-otological evaluations and neuroimaging of 18 patients with unilateral DLP lesions (17 with DLP infarction and 1 with cavernous malformation) from among 506 patients with pontine infarction in a stroke registry.
Einstein (Sao Paulo)
December 2024
Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo, Goiânia, GO, Brazil.
Hemangiomas are benign congenital vascular tumors that commonly arise in the head and neck regions. Although they present with indolent growth and involution in most cases, they can cause facial deformities. Hemangiomas have three subtypes: capillary, cavernous, and mixed.
View Article and Find Full Text PDFPraxis (Bern 1994)
December 2024
Klinik für Neurochirurgie, Klinisches Neurozentrum, Universitätsspital Zürich.
Cerebral cavernous malformations are benign vascular anomalies of the central nervous system (CNS). The clinical presentation of a cavernoma depends on its location. The majority of patients with cavernomas are asymptomatic.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Pontificia Universidad Catolica del Ecuador, Quito, Pichincha, Ecuador.
Carotid-cavernous aneurysms (CCAs) have the potential for growth, and their risk of rupture can lead to severe complications. Treatment is typically recommended to prevent these complications, with endovascular therapy being the preferred approach due to the challenging surgical access. This case presents a rare instance of rupture of a CCA that had been previously treated with a flow-diverting stent, which resulted in the development of a carotid-cavernous fistula, requiring venous access endovascular treatment.
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