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Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

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Chinese Medical Journal 2010年第24期123卷 3519-3523页

作者： TAO Yu-xin QU Qiu-yi WANG Zhen-lin ZHANG Qiu-hang Department of Otolaryngology-Head and Neck Surgery Xuanwu Hospital Capital Medical University Beijing 100053 China

Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous *** The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal *** Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia *** was relieved to various extents in all patients. No serious complications were found. Patient＇s hospital stay ranged from 7 to 20 *** These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

关键词： endoscopy pituitary adenorna cavernous sinus invasion

Therapeutic embolization of cavernous sinus dural arteriovenous fistulas via transvenous approach

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Chinese Medical Journal 2003年第5期116卷 661-664页

作者：侯凯罗祺陈强王宏磊罗毅男王长坤 Department of Neurosurgery First Affiliated Hospital Jilin University Changchun 130021 China

Objective To describe the transvenous catheterization technique for the treatment of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including its indications, complications and *** Eight patients with symptomatic CSdAVFs were treated by endovascular embolization with platinum coils, via the inferior petrosal sinus (IPS) in 6 patients, and via the Sylvian vein after surgical exposure in other 2 *** Complete angiographic resolution of the fistula was obtained in six patients immediately after the procedures, and a complete resolution of symptoms and signs was achieved in all patients. The residual fistulas in two patients disappeared completely in the follow-up *** Transvenous embolization is a useful and safe approach in the management of CSdAVFs.

关键词： cavernous sinus dural arteriovenous fistula therapeutic embolization

Clinical-radiological-pathological correlation of cavernous sinus hemangioma: Incremental value of diffusion-weighted imaging

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World Journal of Radiology 2017年第8期9卷 330-338页

作者： Abhishek Mahajan Vedula Rajni Kanth Rao Gudipati Anantaram Ashwin M Polnaya Sandeep Desai Paresh Desai Rammohan Vadapalli Manas Panigrahi Department of Radio- diagnosis Tata Memorial Centre Department of Radiology Krishna Institute of Medical Sciences Department of Radiodiagnosis Clumax Imaging Department of Radiology Apollo Victor Hospital Department of Radiology Vijaya Diagnostics Department of Neurosurgery Krishna Institute of Medical Sciences

AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10-3 ± 0.2186 cm2/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.

关键词： cavernous sinus hemangioma cavernous sinus Magnetic resonance imaging Diffusion weighted imaging

Transvenous injection of n-Butyl cyanoacrylate combined with placement of coils in cavernous sinus for treatment of cavernous dural arteriovenous fistulae

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Journal of Medical Colleges of PLA(China) 2010年第5期25卷 285-292页

作者： Chen Huairui Bai Ruilin Wu Xiaojun Mei Qiyong Zhang Chenran Lu Yicheng Department of Neurosurgery Changzheng Hospital Second Military Medical University Shanghai 200003 China

Objective： To evaluate the technical aspects, efficacy and safety in the treatment of cavernous dural arteriovenous fistulae （DAVF） by transvenous liquid n-Butyl cyanoacrylate （NBCA） injection combined with coils placement in the cavemous sinus. Methods： Eight patients with cavernous DAVF, treated by transvenous embolization with combination of detachable coils and glue between February 2006 and February 2009 in our hospital, were retrospectively analyzed, including the clinical presentations, patterns of angioarchitecture, methods of treatment and the results of follow-up. Results： In all 8 patients, 9 transvenous and 1 transarterial interventions were carried out. A single endovascular procedure was performed in 6 patients and 2 patients had to be treated twice. Of the nine transvenous approaches, eight approaches were performed via inferior petrosal sinus （IPS） and 1 via the facial vein. Complete angiographic obliteration was achieved in all patients immediately after the embolization. There was no procedure-related morbidity except for mild headache for one to seven days after the embolization. Clinical cure was achieved in all cases during the clinical follow-up periods, ranging from 8 months to 3 years. The follow-up angiography periods averaged 6.6 months with a range of 5-9 months, in which no recurrence was observed. Conclusion： In this small series, embolization with combination of glue and detachable coils by transvenous approaches was a safe, effective and economical method for the treatment of part of symptomatic patients presenting with complex cavernous DAVE

关键词： cavernous sinus Dural arteriovenous fistula Glue Embolization

Rapid-developed Primary Malignant Myoepithelioma in cavernous sinus:Case Report and Review of The Literature

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Rapid-developed Primary Malignant Myoepithelioma in Cavernou...

Rapid-developed primary malignant myoepithelioma in cavernous sinus: Case report and review of the literature

2011年浙江省神经外科学学术年会

作者： Department of Neurosurgery,the 2nd Affiliated Hospital School of Medicine,Zhejiang University Wu qun,Guo Songxue,Chen Ting,Yan Wei,Zhang Jian-min

Myoepithelial carcinoma,also called malignant myepithelioma,is usually reported in the head,neck and lung,which is a rare malignant tumor arising from salivary *** region of cavernous sinus is an uncommon condition of involvement in myoepithelial carcinoma,while there are no finding of the tumor in common sites. Here we describe a 48-year-old female who present a rapid developing myoepithelial carcinoma,with progressively worse clinical symptoms and *** patient eventually showed a worse prognosis,and was advised to pick up a radiotherapy after biopsy and endoscopic transsphennoidal surgery,even if the radiotherapy has showed unclear effect on the *** this report,we discuss the histopathologic and cellular morphologic uniqueness of this rare case.

关键词： Myoepithelial carcinoma cavernous sinus

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Rapid-developed primary malignant myoepithelioma in cavernou...

Effects of castration and testosterone replacement on veno-occlusion during penile erection in the rat

2011中华医学会神经外科学学术会议

作者： Qun Wu1 Songxue Guo1 Ting Chen1 Wei Yan1 Jianmin Zhang1 1.Department of Neurosurgery, the 2 nd Affiliated Hospital School of Medicine, Zhejiang University

Myoepithelial carcinoma, also called malignant myepithelioma, is usually reported in the head, neck and lung, which is a rare malignant tumor arising from salivary glands. The region of cavernous sinus is an uncommon ... 详细信息

关键词： Myoepithelial carcinoma cavernous sinus

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Asian Journal of Andrology 1999年第1期1卷 53-59页

作者： Yu-TianDAI VivienneStopper RonaldLewis ThomasMills DepartmentofSurgeryUrologySection DepartmentofPhysiologyandEndoerinologyMedicalCollegeofGeorgia AugustaGA30912-3000USA

Aim: To determine if androgens directly regulate veno-occlusion or if androgens act indirectly to maintain the penilestructures which control outflow. Methods: Using CASTRATE and TESTO rats, measurement was made of meanarterial pressure (MAP), intracavernosal pressure (CCP), and intracavernosal flow (CCF) during erection resultingfrom stimulation of the autonomic innervation of the penis. CCP and CCF were also measured during saline infusioninto the cavernosal sinuses before and after treatment with sodium nitroprusside (SNP, a nitric oxide donor drag) tofully relax cavernosal smooth muscle. Penile tissue was also collected to measure the content of α actin and proline andhydroxyproline to determine if brief withdrawal of androgenic support led to changes in the number of smooth musclecells or the collagen content of the tissue. Results: Infusion of saline into the cavernosal sinuses demonstrated thatveno-occlusion was defective in CASTRATE rats while reno-occlusion was fully functional in TESTO ***, veno-occlusion could be induced in CASTRATE rats if they were first treated with SNP. Thisobservation suggests that failure of veno-occlusion in the CASTRATE rats is due to a deficiency in the production of NOresulting in a reduction in the degree of relaxation of the penile smooth muscle. The measurements of smooth muscleα actin and proline and hydroxyproline content of collagen showed that both were unaffected by castration and that thebasic structure of the penis did not degenerate after one week without androgenic support. Conclusion: Theseresults can be interpreted to mean that androgens control the veno-occlusive mechanism indirectly via a NO dependentmechanism and not by maintaining the structures of the penis which are essential to reno-occlusion.

关键词： castration testosterone cavernous sinus penile erection nitric oxide androgens

Clinical and pathological features of intracranial meningiomas in children:A retrospective analysis

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Neural Regeneration Research 2006年第6期1卷 573-576页

作者： Kun Yang Lisheng He Linsun Dai Jian Chen Zhixiong Lin Department of Neurosurgery Affiliated Hospital of Hainan Medical College Haikou 570102 Hainan Province China Department of Neurosurgery First Affiliated Hospital of Fujian Medical University Fuzhou 350005 Fujian Province China Department of Neurosurgery Tongji Hospital Tongji Medical University Wuhan 430030 Hubei Province China

BACKGROUND： The attack of meningiomas has sex and age differences. Previous studies indicated that children and adult patients had different clinical and pathological features. Due to the limitation of conditions and technique of diagnosis and treatment, some clinical and pathological features of meningiomas in children should be further recognized. OBJECTIVE： To summarize the clinical and pathological features in 15 children with intracranial meningiomas DESIGN ： A retrospective case analysis SETTING： The hospitals which the first author had been working inPARTICIPANTS ： Fifteen children with intracranial meningiomas were selected from the hospitals the frst author had been working in from June 1996 to June 2006. There were 9 boys and 6 girls, aged 1.8-15 years, with an average of 9.8 years. The duration from attack to diagnosis was 1 month to 2.5 years, with an average of 13 months. Inclusive criteria：（1） Clinically diagnosed, operated and confirmed pathologically; （2）≤ 15 years; （3） The children and their relatives were all informed and agree with the detection. METHOOS ： The clinical manifestations, imaging data, preoperative diagnosis and misdiagnosis, site and size of tumor, operative treatment and pathological data were retrospectively summarized. Thirteen of 15 children with intracranial meningiomas were followed up by means of reexamination for 1-8 years, and the postoperative recurrence were observed. MAIN OUTCOME MEASURES： Clinical manifestations, imaging data, preoperative diagnosis and misdiagnosis, site and size of tumor, operative treatment, pathological data, recurrence conditions of 1 to 8 years follow-up.RESULTS ： Thirteen of the 15 children with intracranial meningiomas were involved in the analysis of results, and 2 lost to the follow-up. （1） The main clinical manifestations at diagnosis were headache in 11 cases （73%, 11/15）, vomiting in 8 cases （53%, 8/15）, papilledema in 9 cases （60%, 9/15）, hypopsia in 6 cases （40%, 6115）, epil

关键词： size of tumor substraction angiography postoperative recurrence diagnosis and treatment gastrointestinal tract cerebellopontine angle recurrence rate cavernous sinus incidence rate carotid artery case analysis optic nerve

Internal carotid artery agenesis with stenosed intercavernous anastomosis:a case report

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The Journal of Biomedical Research 2016年第4期30卷 344-347页

作者： Hongzhou Duan Liang Li Guiping Zhao Yang Zhang Jiayong Zhang Department of Neurosurgery Peking University First HospitalBeijing 100034China. Neurology Peking University First HospitalBeijing 100034China.

We report a rare case of internal carotid artery agenesis with stenosed intercavernous anastomosis. A 59-year- old male patient presented with a new infarction in the left basal ganglia. Magnetic resonance angiography and cerebral angiography showed that the right internal carotid artery disappeared from the origin to the foramen lacerum segment, and there was an anastomotic artery with severe stenosis passed through the floor of the sella and in front of the cavernous sinus. The right A1 segment of the anterior cerebral artery was absent and A2 segment was supplied by the normal contralateral internal carotid artery via the anterior communicating artery.

关键词： internal carotid artery artery agenesis cavernous sinus