Facial nerve involvement in pseudotumor cerebri.
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A woman with history of bifrontal headache, vomiting and loss of vision was diagnosed as a case of pseudotumor cerebri based on clinical and MRI findings. Bilateral abducens and facial nerve palsies were detected. Pseudotumor cerebri in this patient was not associated with any other illness or related to drug therapy. Treatment was given to lower the raised intracranial pressure to which the patient responded. (+info)
A quantitative assay of retrograde transported HSV in the trigeminal ganglion.
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The relationship between the dose of Herpes simplex virus type 1 (HSV) inoculated in the cornea and the amount of actively replicating virus recovered from mouse trigeminal ganglion cells 5 d after corneal scratch and inoculation was investigated with a tissue culture plaque assay. A dose response curve of productive viral replication was obtained. The estimated dose of HSV that produces half-maximal recovery of virus within the ganglion was 9.15 x 10(3) plaque forming units per eye, and the maximal amount of HSV recovered was 1.34 x 10(4) pfu per ganglion. This definition of infectivity as a function of dose will be useful for studying the effects of potential inhibitors of the binding, uptake, and transport of HSV by productively or latently infected trigeminal neurons. (+info)
Polyneuritis cranialis: clinical and electrophysiological findings.
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A 13 year old boy, developed bilateral facial weakness, dysphonia and dysphagia acutely after a febrile illness. Neurological examination and MRI of the brain were normal. The CSF protein level increased. Blink reflex monitoring during clinical recovery was consistent with demyelination of the lower cranial nerves innervating the branchial arch musculature, a rare variant of Guillain-Barre syndrome. (+info)
Intracavernous epidermoid tumor presenting with abducens nerve paresis--case report.
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An unusual case of a pediatric epidermoid tumor entirely located in the cavernous sinus is reported. A 6-year-old boy presented with left abducens nerve paresis which developed over 2 months. Neuroimaging demonstrated a lesion in the left cavernous sinus. Part of the tumor capsule and the pearly contents were removed by the left pterional approach through Dolenc's anterolateral triangle. No bleeding from the cavernous sinus occurred. The tumor was histologically identified as an epidermoid tumor. Postoperatively, the abducens nerve paresis improved. The presence of dural reflection in the lateral wall of the cavernous sinus and displacement of the intracavernous internal carotid artery are useful indicators for intracavernous lesions. (+info)
MR imaging for evaluation of lesions of the cranial vault: a pictorial essay.
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PURPOSE: A variety of diseases affect the calvaria. They may be identified clinically as palpable masses or incidentally in radiologic examinations. There are many diagnostic possibilities, including congenital, neoplastic, inflammatory and traumatic lesions. The purpose of this study is to illustrate the main calvarial lesions through MR imaging, their signal intensity and extension to neighboring sites. METHOD: A retrospective analysis of 81 cases, from November 1996 to July 2001, was conducted. The examinations were performed on a 1.5 T equipment and each one of the cases was pathologically proven. RESULTS: The results were: dermoid cysts [4 cases (5%)], epidermoid cysts [2 cases (2.5%)], cephalocele [14 cases (17.5%)], sinus pericranii [3 cases (3.7%)], leptomeningeal cysts [4 cases (5%)], Langerhans cell histiocytosis [10 cases (12.5%)], lipoma [4 cases (5%)], fibrous dysplasia [13 cases (16.2%)], osteoma [8 cases (10%)], hemangioma [1 case (1.2%)], meningioma [3 cases (3.7%)], chondrosarcoma [5 cases (6.2%)], hemangiosarcoma [1 case (1.2%)], multiple myeloma [3 cases (3.7%)], sarcomatous transformation of Paget disease [1 case (1.3%)], and metastasis [5 cases (6.2%)]. CONCLUSION: MRI identifies bone marrow abnormalities and invasion of adjacent tissues at an early stage. Therefore, it is an essential method when it commes to properly evaluating calvarial lesions. (+info)
Oculomotor neuropathy syndrome. A diagnostic challenge in nasopharyngeal carcinoma.
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Of 22 patients with different kinds of oculomotor neuropathy syndrome (ONS), 18 were initially suspected of suffering from nasopharyngeal carcinoma (NPC). However, in a series of evaluations, their diagnoses eventually proved to be other diseases such as cranial neuritis, aneurysm of intracranial internal carotid artery, chordoma, etc. The remaining four patients initially diagnosed as having aneurysm of skull base or pituitary lesion were actually NPC sufferers. Therefore, one should be very careful in differentiating NPC from many other diseases contributing to the similar manifestation of ONS. (+info)
Unruptured aneurysms with cranial nerve symptoms: efficacy of endosaccular Guglielmi detachable coil treatment.
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OBJECTIVE: To evaluate the efficacy of endosaccular Guglielmi detachable coil (GDC) treatment of unruptured aneurysms causing cranial nerve (CN) symptoms. MATERIALS AND METHODS: Among a database of 218 patients whose aneurysms were treated using GDC, seven patients met the criteria for unruptured aneurysms presenting with symptoms and signs of CN palsy. Changes in CN symptoms before and after GDC treatment were reviewed. RESULTS: Aneurysms were located in the internal carotid-posterior communicating artery (n=3), the basilar bifurcation (n=1) and the cavernous internal carotid artery (n=3). CN symptoms included ptosis (n=6), mydriasis (n=2), and extraocular muscle (EOM) disorder (CN III: n=4; CN VI: n=3). Overall, improvement or resolution of CN symptoms after treatment was noted in five patients. CN symptoms in cases involving small (+info)
Cerebral Aneurysm Multicenter European Onyx (CAMEO) trial: results of a prospective observational study in 20 European centers.
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BACKGROUND AND PURPOSE: This study was designed to investigate the safety and efficacy of the Onyx liquid embolic system in treating a selected population of patients with intracranial aneurysms that presented difficulties for surgical or endovascular alternatives. METHODS: A prospective observational study was conducted in 20 European centers enrolling a consecutive series of 119 patients with 123 aneurysms judged suitable for Onyx treatment. The series consists of findings collected in 97 of 119 patients with 100 of 123 aneurysms, because one center declined to provide data to the study sponsor or allow outside audit. Clinical and angiographic outcomes were recorded at discharge, 3 months, and 12 months. All adverse events and re-treatments were recorded. Seventy-nine aneurysms were large or giant. RESULTS: Twelve-month follow-up angiography findings were available for 71 aneurysms. This angiographic follow-up showed complete occlusion in 56 (79%) aneurysms, subtotal occlusion in nine (13%), and incomplete occlusion in six (8%). Procedure- or device-related permanent neurologic morbidity at final follow-up was present in eight of 97 patients. Seven patients died: two deaths were procedure related; one, disease related; and four, unrelated causes. Seventy-five of the 82 patients alive and with follow-up at 12 months were at Rankin 2 or better status. Delayed occlusion of the parent vessel occurred in nine patients; delayed occlusion was asymptomatic in five and resulted in permanent neurologic deficit in two. CONCLUSION: In selected patients with aneurysms that are unsuitable for coil treatment or in whom previous treatment has failed to occlude the aneurysm, Onyx treatment offers an endovascular alternative. Aneurysm occlusion rates are superior to reported rates of coil occlusion, and treatment morbidity is comparable to that of published prospective data on endovascular results for this subgroup of patients. (+info)