Arteriovenous Fistula Of Cavernous Sinus Research Articles

Injury characteristics and therapeutic strategy of patients injured in "8·8" Jiuzhaigou earthquake

To summarize the injury characteristics and therapeutic strategy of patients injured in "8·8" Jiuzhaigou earthquake. The clinical data of 48 patients injured in "8·8" Jiuzhaigou earthquake who were admitted to Mianyang Central Hospital were analyzed retrospectively. There were 25 males and 23 females with an average age of 36 years (range, 5-87 years). The average interval from injury to admission was 30 hours (range, 3-53 hours). The patients from Sichuan province accounted for 45.8% (22 cases), from other province for 52.1% (25 cases), and from abroad for 2.1% (1 case). Patients were primarily hurted by collapsing houses and flying stones. Thirty-seven patients (77.1%) had single injury, mainly involving 36 patients (75.0%) in limbs, and the other 11 patients (22.9%) had multiple injuries. Ten patients (20.8%) had open fractures, including 1 case rated as typeⅠ, 2 as typeⅡ, 3 as type Ⅲa, 2 as type Ⅲb, and 2 as type Ⅲc according to Gustilo classification criteria. The abbreviated injury scale (AIS) score was 2-3 in 37 patients of single injury, and the injury severity score (ISS) was 8-22 (mean, 13.2) in 11 patients of multiple injuries. Sixteen patients (33.3%) were diagnosed as mental disorders by Hamilton rating scale for anxiety (HAMA), including 8 cases had their anxiety scores≥29, 4 cases of 21-28, 3 cases of 14-20, and 1 case of 7-13. Of the 16 patients, 2 showed suicidal tendency. Except 2 referrals, 30 patients received operation［28 patients (93.3%) for orthopaedic surgeries］and 16 patients received conservative treatment. The procedures included internal fixation, soft tissue debridement, external fixation, bipolar femoral head replacement, embolization of carotid cavernous sinus arteriovenous fistula, and amputation. Among the 46 patients treated in this hospital, 21 discharged from hospital at 2-12 days (mean, 6.7 days) after admission, the others received further rehabilitation in this hospital or local hospital. No undesirable consequence occurred in 16 patients with mental disorders. Five cases of infection occurred out of hospital were cured after debridement. No dead and nosocomial infection case reported. Intensive treatment, specialist management, multidisciplinary team, and early intervention of nosocomial infection and deep venous thrombosis are the key to improve the general level of successful earthquake medical rescue.

A Case of Dural Arteriovenous Fistula of Cavernous Sinus with Trochlear Nerve Palsy, Oculomotor Nerve Palsy and Horner Syndrome

A Case of Dural Arteriovenous Fistula of Cavernous Sinus with Trochlear Nerve Palsy, Oculomotor Nerve Palsy and Horner Syndrome

Endovascular treatment of arteriovenous anastomoses in the cavernous sinus region

Introduction. Arteriovenous fistula in the cavernous sinus is a complex vascular pathology of the brain, its’ treatment is a scabrous problem that requires optimization of used techniques. Materials and methods . In the neurosurgical clinic of Kharkov Regional Hospital — Emergency and Disaster Medicine Center 23 endovascular surgeries were performed in 21 patients with carotid-cavernous sinus and arteriovenous fistulas. Preference was given to endovascular separation using detachable balloons «GoldBalloon» BALT (France). Results . In 16 (76%) cases after endovascular surgery complete regression of ophthalmic disorders was observed. In 2 (9.5%) patients with indirect fistulas repeat embolization of external carotid artery branches was performed 6 months after first operation, complete regression of ophthalmic disorders was achieved. Conclusions. The method of choice in treatment of arteriovenous fistulas of cavernous sinus is endovascular separation using modern materials and different adhesive compositions, which significantly increase treatment effectiveness in these patients.

Rectangular-patterned occipital alopecia areata: A report of three cases

Many reports have described the presence of alopecia areata (AA) associated with other autoimmune diseases, which support the autoimmune nature of AA. Additionally, AA has been reported in association with malignancy as a paraneoplastic symptom. In this report, we describe three patients with diffuse large B-cell lymphoma, alveolar soft part sarcoma, and cavernous sinus arteriovenous fistula with embolization treatment, respectively, who characteristically presented with rectangular-patterned occipital AA.

Evaluation of dural arteriovenous fistulas of cavernous sinus before and after endovascular treatment using time-resolved MR angiography

Digital subtraction angiography (DSA) is the preferred method for confirming dural arteriovenous fistulas (DAVFs), but it has the disadvantage of being invasive. In contrast, time-resolved magnetic resonance angiography (TR-MRA) is a useful, noninvasive imaging technique. The aim of this study was to compare the evaluation of DAVFs of the cavernous sinus (CS) using TR-MRA and DSA. TR-MRA and DSA were obtained in six patients with CS-DAVFs treated with endovascular surgery. TR-MRA and DSA before and after treatment were reviewed by one neuroradiologist without previous knowledge of the existence of CS-DAVFs for the detection and characterization (feeding artery and venous drainage) of CS-DAVFs. DSA showed six CS-DAVFs in the six patients. TR-MRA demonstrated a hyperintensity area in the CS at the arterial phase in six patients. DSA revealed feeding arteries and a drainage vein in all CS-DAVFs. In contrast, the feeding arteries could not be identified with TR-MRA. The details regarding venous drainage could only be speculated upon with TR-MRA as it was only partly visible on the TR-MRA images. DSA after embolization showed no CS-DAVFs in any of the six patients. TR-MRA showed no hyperintensity areas in the CS at the arterial phase in any of the six patients, and with no coil artifacts. In summary, TR-MRA could detect and diagnose CS-DAVF. However, the detail regarding anatomical feeders and draining veins remains poorly visualized by TR-MRA. In this small number of cases, TR-MRA can be a useful screening tool to detect CS-DAVF and possibly also to confirm persistent obliteration following definitive treatment.

Paradoxical worsening with superior ophthalmic vein thrombosis after gamma knife radiosurgery for dural arteriovenous fistula of cavernous sinus: a case report suggesting the mechanism of the phenomenon

Paradoxical worsening with superior ophthalmic vein thrombosis after gamma knife radiosurgery for dural arteriovenous fistula of cavernous sinus: a case report suggesting the mechanism of the phenomenon

Diagnosis of Cavernous Sinus Artenovenous Fistula by Measurement of Ocular Pulse Amplitude

The ocular pulse amplitude (OPA), the difference between the maximum and minimum intraocular pressure (IOP) during the cardiac cycle, has been reported to be elevated in the eye ipsilateral to a cavernous sinus arteriovenous fistula. The OPA was measured with a pneumotonometer in three groups of patients. Patients in group 1 had no orbital disease (n = 50), patients in group 2 had either unilateral or asymmetric orbital disease (n = 30), and patients in group 3 had angiographically proven cavernous sinus arteriovenous fistulas (n = 15). Patients in group 3 had a higher OPA than patients in either group 1 (P less than 0.001) or group 2 (P less than 0.001). The difference in OPA between an individual's eyes (delta OPA) also was higher in patients with cavernous sinus arteriovenous fistulas than in patients without fistulas (P less than 0.0001). A delta OPA of more than 1.6 mmHg was 100% sensitive and 93% specific in identifying patients with cavernous sinus arteriovenous fistulas. There was no difference in delta OPA between direct and dural cavernous sinus arteriovenous fistulas. Successful transvascular embolization of the cavernous sinus arteriovenous fistula normalized the delta OPA by reducing the OPA on the affected side.