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PubMed2004

Unilateral transpedicular course of an ascending lumbar vein through a pedicular foramen mimicking a lytic lesion: an anatomic variant.

An ascending lumbar vein passing through a foramen on the right pedicle of the third lumbar vertebra unilaterally, which was diagnosed incidentally during virtual CT colonoscopy of a patient with a rectal tumor, is described. Recognition of this anatomic variation is important to avoid diagnostic misinterpretations and transpedicular interventions such as percutaneous vertebroplasty or surgical instrumentation that may result in excessive hemorrhage and inadvertent leak of cement when it is present.

Colonography, Computed Tomographic↗

PubMedDate not supplied

Entrapment of the small intestine in the epiploic foramen in horses: a retrospective analysis of 71 cases recorded between 1991 and 2001.

The clinical features of 71 cases in 70 horses in which part of the small intestine became entrapped in the epiploic foramen are described. The horses' sex, age and breed, the month during which they were affected, and whether they exhibited stereotypic behaviour were compared with the same variables in 1279 horses which suffered other types of surgical colic during the same period. Thoroughbred and thoroughbred cross horses were over-represented among the 70 affected horses. There was no age or sex predilection. Fifty-five (77.5 per cent) of the cases occurred between October and March and 15 (21.1 per cent) occurred in January. The cases were significantly more likely to have a history of crib-biting/windsucking than the control group (odds ratio 7.9, 95 per cent confidence interval 4.1 to 15.3). The condition had recurred in two of the horses. Fifty-eight (81.7 per cent) recovered from surgery and 49 (69 per cent) survived until they were discharged from hospital. The median survival time of 31 of the affected horses discharged from the hospital was 700 days, whereas 417 horses with other types of surgical colic had a median survival time in excess of 1931 days.

Animals↗

PubMed2004

An anatomico-radiological study of an accessory mandibular foramen on the medial mandibular surface.

Unnamed foramina are known to be present in the mandible. The present research paper reports the presence of an accessory foramen on the medial surface of the mandible, highlighting its anatomico-radiological details. Accessory foramina in the mandible have been known to transmit branches of nerves supplying the roots of the teeth. Nerve block techniques by local anaesthetics might fail if any of these nerves or their branches pass through these accessory foramina and thus escape the nerve block. Dental surgeons performing extractions should be aware of accessory foramina on the mandible and thus plan anaesthesia at an appropriate anatomical site. The presence of such foramina might also be an alternate route for tumour spread following radiation therapy. Precise knowledge and awareness of such accessory mandibular foramina would therefore be important for dental surgeons performing nerve block and also for oncologists in planning radiation therapy.

Humans↗

PubMed2004

[Influence of steroid therapy local injection of steroidal in the region of the stylomastoid foramen and physiotherapy on the recovery of stapedial reflex in patients with facial nerve paralysis].

There are much more publications which informates about positive effects of advisability propose steroid's cure in patients with facial nerve palsy. The aim of the studies was to evaluate the influence of steroidal and physical treatment on the recovery of stapedial reflex and of functions of the damaged nerve. The studies were performed on 37 patients with palsy of facial nerve. Taking into account the stapedial reflex (before the beginning of the treatment) and local injection of steroidal in the region of the stylomastoid foramen, the patients were divided into two groups: I group--21 persons with lacking stapedial reflex, who were not given steroid, II group--16 persons with lacking stapedial reflex who received steroid. Evaluation of results of treatment was performed by means of the Pietruski, House and Brackmann scales, registration of stapedial reflex and accommodation coefficient. The results indicate that local steroid in palsy facial nerve is the treatment of choice in cases of intratemporal branches injury (lack of stapedial reflex) and shortens of duration of stapedial reflex and the nerve function recovery.

Adolescent↗

PubMed2004

[Patent foramen ovale--demographic, clinical and echocardiographic characteristics].

UNLABELLED: Patent foramen ovale (PFO) represents the most common persistent abnormality of fetal origin. The aim of the study was to analyze the incidence and characteristics of PFO and to assess PFO as the risk factor of paradoxical embolism. 945 consecutive pts (442F and 503M aged 13-85, mean 53.02 +/- 14.42 years) in whom TEE was performed and flow through PFO was detected in basal conditions (colour-Doppler) and/or during provocation (Valsalva/cough manoeuvre) with contrast (saline infusion) at the period 1998-2002 was retrospectively analyzed. 183 pt had a history of systemic embolisation (SE) or transient ischemic attack (TIA). PFO was diagnosed [PFO(+)] in 57 pts (6%)-22F, 35M aged 14-77 years, mean 52.44 +/- 14.84 years. 888 pts without PFO [PFO(-)] created a control group. Two subgroups were analyzed in the study group: xPFO(+) - 28 pts with PFO as the only abnormality, yPFO(+) - 29 pts with PFO and other heart/aortic disease. Similarly, in the control group two subgroups were analysed: xPFO(-) - pts with normal TEE and negative history of heart/aortic disease and yPFO(-) - pts without PFO but with other heart/aortic disease. Aneurysmal formation of interatrial septum was detected in 24 pts, and in 6 pts it coexisted with PFO. The intensity of shunt was significantly higher in yPFO(+) than in xPFO(+) group. In 5 pts permanent shunt through PFO at the basal stage was observed (4 pts with significant regurgitation of the atrio-ventricular valves and one patient with tricuspid stenosis). Percentage of pts with the history of SE/TIA was significantly higher in group xPFO(+) than in xPFO(-) (p < 0.01). CONCLUSIONS: (1) PFO is a risk factor of SE/TIA only in group xPFO(+). (2) Flow through PFO in group xPFO(+) is generally minimal. (3) In case of coexisting heart pathology PFO may provoke significant right-to-left or even left-to-right shunt.

Adolescent↗

PubMed2005

Different signal intensities between intra- and extracranial components in jugular foramen meningioma: an enigma.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate retrospectively differences in MR signal intensity and contrast enhancement between intra- and extracranial components of jugular foramen meningioma (JFM). METHODS: MR studies of eight patients who underwent surgery for histologically confirmed JFM were reviewed retrospectively. Signal intensity differences between intra- and extracranial components of all eight JFMs on axial T1-, T2-, and postcontrast T1-weighted images were evaluated visually. In six of the eight JFMs, quantitative signal intensity evaluations were also performed by using relative signal intensity ratios of the intra- and extracranial components of JFM to CNS tissue at the same level. Paired t tests were used to evaluate differences in relative signal intensity ratios in each JFM between intra- and extracranial components. RESULTS: Both visual and quantitative signal intensity evaluations revealed that signal intensities of the intracranial component of JFM were significantly higher than those of the extracranial component on T1-, T2-, and postcontrast T1-weighted images. Results of relative signal intensity ratios were 0.89 +/- 0.04 versus 0.77 +/- 0.02 on T1-weighted images (P = .002); 1.66 +/- 0.28 versus 0.88 +/- 0.14 on T2-weighted images (P = .003); and 2.16 +/- 0.29 versus 1.77 +/- 0.26 on postcontrast T1-weighted images (P = .01). CONCLUSION: Intra- and extracranial components of JFM display different signal intensity and enhancement patterns. These differences may be related to histologic composition, and in particular, collagen content.

Adult↗

PubMedDate not supplied

[Pharmacoresistant temporal-lobe epilepsy. Exploration with foramen ovale electrodes and surgical outcomes].

AIM: To report our experience in the surgical treatment of temporal-lobe epilepsy. PATIENTS AND METHODS: An analysis was performed of the outcomes of 137 patients submitted to surgery between 1990 and 2001, with a follow-up of more than two years. A study was conducted of the percentages of successful detection by the different complementary tests--MRI, EEG, interictal SPECT, video-EEG with foramen ovale electrodes (FOE), neuropsychological study (NPS)--and the precision with which they reported the epileptogenic focus. RESULTS AND CONCLUSIONS: Successful surgical outcomes (Engel grades I-II): 73.4%. No surgical mortality occurred, although some mild, reversible morbidity was observed. Surgical outcomes were not affected by sex, age, age of onset and the length of time the patient had had the disease, or the frequency of the seizures. No association was found between seizures in the immediate post-operative period and a poorer long term control of the epilepsy. MR images were normal in 25% of patients; in these cases the surgical outcomes (Engel grades I-II at two years: 62%) were significantly poorer than in cases of tumours/cavernomas (86%); RMI studies of other types of lesions gave intermediate results (72%). With respect to the capacity of the different tests to lateralise/locate the epileptogenic focus, video-EEG-FOE proved to be the best, followed by MRI, SPECT, EEG and NPS.

Adolescent↗

PubMed2005

[Intracardiac echocardiography during percutaneous closure of atrial septal defect and patent foramen ovale].

Intracardiac echocardiography is a new technique based on the use of ultrasonic diagnostic catheters. The most significant current experience has been obtained with the AcuNav catheter, with a "phased array" high frequency (5.5 to 10 mHz) detector, which obtains bidimensional echocardiographic views, coupled to pulsed and colour Doppler. Image acquisition is made from an intracardiac position, usually the right atrium. This review touches on the technical aspects of this method, applied to the examination of the intra-atrial septum, as well as the results currently obtained during inter-atrial communication and patent foramen ovale closure procedures. In effect it is in this field of application that intracardiac ultrasound has now found its niche, providing equivalent information to the reference technique of transoesophageal echocardiography. Intracardiac echocardiography allows complete examination of the inter-atrial septum and septal defects, as well as accurate surveillance of the positioning of percutaneous closure devices. An important advantage of intracardiac echocardiography is the possibility of avoiding a general anaesthetic, usually necessary with the transoesophageal route. At present, the main limiting factor to its systematic use is its high cost, linked to the single use catheters.

Balloon Occlusion↗

PubMed2005

[Platypnea-orthodeoxia syndrome, atrial septal aneurysm and right hemidiaphragmatic elevation with a right-to-left shunt through a patent foramen ovale].

Platypnea-orthodeoxia is an uncommon syndrome of dyspnea and hypoxemia induced by upright position, which is subsequently relieved by recumbency. The case reported involved a 75-year-old man with a seven days history of dyspnea in the upright position. The chest radiograph and CT scan demonstrated an elevated right hemidiaphragm. A surface echocardiogram with saline solution showed a patent foramen ovale (PFO) and atrial septal aneurysm. A pulmonary arteriogram was performed showing no evidence of pulmonary embolism and normal pulmonary arterial pressures. Later, he also developed dyspnea in the supine position and a transesophageal echocardiogram with contrast demonstrated a large right to left shunt through a PFO. The closure by a catheter-deployed double-umbrella device caused an immediate improvement in the patient's oxygenation.

Aged↗

PubMed2004

Tumour of great occipital foramen.

We present the case of tumour of the great occipital foramen in a patient who was having headaches and significant mobility restriction of the cervical spine. Attention is called to diagnostic and surgical difficulties related to this location of neoplasm.

Humans↗

PubMed2005

Use of a new 8 French intracardiac echocardiographic catheter to guide device closure of atrial septal defects and patent foramen ovale in small children and adults: initial clinical experience.

Intracardiac echocardiography (ICE) has become an accepted imaging modality to guide device closure of atrial septal defect (ASD) and patent foramen ovale (PFO). The use of ICE to guide device closure of ASDs in small children (< 20 kg) has been very limited. We report on the use of a new, 8 Fr ICE catheter that possesses full color Doppler capabilities to guide device closure of ASDs in small children as well as to guide device closure of ASDs and PFOs in adult patients.

Adult↗

PubMed2005

[Pulmonary embolism complicated with right-sided intracardiac thrombus entrapped in a patent foramen ovale].

With the increasing possibilities of and clinical demand for diagnostic imaging in the management of acute cardiovascular disease, the probability of uncovering complicated cases increases. These cases are often challenging to the clinician in determining the best method of treatment. We present a case of pulmonary embolism in which an intracardiac thrombus entrapped in a patent foramen ovale without penetrating it was discovered. The patient received thrombolytic therapy without complications and was discharged in good condition six days after thrombolysis.

Aged↗

PubMed2005

Patent foramen ovale and stroke: what we do and don't know.

Paradoxical embolism through a patent foramen ovale (PFO) is a commonly identified mechanism of ischemic stroke, especially in young patients. The ability to detect PFOs in life improved dramatically with the development of aerated ultrasound contrast, transesophageal echocardiography, and transcranial Doppler ultrasound. Similarly, the ability to detect source venous thromboemboli is improving with pelvic magnetic resonance venography. Coexisting atrial septal aneurysm is the only definite potentiator of stroke risk in patients with PFO. PFO size and degree of functional shunting may be additional risk factors. Currently, PFOs are treated variably with antiplatelet agents, anticoagulants, surgical closure, or, increasingly, percutaneous closure devices. Completion of randomized clinical trials is urgently needed to clarify if the risks of invasive endovascular device placement are outweighed by a long-term reduction in recurrent vascular events.

Brain Ischemia↗

PubMed2006

Anomalous intracranial drainage of the nasal mucosa: a vein of the foramen caecum?

The existence of the vein of the foramen caecum (VFC) in humans is still controversial. We present 2 patients with intracranial drainage of the nasal mucosa by a frontal cortical vein into a superior sagittal sinus, demonstrated by digital subtraction angiography. In both, the position of the intracranial passage was found to be slightly paramedian. An analogy to the VFC is made.

Adult↗

PubMed2006

Percutaneous transcatheter closure of patent foramen ovale.

In presence of a patent foramen ovale (PFO) with cryptogenic cerebral embolism, traditional therapy consists of oral anticoagulation or antiplatelet therapy. Surgery was considered only in case of recurrence. Transcatheter closure of PFO is currently performed. The availability of new user friendly devices and the increasing knowledge of pathophysiology, epidemiology, and follow-up of these patients has broadened the indications and marked reduced morbidity related to interventional PFO closure. This review presents the current knowledge and our own data concerning transcatheter closure of PFO.

Cardiac Catheterization↗

PubMed2006

Early systemic device embolization after transcatheter patent foramen ovale closure.

Serious complications after percutaneous atrial septal abnormality closure are uncommon. We present a case of patent foramen ovale closure with early mobilization of the device and asymptomatic embolization into the descending aorta without sequels. Percutaneous retrieval of the device was successful down to the femoral artery from where it was extracted surgically.

Aged, 80 and over↗

PubMed2006

[Paraganglioma of the jugular foramen presenting with initial isolated vertigo].

The more common symptoms of the jugulotympanic paragangliomas are hearing loss, tinnitus and palsy of cranial nerves. Diagnosis is often delayed due to the slow growth of the tumour. We report one case with affectation of jugular foramen which clinically debuted as a peripheral vertigo and the diagnosis was made by CT, IRM and angiography. The patient was treated by Neurosurgery using Gamma Knife (radiosurgery) with good result.

Adult↗

PubMed2006

Paradoxical and pulmonary embolism due to a thrombus entrapped in a patent foramen ovale.

A 70-year-old woman, with a history of recent thromboembolic stroke, was admitted to our hospital because of sudden dyspnea due to pulmonary thromboembolism. Transthoracic echocardiography revealed a tubular thrombus entrapped in a patent foramen ovale. Transesophageal echocardiography confirmed this finding and also revealed an atrial septal aneurysm. Because her cerebral status contraindicated surgical intervention, medical therapy with heparin and warfarin was started. Follow-up transthoracic echocardiography, performed 3 weeks after the initiation of therapy, revealed complete resolution of the thrombus. Medical therapy can be an alternative to surgical therapy in high-risk patients who have entrapped thrombi.

Aged↗