A Simple Surgical Technique for Pediatric Sinus Pericranii: Intraoperative Manual Compression of a Major Shunting Point

2021 ◽  
pp. 1-6
Author(s):  
Yuki Fujimoto ◽  
Ryota Ishibashi ◽  
Yoshinori Maki ◽  
Masashi Kitagawa ◽  
Masanori Kinosada ◽  
...  
Keyword(s):  
Vascular Anomaly ◽  
Surgical Removal ◽  
Manual Compression ◽  
Intraoperative Bleeding ◽  
Case Presentation ◽  
Sinus Pericranii ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
Subcutaneous Mass ◽  
Computed Tomography Venography

<b><i>Introduction:</i></b> Sinus pericranii is a vascular anomaly with extra- and intracranial venous connections. Sinus pericranii is categorized into 2 groups according to its contribution to the normal venous circulation. The accessory type sinus pericranii, which does not contribute to the normal major venous circulation, can be managed. Despite several proposed operative maneuvers, a standardized technique is yet to be established to control intraoperative bleeding. <b><i>Case Presentation:</i></b> A 2-week-old neonate underwent examination of a subcutaneous mass in the parieto-occipital region. The subcutaneous mass had a major venous connection to the superior sagittal sinus on ultrasonography. The subcutaneous mass was partially thrombolized on magnetic resonance imaging and was minimally enhanced on computed tomography venography. The subcutaneous mass seemed not to contribute to the normal venous circulation. Surgical removal of the subcutaneous mass was performed due to its increased size at the age of 1 year and 3 months. While subcutaneous mass was detached from the scalp, the major venous connection was manually compressed, and minor venous connections were easily detected. The intraoperative bleeding was controllable. The pathological diagnosis was sinus pericranii. The patient is now followed up in the outpatient clinic. No recurrence was seen 18 months after the surgery. <b><i>Discussion/Conclusion:</i></b> Intraoperative hemostasis is essential while sinus pericranii is detached from the cranium. Hemostatic agents such as bone wax or absorbable gelatin and heat coagulation seem to be useful. However, complicative hemorrhage concerning to the preceded technique has been also reported. As seen in our case, to detect minor shunting points between the sinus pericranii and the intracranial veins, the major venous connection was manually compressed. Intraoperative manual compression of a major venous connection of sinus pericranii can be an option to manage intraoperative bleeding.

scholarly journals Bilateral Frontal Sinus Pericranii with an Intratabular Course

2010 ◽  
Vol 16 (2) ◽  
pp. 179-182 ◽  
Author(s):  
B. Schenk ◽  
P.A. Brouwer
Keyword(s):  
Frontal Sinus ◽  
Unusual Case ◽  
Superior Sagittal Sinus ◽  
Venous System ◽  
Venous Anomaly ◽  
Sinus Pericranii ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
Bridging Vein

Sinus pericranii is a rare venous anomaly, representing a transosseous connection between the intracranial venous system and the epicranial venous system. We present an unusual case of bilateral frontal sinus pericranii in a 12-year-old boy, with associated lacrimation. Instead of the usual short bridging vein between the intra- and extracranial venous circulation, in our case the veins connecting the superior sagittal sinus and the left superior ophthalmic/orbital vein coursed intratabularly over a distance of several centimeters. To our knowledge, such a course has not previously been reported in literature.

scholarly journals Multiple lateral sinus pericranii: A case report

2015 ◽  
Vol 72 (9) ◽  
pp. 845-849
Author(s):  
Drazen Ivetic ◽  
Goran Pavlicevic ◽  
Branislav Antic ◽  
Dejan Kostic
Keyword(s):  
Case Report ◽  
Endovascular Procedures ◽  
Vascular Anomaly ◽  
Transverse Sinus ◽  
Venous System ◽  
Lateral Sinus ◽  
Sinus Pericranii ◽  
Sagittal Sinus ◽  
Emissary Veins ◽  
Midline Sinus

Introduction. Sinus pericranii is a rare vascular anomaly. It is characterized by abnormal communication between the extracranial and intracranial venous system, usually involving the superior sagittal sinus and occasionally the transverse sinus. Off the midline lesions are extremely rare. Multiplicity, associated venous lakes, venous angioma and lateral location are unusual and unique presentation of sinus pericranii. Case report. A case of multiple congenital off-midline sinus pericranii in the left frontotemporal and parietal region is presented. Magnetic resonance imaging showed an extracranial vascular anomaly connected with the intracranial venous system through abnormal diploic or emissary veins. The lesions were removed completely by surgery. Conclusion. Sinus pericranii is a rare vascular malformation with unique clinical and radiological features. Sinus pericranii may cause fatal complications, and it must be treated by surgical or endovascular procedures.

scholarly journals Laparoscopic treatment for celiac artery stenosis caused by median arcuate ligament compression with Adachi V type vascular anomaly: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroshi Saito ◽  
Koichiro Sawada ◽  
Jyunichi Ogawa ◽  
Masashi Hashimoto ◽  
Masahiro Oshima ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Vascular Anomaly ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Case Presentation ◽  
Arcuate Ligament ◽  
Major Vascular Injury

Abstract Background Median arcuate ligament syndrome (MALS), which results from compression of the median arcuate ligament (MAL), is a rare cause of abdominal pain and weight loss. Treatment is dissection of the MAL; however, the laparoscopic procedure is not yet established and it involves the risk of major vascular injury, especially in cases with an anomaly. Case presentation A 47-year-old man was evaluated at the hospital for epigastric pain. Contrast computed tomography scan revealed stenosis of the celiac artery origin due to the MAL. An Adachi V type vascular anomaly was also observed. Laparoscopic treatment was performed to release pressure on the celiac artery. Laparoscopic ultrasonography was used to less invasively confirm the release of the MAL. Despite a concomitant Adachi V type vascular anomaly, surgery was safely performed using the laparoscopic magnification view and intraoperative ultrasonography. Follow-up ultrasonography confirmed the celiac artery stenosis has not recurred. Conclusions A rare case of MALS with an Adachi V type vascular anomaly is presented and the laparoscopic treatment is detailed.

scholarly journals Two different clinical forms of squamous cell carcinoma (SCC) in the perineum and vulva of two mares

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Andrzej Raś ◽  
Iwona Otrocka-Domagała ◽  
Małgorzata Raś-Noryńska
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Reproductive Organs ◽  
Malignant Neoplasms ◽  
Surgical Removal ◽  
Chemotherapy Treatment ◽  
Case Presentation

Abstract Background Genital malignant neoplasms in mares are relatively rare. The treatment involve surgical removal of the tumour masses, chemotherapy or both. Case presentation Two elderly warmblood mares, aged 16 and 20 were presented in University Clinic with the lumpy lesions at the region of perineum and left labia. Surgical removals of tumour masses were performed on standing animals. Removed tissues were subjected to histopathological examination which confirmed SCC. Conclusions Clinical and ultrasound examination of reproductive organs in both mares showed no inflammatory or neoplastic changes. Both mares healed within 2 weeks after surgery and showed no signs of tumour recurrence for the following year despite no chemotherapy treatment.

Sinus pericranii: radiological and etiopathological considerations

1992 ◽  
Vol 77 (3) ◽  
pp. 469-472 ◽  
Author(s):  
Alicia Bollar ◽  
Alfredo G. Allut ◽  
Angel Prieto ◽  
Miguel Gelabert ◽  
Eugenio Becerra
Keyword(s):  
Vascular Endothelium ◽  
Vascular Anomaly ◽  
Pathological Examination ◽  
Persistent Trigeminal Artery ◽  
Resonance Imaging ◽  
Content Type ◽  
Sinus Pericranii ◽  
Congenital Origin ◽  
Cranial Injury ◽  
Fine Print

✓ Sinus pericranii is a rare vascular anomaly involving an abnormal communication between the extracranial and intracranial circulations. A case of frontal sinus pericranii is presented which appeared to be a posttraumatic sinus because it developed 2 years after a cranial injury. However, the presence of vascular endothelium in the pathological examination and its association with a vascular anomaly (persistent trigeminal artery) suggested a congenital origin. The lesion, pericranial blood sinuses, and bone were totally removed. The computerized tomography, angiography, and magnetic resonance imaging findings are presented. The literature is reviewed and the pathogenesis of sinus pericranii is discussed.

scholarly journals Metal Foreign Bodies Have Been in the Lungs for Five Years: a Case Report

2021 ◽  
Author(s):  
Yuan Li ◽  
Zhong Li ◽  
Jun-Cai Liu
Keyword(s):  
Foreign Body ◽  
Pulmonary Artery ◽  
Foreign Bodies ◽  
Treatment Plan ◽  
High Density ◽  
Surgical Removal ◽  
Metallic Foreign Body ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Limb Trauma

Abstract Background: Metallic foreign body migration into the pulmonary artery after limb trauma is extremely rare. If not treated in time, the patient may die. The metallic foreign body was implanted from the thigh into the pulmonary artery and remained for 5 years. It has never been reported in limb trauma.Case Presentation: The patient was a 51-year-old male who had a small metal foreign body embedded in the middle and lower left thigh due to trauma. The foreign body was not found during emergency debridement operation. During the operation, a full-body X-ray was used to reveal a high-density shadow in the left upper lung. The 3D-CT of the chest immediately confirmed that the high-density shadow was a small iron foreign body, and the iron fragment foreign body was present in the pulmonary artery branch, but no abnormal symptoms were observed. He was hospitalized for observation for 3 days without obvious discomfort and refused to open his chest. The patient then decided to leave the hospital voluntarily.Conclusion: Surgical removal of all foreign bodies traveling to the pulmonary artery is not necessary, and the most appropriate treatment plan should be made considering the location of the foreign body, the patient's wishes and the general condition.

scholarly journals A case report of a spontaneous sternocleidomastoid hematoma: a challenging diagnosis in infantile neck swellings

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Monia Ghammam ◽  
Lobna Chouchane ◽  
Jihene Houas ◽  
Mouna Bellakhdher ◽  
Heyfa Bel Hadj Miled ◽  
...  
Keyword(s):  
Vascular Malformations ◽  
Past History ◽  
Surgical Removal ◽  
Imaging Features ◽  
Case Presentation ◽  
Cervical Hematoma ◽  
Neck Masses ◽  
Common Complaint ◽  
History Of ◽  
Malignant Lesions

Abstract Background Pediatric neck masses are a common complaint in children. The most common etiologies include congenital lesions, lymphadenopathy, vascular malformations, inflammatory, and malignant lesions. Spontaneous sternocleidomastoid hematoma is exceptional in infant. Case presentation We describe a case of spontaneous cervical hematoma diagnosed in a 4-month-old child. Past history did not reveal a neck trauma, a history of difficult labor, a bleeding disorder or a pertinent family history. The diagnosis was suspected based on the imaging features and confirmed after surgical removal. Conclusions Sternocleidomastoid swelling is commonly encountered in infancy. Ultrasound still remains the initial modality of choice. The management modalities are controversial.

scholarly journals An unusual case of bone regeneration of a necrotic mandible with pathologic fracture in an elderly hemodialysis patient with medication-related osteonecrosis of the jaw: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kunio Yoshizawa ◽  
Akinori Moroi ◽  
Ran Iguchi ◽  
Akihiro Takayama ◽  
Junko Goto ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Unusual Case ◽  
Pathologic Fracture ◽  
Osteonecrosis Of The Jaw ◽  
Intraoperative Bleeding ◽  
Case Presentation ◽  
Old Japanese ◽  
Systemic Condition ◽  
Intravenous Bisphosphonate ◽  
Rare Report

Abstract Background Bisphosphonates are frequently used for osteoporosis. Medication-related osteonecrosis of the jaw, a complication of bone-modifying agents, including bisphosphonates or angiogenic inhibitors, can be challenging to treat in elderly patients with numerous preexisting conditions. Achieving good treatment outcomes is especially difficult in patients with pathological fractures accompanied with extraoral fistulae. Case presentation We report an unusual case of prominent bone regeneration following palliative surgical treatment in a 72-year-old Japanese female patient undergoing hemodialysis. She previously had severe osteoporosis due to renal osteodystrophy and was receiving antiresorptive intravenous bisphosphonate. Computed tomography revealed a discontinuous left lower mandibular margin with a pathologic fracture and extensive, morphologically irregular sequestrum formation (80 × 35 × 20 mm). The patient was diagnosed with stage III medication-related osteonecrosis of the jaw and pathologic mandibular fracture. Immediately before the surgery, the anticoagulant used for dialysis was changed from heparin to nafamostat mesylate to reduce the risk of intraoperative bleeding. Sequestrectomy was performed under general anesthesia. Postoperative infection was not observed, the intraoral and submandibular fistula disappeared, and, surprisingly, prominent spontaneous bone regeneration was observed postoperatively at 6 months. Despite the severe systemic condition of the patient, the conservative surgical approach with sequestrectomy has yielded desirable results for more than 6 years since the surgery. Conclusions This rare report of spontaneous bone regeneration in a patient of advanced age and poor general condition is the oldest case of mandibular regeneration ever reported.

Oxygen tensions measured in cat cerebral cortex under hyperbaric conditions

1979 ◽  
Vol 46 (1) ◽  
pp. 53-60 ◽  
Author(s):  
F. G. Hempel
Keyword(s):  
Cerebral Cortex ◽  
Venous Blood ◽  
Sagittal Sinus ◽  
Venous Circulation ◽  
Arterial Blood ◽  
The Mean ◽  
Oxygen Tensions ◽  
The Brain ◽  
Cat Cerebral Cortex ◽  
Hyperbaric Conditions

Pyrenebutyric acid (PBA), the intracellular fluorescent indicator, was used to measure the partial pressure of oxygen (PO2) in the exposed cerebral cortex of anesthetized cats at hyperbaric pressures up to 4 ATA. The validity of the PBA method for determining cortical PO2 was confirmed by demonstrating a precise linear relationship between Pao2 and the reciprocal of the fluorescence of PBA in the brain as the cat was ventilated with sequentially greater oxygen pressures while holding the Paco2 nearly constant. Increments in the Paco2 while the Pao2 was maintained at a high (about 2,000 Torr) level resulted in stepwise greater oxygen tensions in the brain until an oxygenation end point was reached with a Paco2 averaging near 122 Torr. Greater amounts of CO2 did not bring the mean PO2 of the brain, 1,017 Torr, closer to 2,000 Torr. During normocapnia the cortical PO2 was greater than the PO2 of cerebral venous blood collected from the superior sagittal sinus; however, in hypercapnia (PaCO greater than 45 Torr), the PO2 of the sinus blood exceeded the value determined in the cortex. This latter observation is taken as evidence for convective shunting of cerebral arterial blood to venous circulation when hypercapnia is present.

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