A healthy woman in her 60s presented acutely with right-sided periorbital edema, erythema, neck pain, and fever. Initial examination and investigations suggested right-sided orbital cellulitis with contralateral pansinusitis. Despite treatment with IV antibiotics, her symptoms worsened, and inflammatory markers continued to rise. Further imaging revealed thrombosis of the right superior ophthalmic vein extending into the cavernous sinus and right jugular vein. She underwent urgent left functional endoscopic sinus surgery followed by long-term anticoagulation. After six months of anticoagulation, she remained free of morbidity, and repeat imaging confirmed the resolution of the thrombosis.
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http://dx.doi.org/10.7759/cureus.71192 | DOI Listing |
Cureus
November 2024
Neurosurgery, University of Illinois College of Medicine Peoria, Peoria, USA.
Petroclival approaches remain challenging given abundant cranial nerves and vessels. Common trajectories include transsphenoidal, transoral, middle fossa-extradural, and posterior through the cerebellar peduncle. We report a unique intra-axial, intradural approach to the petroclival and cavernous sinus.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Neurosurgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fu Jian, China. Electronic address:
Objective: This study aims to elucidate the anatomical principles governing the surrounding venous structures (VS) of the horizontal part of the third segment of the vertebral artery (V3h) and develop a safe and bloodless surgical technique for exposing V3h.
Methods: This study used ten formalin-infused cadaveric head specimens. The dissections were performed stepwise to simulate the far lateral approach process, exposing the V3h with a novel technique.
Pract Neurol
December 2024
Neurosciences ICU, Mayo Clinic, Rochester, Minnesota, USA
Front Surg
December 2024
Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Background: The surgical treatment of pituitary adenomas (PAs) is aimed at achieving maximal tumor resection, relieving the compression, and correcting the disorders of pituitary hormones. Parasellar dural invasion is a primary factor in the failure of the surgery. By comparing the two operations of tumor excision combined with resection of the medial wall of the cavernous sinus (MW) and simple tumor excision, we further confirmed the clinical effectiveness and safety of the resection technique of the MW.
View Article and Find Full Text PDFCureus
November 2024
Otolaryngology - Head and Neck Surgery, Tokyo Medical University, Tokyo, JPN.
Invasive fungal rhinosinusitis can be fatal if it spreads from the orbit to the cranium. The primary treatment involves thorough lesion debridement; however, complete removal may be challenging in cases involving intracranial extension. Here, we report a case of invasive fungal rhinosinusitis with intracranial and orbital invasion successfully managed with maximal surgical debridement and antifungal therapy.
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