scholarly journals Cerebral abscess secondary to embolization of arteriovenous malformation: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 553
Author(s):  
João Vitor Fernandes Lima ◽  
Marcos Devanir Silva da Costa ◽  
Bruno Loof de Amorim ◽  
Jose Ernesto Chang Mulato ◽  
Hugo Leonardo Doria Netto ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Endovascular Procedures ◽  
Infectious Complications ◽  
Surgical Performance ◽  
Procedural Complication ◽  
Significant Clinical Improvement ◽  
Procedural Complications ◽  
The Central Nervous System ◽  
The One

Background: Infectious complications of the central nervous system secondary to endovascular procedures have rarely been reported. However, the number of complications has grown exponentially owing to the popularization of these procedures. The success rate of these procedures varies with the pathology, the patient, and surgical performance. Although brain abscesses have been extensively reported, their presence after endovascular procedures has not been described in detail in the literature. We present a case of brain abscess induced by embolization of an arteriovenous malformation (AVM), discuss the main indications, techniques, procedural complications, and review the associated literature. Case Description: A 13-year-old boy presented to us with a history of hemorrhagic stroke secondary to a cerebral AVM rupture. He underwent incomplete AVM resection (2014), with subsequent incomplete embolization (2017), and permanence of the endovenous catheter as a procedural complication. Physical examination revealed purulent exudate through the cervical surgical wound. We performed cervicotomy to remove the catheter but had no success in removing the intracranial material segment. The patient was subsequently diagnosed with a brain abscess (2018) and treated with antibiotics. Our team performed resection of the residual AVM, abscess, and the catheter-associated with the region. Conclusion: The patient showed significant clinical improvement after surgical resection of the malformation. No residual lesions were observed in the imaging examinations. Further, we reviewed the literature to find other cases of similar complications and their association with the endovascular procedure. We did not find complications in patients younger than the one presented in this case. Factors such as incomplete embolisation increase the risk of unfavourable outcomes.

Central Nerve System Impairment, AMA Guides, Sixth Edition: An Overview

2018 ◽  
Vol 23 (1) ◽  
pp. 10-13
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Neurological Impairment ◽  
Sixth Edition ◽  
Central Nerve System ◽  
The Central Nervous System ◽  
The One ◽  
Nerve System ◽  
The Brain

Abstract Injuries that affect the central nervous system (CNS) can be catastrophic because they involve the brain or spinal cord, and determining the underlying clinical cause of impairment is essential in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), in part because the AMA Guides addresses neurological impairment in several chapters. Unlike the musculoskeletal chapters, Chapter 13, The Central and Peripheral Nervous System, does not use grades, grade modifiers, and a net adjustment formula; rather the chapter uses an approach that is similar to that in prior editions of the AMA Guides. The following steps can be used to perform a CNS rating: 1) evaluate all four major categories of cerebral impairment, and choose the one that is most severe; 2) rate the single most severe cerebral impairment of the four major categories; 3) rate all other impairments that are due to neurogenic problems; and 4) combine the rating of the single most severe category of cerebral impairment with the ratings of all other impairments. Because some neurological dysfunctions are rated elsewhere in the AMA Guides, Sixth Edition, the evaluator may consult Table 13-1 to verify the appropriate chapter to use.

Heads-up 3D eye surgery: Safety outcomes and technological review after 2 years of day-to-day use

2021 ◽  
pp. 112067212110128
Author(s):  
Claudia Del Turco ◽  
Giuseppe D’Amico Ricci ◽  
Marco Dal Vecchio ◽  
Caterina Bogetto ◽  
Edoardo Panico ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Case Series ◽  
Depth Of Field ◽  
Procedural Complication ◽  
Long Time ◽  
Procedural Complications ◽  
Resolution Imaging ◽  
Visualization Systems ◽  
3D Surgery

Background: 3D heads-up visualization systems are aimed to improve the surgical experience by providing high-resolution imaging. Objective of our study is to analyze, over a long-time span, the grade of satisfaction and safety of day-to-day 3D surgery compared to standard surgery and to investigate the technical distinctiveness between the heads-up systems currently in use. Methods: In this retrospective observational case series. we reviewed all surgical records of our ophthalmology-dedicated operatory rooms since the arrival of 3D heads-up viewing system, in November 2017. In particular, we compared the procedural complications of 3D-equipped operatory room (3DR) with the standard microscope operatory room (2DR). Moreover, a satisfaction questionnaire was administered to those surgeons shifting on both rooms to test their preferences on seven specific parameters (comfort, visibility, image quality, depth perception, simplicity of use, maneuverability and teaching potential). Results: 5483 eye surgeries were considered. 2777 (50.6%) were performed in 3DR and 2706 (49.3%) in 2DR. Procedural complication rate was comparable in 3DR and 2DR, also when considering different subtypes of surgery. Twelve surgeons (100% of our surgery team) participated in our satisfaction survey, expressing highest satisfaction score for 3D when applied in retina surgery. For cataract surgery, 3D scored best in all the parameters except for facility in use and depth of field perception. Conclusion: Long-term day-to-day use of 3D heads-up visualization systems showed its safety and its outstanding teaching potential in all ophthalmic surgical subtypes, with higher surgeons confidence for retina and cataract surgery.

COGNITIVE AGING AND COGNITIVE RESERVE: POINT OF CONTACT

2020 ◽  
pp. 256-264
Author(s):  
В. С. Мякотных ◽  
А. П. Сиденкова ◽  
Е. С. Остапчук ◽  
И. А. Кулакова ◽  
Н. А. Белых ◽  
...  
Keyword(s):  
Cognitive Aging ◽  
Cognitive Reserve ◽  
Cognitive Disorders ◽  
The Elderly ◽  
Educational Process ◽  
Special Role ◽  
Age Related ◽  
The Central Nervous System ◽  
The One

Высокий риск когнитивных расстройств у лиц пожилого и старческого возраста заставляет, с одной стороны, искать их причины, с другой - возможности профилактики. В связи с этим в последние годы получило распространение понятие когнитивного резерва, подразумевающего совокупность количественных параметров головного мозга и его способности сохранять высокую функциональную активность в процессе старения и на фоне связанной с возрастом патологии головного мозга. Представленный в статье материал на основе обзора научной литературы освещает два основных момента, касающихся возможности сохранения когнитивного резерва, - гендерный и образовательный факторы. Указывается на разные возможности женщин и мужчин, связанные со структурными и функциональными особенностями ЦНС у представителей разного пола, и на особую роль поддерживаемого в течение всей жизни образовательного процесса. Обозначена авторская позиция о необходимости разделения понятий образования и образованности, то есть уровня общей культуры и создания удобного инструмента для определения последнего. Это, в свою очередь, помогло бы в разработке модели когнитивного резерва, нацеленной на предотвращение трансформации физиологического когнитивного старения в патологическое. The high risk of cognitive disorders in the elderly and senile age makes, on the one hand, to look for their causes, on the other - the possibility of prevention. In this regard, in recent years, the concept of cognitive reserve has become widespread, implying a set of quantitative parameters of the brain and its ability to maintain high functional activity in the process of aging and against the background of age-related brain pathology. The material presented in the article on the basis of the review of scientific literature highlights two main points concerning the possibility of preserving the cognitive reserve-gender and educational factors. It is pointed to the different opportunities of women and men associated with the structural and functional characteristics of the Central nervous system in representatives of different sexes and the special role of the educational process supported throughout life. The author’s position on the need to separate the concepts of education and the level of General culture, and the creation of a convenient tool for determining the latter is indicated. This, in turn, would help in the development of a cognitive reserve model aimed at preventing the transformation of physiological cognitive aging into pathological aging.

scholarly journals Staphylococcus intermedius Brain Abscess as a Complication of Pulmonary Arteriovenous Malformation in a Patient With Hereditary Hemorrhagic Telangiectasia

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Leon S Moskatel ◽  
Joslyn N Vo ◽  
Keshav R Nayak ◽  
Nancy F Crum-Cianflone
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
Pulmonary Arteriovenous Malformation ◽  
Staphylococcus Intermedius ◽  
First Case ◽  
Human Infections ◽  
The Brain

Abstract Staphylococcus intermedius is a rare cause of human infections ranging from skin and soft tissue infections to bacteremia. It is particularly known for its association with exposure to dogs. We report an unusual case of a 73-year-old female with a brain abscess caused by S intermedius who was recently diagnosed with hereditary hemorrhagic telangiectasia and a pulmonary arteriovenous malformation. The patient underwent debridement of the brain abscess followed by a 6-week course of vancomycin and rifampin, after which she made a near complete recovery. This is the first case of a brain abscess in an adult due to S intermedius in the published literature, and we provide a comprehensive review of the literature of all human infections caused by this pathogen and summarize its clinical manifestations, treatment recommendations, and outcomes.

scholarly journals Ventricular arteriovenous malformation bleeding: a rare cause of headache in children. Case report

2004 ◽  
Vol 62 (2b) ◽  
pp. 528-530 ◽  
Author(s):  
Hilton Mariano da Silva ◽  
Luciano Ricardo França da Silva ◽  
Eric Homero Albuquerque Paschoal ◽  
Feres Eduardo Aparecido Chaddad Neto ◽  
Carlos Alberto Bordini ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Venous Drainage ◽  
Nuchal Rigidity ◽  
Clinical Presentations ◽  
Traumatic Subarachnoid Haemorrhage ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Anterior Choroidal ◽  
Grade 3 ◽  
Choroidal Artery

Headache as a chief complaint is rare in the paediatric emergency room. Actually, very seldom cases secondary to life threatening conditions as non-traumatic subarachnoid haemorrhage have been reported. A child with severe headache and nuchal rigidity and no other abnormalities on the physical examination is reported. Magnetic resonance angiography and cerebral angiography disclosed a ventricular arteriovenous malformation in the choroid plexus, supplied by the anterior choroidal artery, classified according to Spetzler grading system as grade 3 (deep venous drainage: 1; eloquence area: 0 and size: 2). The differences in the clinical presentations of the central nervous system arteriovenous malformation between children and adults are discussed.

scholarly journals Identification of a Novel BRCA1 Alteration in Recurrent Melanocytoma Resulting in Increased Proliferation

2020 ◽  
Vol 79 (11) ◽  
pp. 1233-1238
Author(s):  
Teresa San-Miguel ◽  
Lara Navarro ◽  
Beatriz Sánchez-Sendra ◽  
Javier Megías ◽  
Lisandra Muñoz-Hidalgo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Prognostic Value ◽  
Proliferation Index ◽  
Benign Neoplasms ◽  
Epigenetic Changes ◽  
Epigenetic Landscape ◽  
Meningeal Melanocytoma ◽  
The Central Nervous System ◽  
The One

Abstract Primary meningeal melanocytomas are rare tumors of the central nervous system. Although they are considered benign neoplasms, some reports describe recurrent rates up to 45%. Little is known about their genetic and epigenetic landscape because of their infrequency. Even less has been described about markers with prognostic value. Here we describe a patient who developed a primary meningeal melanocytoma, suffered 3 recurrences in a period of 6 years and died of the tumor. The genetic and epigenetic changes explored confirmed GNAQ mutation as an initiating event. We found an epigenetic alteration of GSTP1, a feature that has recently been described in meningiomas, from the beginning of the disease. In addition, there was loss of heterozygosity in BRCA1 beginning in the second recurrence that was linked to an increase in the proliferation index; this suggested a progression pathway similar to the one described in uveal melanomas. These findings underscore the necessity of further research focused on these tumors.

scholarly journals Endovascular Surgery for Ruptured Aneurysms with Vasospasm

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 48-52 ◽  
Author(s):  
A. Kurata ◽  
S. Suzuki ◽  
J. Niki ◽  
H. Ozawa ◽  
M. Yamada ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Coil Embolization ◽  
Preliminary Report ◽  
Endovascular Procedures ◽  
Neurological Deficits ◽  
Parent Artery ◽  
Ruptured Aneurysms ◽  
Number Of Patients ◽  
Endovascular Coil Embolization ◽  
The One

With the existence of vasospasm, it is recommended that direct clipping surgery for a ruptured aneurysm be delayed until its disappearance, but this may be associated with aneurysmal re-rupture resulting in a poor outcome for the patients. Indications for endovascular coil embolization in such cases are discussed. Since November in 2003, we have applied endovascular coil embolization in 11 consecutive patients with ruptured aneurysms and apparent vasospasm of the parent artery from two to 17 days (average: eight days) after initial subarachnoid hemorrhage. Three patients had aneurysmal re-rupture before treatment, but the other eight had only experienced the one episode of subarachnoid hemorrhage. With one exception, all endovascular procedures could be successfully performed, resulting in complete occlusion of aneurysms and remarkable dilatation of inserted spastic vessels without technical complications or aneurysmal re-rupture. For the one case of failure because of a tortuous artery, direct clipping surgery was performed after disappearance of vasospasm. Cerebral infarction occurred in four, but only one correlated with the distribution of catheterization, and neurological deficits had completely disappeared three months after the onset. This preliminary report concerning a small number of patients suggests that endovascular coil embolization is not contra-indicated for aneurysms with vasospasm requiring catheterization. A large study for confirmation is now warranted.

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