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At least 469 records · Page 26Linked to original sources

PubMed2000

Precise cannulation of the foramen ovale in trigeminal neuralgia complicating osteogenesis imperfecta with basilar invagination: technical case report.

OBJECTIVE AND IMPORTANCE: Trigeminal neuralgia is a rare feature of basilar invagination, which is itself a complication of osteochondrodysplastic disorders. Microvascular decompression is an unattractive option in medically refractory cases. The conventional percutaneous approach to the trigeminal ganglion is anatomically impossible because the foramen ovale points inferiorly and posteromedially. We report a new technique for image-guided trigeminal injection in a patient with basilar invagination complicating osteogenesis imperfecta. CLINICAL PRESENTATION: A 26-year-old woman with osteogenesis imperfecta presented with a 3-year history of typical left maxillary division trigeminal neuralgia, which was poorly controlled by carbamazepine at the maximum tolerated dose. She had obvious cranial deformities, left optic atrophy, delayed left eye closure, tongue atrophy, but normal facial sensation and corneal reflexes. A computed tomographic scan and magnetic resonance imaging confirmed severe basilar invagination. TECHNIQUE: Frameless stereotactic glycerol injection of the left trigeminal ganglion was performed under general anesthesia using the infrared-based EasyGuide Neuro system (Philips Medical Systems, Best, The Netherlands) with magnetic resonance imaging and computed tomographic registration. The displaced and distorted left foramen ovale was cannulated via a true frameless stereotactic method with the trajectory determined by virtual pointer elongation. The needle placement was confirmed with injection of contrast medium into the trigeminal cistern. The path needed to enter the foramen traversed the right cheek, soft palate, and left tonsil. The patient went home pain-free with a preserved corneal reflex and no complications. CONCLUSION: Frameless stereotaxy allows customization to individual patient anatomy and may be adapted to a variety of percutaneous procedures used in areas where the anatomy is complex.

Adult↗

PubMed2000

Herniation of the hepatic flexure through the foramen of Winslow: a case report.

Herniation through the foramen of Winslow is among the rarest of internal hernias. Predisposing factors include an enlarged epiploic foramen, a mobile cecum and ascending colon, and an abnormal length of small bowel mesentery. Obstruction, strangulation, and perforation with associated metabolic and septic sequelae are the major complications associated with this disease. We report a case of herniation through the foramen of Winslow in which the diagnosis was established preoperatively.

Aged↗

PubMed2003

Successful percutaneous closure of patent foramen ovale seven years after surgical closure.

Through advancements in transcatheter technology, a patent foramen ovale (PFO) can now be closed by either a percutaneous or surgical procedure. This report presents a patient who suffered an embolic stroke secondary to a PFO. The PFO was successfully closed surgically, but 7 years later the foramen ovale was found to be widely patent. The patient underwent successful percutaneous PFO closure and the foramen ovale remains closed. This case demonstrates that percutaneous PFO closure may be viable in patients in whom surgical closure has not provided long-term closure.

Adult↗

PubMed1992

Structural variations in the jugular foramen of the human skull.

The jugular foramen was examined in 300 Anatolian skulls from the 17th and 18th centuries. In 61.6% the foramen was larger on the right and in 26% on the left, with the remainder being of almost equal size. An obvious dome caused by a superior jugular bulb was present bilaterally in 49%, on the right only in 36%, on the left only in 6%; it was absent bilaterally in 10.3%. Complete bony septation occurred in 5.6% on the right and in 4.3% on the left, partial septation was observed in 2.6% on the right and in 19.6% on the left. Another foramen which is completely separated by a spicule of bone and which transmits the inferior petrosal sinus was present in 5.6% of skulls on the right and in 4.6% on the left.

Cranial Nerves↗

PubMed2003

A vertebral artery tortuous course below the posterior arch of the atlas (without passing through the transverse foramen). Anatomical report and clinical significance.

A vertebral artery (VA) coursing below the posterior arch of the atlas (C1) without passing through the transverse foramen of C1, combined with a tortuous course within the spinal canal has rarely been reported in the literature. This article describes a case encountered during an anatomical study of the far-lateral approach, and reviews its embryonic development and clinical significance. The suboccipital triangle was filled with numerous venous plexures. After exiting from the transverse foramen of C2, instead of passing upwards through the transverse foramen of C1, the VA turned directly medially towards the spinal canal. At the spinal canal, it first formed an angle downwards, then turned upwards, piercing and entering the lateral part of the dura at C1 level. The diameter of this VA seemed to be within its normal limits. The course of the contralateral (right) VA was normal but with a small caliber and mainly supplied the posterior inferior cerebellar artery (PICA); after PICA, it became much thinner and dysplastic, the basilar artery was mainly supplied by the left VA. The bilateral posterior communicating arteries were large in diameter but there was dysplasia of the P1 segment of the posterior cerebral arteries bilaterally. Marked tortuosity of the bilateral intracavernous internal carotid artery (ICA) was also found. We did not find any osseous abnormality in the occipito-axial region or of C1-C2 joint. An abnormal course of the VA should be kept in mind during exposure of the craniocervical junction, especially in the variety of lateral approaches; due to compression of the nerve roots or the spinal cord, this abnormal course of the VA could give rise to clinical symptoms, which could be resolved by microvascular decompression technique.

Aged↗

PubMed2004

[Postauricular tran-supracondylar approach removed jugular foramen and hypoglossal canal tumors].

OBJECTIVE: Discuss the surgical treatment of jugular foramen and hypoglossal canal tumor, and choice of the best surgical approach. METHODS: 32 patients with jugular foramen and hypoglossal canal tumor were operated through the postauricular tran-supracondylar approach, 13 neurinoma, 7 glomus jugular tumors, 4 meningioma, 3 chordoma. 23 were total removed, with a subtotal of 9. RESULTS: 21 patients were followed up, mean 2.5 years. 18 patients work normally, 7 of them were hoarseness, 2 of other 3 patients lived by themselves, 1 of existed obstruct of limbs. CONCLUSIONS: Postauricular tran-supracondylar approach exposes satisfactory for the dumbbell-shape tumors of intra-or extra cranial. It has high rate of total removal and low rate of complications. It is the best approach of treatment in jugular foramen and hypoglossal canal tumors. The outcome is good.

Adult↗

PubMed2004

Transcatheter closure of a patent foramen ovale in an adult with hypoxemia after cardiac transplantation.

We describe a case of refractory hypoxemia secondary to a patent foramen ovale immediately after orthotopic heart transplantation in a 60-year-old woman. The patent foramen ovale was successfully closed with a septal occlusion device, with resolution of the hypoxemia. To our knowledge, transcatheter closure of a patent foramen ovale in an adult patient with refractory hypoxemia during the immediate post-transplant period has not previously been reported.

Aged↗

PubMed1992

Handedness and the bilateral asymmetry of the jugular foramen.

This paper examines the proposed association of bilateral asymmetry of the jugular foramen as an indicator of handedness observable from cranial morphology. The jugular foramina of 54 subjects were observed for size asymmetry during routine autopsy procedures. Hand preference data were collected on each subject from family members. Of the 54 subjects, 47 were documented as being right-handed and 7 as being left-handed. These values approximate the average percentage of right-handed versus left-handed individuals from larger populations. Jugular foramen asymmetry was qualitatively identified for 36 subjects (66.7%) and was judged equivocal for the other 18 (33.3%). Of the 36 subjects exhibiting asymmetry, 28 (77.7%) showed positive correlation between the asymmetry direction and handedness. This moderate level of congruence, coupled with the result that 4 of the 7 left-handers exhibited dominant right-side foramina, casts doubt on the reliable use of jugular foramen asymmetry for estimating handedness.

Adolescent↗

PubMed2004

Radiographic and anatomic locations of mental foramen in northern Nigerian adults.

This study was undertaken to provide information on the most probable positions of the mental foramen among northern Nigerian adults. 157 panoramic radiographs randomly selected from patient's records at the Department of Dental Surgery, University of Maiduguri Teaching Hospital and 32 unsexed mandibles from the collection of bones in the Department of Human Anatomy, University of Maiduguri, were examined for the location of the mental foramen. The most common location was the interdental space between the first and second mandibular premolars (radiographs=34% , dry mandibles=32.8% ), closely followed by the position apical to the second premolars (radiographs=25.5% , dry mandibles=35.9% ). No significant difference in the distribution between males and females and the quantitative position was found to be bilaterally symmetrical in most cases. There is almost an equal chance of locating the mental foramen between the mandibular premolars and apical to the mandibular second premolar. This is of clinical importance with regards to the achievement of effective mental nerve block anaesthesia and the prevention of injury to the mental nerve during surgical procedures.

Adult↗

PubMedDate not supplied

Extraskeletal myxoid chondrosarcoma of the jugular foramen.

OBJECTIVE: To report a case of an extraskeletal myxoid chondrosarcoma (EMC) arising from the jugular foramen. EMCs are tumors usually seen in the deep soft tissues of the extremities and are rarely seen within the intracranial cavity. The histological differential diagnosis includes chordoma, conventional chondrosarcoma and chordoid meningioma, among others. A distinguishing feature of EMC is their characteristic reciprocal translocation t(9;22)(q22;q12). MATERIAL: A 63-year-old man presented with progressive hearing loss and gait imbalance. Magnetic resonance imaging showed a heterogeneously enhancing 2.4 cm mass in the cerebellopontine angle. A right far lateral transcondylar skull base approach with gross total removal of the tumor was performed. Intraoperative findings showed that the mass appeared to arise from the glossopharyngeal nerve within the jugular foramen. METHOD: Histology, immunohistochemistry, and fluorescence in situ hybridization studies were performed. RESULTS: Histological and immunohistochemical studies were compatible with the diagnosis of EMC. Fluorescence in situ hybridization studies showed disruption of the EWS gene locus at 22q12 and added further support to the diagnosis. CONCLUSIONS: We report a rare case of EMC arising from the jugular foramen, and the diagnosis of EMC can be supported by confirmation of disruption of the EWS gene locus.

Brain Neoplasms↗

PubMed2005

[The clinical study of multi-slice helical CT three-dimensional reconstruction in the sphenopalatine foramen].

OBJECTIVE: Used multi-slice helical CT to observe the reconstruction of the surface structure of nasal lateral wall "sphenopalatine foramen" and compared with anatomical specimens to verify the dependability of 3D data. METHOD: The position, shape, size and their correlational data of sphenopalatine foramen of 5 cadaver heads (10 sides) in adults fixed with formalin were dissected and measured. RESULT: Multi-slice helical CT has more rapid speed of 3D reconstruction and clearer imaging. The technique of Shade surface display and Volume rendering can give very clear structure of nasal lateral wall "sphenopalatine foramen". The 3D data makes no statistic difference with anatomical measurement. The 3D data can instruct the clinic directly. CONCLUSION: Multi-slice helical CT three-dimensional reconstruction can be used to orientation of surgery.

Adult↗

PubMed2005

The localization and anthropometry of mental foramen on late Byzantine mandibles.

Comprehensive studies of the human skeletal features and variations between and within populations are beneficial both for clinical applications and determination of racial characteristics of populations. The aim of this study was to examine the location and anthropometric characteristics of the mental foramen in 36 adult male mandibles of the Late Byzantine period. The results demonstrated that the most common position of the mental foramen was in line with the longitudinal axis of the second premolar (50% right side; 47% left side) followed by a location between the first and second premolars (33% right side; 36% left side). When compared with the results of previous similar studies, the results obtained in the present study suggest that traits such as the localization of mental foramen may not only differ between populations of different geographic environment but also within the inhabitants of the same geography.

Adult↗

PubMed2005

Postoperative herniation of the caecum through the gastroepiploic foramen.

Herniation through the gastroepiploic foramen into the lesser sac is a rare cause of intestinal obstruction. The nonspecific nature of its presentation makes early diagnosis of this condition difficult. Internal herniation should be considered with a high index of suspicion in intestinal obstruction due to the high rate of morbidity and mortality associated with delayed treatment. We report the first case of caecal herniation with strangulation in the gastroepiploic foramen occurring in a postoperative patient. Decompression and reduction of the strangulated caecum was performed, followed by a right hemicolectomy. The clinical and radiological features are presented from a review of the literature on gastroepiploic foramen herniation.

Abscess↗

PubMed1992

Hypoglycemia and hepatic ischemic necrosis after small intestinal incarceration through the epiploic foramen in a horse.

A 16-year-old stallion was presented to the Louisiana State University Veterinary Teaching Hospital for evaluation of acute abdominal pain. Physical examination and diagnostic procedures indicated a strangulating obstruction of the small intestine. At exploratory celiotomy, a strangulating incarceration of the jejunum through the epiploic foramen was found. The incarcerated small intestine was reduced, then resection of the nonviable bowel and anastomosis performed. After surgery, the horse exhibited clinical signs and laboratory findings associated with hypoglycemia and died in spite of emergency treatment. On post-mortem examination, a large thrombus was present in the portal vein at the level of the epiploic foramen and the liver had multiple large infarcted areas. The post-operative signs of hypoglycemia and necropsy findings of widespread hepatic ischemic necrosis are complications of epiploic foramen incarceration of the small intestine not previously reported and may in part explain the high mortality rate described for this lesion.

Abdominal Pain↗

PubMedDate not supplied

[Percutaneous closure of patent foramen ovale with amplatzer device. Report of two cases].

OBJECTIVE: We present two cases of Patent Foramen Ovale (PFO) treated with percutaneous Amplatzer device. METHOD: The first case corresponds to 48 years old woman with Ebstein's disease with moderate to severe hemodynamic repercussion and three cerebrovascular accidents, the last one under coumarin treatment, she received antiarrhythmic medication and despite of it developed 1st degree AV block, supraventricular and ventricular ectopia, rigth branch block. The second case corresponds to a 22 years old man with antecedents of cerebrovascular accident at the age of 21 with sequelae of convulsive crisis. Both patients were percutaneously treated with Amplatzer devices. The first patient was treated with a foramen ovale device and second with septal occluder due to the diameter of the foramen. Both patients have remained asymptomatic during the follow-up period. CONCLUSIONS: The PFO devices are indicated for patients with a history of cerebrovascular accidents.

Adult↗

PubMed2006

[Transcatheter closure of patent foramen ovale in patients with platypnea-orthodeoxia].

Platypnea-orthodeoxia is a rare syndrome characterized by the occurrence of dyspnea and hypoxemia on adoption of an upright posture (i.e., orthodeoxia) and by the absence of symptoms and hypoxemia in decubitus. This syndrome is frequently related to patent foramen ovale and right-to-left shunting. We describe two patients in whom patent foramen ovale with right-to-left shunting was observed on transthoracic and transesophageal echocardiography and who had platypnea-orthodeoxia in the absence of pulmonary disease. They underwent transcatheter closure using an Amplatz device. The echocardiographic diagnosis and closure procedure are discussed. These case reports demonstrate that closure of patent foramen ovale is an effective treatment for platypnea-orthodeoxia.

Aged↗

PubMed2006

[Surgery of jugular foramen region tumors].

OBJECTIVE: To evaluate the various surgical approaches in removing the jugular foramen region tumors in order to obtain the maximal functional preservation. METHODS: Between March 1993 and May 2005, 32 patients with jugular foramen region tumors were operated. The mastoid and neck approach, the infratemporal fossa approach with and without rerouting the facial nerve, the combined transcochlear and infratemporal fossa approach were respectively used according to the tumor type, size, auditory, facial and lower cranial nerve functions. The cranial nerve monitoring was used and a postoperative CT or MRI scanning was taken in all cases. RESULTS: In this series of 32 patients, 13 were paragangliomas, 10 schwannomas,2 meningiomas, 2 giant cell tumors, 1 chondrosarcoma, 1 mucochondrosarcoma, 1 adenoid cystic carcinoma, 1 rhabdomyosarcoma and 1 case cholesterol Granuloma. The follow-up period was 3-60 months. Total removals were achieved in 26 cases, near-total removal in 5 cases, and subtotal removal in one case. One patient died after surgery because of intracranial hemorrhage. Another patient died two year after operation because of recurrence. Postoperative cerebrospinal fluid leakage was occurred in 5 cases and meningitis in two cases. They were all treated conservatively. The facial function one week after operation was grade 1-2 in 13 cases, grade 3-4 in 12 cases and grade 5-6 in 7 cases. It changed into grade 1-2 in 23 cases, grade 3-4 in 7 cases and grade 5-6 in 2 cases. The postoperative hearing was improved in 4 cases, stable in 10 cases, deteriorated in 11 cases and totally lost in 7 cases. The lower cranial nerve function was normal in 9 cases, transient palsy in 11 cases, permanent paralysis with compensation in 10 cases and without compensation in 2 cases. CONCLUSION: The jugular foramen region tumor could be removed with maximal function preservation by using various surgical approaches. The postoperative life quality was acceptable in most cases. Surgical techniques and postoperative complications management were fundamental in achieving a good result.

Adult↗

PubMed1991

Crossover ilioprofunda reconstruction: an expanded role for obturator foramen bypass.

The standard obturator foramen bypass extends from the aorta or iliac artery to the ipsilateral superficial femoral or popliteal artery. This operation has been both effective and versatile as an indirect bypass procedure for circumventing difficult vascular problems in the femoral triangle. A case is presented of a patient whose limb was salvaged by an obturator foramen bypass from the contralateral iliac artery to the profunda femoris artery. This unique case is compared to other published cases to emphasize the potential advantages of the profunda femoris as the preferred graft outflow in selected cases of arterial reconstruction through the obturator foramen.

Aged↗