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Search on : Abducens and Nerve and Injury [Words]
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[PMID]: 29298208
[Au] Autor:Hariharan P; Balzer JR; Anetakis K; Crammond DJ; Thirumala PD
[Ad] Address:Departments of Neurological Surgery and.
[Ti] Title:Electrophysiology of Extraocular Cranial Nerves: Oculomotor, Trochlear, and Abducens Nerve.
[So] Source:J Clin Neurophysiol;35(1):11-15, 2018 Jan.
[Is] ISSN:1537-1603
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180103
[Lr] Last revision date:180103
[St] Status:In-Process
[do] DOI:10.1097/WNP.0000000000000417

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[PMID]: 28967311
[Au] Autor:Elarjani T; Shetty R; Singh H; da Silva HB; Sekhar LN
[Ad] Address:Department of Neurological Surgery, University of Washington, Seattle, Washington; and.
[Ti] Title:Transpetrosal approach to petro-clival meningioma.
[So] Source:Neurosurg Focus;43(VideoSuppl2):V1, 2017 Oct.
[Is] ISSN:1092-0684
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:A 38-year-old woman had a 3-week gradual onset of right-sided weakness in the upper and lower extremities. MRI showed a large left petro-clival meningioma encasing the basilar and left superior cerebellar artery and compressing the brainstem. A posterior transpetrosal approach, with a left temporal and retrosigmoid craniotomy and mastoidectomy, was performed. The tumor was removed in a gross-total resection with questionable remnants adherent to the brainstem. Intraoperative partial iatrogenic injury to the left oculomotor nerve was repaired with fibrin glue. Postoperatively, the hemiparesis improved, and the patient was discharged to the rehabilitation center with left oculomotor and abducens palsies. A postoperative MRI scan showed complete resection of tumor with no remnants on the brainstem. A 6-month follow-up examination showed complete resolution of motor symptoms and complete recovery of cranial nerve (CN) palsies affecting CN III and CN VI. The video can be found here: https://youtu.be/vOu6YFA8uoo .
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171002
[Lr] Last revision date:171002
[St] Status:In-Process
[do] DOI:10.3171/2017.10.FocusVid.17214

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[PMID]: 28673673
[Au] Autor:Ravindran K; Lorensini B; Gaillard F; Kalus S
[Ad] Address:Department of Radiology, The Royal Melbourne Hospital, Parkville, VIC, Australia. Electronic address: ravindrank@student.unimelb.edu.au.
[Ti] Title:Bilateral traumatic abducens nerve avulsion: A case series and literature review.
[So] Source:J Clin Neurosci;44:30-33, 2017 Oct.
[Is] ISSN:1532-2653
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:Although abducens nerve palsy is an established sequela of head trauma - given the prolonged intracranial course of the nerve - bilateral injury is rare. Here, we present two cases of bilateral traumatic abducens nerve avulsion, in the absence of regional fractures, one of which presented two months following the initial trauma. Additionally, we review the current literature on bilateral abducens nerve palsy secondary to trauma, discussing the anatomy of the nerve's course and potential mechanisms of injury.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170903
[Lr] Last revision date:170903
[St] Status:In-Process

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[PMID]: 28616041
[Au] Autor:Zhou LY; Li XM; Liu TJ; Ji XJ; Zhao M; Su C; Liu JC; Sun JY
[Ad] Address:Ocular Motility Disorder Treatment & Rehabilitation Center, Department of Acupuncture, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
[Ti] Title:Efficacy of intraorbital electroacupuncture for diabetic abducens nerve palsy: study protocol for a prospective single-center randomized controlled trial.
[So] Source:Neural Regen Res;12(5):826-830, 2017 May.
[Is] ISSN:1673-5374
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Abducens nerve palsy (ANP) is commonly seen in patients with diabetes mellitus. The validity of acupuncture as a traditional Chinese medicine method in peripheral nerve repair is well established. However, its efficacy in randomized controlled trials remains unclear. Herein, we designed a protocol for a prospective, single-center, randomized controlled trial to investigate the effect of intraorbital electroacupuncture on diabetic ANP. We plan to recruit 60 patients with diabetic ANP, and randomly divide them into treatment and control groups. Patients in both groups will continue their glucose-lowering therapy. A neural nutrition drug will be given to both groups for six weeks. The treatment group will also receive intraorbital electroacupuncture therapy. We will assess efficacy of treatment, eyeball movement, diplopia deviation and the levels of fasting blood-glucose and glycosylated hemoglobin before treatment at 2, 4, and 6 weeks after treatment. The efficacy and recurrence will be investigated during follow-up (1 month after intervention). This protocol was registered at Chinese Clinical Trial Registry on 16 January 2015 (ChiCTR-IPR-15005836). This study was approved by the Ethics Committee of First Affiliated Hospital of Harbin Medical University of China (approval number: 201452). All protocols will be in accordance with , formulated by the World Medical Association. Written informed consent will be provided by participants. We envisage that the results of this clinical trial will provide evidence for promoting clinical use of this new therapy for management of ANP.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/1673-5374.206654

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[PMID]: 28364580
[Au] Autor:Patel VA; Zacharia TT; Goldenberg D; McGinn JD
[Ad] Address:Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
[Ti] Title:End-organ radiographic manifestations of cranial neuropathies: A concise review.
[So] Source:Clin Imaging;44:5-11, 2017 Jul - Aug.
[Is] ISSN:1873-4499
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cranial neuropathies are a spectrum of disorders associated with dysfunction of one or more of the twelve cranial nerves and the subsequent anatomic structures they innervate. OBJECTIVE: The purpose of this article is to review radiographic imaging findings of end-organ aberrations secondary to cranial neuropathies. METHOD: All articles related to cranial neuropathies were retrieved through the PubMed MEDLINE NCBI database from January 1, 1991 to August 31, 2014. These manuscripts were analyzed for their relation to cranial nerve end-organ disease pathogenesis and radiographic imaging. RESULTS: The present review reveals detectable end-organ changes on CT and/or MRI for the following cranial nerves: olfactory nerve, optic nerve, oculomotor nerve, trochlear nerve, trigeminal nerve, abducens nerve, facial nerve, vestibulocochlear nerve, glossopharyngeal nerve, vagus nerve, accessory nerve, and hypoglossal nerve. CONCLUSION: Radiographic imaging can assist in the detailed evaluation of end-organ involvement, often revealing a corresponding cranial nerve injury with high sensitivity and diagnostic accuracy. A thorough understanding of the distal manifestations of cranial nerve disease can optimize early pathologic detection as well as dictate further clinical management.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170610
[Lr] Last revision date:170610
[St] Status:In-Process

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[PMID]: 28124175
[Au] Autor:Yang K; Ikawa F; Onishi S; Kolakshyapati M; Takeda M; Yamaguchi S; Ishifuro M; Akiyama Y; Morishige M; Kurisu K
[Ad] Address:Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
[Ti] Title:Preoperative simulation of the running course of the abducens nerve in a large petroclival meningioma: a case report and literature review.
[So] Source:Neurosurg Rev;40(2):339-343, 2017 Apr.
[Is] ISSN:1437-2320
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:One of the most important and useful pieces of information in the preoperative evaluation of a large petroclival meningioma is the running course of the abducens nerve. The abducens nerve is small and has a long intracranial course, making it prone to compression by the tumor at various anatomical points. In relatively large tumors, it is difficult to confirm the entire course of the abducens nerve, even by heavy T2-thin slice imaging. We report a case of successful preoperative estimation of the course of the abducens nerve that aided in its complete preservation during the resection of a large petroclival tumor.
[Mh] MeSH terms primary: Abducens Nerve/diagnostic imaging
Brain Neoplasms/diagnostic imaging
Cranial Fossa, Posterior/diagnostic imaging
Meningioma/diagnostic imaging
Petrous Bone/diagnostic imaging
[Mh] MeSH terms secundary: Abducens Nerve/surgery
Abducens Nerve Injury/etiology
Abducens Nerve Injury/prevention & control
Adult
Brain Neoplasms/surgery
Computer Simulation
Cranial Fossa, Posterior/surgery
Female
Humans
Magnetic Resonance Imaging
Meningioma/surgery
Neurosurgical Procedures/adverse effects
Petrous Bone/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1706
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[Js] Journal subset:IM
[Da] Date of entry for processing:170127
[St] Status:MEDLINE
[do] DOI:10.1007/s10143-017-0816-1

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[PMID]: 27923754
[Au] Autor:Wajima D; Nakagawa I; Park HS; Yokoyama S; Wada T; Kichikawa K; Nakase H
[Ad] Address:Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan. Electronic address: wajima@naramed-u.ac.jp.
[Ti] Title:Successful Coil Embolization of Pediatric Carotid Cavernous Fistula Due to Ruptured Posttraumatic Giant Internal Carotid Artery Aneurysm.
[So] Source:World Neurosurg;98:871.e23-871.e28, 2017 Feb.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery. However, for the ipsilateral posttraumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high-flow direct CCF is better for the prevention of hyperperfusion syndrome and intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy had severe head trauma caused by being hit by a car. He was transferred to our department and diagnosed as having left acute subdural hematoma and acute brain swelling. Emergent evacuation of hematoma and external decompression were performed. He was treated for severe brain swelling in the intensive care unit for 2 months. Cranioplasty was performed 3 months after the injury. His right hemiparesis and aphasia persisted, so he was transferred to a rehabilitation hospital. However, 2 years after the head injury, he was referred to our department because of abducens nerve palsy. He was diagnosed as having a symptomatic posttraumatic direct CCF, which was caused by a ruptured left cavernous giant internal carotid artery aneurysm. The direct CCF was treated with coil embolization of the giant aneurysm and parent artery occlusion. CONCLUSIONS: Coil embolization of the aneurysm and parent artery occlusion for the posttraumatic direct CCF was a good option to manage the abducens nerve palsy and to prevent postoperative hyperperfusion.
[Mh] MeSH terms primary: Aneurysm, Ruptured/complications
Carotid-Cavernous Sinus Fistula/etiology
Carotid-Cavernous Sinus Fistula/surgery
Embolization, Therapeutic/instrumentation
Embolization, Therapeutic/methods
Intracranial Aneurysm/complications
[Mh] MeSH terms secundary: Aneurysm, Ruptured/diagnostic imaging
Aneurysm, Ruptured/surgery
Carotid-Cavernous Sinus Fistula/diagnostic imaging
Cavernous Sinus/surgery
Child
Coronary Angiography
Humans
Intracranial Aneurysm/diagnostic imaging
Intracranial Aneurysm/surgery
Male
Tomography Scanners, X-Ray Computed
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170919
[Lr] Last revision date:170919
[Js] Journal subset:IM
[Da] Date of entry for processing:161208
[St] Status:MEDLINE

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[PMID]: 28035290
[Au] Autor:Borghei-Razavi H; Tomio R; Fereshtehnejad SM; Shibao S; Schick U; Toda M; Yoshida K; Kawase T
[Ad] Address:Department of Neurosurgery, Clemens Hospital, Münster, Germany; Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.
[Ti] Title:Pathological Location of Cranial Nerves in Petroclival Lesions: How to Avoid Their Injury during Anterior Petrosal Approach.
[So] Source:J Neurol Surg B Skull Base;77(1):6-13, 2016 Feb.
[Is] ISSN:2193-6331
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used. The anatomical variations of cranial nerves IV-VI related to the tumor were divided into several location categories: superior lateral (SL), inferior lateral (IL), superior medial (SM), inferior medial (IM), and encased (E). These data were then analyzed taking into consideration pathologic subgroups of meningioma, epidermoid, and schwannoma. In 41% of meningiomas, the trigeminal nerve is encased by the tumor. In 38% of the meningiomas, the trigeminal nerve is in the SL part of the tumor, and it is in 20% of the IL portion of the tumor. In 38% of the meningiomas, the trochlear nerve is encased by the tumor. The abducens nerve is not always visible (35%). The pathologic nerve pattern differs from that of meningiomas for epidermoid and trigeminal schwannomas. The pattern of cranial nerves IV-VI is linked to the type of petroclival tumor. In a meningioma, tumor origin (cavernous, upper clival, tentorial, and petrous apex) is the most important predictor of the location of cranial nerves IV-VI. Classification of four subtypes of petroclival meningiomas using magnetic resonance imaging is very useful to predict the location of deviated cranial nerves IV-VI intraoperatively.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1612
[Cu] Class update date: 170220
[Lr] Last revision date:170220
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1055/s-0035-1555137

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[PMID]: 27929602
[Au] Autor:Leonetti JP; Nadimi S; Marzo SJ; Anderson D; Vandevender D
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153. jleonet@lumc.edu.
[Ti] Title:Facial reanimation according to the postresection defect during lateral skull base surgery.
[So] Source:Ear Nose Throat J;95(12):E15-E20, 2016 Dec.
[Is] ISSN:1942-7522
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The vast majority of benign tumors of the cerebellopontine angle, temporal bone, and parotid gland can be successfully resected without permanent injury to the facial nerve. Malignant tumors or recurrent disease may require facial nerve sacrifice, especially if preoperative facial paresis is present. This article will present case examples of the various methods to reconstruct facial animation after lateral skull base resections that require sacrifice of cranial nerve VII, and the associated mimetic facial musculature. Facial mimetic outcome after reanimation was graded using the House-Brackmann scale. Primary neurorrhaphy or interposition grafting may be performed when both the proximal and distal portions of the facial nerve are available and viable facial musculature is present. If only the distal facial nerve and viable facial musculature are available, a split hypoglossal to facial nerve anastomosis is used. A proximal facial nerve to microvascular free flap is performed when the proximal facial nerve is available without distal nerve or viable musculature. A cross-facial to microvascular free flap is performed when the proximal and distal facial nerve and facial musculature are unavailable. The above methods resulted in a House-Brackmann score of III/VI in all case examples postoperatively. The method of facial reanimation used depends on the availability of viable proximal facial nerve, the location of healthy, tumor-free distal facial nerve, and the presence of functioning facial mimetic musculature.
[Mh] MeSH terms primary: Abducens Nerve Injury/surgery
Facial Paralysis/surgery
Neurosurgical Procedures/methods
Postoperative Complications/surgery
Skull Base/surgery
[Mh] MeSH terms secundary: Abducens Nerve Injury/etiology
Abducens Nerve Injury/physiopathology
Adult
Aged
Face/physiopathology
Face/surgery
Facial Muscles/physiopathology
Facial Muscles/surgery
Facial Paralysis/etiology
Facial Paralysis/physiopathology
Female
Free Tissue Flaps
Head and Neck Neoplasms/surgery
Humans
Male
Postoperative Complications/etiology
Reconstructive Surgical Procedures/methods
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170412
[Lr] Last revision date:170412
[Js] Journal subset:IM
[Da] Date of entry for processing:161209
[St] Status:MEDLINE

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[PMID]: 27843685
[Au] Autor:Sharma A; Nguyen HS; Sharma A; Lozen A; Kurpad S
[Ad] Address:Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
[Ti] Title:Delayed hydrocephalus associated with traumatic atlanto-occipital dislocation: Case report and literature review.
[So] Source:Surg Neurol Int;7(Suppl 25):S679-S681, 2016.
[Is] ISSN:2229-5097
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND: Traumatic atlanto-occipital dislocation (AOD) is a rare but often fatal injury. Consequently, long-term data regarding surviving patients have been limited. In particular, the occurrence of hydrocephalus is not well-documented. CASE DESCRIPTION: A 33-year-old male sustained AOD as a consequence of a motor vehicle collision. Although he did well initially after an occipitocervical fusion, 1 month after his operation, he exhibited signs of increased intracranial pressure (bilateral abducens nerve palsies, worsening headaches, and fatigue). He was found to have hydrocephalus, which was responsive to shunting. CONCLUSION: Manifestations of hydrocephalus after AOD can be variable, ranging from interval ventricular dilatation to pseudomeningoceles and syringomyelia. In addition, the timing of presentation can be acute, requiring emergent external ventricular drainage, or delayed, requiring ongoing vigilance. Consequently, as more patients survive this once thought to be fatal injury, caution for hydrocephalus is stressed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1611
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE


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