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At least 577 records · Page 32Linked to original sources

Left atrial electrograms recorded through the patent foramen ovale.

The presence of a patent foramen ovale allows direct recording of a left atrial (LA) electrogram. Three patients are reported in whom simultaneous high right atrial (HRA), coronary sinus (CS), and direct LA electrograms were obtained. In two patients with normal surface ECG P waves the direct LA lead depolarized before the CS or low RA. The HRA to LRA and HRA to CS conduction times were similar to those reported previously. In a patient with a prolonged surface ECG P wave, the direct LA electrogram occurred late and after low RA depolarization. Recording LA electrograms through a patent foramen ovale is a useful technique, and these defects should be sought in all patients undergoing electrophysiological study.

Aged↗

Infective endocarditis resulting from CardioSEAL closure of a patent foramen ovale.

Patent foramen ovale and atrial septal aneurysm are associated with an increased risk of cryptogenic stroke and recurrent thromboembolic events. Percutaneous closure is a therapeutic option to medical therapy and surgical closure. We present the first case of endocarditis associated with a CardioSEAL device closing a patent foramen ovale.

Adult↗

The concurrence of fetal supraventricular tachycardia and obstruction of the foramen ovale.

Fetal supraventricular tachycardia (FSVT) is a cardiac arrhythmia that bears a high mortality rate. In the majority of cases no morphological anomalies are found and death is caused by congestive heart failure. This report presents two cases of FSVT in which cross sectional echocardiography revealed obstruction of the foramen ovale with dilatation of the right heart without structural cardiac anomalies. After birth sinus rhythm re-established under digitalis medication in both cases. The association between premature obstruction of the foramen ovale and unexplained intrauterine death in the third trimester of gestation is suggested.

Adult↗

Patent foramen ovale complicated by paradoxical embolism and brain infarct in a patient with advanced ovarian cancer.

BACKGROUND: Recent investigations of patients with cerebral and peripheral arterial emboli of unknown cause suggest that paradoxical embolism through a patent foramen ovale might be responsible for more arterial embolic events than previously realized. CASE: A 60-year-old woman with advanced ovarian cancer presented with sudden onset of expressive aphasia and right upper hemiplegia postoperatively. A patent foramen ovale diagnosed by echocardiography with contrast combined with the presence of thrombosis in her right femoral vein leads us to speculate that her stroke was secondary to a paradoxical embolism. CONCLUSION: Paradoxical embolism should be considered in the differential diagnosis of ovarian cancer patients with embolic stroke and it may be appropriate to include a cardiac echo as part of the diagnostic evaluation.

Brain Infarction↗

Computed tomography of the intervertebral foramen.

52 cases with pathologic lesions in the intervertebral foramen, studied with CT, are analyzed. The most frequent lesions are intraforaminal disc herniations. These are characterized by their hyperdensity in comparison to the dural sac (34 of 34 cases) and their broad contact with the intervertebral disc space (31 of 34 cases). Foraminal size and contour are usually normal. In contradistinction to disc herniations, benign tumors often show bone erosion of the pressure-type with enlargement of the foramen. Bone infiltration was seen only in malignant lesions and in the single case of Echinococcosis. Preoperative diagnosis of vascular lesions which present with foraminal enlargement is most important for the choice of the appropriate operative approach. Correct CT diagnosis of such vascular lesions is only possible with dynamic CT.

Diagnosis, Differential↗

Accessory nerve neuroma presenting as recurrent jugular foramen syndrome.

We report a patient with spontaneous recovery and recurrence of a jugular foramen syndrome secondary to an accessory nerve neuroma. He showed sudden onset of unilateral palsy of the ninth, tenth and eleventh cranial nerves in 1982. He recovered almost fully and in 1990 the palsies recurred. MRI revealed a small mass in the right jugular foramen. The tumour was resected via suboccipital craniectomy, and diagnosed as a neuroma of the eleventh cranial nerve.

Accessory Nerve↗

Right atrial to left atrial shunt through foramen ovale during pneumoperitoneum for laparoscopic cholecystectomy.

A 62-year old female patient in whom paradoxical right atrial to left atrial shunt flow through the foramen ovale was detected by transesophageal echocardiography during pneumoperitoneum for laparoscopic cholecystectomy was reported. This patient had a history of mitral valve replacement with residual tricuspid valve regurgitation. It was considered that the onset of paradoxical interatrial shunting through the foramen ovale might be caused not only by mechanical ventilation with positive end-expiratory pressure but also by pneumoperitoneum, especially in patients with heart disease, even if the intra-abdominal pressure was maintained at 12 mmHg.

Cholecystectomy, Laparoscopic↗

Herniation of the gallbladder through the foramen of Winslow.

A rare case of herniation of the gallbladder through the foramen of Winslow is presented. There are only six surgically proven previously reported cases. This condition should be suspected where symptoms suggest gallbladder disease in the presence of normal functioning gallbladder. A simultaneous cholecystogram and an upper gastrointestinal study is necessary to confirm the diagnosis. A cholecystectomy with plication of the foramen of Winslow is the suggested treatment.

Adult↗

Intracranial neurinomas of the nerves of the jugular foramen. Report of 12 personal cases.

12 patients, 10 women and 2 men, were operated on for removal of a jugular foramen neurinoma. Removal was total in 11 cases and operative mortality was 16.6%. As there are no clinical or instrumental signs that permit sure distinction between these tumours and those of the cerebellopontine angle, only a thorough radiological study of the jugular foramen allows correct diagnosis. Often, however, the diagnosis is made during the operation.

Accessory Nerve↗

Extirpation of a jugular foramen schwannoma via the transcervical-transmandibular approach.

Schwannomas of the jugular foramen are rare lesions. We present a case of a schwannoma of the spinal accessory nerve that occurred in the jugular foramen and skull base of a 52-year-old woman. The tumor was completely extirpated via a transcervical-transmandibular approach with an excellent functional result. The approach used afforded excellent exposure of the lateral or midline skull base, as well as maximum control of the major neurovascular structures in the upper neck and skull base.

Accessory Nerve↗

Anatomic considerations of the principal nutrient foramen and artery on internal surface of the ilium.

Direct measurements of the nutrient foramen of thirty dried ilia using digital calipers and observations of the nutrient a. from ten cadaveric specimens were made in the present study. The nutrient foramen was situated 12.5 +/- 2.7 mm lateral to the anterosuperior sacroiliac joint line but perpendicular to this line and 23.5 +/- 5.8 mm above the pelvic brim parallel to the sacroiliac joint line. The nutrient a. originated from the iliolumbar a. as it coursed across the anterosuperior aspect of the sacroiliac joint. The present anatomic study indicates that the nutrient a. on the internal surface of the ilium is prone to injury as a result of traumatic disruption of the sacroiliac joint, sacral alar fractures and during the anterior approach to the sacroiliac joint.

Aged↗

Diagnosis of neurinoma in the region of the jugular foramen--a case report.

Neurinomas in the region of the jugular foramen are extremely rare, are difficult to diagnose before surgery, and have seldom been described in the literature. The typical jugular foramen syndromes (Collet-Sicard syndrome, Vernet's paralysis) may be caused by many various disorders. The diagnostic problems are illustrated using one of our cases as an example. The differential diagnosis was made before surgery using currently available radiologic techniques. The tentative diagnosis "neurinoma of the hypoglossal nerve" was confirmed intraoperatively and histologically.

Cerebral Angiography↗

Perinatal unilateral hydrocephalus. Atresia of the foramen of Monro.

Unilateral hydrocephalus is rare, and is usually associated with a neoplasm or inflammatory response at the foramen of Monro. It is even more uncommon with congenital atresia of one foramen of Monro. We report the fifth such case documented in the perinatal period, and the second case of unilateral hydrocephalus diagnosed by prenatal ultrasound.

Cerebral Ventricles↗

Herniation through the foramen of Winslow.

A patient with herniation of the cecum through the foramen of Winslow is described. Herniation through the foramen of Winslow is among the rarest of hernias. Preoperative diagnosis is unusual but is possible for the astute clinician who, on abdominal x-ray, notices air in the lesser sac with displacement of the stomach anteriorly and to the left. Treatment, of course, is prompt surgical intervention with reduction of the hernia and resection of any nonviable bowel.

Cecal Diseases↗

Foramen of Monro mass: MRI appearances permit diagnosis of cavernous haemangioma.

Cavernous haemangiomas are most commonly found in the subcortical white matter, the pons and the external capsule. We present a case of a cavernous haemangioma that appeared as an intraventricular mass at the foramen of Monro. Despite the unusual location the diagnosis was established by MRI because of the typical appearance. The differential diagnosis included primary and secondary neoplasms at the foramen of Monro.

Cerebral Ventricle Neoplasms↗

Transcatheter closure of patent foramen ovale in patients with platypnea-orthodeoxia: results of a multicentric French registry.

BACKGROUND: Dyspnea and the decrease in arterial saturation in the upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS). POS is secondary to the occurrence of an atrial right-to-left shunt through a patent foramen ovale (PFO). METHODS: This French multicentric study reports on 78 patients (mean age 67 +/- 11.3 years) with POS who had transcatheter closure of the PFO; frequently associated diseases were pneumonectomy (n = 36) and an ascending aortic aneurysm (n = 11). In all patients, the diagnosis was confirmed by transthoracic or/and transesophageal echocardiography. Five different closure devices were used: Amplatz (n = 45), Cardioseal (n = 13), Sideris (n = 11), Das Angel Wings (n = 8) and Starflex (n = 1). Closure was successful in 76 patients (97%). RESULTS: Oxygen saturation increased immediately after occlusion from 84.6 +/- 10.7% to 95.1 +/- 6.4% (p < 0.001) and dyspnea improved from grade 2.7 +/- 0.7 to grade 1 +/- 1 (p < 0.001). A small residual shunt was immediately observed in 5 patients (3 with the Cardioseal device, 1 with the Sideris and 1 with the Amplatz) leading to the implantation of a second device in one case (Cardioseal). Two early deaths occurred unrelated to the procedure (one due to sepsis probably related to pneumonectomy, another due to respiratory insufficiency). Other complications were: a small shunt between the aorta and the left atrium, two atrial fibrillations and a left-sided thrombus which disappeared with anticoagulant therapy. At a mean follow-up of 15 +/- 12 months, there were 7 late deaths related to the underlying disease. CONCLUSION: Percutaneous occlusion of the foramen ovale is safe and gives excellent results thanks to continuing improvement in available devices. This technique enables some patients in an unstable condition to avoid a surgical closure.

Aged↗

The incidence of the foramen thyroideum in Turkish population.

This study was undertaken to investigate the incidence and characteristics of the foramen thyroideum (FT) in Turkish population. A total of 50 cadaver specimens were dissected which were a randomly selected sample of population from the criminal laboratory of the Republic of Turkey's Ministry of Justice (Istanbul). Larynges were dissected with a surgical SMZ 10 Nikon stereomicroscope. Six of the 50 specimens dissected had distinctly identifiable foramina with neurovascular component. One specimen had bilateral foramina, five specimens had unilateral foramina, and two had it in the left side, three in the right. One specimen had a double foramen in the left side. All of them were male and contained neurovascular components. Our data showed 12% incidence of FT in Turkish population.

Adolescent↗

Choroid plexus cyst of the left lateral ventricle with intermittent blockage of the foramen of Monro, and initial invagination into the III ventricle in a child.

A cyst of the choroid plexus of the left lateral ventricle with intermittent blockage of the foramen of Monro and initially with invagination of the III ventricle in a child is described. In a 6-week-old boy a ventriculoatrial shunt was implanted for correction of an active asymmetrical hydrocephalus of unknown origin. When he was 3 months of age a water-soluble contrast CT ventriculography revealed a noncolloid cyst localised predominantly in the upper portion of the III ventricle. At that time the ventricular catheter obstructed with choroid plexus was removed; new bilateral catheters in a parieto-occipital region were implanted. In the course of the next 4 years, first the atrial catheter had to be extracted and then the peritoneal catheter was changed, in both cases because of obstruction. Periods of normal life alternated with periods of transient and intermittent symptoms of increased intracranial pressure, papilloedema, and myoclonic jerks. Repeated computed tomography (CT) and magnetic resonance imaging (MRI) showed stabilised hydrocephalus with an enlarged left lateral ventricle. When the boy was 16 years old MRI revealed a choroid plexus cyst in the left lateral ventricle 2 cm in diameter, with a ballvalve type of obstruction of the foramen of Monro. CT stereoendoscopic resection of the wall of a large cyst filled with cerebrospinal fluid was performed, and two additional adnexal small cysts were coagulated using the bipolar coagulator, Diomed 25 laser and scissors; the symptoms then regressed, except for superior bilateral altitudinal anopsia. Light and electron microscopy of the cyst wall is reported. The cyst was composed of collagenic connective tissue lined with a basal lamina lacking in epithelial cells. The preoperative and postoperative MRI are presented. Choroid plexus cysts localised in the anterior part of lateral ventricles are very rare, and all reported cases have been in male patients. According to the literature our case is only the third ever described in a child.

Brain Diseases↗