- Vagal Nerve Palsy After Transarterial Embolization of Transverse-Sigmoid Dural Arteriovenous Fistula Using Onyx. [Journal Article]
- JSJ Stroke Cerebrovasc Dis 2018 Nov 10
- CONCLUSIONS: TAE with Onyx appears to be effective for aggressive TS-DAVF with a widely distributed shunt. However, the blood supply to the cranial nerves and potentially dangerous anastomoses between the external-internal carotid artery and vertebral artery should be taken into account to avoid serious complications.
- Rapid detection of Listeria monocytogenes rhombencephalitis in an immunocompetent patient by multiplexed PCR. [Journal Article]
- BCBMJ Case Rep 2018 Nov 08; 2018
- A 46-year-old previously healthy man presented with 1 week of headache, nausea, vomiting and dizziness. He was found to have cranial nerve deficits, his cerebrospinal fluid (CSF) demonstrated a lymph...
A 46-year-old previously healthy man presented with 1 week of headache, nausea, vomiting and dizziness. He was found to have cranial nerve deficits, his cerebrospinal fluid (CSF) demonstrated a lymphocytic pleocytosis and brain MRI suggested rhombencephalitis. Although Gram stains and cultures of his CSF did not identify a pathogen, Listeria monocytogenes DNA was detected by the FilmArray Meningitis/Encephalitis panel within 2 hours of performing a lumbar puncture. He was treated with ampicillin and gentamicin and had a near-complete recovery. This case highlights the importance of recognising L. monocytogenes infection as a cause of acute cranial nerve impairment with MRI findings suggestive of brainstem encephalitis. It also highlights the frequently atypical CSF profile and low yield of culture in L. monocytogenes rhombencephalitis and the value of multiplex PCR testing of CSF to rapidly identify this pathogen and permit targeted therapy.
- Delayed Trochlear Nerve Palsy Following Traumatic Subarachnoid Hemorrhage: Usefulness of High-Resolution Three Dimensional Magnetic Resonance Imaging and Unusual Course of the Nerve. [Journal Article]
- KJKorean J Neurotrauma 2018; 14(2):129-133
- Cranial nerve palsies are relatively common after trauma, but trochlear nerve palsy is relatively uncommon. Although traumatic trochlear nerve palsy is easy to diagnose clinically because of extraocu...
Cranial nerve palsies are relatively common after trauma, but trochlear nerve palsy is relatively uncommon. Although traumatic trochlear nerve palsy is easy to diagnose clinically because of extraocular movement disturbances, radiologic evaluations of this condition are difficult to perform because of the nerve's small size. Here, we report the case of a patient with delayed traumatic trochlear nerve palsy associated with a traumatic subarachnoid hemorrhage (SAH) and the related radiological findings, as obtained with high-resolution three-dimensional (3D) magnetic resonance imaging (MRI). A 63-year-old woman was brought to the emergency room after a minor head trauma. Neurologic examinations did not reveal any focal neurologic deficits. Brain computed tomography showed a traumatic SAH at the left ambient cistern. The patient complained of vertical diplopia at 3 days post-trauma. Ophthalmologic evaluations revealed trochlear nerve palsy on the left side. High-resolution 3D MRI, performed 20 days post-trauma, revealed continuity of the trochlear nerve and its abutted course by the posterior cerebral artery branch at the brain stem. Chemical irritation due to the SAH and the abutting nerve course were considered causative factors. The trochlear nerve palsy completely resolved during follow-up. This case shows the usefulness of high-resolution 3D MRI for evaluating trochlear nerve palsy.
- Vernet's Syndrome Associated with Internal Jugular Vein Thrombosis. [Journal Article]
- JSJ Stroke Cerebrovasc Dis 2018 Nov 02
- Our objective is to present a case of Vernet's syndrome (cranial nerve (CN) IX, X, and XI palsy) associated with cerebral venous thrombosis (CVT) in an internal jugular vein. The patient presented wi...
Our objective is to present a case of Vernet's syndrome (cranial nerve (CN) IX, X, and XI palsy) associated with cerebral venous thrombosis (CVT) in an internal jugular vein. The patient presented with acutely developed dysphagia. The weakness of the left sternocleidomastoid and trapezius muscles was observed. The initial magnetic resonance imaging and computed tomography (CT) with contrast enhancement showed contrast-filling defect in the left internal jugular vein inside the jugular foramen. The magnetic resonance venography with contrast enhancement revealed a partial filling defect in the left sigmoid sinus and total occlusion of the left internal jugular vein. Under the diagnosis of CVT associated with CN IX, X palsy, anticoagulation therapy with low-molecular-weighted heparin was initiated. Despite the continued anticoagulation therapy for 3 months, neither the burden of thrombosis in the left sigmoid sinus and internal jugular vein on neck CT nor dysphagia symptoms improved. Clinicians need to be aware of internal jugular venous thrombosis as one of the differential diagnoses in Vernet's syndrome in patients in a hypercoagulable state. Further reporting of similar cases is needed to confirm the association between CVT and Vernet's syndrome.
- Ischemic Stroke due to Virologically-Confirmed Varicella Zoster Virus Vasculopathy: A Case Series. [Journal Article]
- JSJ Stroke Cerebrovasc Dis 2018 Nov 01
- CONCLUSIONS: Cranial nerve palsies may be prodromal symptoms of VZV-associated stroke. Increased levels of thrombotic markers may support the use of antithrombotic agents, although the benefit of combined treatment should be determined through larger studies.
- Endovascular coil embolization with LVIS Jr. stent for ruptured dissecting aneurysm of proximal superior cerebellar artery - a case report and literature review. [Journal Article]
- WNWorld Neurosurg 2018 Oct 31
- CONCLUSIONS: Endovascular treatment assisted with LVIS Jr stent for proximal SCA dissecting aneurysm arising from small parent artery was safely and effectively feasible.
- Hypoglossal canal schwannoma causing isolated left 12th cranial nerve palsy. [Journal Article]
- BCBMJ Case Rep 2018 Nov 01; 2018
- A 40-year-old woman presented with insidious onset, gradually progressive dysarthria and inability to manoeuvre bolus of food in her mouth while eating. The duration of her symptoms was 3 months. On ...
A 40-year-old woman presented with insidious onset, gradually progressive dysarthria and inability to manoeuvre bolus of food in her mouth while eating. The duration of her symptoms was 3 months. On evaluation, the left half of her tongue was wasted. The tongue deviated to the left on protrusion. There were no clinical features suggestive of involvement of the ipsilateral 9th, 10th or 11th cranial nerves. MRI of the brain showed a large, fusiform lesion in the left hypoglossal canal, extending into the jugular canal. The lesion was surgically excised and found to be a schwannoma.
- Asymmetric Lateral Rectus Muscle Insertion Presenting as Esotropia in a Child With Alagille Syndrome. [Journal Article]
- JPJ Pediatr Ophthalmol Strabismus 2018 Nov 02; 55:e36-e38
- A 2-year-old boy with Alagille syndrome who had esotropia underwent bilateral medial rectus recession. One month postoperatively, esotropia reoccurred and was aggravated thereafter. Right lateral rec...
A 2-year-old boy with Alagille syndrome who had esotropia underwent bilateral medial rectus recession. One month postoperatively, esotropia reoccurred and was aggravated thereafter. Right lateral rectus resection was unsuccessful because the insertion site could not be identified. Careful preoperative imaging may be necessary in patients with Alagille syndrome to detect any abnormal extraocular muscle insertion. [J Pediatr Ophthalmol. 2018;55:e36-e38.].
- Like a hole in the head: Development, evolutionary implications and diseases of the cranial foramina. [Review]
- SCSemin Cell Dev Biol 2018 Oct 30
- Cranial foramina are holes in the skull through which nerves and blood vessels pass to reach both deep and superficial tissues. They are often overlooked in the literature; however they are complex s...
Cranial foramina are holes in the skull through which nerves and blood vessels pass to reach both deep and superficial tissues. They are often overlooked in the literature; however they are complex structures that form within the developing cranial bones during embryogenesis and then remain open throughout life, despite the bone surrounding them undergoing constant remodelling. They are invaluable in assigning phylogeny in the fossil record and their size has been used, by some, to imply function of the nerve and/or blood vessel that they contained. Despite this, there are very few studies investigating the development or normal function of the cranial foramina. In this review, we will discuss the development of the cranial foramina and their subsequent maintenance, highlighting key gaps in the knowledge. We consider whether functional interpretations can be made from fossil material given a lack of knowledge regarding their contents and maintenance. Finally, we examine the significant role of malformation of foramina in congenital diseases such as craniosynostosis.
New Search Next
- Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinus: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(44):e13027
- CONCLUSIONS: Primary head and neck Ewing sarcoma can lead to compressive optic neuropathy, but the tumor responded well to the chemotherapy. Early diagnosis and immediate treatment by close cooperation between the ophthalmologist and oncologist can prevent from permanent visual loss.