1/38. Unusual cranial nerve palsy caused by cavernous sinus aneurysms. Clinical and anatomical considerations reviewed.BACKGROUND: Two cases of intracavernous internal carotid artery aneurysm with unusual clinical findings are reported. The pathomechanism and clinical significance are discussed. CASE DESCRIPTION: The first patient was a 49-year-old woman who presented with 6th nerve palsy and Horner's syndrome caused by a posteriorly located intracavernous aneurysm. The symptoms improved gradually in proportion to the size of the aneurysm. The second patient was a 69-year-old woman with isolated oculomotor superior division palsy caused by an anteriorly located large aneurysm. CONCLUSION: In the first case, a local aneurysmal compression at both the 6th nerve and the sympathetic fibers sent from the plexus on the intracavernous internal carotid artery is the most probable explanation. In the second case, the aneurysm might have selectively compressed the superior division of the oculomotor nerve at the anterior cavernous sinus. Clinical recognition of these syndromes results in a better diagnostic orientation. The authors discuss the pertinent anatomy and pathophysiology of the lesions because these findings are rarely seen clinically or in the literature.- - - - - - - - - - ranking = 1keywords = aneurysm (Clic here for more details about this article) |
2/38. Extensor pollicis longus paralysis following thoracoscopic sympathectomy.Thoracoscopic sympathectomy is an acceptable form of treatment for palmar hyperhidrosis. Many authors have reported favourable results. Complications range from pneumo-haemothorax, Horner's syndrome, compensatory hyperhidrosis and bleeding. Plas et al reported 2.7% of the procedures had complications requiring intervention and 9.7% had non-interventive complications. There have been isolated reports of other rare complications including false aneurysm of intercostal artery, inferior brachial plexus injury and abnormal suntanning. We report an unusual case of isolated extensor pollicis longus paralysis after a thoracoscopic sympathectomy for palmar hyperhidrosis, in a fit young male. Such complications have not been previously reported. We recognise that such isolated nerve injury is uncommon.- - - - - - - - - - ranking = 0.1keywords = aneurysm (Clic here for more details about this article) |
3/38. Guglielmi detachable coil treatment of a partially thrombosed giant basilar artery aneurysm in a child.We report a partially thrombosed giant of the aneurysm basilar artery with prominent mass effect, diagnosed in an 11 year-old child who presented with neurological deficits due to brain stem compression. After the patent portion of the aneurysm was embolised with Guglielmi detachable coils, remarkable clinical improvement occurred. angiography demonstrated complete occlusion of the aneurysm and MRI revealed dramatic shrinkage of the aneurysm at 6-month and 1-year follow-up.- - - - - - - - - - ranking = 0.8keywords = aneurysm (Clic here for more details about this article) |
4/38. Intracavernous aneurysm with isolated 6th nerve palsy.A 35-year-old white man with a history of migraine and acute isolated 6th nerve palsy was found to have a large intracavernous aneurysm of the carotid artery. The case demonstrates that a 6th nerve palsy may infrequently be due to an intracavernous aneurysm and, therefore, one should rule out this and other intracranial lesions or systemic disease before accepting the diagnosis of ophthalmoplegic migraine.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
5/38. Aneurysmal bone cyst of the sphenoid sinus.Aneurysmal bone cyst is now recognized as a distinct clinicopathologic entity. It has characteristic clinical, radiologic, and pathologic feactures. The two modalities of treatment are surgical resection or curettage and radiotherapy: recurrence rates with each modality are discussed. A case report of an aneurysmal bone cyst presenting in the sphenoid sinus and treated with the compbined modalities of irradiation and surgical curettage is presented.- - - - - - - - - - ranking = 0.1keywords = aneurysm (Clic here for more details about this article) |
6/38. Isolated bilateral abducens nerve palsies caused by the rupture of a vertebral artery aneurysm.We report two cases with isolated bilateral abducens nerve palsies due to the rupture of a vertebral aneurysm. Surgery revealed that the aneurysm did not directly compress the abducens nerve. Within a year after the subarachnoid hemorrhage, the patients gained full recovery from the bilateral abducens nerve palsies. In view of the clinical and operative findings, it may be regarded as a compression and/or stretching of the bilateral abducens nerves by a thick clot in the prepontine cistern, and not as a manifestation of the raised intracranial pressure. The mechanisms of the isolated abducens nerve palsy are discussed.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
7/38. Ruptured anterior communicating artery aneurysm causing bilateral abducens nerve paralyses--case report.A rare case of bilateral abducens nerve paralyses after rupture of an anterior communicating artery (AcoA) aneurysm occurred in a 56-year-old female after sudden onset of severe headache. Bilateral abducens nerve paralyses were present without additional neuro-ophthalmological signs. Computed tomography revealed subarachnoid hemorrhage (SAH). angiography showed an AcoA aneurysm (15 mm in diameter, directed antero-inferiorly) that was successfully clipped. Postoperatively, the bilateral abducens nerve paralyses gradually recovered and disappeared 3 months after onset. Bilateral abducens nerve paralyses may occur after SAH due to ruptured AcoA aneurysm, and neurosurgeons should be alert to this possibility.- - - - - - - - - - ranking = 0.7keywords = aneurysm (Clic here for more details about this article) |
8/38. Unilateral lower extremity paralysis after coil embolization of an internal iliac artery aneurysm.Neurologic complications after treatment of internal iliac artery (IIA) aneurysms are rare, especially if confined to one IIA. We report a patient in whom profound right lower extremity paresis developed after unilateral right IIA coil embolization for treatment of a 4-cm IIA aneurysm, despite the presence of a patent contralateral IIA. This case illustrates the important, yet unpredictable, nature of pelvic blood flow to the distal spinal cord and lumbosacral plexus and the unpredictable consequence of IIA occlusion.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
9/38. femoral nerve palsy secondary to traumatic pseudoaneurysm and iliacus hematoma.The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discussion of its treatment. A 20-year-old man was assaulted and presented to the authors's institution with a 1-week history of severe pain in the left anterior thigh and groin, weakness in the left quadriceps muscle, and numbness in the anterior thigh and medial distal leg. Imaging studies demonstrated a large, 9.4 x 6.4 x 5.2-cm iliacus hematoma as well as a pseudoaneurysm originating from the left iliolumbar artery. The patient underwent angiographic embolization of the pseudoaneurysm followed by surgical evacuation of the hematoma. The embolization was performed before surgery to prevent any possible rebleeding from the pseudoaneurysm during evacuation of the hematoma. femoral nerve palsy caused by traumatic iliacus hematoma is an infrequent diagnosis often missed because of its insidious presentation. In this case, embolization of the iliolumbar artery pseudoaneurysm followed by surgical evacuation of the hematoma resulted in a nearly full recovery of the femoral nerve as of the last follow-up examination.- - - - - - - - - - ranking = 2.0839162925038keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
10/38. Posterior inferior cerebellar artery (pica) aneurysm presenting with SAH and contralateral crural monoparesis: a case report.A patient with contralateral monoparesis of the leg due to subarachnoid hemorrhage (SAH) from an aneurysm of the first posterior inferior cerebellar artery (pica) segment is reported. The monoparesis may well be associated with the close anatomical relationships between the site of the aneurysm and the pica blood supply of the corticospinal fibers to the contralateral leg.- - - - - - - - - - ranking = 0.6keywords = aneurysm (Clic here for more details about this article) |
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