scholarly journals Acute ICA occlusion due to pituitary apoplexy resulting In Internal Carotid Artery Occlusion and Stroke: Case Report, Review of The Literature, and Treatment Rationale

2017 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Ramu Adepu
Keyword(s):  
Tumor Resection ◽  
Rare Event ◽  
Treatment Strategies ◽  
Pituitary Tumors ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Sudden Onset ◽  
First Case ◽  
Work Up ◽  
Transsphenoidal Resection

We report the case of a 63 year-old man who presented with sudden-onset, severe headache. Work-up revealed a hemorrhagic pituitary macroadenoma. He then suffered sudden-onset aphasia and right hemiparesis. Further evaluation revealed left ICA occlusion. Emergent transsphenoidal resection of the tumor produced recanalization of the occluded ICA, but his neurological symptoms persisted. ICA occlusion following pituitary tumor apoplexy is a rare event that must be recognized early for optimal patient outcomes. We report the first case with demonstration of carotid recanalization after tumor resection, review the incidence of ICA occlusion due to pituitary tumors, describe the possible mechanisms, and recommend optimal treatment strategies.

scholarly journals STMO-06 SMART CYBER OPERATING THEATER REALIZED BY INTERNET OF THINGS - RESULTS OF CLINICAL STUDY FOR 56 CASES

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii19-ii19
Author(s):  
Muragaki Yoshihiro ◽  
Jun Okamoto ◽  
Taiichi Saito ◽  
Satoshi Usui ◽  
Ushio Yonezawa ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Removal Rate ◽  
Tumor Resection ◽  
Pituitary Tumors ◽  
Residual Tumor ◽  
Clinical Results ◽  
Digital Data ◽  
Clinical Effects ◽  
Operating Theater ◽  
First Case

Abstract PURPOSE Unlike conventional operating rooms that provide a sterilized space, we have developed a Smart Cyber Operating Theater (SCOT) in which the room itself performs treatment as a single medical device. We report the clinical results of 3 types of SCOT. METHODS Basic SCOT packaged with intraoperative MRI (0.4Tesla) was introduced in Hiroshima University in 2016. Standard SCOT networked with middleware OPeLiNK was introduced to Shinshu University in 2018, and Hyper SCOT introduced to Tokyo Women’s Medical University in 2019. RESULTS The average of all 56 patients was 44 years old. There were 38 brain tumors (68%), 11 functional diseases (19%), and 7 orthopedic diseases (13%). Basic SCOT is used for 41 cases (/56; 73%) with 22 gliomas, 10 epilepsies, 7 bone tumors, and 2 benign brain tumors. Standard SCOT with 20 networked devices is used for 14 cases (/56; 25%) with 6 gliomas including brain stem and thalamus, 6 pituitary tumors and 2 benign brain tumors. The strategy desk can display a variety of digital data synchronized in time, and the review and comment functions also operate. It is useful for remote advice through mutual communication via strategy desk. Hyper SCOT was used in February 2019 for the first case (1/56 cases; 2%). MRI images were taken with an average of 1.3 shots with good image quality. For 46/56 neoplastic lesions (82%), additional removal of residual tumor was performed in 31/46 cases (67%), and 26/46 cases (57%) were totally removed, with an average removal rate of 89.2%. There was no reoperation (0%) within 1 month in all cases. CONCLUSIONS Three types of SCOT contributed to planned surgical outcome including maximal tumor resection without serious related complications. We will proceed with verification of clinical effects, and develop robotized devices, and utilize AI for strategy desk at Hyper SCOT.

scholarly journals Treatment Strategies for Acute Ischemic Stroke Caused by Carotid Artery Occlusion

2016 ◽  
Vol 5 (3-4) ◽  
pp. 148-156 ◽  
Author(s):  
Wei Li ◽  
Qin Yin ◽  
Gelin Xu ◽  
Xinfeng Liu
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Treatment Strategies ◽  
Recombinant Tissue Plasminogen Activator ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Current Status ◽  
Tissue Plasminogen ◽  
Potential Strategy

Background: Acute ischemic stroke caused by internal carotid artery (ICA) occlusion usually has a poor prognosis, especially the T occlusion cases without functional collaterals. The efficacy of intravenous (IV) or intra-arterial (IA) thrombolysis with recombinant tissue plasminogen activator (rt-PA) remains ambiguous in these patients. Eendovascular recanalization of the occluded carotid has been attempted in recent years as a potential strategy. However, the different etiologies of ICA occlusion pose a significant challenge to neurointerventionists. Recently, several endovascular evolvements have been reported in treating carotid occlusion-related stroke. This review summarizes the current status of treatment for acute ICA occlusion.

scholarly journals Stenting in the Remnant of the Third Aortic Arch in a Case of Post-Irradiation Occluded Internal Carotid Artery

2011 ◽  
Vol 17 (1) ◽  
pp. 22-26
Author(s):  
H.-C. Chen ◽  
C.-J. Lin ◽  
F.-C. Chang ◽  
C.-B. Luo ◽  
Y.-J. Lai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Transluminal Angioplasty ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
External Carotid ◽  
First Case ◽  
Internal Carotid Arteries

Collateral networks between the external carotid artery and internal carotid arteries become crucial for cerebral perfusion after occlusion of internal carotid arteries. We report the first case of a patient who received percutaneous transluminal angioplasty and stenting in a collateral vessel between the external and internal carotid artery for treatment of radiation induced severe stenosis of the internal carotid artery in the context of a contralateral internal carotid artery occlusion.

scholarly journals Paracentral acute middle maculopathy in the setting of central retinal artery occlusion following COVID-19 diagnosis

2021 ◽  
pp. 112067212199534
Author(s):  
Neslihan Turedi ◽  
Betul Onal Gunay
Keyword(s):  
Vision Loss ◽  
Central Retinal Artery Occlusion ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Central Retinal Artery ◽  
Significant Past Medical History ◽  
Normal Limits ◽  
First Case ◽  
Retinal Artery ◽  
Work Up

Background: Since its emergence in Wuhan, China, COVID-19 has disseminated across many other countries worldwide. In this report, we firstly presented a patient with mild COVID-19 disease who developed paracentral acute middle maculopathy (PAMM) due to CRAO. Case presentation: A 54-year-old male patient who reported a contact with a COVID-19 patient applied to the hospital and tested positive for SARS-CoV-2 by polimerase chain reaction testing. He had no significant past medical history. Chest computed tomography was not notable. He had a mild COVID-19 course during hospitalization. Two weeks following COVID-19 diagnosis, he reported profund vision loss (counting fingers) in his right eye where central retinal artery occlusion (CRAO) was detected on fundoscopic examination. Coagulation profile was within normal limits. Hypercoagulable work up was also not notable. Treatment was given for CRAO. Visual acuity was counting fingers at 30 cm. Five days following treatment. Optical coherence tomography analysis showed increased diffuse reflectance and thickening at the level of inner nuclear layer consistent with PAMM. Fluorescein angiography illustrated no perfusion defect. Conclusion: This is the first case that reports PAMM in the setting of CRAO following COVID-19 diagnosis. Viral induced microangiopathy may involve in the development of CRAO in our patient without a hypercoagulable state and additional risk factors. Physicians should be vigilant to seek for retinal evaluation in patients with significant visual loss even after a mild COVID-19 history.

scholarly journals First Case of Isolated Cystic Brain Metastasis from Endometrial Adenocarcinoma Treated by Surgery

2018 ◽  
Vol 27 (2) ◽  
pp. 122-124
Author(s):  
Vinicius Ricieri Ferraz ◽  
João Luiz Vitorino Araújo ◽  
Alexandros Theodoros Panagopoulos ◽  
Guilherme Brasileiro De Aguiar ◽  
José Carlos Esteves Veiga
Keyword(s):  
Brain Metastasis ◽  
Endometrial Adenocarcinoma ◽  
Cell Cancer ◽  
Tumor Resection ◽  
Rare Event ◽  
Gastrointestinal Carcinoma ◽  
En Bloc ◽  
Cancer Breast ◽  
First Case ◽  
The Brain

Introduction: Lung cancer, breast cancer, renal cell cancer, gastrointestinal carcinoma, and melanoma are common sources of cerebral metastasis. Brain metastasis from malignant gynecological tumors are considered rare. According to the literature, fewer than 3% of all brain metastases originate from gynecological lesions. The primary mechanism of metastatic spread from genital tract cancers to the brain is through the hematogenous rout. The endometrial carcinoma metastasis to the brain is a very rare event. The objective of this study is to describe this rare event and conduct a brief review of the literature. Case description: We report on a unique case of a cystic endometrial adenocarcinoma metastasis treated by neurosurgical procedure. The patient underwent “en bloc” tumor resection guided by neuronavigation and there were no complications during surgery. After discharge, she underwent whole brain radiation therapy, currently makes quarterly outpatient follow-up and showed no signals of tumor recurrence. Conclusion: In this article we present a case of cystic brain metastasis from an endometrial adenocarcinoma that was successfully treated by neurosurgery tumoral resection. To our knowledge, this condition has not been reported previously in the literature.

Abstract 1122‐000219: Thrombectomy Treatment Strategies for Refractory Occlusions

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Nirav A Vora ◽  
Natalie Horn ◽  
William Hicks ◽  
Brian Katz ◽  
Vivek Rai ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Aspiration Thrombectomy ◽  
T Score ◽  
Endovascular Interventions ◽  
Procedural Time ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction : We sought to compare endovascular strategies in patients with intracranial occlusions refractory to stentriever thrombectomy. Methods : With approval, we retrospectively reviewed all acute stroke endovascular interventions from our center from July 2013 to September 2016. Of 294 interventions, we reviewed 151 patients with an intracranial internal carotid artery occlusion or middle cerebral artery M1 occlusion. Of these, 107 were treated initially with a stentriever, and had a completed procedure with < 2 device passes. Forty‐three had > 2 passes and were grouped as continued intervention with the same device (Group 1), switch to a different stentriever design (Group 2), switch to aspiration (Group 3), or alternating therapy with continued mechanical and aspiration thrombectomy (3 patients). Our endpoint was procedural time from ground puncture to end of intervention. We used a t test to compare mean procedural times of Groups 2 and 3 against Group 1 to assess for meaningful differences in treatment duration. Results : We identified 15 patients in Group 1 with a mean procedural time of 95 minutes (sd 21 minutes); 13 patients in Group 2 with a mean procedural time 89 minutes (sd 1 minute); and 12 patients in Group 3 with a mean procedural time of 81 minutes (sd 9 minutes). We observed a trend toward shorter procedure times when switching to a different stentriever design after two failed attempts with an original device (t score 1.0, 95% CI ‐18‐6, p = 0.31). A statistically lower difference procedural time was noted with a transition to aspiration (t score 2.2, 95% CI ‐27–0.6, p = 0.04). Conclusions : When dealing with refractory occlusions to mechanical embolectomy, switching therapy to direct aspiration may benefit over continued use of the same or different stentriever design. The possibility of shorter procedural times suggests the value of a prospective design to study this clinical question.

Republished: Emergency placement of stent-graft for symptomatic acute carotid artery occlusion after endarterectomy

2015 ◽  
Vol 8 (3) ◽  
pp. e9-e9
Author(s):  
Jun Kyeung Ko ◽  
Chang Hwa Choi ◽  
Sang Weon Lee ◽  
Tae Hong Lee
Keyword(s):  
Carotid Artery ◽  
Stent Graft ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Dramatic Improvement ◽  
Acute Infarction ◽  
Atherosclerotic Lesions ◽  
First Case ◽  
Stent Graft Implantation ◽  
Graft Implantation

A patient underwent a left-sided carotid endarterectomy (CEA) for an asymptomatic 80% carotid artery (CA) stenosis. There were no signs of intolerance during the carotid cross-clamping and an initially uneventful awakening was observed. However, in the third postoperative hour he experienced left amaurosis and dysarthria. An urgent MRI showed an occluded internal CA on the operated site without evidence of acute infarction. To recanalize the occluded internal CA and minimize leakage from the arteriotomy site, a self-expandable stent-graft was placed, covering the dissection and the distal atherosclerotic lesions. Complete recanalization of the left internal CA was achieved and the patient showed a dramatic improvement of his preoperative deficits. To our knowledge, this is the first case of stent-graft implantation for a symptomatic acute CA occlusion following CEA. Stent-graft placement should be considered as an alternative method of treatment for acute CA occlusion or dissection following CEA.

Glioblastoma multiforme metastasis to the axis

2005 ◽  
Vol 102 (3) ◽  
pp. 540-542 ◽  
Author(s):  
Satoshi Utsuki ◽  
Satoshi Tanaka ◽  
Hidehiro Oka ◽  
Kazuhisa Iwamoto ◽  
Takao Sagiuchi ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Magnetic Resonance ◽  
Tumor Resection ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
Content Type ◽  
Magnetic Resonance Studies ◽  
First Case ◽  
History Of ◽  
Multiple Bone Metastases

✓ Extracranial bone metastasis from glioblastoma multiforme (GBM) has rarely been reported in the literature, and most metastatic GBMs are multiple bone metastases. The authors describe the first case of a GBM with metastasis only to the axis. This 42-year-old man presented with a 2-month history of headache, nausea, vomiting, and disorientation. Magnetic resonance imaging demonstrated a right temporal tumor, which was diagnosed as a GBM based on tumor resection. The patient was treated using radiation (6000 cGy) and the intravenous administration of nimustine hydrochloride. Eighteen months thereafter, he experienced the sudden onset of neck pain. Magnetic resonance studies revealed a tumor in the axis that was diagnosed as GBM based on biopsy procedure.

Complex effects of apoplexy secondary to pituitary adenoma

2017 ◽  
Vol 28 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Rui-Cheng Zhang ◽  
Ying-Feng Mu ◽  
Jing Dong ◽  
Xiao-Qian Lin ◽  
De-Qin Geng
Keyword(s):  
Pituitary Adenoma ◽  
Case Reports ◽  
Spontaneous Remission ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Sudden Onset ◽  
Clinical Syndrome ◽  
Metabolic Demand ◽  
Releasing Factors ◽  
High Metabolic Demand

AbstractPituitary adenoma apoplexy is a well-known clinical syndrome induced by insulin infusion, cardiac surgery, trauma, and hypothalamic releasing factors. Pituitary apoplexy can cause secondary cerebral infarct and internal carotid artery occlusion. With blockade of tumor perfusion, apoplexy triggers a sudden onset of headache, visual impairment, cranial nerve palsy, disturbances of consciousness, eyelid ptosis, and hemiparesis. However, pituitary adenoma cells with high metabolic demand cannot survive with deficient blood supply and glucose concentrations. Moreover, a number of case reports have shown that spontaneous remission of syndromes, such as acromegaly, may be caused by pituitary adenoma after apoplexy. Therefore, understanding mechanism that underlies the balance between pituitary adenoma apoplexy and subsequent spontaneous remission of syndromes may suggest new approaches for treatment of pituitary adenoma apoplexy.

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