Hyperostotic Sphenoid Wing Meningioma with Proptosis: A Rare Case Report with Literature Review.

BACKGROUND: We present a case of proptosis with headache, decrease in vision and orbital pain where patient underwent sphenoid-orbital decompression, and excision of mass, resulting in significant improvement in her vision with complete resolution of proptosis, headache and orbital pain. This study was done to diagnose and evaluate clinical outcome of hyperostotic sphenoid wing meningioma with orbital involvement after surgery. CASE: A 40 year-female presented with severe headache, right eye swelling, periorbital pain and decreasing in vision for two years, and right eye proptosis more severe for three months. OBSERVATIONS: She underwent right frontotemporal craniotomy with removal of hyperostotic sphenoid wing and excision of meningioma after magnetic resonance imaging demonstrated a right sphenoid wing meningioma extending orbital and middle cranial fossa. She had improvement of her symptoms post-operatively. CONCLUSION: Surgical decompression of orbit with total resection of meningioma and sphenoid wing hyperostosis can result in significant improvement in the vision and proptosis.

Surgical Excision of Cirsoid Aneurysm of the Scalp: Case Series and Review of the Literature.

BACKGROUND: Cirsoid aneurysms, also known as arteriovenous malformations (AVMs), of the scalp are relatively rare lesions. They may be found incidentally or with symptoms such as an enlarging pulsatile mass, headache, or bleeding. METHODS: This retrospective case series comprised 10 cases of scalp AVMs that were treated with surgical excision from January 2010 to January 2020. Diagnosis was made with simple palpation and computed tomography angiography. Scalp AVMs were categorized according to the Schobinger classification. RESULTS: There were 10 patients, 8 males and 2 females, with a mean age of 22.6 years (range, 10-40 years). All patients underwent ligation of the feeding artery with total excision of the AVM. There were no postoperative complications or recurrences during a mean follow-up of 21.6 months. CONCLUSIONS: Preoperative embolization reduces vascularity and helps in easy identification as well as complete excision of cirsoid aneurysms during surgery. However, surgical excision alone of cirsoid aneurysms also results in excellent outcomes.

Complications associated with diagnostic cerebral angiography: A retrospective analysis of 644 consecutive cerebral angiographic cases.

AIM: This study was conducted to evaluate complications (minor and major) that occurred in patients who underwent modern cerebral angiography. MATERIALS AND METHODS: A retrospective assessment of 644 consecutive cerebral angiographic cases was undertaken with specific emphasis on complications. RESULTS: The most common complication of diagnostic cerebral angiography was groin hematoma seen in 10 (1.55%) patients. One patient had complications arising from the development of a femoral artery pseudoaneurysm. Neurologic complications occurred in 4 (0.62%) cases. Three (0.47%) cases had transient complications which resolved completely within 24 h. One patient (0.16%) was left with permanent hemiplegia. There were 6 (5%) cases of contrast-induced nephropathy out of the 120 cases in whom subarachnoid hemorrhage had occurred and who possessed complete data of kidney function tests. Five of them were reversible, and one was permanent. One patient (0.16%) died from air emboli. CONCLUSIONS: Neurologic complications following cerebral angiography are rare but must be minimized by careful case selection and training. Although the risk is small, complications such as permanent disability or even death cannot be completely obviated.

Large and giant pituitary adenoma resection by microscopic trans-sphenoidal surgery: Surgical outcomes and complications in 123 consecutive patients.

To evaluate surgical outcomes and complications of patients who underwent microscopic trans-sphenoidal surgery (MTS) for large and giant pituitary adenomas (PAs). A retrospective study of electively operated cases of PA over a six year period was performed. Surgical outcomes and complications of 64 patients with large PAs (≥3cm) and 59 patients with giant PAs (>4cm), who underwent MTS at same period, were reviewed. Medical reports of all selected patients were assessed to collect demographic information such as age, sex, clinical symptoms, PA size, the extent of PA extension and resection, outcomes and complications. Patients with large PAs had improvement in visual improvement (78.1%; 50/64), gross total resection (84.4%; 54/64) compared to patients with giant PAs who had improvement in visual (71.2%; 42/59) and gross total resection (74.6%; 44/59). The rate of CSF leakage was 7.8% and 23.7% for large and giant PAs (p=0.0399). After a mean follow-up period of 40.8 (6-75) months, 10 (15.6%) patients with large PAs experienced tumor recurrence, while 2 giant PA patients (3.4%) experienced tumor recurrence after a mean follow-up period of 40.6 (3-70) months (p=0.0314). Resection of both large and giant pituitary adenomas by microscopic trans-sphenoidal surgery may be safe and effective surgical technique with low morbidity and mortality.

Relationship between venous drainage subtypes and sub-arachnoid hemorrhage subtypes: a meta-analysis.

BACKGROUND: To investigate whether associations exist between venous drainage subtypes (types I, II, and III) and the risk of subarachnoid hemorrhage subtypes. METHODS: Published case-control and case series from 2010 to 2014 which met all the inclusion criteria for the meta-analysis were selected and subjected to rigorous statistical analysis. RESULTS: A total of 11 studies with an overall patient population (case and controls) of 891 were involved in the study. Types I and II venous drainage had odds against peri-mesencephalic subarachnoid hemorrhage. The odds were in favor of type III venous drainage and peri-mesencephalic sub-arachnoid hemorrhage and idiopathic sub-arachnoid hemorrhage (ISAH). CONCLUSIONS: Type I deep venous drainage may not be associated with the risks of peri-mesencephalic subarachnoid hemorrhage and ISAH, however, types II and III may be associated with high risk of peri-mesencephalic subarachnoid hemorrhage and ISAH, respectively.