Cavernous malformations (CVMs) located in the thalamus are uncommon. However, they pose difficulties for resection because of their close proximity to eloquent areas of the brain and vascular structures, and all surgical corridors to access them are narrow. In this video, we report the case of a 19-year-old woman who presented with a long-standing history of right hemiparesis with recent deterioration. MRI revealed a large CVM located in the left thalamus, with signs of recent hemorrhage extending to the left cerebral peduncle. Resection was achieved with a paramedian contralateral supracerebellar infratentorial approach in a semisitting position, with an uneventful postoperative course. The video can be found here: https://youtu.be/Arvu52FkHOE.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541819 | PMC |
http://dx.doi.org/10.3171/2019.7.FocusVid.19167 | DOI Listing |
Interv Pain Med
September 2024
Jordan Young Institute, Virginia Beach, VA, USA.
This series of FactFinders presents a brief summary of the evidence and outlines recommendations to minimize risks associated with cervical epidural injections. Evidence in support of the following facts is presented. - 1) CILESIs should be performed at C6-C7 or below, with C7-T1 as the preferred access point due to the more generous dorsal epidural space at this level compared to the more cephalad interlaminar segments.
View Article and Find Full Text PDFCureus
September 2024
Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Zarqa, JOR.
Nine syndrome is a rare variant of one-and-a-half syndrome that results from a stroke in the posterior circulation, mainly manifesting as ipsilateral horizontal gaze palsy, facial palsy, and contralateral hemiataxia. Awareness of the clinical signs of this syndrome is crucial for accurate localization of the lesion and guiding further investigations. We report a case of nine syndrome presenting with signs of one-and-a-half syndrome, ipsilateral facial nerve palsy, hemiataxia, and hemiparesis.
View Article and Find Full Text PDFJ Craniofac Surg
September 2024
Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, St Joseph's Healthcare Centre, Western University, London, ON, Canada.
Purpose: The reconstruction of full-thickness nasal defects poses a significant challenge following oncologic resection. This study aims to share a technique using paired pericranial forehead flap (PCF) with contralateral paramedian flap (PMF) for such defects. Patient outcomes were reviewed, and the advantages and disadvantages of the reconstructive technique are discussed.
View Article and Find Full Text PDFPain Pract
November 2024
Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
Background: Recent advancements in cervical interlaminar epidural steroid injections have given rise to the modified paramedian interlaminar (mPIL) approach. The objective of this study was to perform an analysis of the contrast spread pattern within the cervical epidural space, taking into account different needle tip positions in the mPIL approach.
Methods: A total of 48 patients were included in the study and randomly assigned to either the medial or lateral group based on the needle tip's position in the anterior-posterior view.
Internuclear ophthalmoparesis (INO) is a horizontal eye movement disorder that is associated with a lesion at the medial longitudinal fasciculus (MLF). One-and-a-half syndrome occurs when the lesion involves the MLF and the ipsilateral abducens nuclei or the paramedian pontine reticular formation (PPRF) in the dorsomedial tegmentum of the pons. When the lesion is large enough, the fascicles of the facial nerve (CNVII) can also be involved, resulting in an ipsilateral facial nerve palsy.
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