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At least 721 records · Page 40Linked to original sources

PubMed1995

The incidence of patent foramen ovale in 1,000 consecutive patients. A contrast transesophageal echocardiography study.

STUDY OBJECTIVE: Patent foramen ovale (PFO) is present in 10 to 35% of people and has been reported to be an important risk factor for cardioembolic cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAs), especially in younger patients. While contrast transthoracic echocardiography has been used to detect PFO, contrast transesophageal echocardiography (TEE) has a greater sensitivity. Prior studies reported the incidence of PFO in patients presenting with a CVA or TIA. DESIGN: To determine the incidence of PFO in a more general population, we reviewed 1,000 consecutive TEEs performed with contrast and color Doppler for the presence of PFO and other cardioembolic risk factors, including atrial septal aneurysm (ASA), aortic plaque, atrial fibrillation (AFib), and atrial thrombi. While imaging with monoplane or biplane TEE, multiple injections of agitated saline solution were injected during cough or Valsalva maneuver to detect flow through a PFO. PATIENTS: There were 482 male and 518 female patients with mean age of 60 +/- 17 years (range 11 to 93 years). RESULTS: Patent foramen ovale was found in 9.2% of all patients and, though seen in all age groups divided by decade, the incidence in patients aged 40 to 49 years was greater than those aged 70 to 79 years (12.96% vs 6.15%, p = 0.03). Contrast TEE had a much higher detection rate than color Doppler alone. Importantly, there was no greater incidence of PFO in patients with CVA vs those without CVA, or in male vs female patients. Also, there was a very strong correlation between the presence of ASA and PFO (p < .001). CONCLUSION: Thus, PFO detected by TEE, frequently seen with ASA, is seen in all age groups and does not in itself present a risk factor for CVA. The association of PFO with peripheral thrombosis and CVA needs further study.

Adolescent↗

PubMed1982

Cyanosis following right pneumonectomy: importance of patent foramen ovale.

A patient with chronic lung disease became cyanotic following right pneumonectomy for cancer. He was found to have right-to-left shunting through a patent foramen ovale in the absence of pulmonary hypertension, and he improved remarkable after surgical therapy. This case vividly illustrates the subtlety with which acquired right-to-left shunting may appear in the setting of chronic hypoxemia. The frequency of patent foramen ovale in the general population (20 percent) and the ease and efficacy of treatment for this lesion underscore the need for general awareness of this potential problem in the chronically or critically ill.

Cyanosis↗

PubMed1986

Danger of vasodilator therapy for pulmonary hypertension in patent foramen ovale.

A 23-year-old woman with systemic lupus erythematosus was found to have severe pulmonary hypertension with secondary patency of the foramen ovale. Infusion of hydralazine increased the basal right-to-left shunt and resulted in a dramatic fall in arterial oxygen pressure, with subsequent irreversible cardiovascular collapse. Vasodilator therapy appears to be hazardous in patients with severe pulmonary hypertension and patent foramen ovale.

Adult↗

PubMed1987

Patent foramen ovale complicating heart transplantation. A window on posttransplantation hemodynamics.

A patient developed refractory hypoxemia and right-to-left shunt across a patent foramen ovale after orthotopic cardiac transplantation. The right-to-left shunt was produced by volume overload of the donor right ventricle during the period of early postoperative myocardial depression and resolved with preload reduction and diuresis. Increased preload of the right heart needs to be considered in the early postoperative management after cardiac transplantation. The foramen ovale of the donor and recipient should be evaluated at operation by visual and probe examination and securely closed if either is patent, since this pattern of hemodynamic changes is common following cardiac transplantation.

Adult↗

PubMed2005

Impending paradoxical embolism across a patent foramen ovale: case report.

We describe a case of impending paradoxical embolism in a 43-year-old male patient with pulmonary embolism. Transesophageal echocardiography revealed a thromboembolus straddling a patent foramen ovale. The patient underwent emergency removal of the intracardiac clot with closure of the patent foramen ovale. A postoperative work-up for a hypercoagulable state revealed a protein-S deficiency and bilateral lower extremity deep vein thromboses. A Greenfield inferior vena cava filter was inserted, anticoagulation was performed, and warfarin treatment was continued after the patient was discharged home.

Adult↗

PubMed2005

Patent foramen ovale.

Patent foramen ovale is incriminated in patients with cryptogenic stroke; however, concrete evidence that closure of patent foramen ovale using various devices is superior to continued medical therapy is not yet available. Controlled randomized trials are well underway to address this issue.

Adult↗

PubMed2006

The importance of apical patency and cleaning of the apical foramen on root canal preparation.

The apical limit of root canal instrumentation has always been a matter of great controversy. Despite the large number of published studies on this subject, a consensus has not yet been reached. In fact, the recent discussion on apical patency and cleaning of the apical foramen, as well as the incorporation of these procedures to the endodontic treatment, seem to have raised even more polemics. It is likely that all this polemics has its roots in the lack of interrelation between the theoretical knowledge of pulp stump and periapical tissues and the real clinical practice. By addressing the most important aspects of this theme, this paper aims to present news concepts about the importance of apical patency and cleaning of the apical foramen during root canal preparation.

Humans↗

PubMed1997

Petrous bone meningioma originating from the jugular foramen--case report.

A 49-year-old female presented with a rare meningioma in the petrous bone. High resolution computed tomography and magnetic resonance imaging demonstrated that the tumor had developed in the jugular foramen and extended into the infralabyrinthine area of the petrous bone and intracranially into the cerebellopontine angle. The operative findings confirmed these observations. Meningiomas of the petrous bone may originate from the jugular foramen.

Female↗

PubMed2002

Neuroendoscopic treatment of idiopathic occlusion of the foramen of Monro in adults--two case reports.

Two adults presented with hydrocephalus due to idiopathic obstruction of the bilateral foramina of Monro, manifesting as clinical signs of chronically elevated intracranial pressure. No inflammation was present. The primary surgical treatment was neuroendoscopic reconstruction of the right foramen of Monro. A 37-year-old man had a spontaneous perforation of the septum pellucidum. The patient required a ventriculoperitoneal shunt, although postoperative ventriculography proved free passage of cerebrospinal fluid from the lateral ventricle into the third ventricle. A 62-year-old man underwent additional septostomy and third ventriculostomy, and the neuroendoscopic intervention relieved the presenting symptoms without additional treatment. The biopsy specimens showed no evidence of malignancy in either case. Neuroendoscopic intervention is an alternative treatment in the management of hydrocephalus due to idiopathic obstruction of the foramen of Monor. The procedure is less invasive than open microsurgical reconstruction and can even avoid ventriculoperitoneal or ventriculoatrial shunting.

Adult↗

PubMed2006

Neuroendoscopic appearance of an intraventricular cavernous angioma blocking the foramen of monro - case report.

A 47-year-old woman presented with unilateral ventricular enlargement detected by magnetic resonance imaging during a medical checkup. Neuroendoscopic exploration identified a multilocular lesion in which dark red fluid formed a niveau near the right side of the foramen of Monro. The diagnosis was intraventricular cavernous angioma. Restricted flow of cerebrospinal fluid at the foramen of Monro was observed. Xanthochromia, which seemed to be due to previous bleeding, was observed at the fornix. When the neuroendoscope touched the angioma, the wall collapsed and bled. Endoscopic removal of the angioma was abandoned, and craniotomy and resection of the angioma were performed. No new neurological anomalies were observed after surgery. Preoperative diagnosis of intraventricular cavernous angioma is difficult based on neuroimaging. Neuroendoscopy is effective for diagnosis and the decision-making process regarding treatment.

Cerebral Arteries↗

PubMed1992

Anatomical study of the accessory mental foramen and the distribution of its nerve.

We examined the range of the accessory mental foramen [AMF] and its accessory mental nerve in three Japanese cadavers. The diameters of the AMF were relatively small: 0.74 mm, 0.80 mm and 0.89 mm. The distances between the mental foramen and AMF were: 0.67 mm, 2.1 mm and 5.74 mm. The distribution of the accessory mental nerve was different in the three cases. These nerves communicated with the branches of the facial and buccal nerves.

Aged↗

PubMed2004

The microsurgical anatomy of the glossopharyngeal nerve with respect to the jugular foramen lesions.

Removal of lesions involving the jugular foramen region requires detailed knowledge of the anatomy and anatomical landmarks of the related area, especially the lower cranial nerves. The glossopharyngeal nerve courses along the uppermost part of the jugular foramen and is well hidden in the deep layers of the neck, making this nerve is the most difficult one to identify during surgery. It may be involved in various pathological entities along its course. The glossopharyngeal nerve can also be compromised iatrogenically during the surgical treatment of such lesions. The authors define landmarks that can help identify this nerve during surgery and discuss the types of lesions that may involve each portion of the glossopharyngeal nerve.

Cerebellopontine Angle↗

PubMed2004

Anatomy involved in the jugular foramen approach for jugulotympanic paraganglioma resection.

The goal in paraganglioma resection is to allow adequate exposure to remove the lesion while preserving cranial nerve function. Knowledge of the anatomy of the jugular foramen is crucial to this endeavor. In this report the authors describe a jugular foramen approach for the resection of glomus jugulare tumors in cases in which rerouting of the facial nerve can be avoided. This approach provides adequate exposure of the jugular bulb for many jugulotympanic paragangliomas without increased risk of injury to the facial nerve. In addition, special circumstances surrounding intracranial and carotid artery involvement are briefly discussed.

Cranial Nerve Injuries↗

PubMed2006

Cavernoma of the foramen of Monro. Case report and review of the literature.

The authors report on a patient who presented with an intraventricular mass located at the level of the foramen of Monro. The clinical presentation and neuroimaging appearance of the mass led to an initial diagnosis of colloid cyst. A neuroendoscopic approach offered a direct view of the ventricular lesion, which was found to be a cavernous angioma partially occluding the foramen of Monro. The lesion was then removed using microsurgery. In this report the authors highlight possible pitfalls in the diagnosis of some lesions of the third ventricle, and the possible advantages of using a combined endoscopic and microsurgical technique when approaching such lesions.

Adult↗

PubMed1987

CT-stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle.

Colloid cysts in the foramen of Monro and third ventricle account for 0.5% to 1% of all intracranial space-occupying lesions. The introduction of computerized tomography (CT) and magnetic resonance imaging has represented a major advance in the early detection of these cysts. The risks associated with the management of benign space-occupying lesions by open surgical procedures have made it necessary to search for safer techniques. The CT-stereotaxic method provides a simple, precise, and safe method of puncturing deep-seated space-occupying cysts. Between January, 1979, and December, 1984, 12 patients with colloid cysts in the foramen of Monro and third ventricle were operated on by this method. The operations were successful, and there were no intraoperative or postoperative complications. The advantages of the CT-stereotaxic method are discussed and the results are presented.

Adult↗

PubMed1991

Microvascular anatomy of foramen caecum medullae oblongatae.

The foramen caecum (FC) is a triangular-shaped fossa situated in the midline on the base of the brain stem, at the pontomedullary junction. Although this area is known to have a very high concentration of brainstem perforating vessels, its microvascular anatomy has not been studied in detail. The purpose of this study was to detail the microvasculature of this territory. Twenty unfixed brains were injected with silicone rubber solution and dissected under a microscope equipped with a camera. The origin, course, outer diameter, and branching pattern of the perforators were examined. The total number of perforators found in the 20 brains was 287, with an average (+/- standard deviation) of 14.35 +/- 1.24 perforators per brain (range seven to 28). Their origin was as follows: right vertebral artery in 52 perforators (18.11%); left vertebral artery in 35 (12.19%); basilar artery below the anterior inferior cerebellar artery (AICA) in 139 (48.43%); basilar artery above the AICA in 46 (16.02%); AICA in 10 (3.48%); and anterior spinal artery in five (1.74%). Most of the perforators arose as sub-branches of larger trunks; their average outer diameter was 0.16 +/- 0.006 mm while that of trunks was 0.35 +/- 0.02 mm. These anatomical data are important for those wishing 1) to study the pathophysiology of vascular insults to this area caused by atheromas, thrombi, and emboli; 2) to plan vertebrobasilar aneurysm surgery; 3) to plan surgery for vertebrobasilar insufficiency; and 4) to study foramen magnum neoplasms.

Arteriovenous Anastomosis↗

PubMed1994

Improved visualization of the foramen ovale for percutaneous approaches to the gasserian ganglion. Technical note.

Percutaneous procedures for treating trigeminal neuralgia involve the penetration of foramen ovale using cutaneous landmarks and radiological guidance. The placement of radiopaque markers over the commonly used "zygomatic points" in front of the ears provides landmarks on intraoperative radiological studies that facilitate localization of the foramen ovale. Speed and safety of percutaneous trigeminal procedures should be enhanced. There is no increase in radiation exposure over that in other commonly used approaches.

Fluoroscopy↗

PubMed2005

Lipoma with dumb-bell extradural extension through the intervertebral foramen into the spinal canal. Case report.

The authors present the case of a 60-year-old woman with a neck lipoma that developed dumb-bell extradural extension, causing radiculopathy. To the best of the authors' knowledge, this is the first report of a lipoma originating in the neck with dumb-bell extradural extension through the intervertebral foramen and into the spinal canal. The lipoma was first excised from the foramen via a posterior approach to allow decompression of the nerve roots. The remaining lipomatous tissue was then resected via an anterior approach to avoid the region around the vertebral artery.

Cervical Vertebrae↗