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Holmes' tremor caused by midbrain cavernoma

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Chinese Medical Journal 2007年第22期120卷 2059-2061页

作者： ZHONG Jun LI Shi-ting XU Shun-qing WAN Liang Department of Neurosurgery Xinhua Hospital Shanghai JiaoTong University School of Medicine Shanghai 200092 China

Holmes＇ tremor has been postulated as a syndrome .attributed to those lesions that interrupt the dentatethalamic and the nigrostriatal tracts thus causing both an action and a rest tremor. It may arise from various underlying structural disorders including multiple sclerosis, stroke, or tumors. So far, to our knowledge, few studies on Holmes＇ tremor secondary to cavemoma have been reported. Here we report a case of disabling tremor, who harbored a cavemoma in the midbrain.

关键词： Holmes＇tremor cavernoma midbrain

Navigation-assisted transcortical transventricular approach for paraventricular cavernoma:A technical note and review of the literature

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Laparoscopic, Endoscopic and Robotic Surgery 2018年第3期1卷 66-69页

作者： Xinwei Li Kun Wang Xueying Xu Yirong Wang Lutz Dorner Department of Neurosurgery Sir Run Run Shaw HospitalZhejiang University School of MedicineQingchun East Road 3Hangzhou 310016China Department of Neurosurgery Xiasha CampusSir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310020China Department of Neurosurgery Universit€atsklinikum Schleswig-HolsteinCampus KielArnold-Heller Straße 3Kiel 24105Germany

The surgery of paraventricular cavernoma remains a challenge for the neurosurgeon.Few approaches have been specially described for paraventricular cavernoma in literature.We present a patient with a symptomatic paraventricular cavernoma in the dorsal portion of the right lateral ventricles roof causing ventricular hemorrhage,and review his surgical approaches.This patient underwent a navigationassisted transcortical transventricular approach resulting in a complete resection without any neurologic deficits.The approach allows a safe and effective resection of paraventricular cavernomas.

关键词： Paraventricular Neuronavigation cavernoma Transcortical transventricular approach

Prognostic factors in non-malignant and non-cirrhotic patients with portal cavernoma: An 8-year retrospective single-center study

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World Journal of Gastroenterology 2013年第42期19卷 7447-7454页

作者： Xing-Shun Qi Ming Bai Chuang-Ye He Zhan-Xin Yin Wen-Gang Guo Jing Niu Fei-Fei Wu Guo-Hong Han Department of Liver Diseases and Digestive Interventional Radiology Xijing Hospital of Digestive DiseasesFourth Military Medical University

AIM:To evaluate the outcome of non-malignant and non-cirrhotic patients with portal cavernoma and to determine the predictors for survival.METHODS:Between July 2002 and June 2010,we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of portal cavernoma without abdominal malignancy or liver cirrhosis.The primary endpoint of this observational study was death and cause of death.Independent predictors of survival were identified using the Cox regression model.RESULTS:A total of 64 patients were enrolled in the study.During a mean follow-up period of 18±2.41mo,7 patients died.Causes of death were pulmonary embolism(n=1),acute leukemia(n=1),massive esophageal variceal hemorrhage(n=1),progressive liver failure(n=2),severe systemic infection secondary to multiple liver abscesses(n=1)and accident(n=1).The cumulative 6-,12-and 36-mo survival rates were 94.9%,86%and 86%,respectively.Multivariate Cox regression analysis demonstrated that the presence of ascites(HR=10.729,95%CI:1.209-95.183,P=0.033)and elevated white blood cell count(HR=1.072,95%CI:1.014-1.133,P=0.015)were independent prognostic factors of non-malignant and non-cirrhotic patients with portal cavernoma.The cumulative 6-,12-and 36-mo survival rates were significantly different between patients with and without ascites(90%,61.5%and 61.5%vs 97.3%,97.3%and 97.3%,respectively,P=0.0008).CONCLUSION:The presence of ascites and elevated white blood cell count were significantly associated with poor prognosis in non-malignant and non-cirrhotic patients with portal cavernoma.

关键词： Extrahepatic portal vein obstruction Portal cavernoma Survival Prognostic factors Ascites

Parasellar extra-axial cavernoma mimicking meningioma: a case report

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Neuroimmunology and Neuroinflammation 2017年第1期4卷 16-19页

作者： Arun Oommen Thara Pratap Sushil Chandi Muhammed Jasim Abdul Jalal Department of Neurosurgery VPS Lakeshore Hospital KochiKerala 682040India Department of Radiology VPS Lakeshore HospitalKochiKerala 682040India Department of Pathology Lisie HospitalKochiKerala 682040India Department of Internal Medicine and Rheumatology VPS Lakeshore HospitalKochiKerala 682040India

Parasellar extra-axial cavemomas are rare lesions.The authors report a case of extra-axial cavemoma in a 50-year-old male patient,who presented with occipital headache and double vision.The magnetic resonance imaging showed an enhancing extra-axial dural-based mass in the left parasellar region invading cavernous sinus,hyper-intense on T2-weighted images,iso-intense on Tl-weighted images and high relative cerebral blood velocity on magnetic resonance perfusion.The patient underwent a left pterional craniotomy and parasellar space occupying lesion was excised.Histopathology was suggestive of cavernous hemangioma.

关键词： Extra-axial cavernoma parasellar cavernoma meningioma

Intraoperative high-field magnetic resonance imaging, multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas

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Chronic Diseases and Translational Medicine 2016年第3期2卷 -页

作者： Fang-ye Li Xiao-lei Chen Bai-nan Xu Department of Neurosurgery Chinese People's Liberation Army General Hospital Beijing 100853 China

OBJECTIVE:To determine the beneficial effects of intraoperative high-field magnetic resonance imaging (MRI), multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas.;METHODS:Twelve patients with 13 supratentorial cavernomas were prospectively enrolled and operated while using a 1.5 T intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. All cavernomas were deeply located in subcortical areas or involved critical areas. Intraoperative high-field MRIs were obtained for the intraoperative "visualization" of surrounding eloquent structures, "brain shift" corrections, and navigational plan updates.;RESULTS:All cavernomas were successfully resected with guidance from intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. In 5 cases with supratentorial cavernomas, intraoperative "brain shift" severely deterred locating of the lesions; however, intraoperative MRI facilitated precise locating of these lesions. During long-term (>3 months) follow-up, some or all presenting signs and symptoms improved or resolved in 4 cases, but were unchanged in 7 patients.;CONCLUSIONS:Intraoperative high-field MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring are helpful in surgeries for the treatment of small deeply seated subcortical cavernomas.

关键词： cavernoma Intraoperative electrophysiological monitoring Intraoperative magnetic resonance imaging Multimodal neuronavigation

Surgical treatment of brainstem cavernous malformations with three basic skull base approaches and minimally invasive techniques: Observations in 20 patients

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Translational Neuroscience and Clinics 2017年第2期3卷 74-83页

作者： Wen Yin Jianrong Ma Yiwei Liao Department of Neurosurgery Xiangya Hospital Central South University

Objective: Brainstem cavernous malformation(BSCM) is extremely challenging for neurosurgeons in terms of surgical approach choices. In this article, we summarized our experience in skull base approaches of BSCM, and elucidated the advance of surgical treatments of brain stem cavernous malformation through reviewing recent relevant articles. Methods: We retrospectively reviewed 20 consecutive patients who underwent resection between May 1, 2014 and April 30, 2016. Only midline suboccipital, subtemporal approach and retrosigmoid approach were used in this series. The diagnoses of all patients were confirmed by radiological and histological examination. Results: All 20 patients were completely extirpated without surgical-related mortality.The mean follow-up period was 9.5 months(range, 2-20 months). Of the 20 patients, 80%symptomatic patients underwent surgery after first bleeding episode within 3 months,20% after two or more bleeding episodes by magnetic resonance imaging. After resection and during follow-up, 75% of patients had an improvement in their modified Rankin scale(m RS) scores, whereas 10% were worse compared with their preoperative presentation; 15% were unchanged. Conclusion: Appropriate basic surgical approach and minimally invasive techniques are necessary in preventing impairment of neurologic function. The three common basic skull base approaches, combined with minimally invasive techniques can handle most of BSCMs with good surgical results.

关键词： brainstem cavernous malformation cavernoma microsurgery

<i>De Novo</i>Cavernous Malformation after Radiosurgery

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Open Journal of Modern Neurosurgery 2013年第1期3卷 1-3页

作者： Catarina Viegas Bruno Santiago Joana Boléo Tomé Manuel Cunhae Sá Department of Neurosurgery Hospital Garcia de Orta Almada Portugal

Background: The general use of radiation therapy and radiosurgery as first-line or adjuvant treatment of central nervous system (CNS) lesions has been associated with several harmful effects. Case Description: We report the case of a 16-year-old male patient, submitted at the age of seven to surgical removal of a world heath organization (WHO) grade II diffuse astrocytoma and referred for adjuvant radiosurgery after three further surgeries due to local recurrences. Seven years after radiosurgical treatment, he presented with symptoms of intracranial hypertension. Magnetic resonance imaging (MRI) at the time showed a cavernous malformation in the tumor bed, histologically confirmed, without tumoral recurrence. Conclusion: This case report emphasizes the relation between radiosurgery and the appearance of the novo cavernous malformations, only described previously in one adult patient.

关键词： Cavernous Malformation Radiosurgery Radiation Induced cavernoma Grade II Astrocytoma

Imaging and radiological interventions in extra-hepatic portal vein obstruction

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World Journal of Radiology 2016年第6期8卷 556-570页

作者： Sudheer S Pargewar Saloni N Desai S Rajesh Vaibhav P Singh Ankur Arora Amar Mukund Division of Interventional Radiology Department of RadiologyInstitute of Liver and Biliary Sciences Division of Diagnostic Radiology Department of RadiologyInstitute of Liver and Biliary Sciences

Extrahepatic portal vein obstruction(EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension(PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt(PSS) and revision of PSS.

关键词： Extrahepatic portal venous obstruction Portal cavernoma Portal hypertension Transjugular intrahepatic portosystemic shunt Splenic embolization