Abstract:
:Extravasation of Onyx is a rare complication during embolization of arteriovenous malformations (AVM). We present a case of embolization that was complicated by leakage of Onyx into the cerebellum which was later encountered during surgical excision of the AVM. Our goal is to report this rare event and to outline successful treatment of this complication. The patient's records were reviewed for medical history, laboratory and radiologic workup, and outpatient clinical follow-up. A 62-year-old female presented with Hunt Hess grade 2 and modified Fisher grade 2 subarachnoid hemorrhage (SAH) secondary to ruptured left posterior inferior cerebellar artery (PICA) aneurysm associated with a superior cerebellar vermian AVM. Following endovascular intervention, the aneurysm was completely embolized; however, only 75% of the AVM could be safely obliterated. Extravasation of Onyx from the ruptured aneurysm was noted on her initial angiogram. Elective suboccipital craniectomy was subsequently planned for resection of the residual AVM where the extravasated Onyx posed an operative nuisance during resection. Post-op angiogram confirmed complete resection of the AVM, as well as the bulk of the extravasated Onyx. Patient did well post-operatively, remaining neurologically intact throughout her hospital course. Although infrequently reported in the literature, Onyx extravasation is a potential complication that neurosurgeons should be ready to face. Adherence of Onyx to surrounding parenchyma could hinder optimal surgical resection of AVM and increase complications. Therefore, careful surgical dissection should be performed with special care to delicate neurovasculature. In this case, complete resection of the AVM and Onyx mass was safely achieved.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Solli E,Jumah F,Narayan V,Quinoa T,Xiong Z,Gupta G,Alharfoush E,Nanda Adoi
10.1007/s00701-019-04199-3subject
Has Abstractpub_date
2020-04-01 00:00:00pages
923-928issue
4eissn
0001-6268issn
0942-0940pii
10.1007/s00701-019-04199-3journal_volume
162pub_type
杂志文章,评审abstract:BACKGROUND:Treatment of small ruptured aneurysms (SRAs) remains controversial, with literature reporting difficulty with endovascular versus microsurgical approaches. This paper analyzes outcomes after endovascular coiling and microsurgical clipping among patients with SRAs prospectively enrolled in the Barrow Ruptured...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04602-4
更新日期:2021-01-01 00:00:00
abstract::We report the case of a large osteoblastoma arising in the frontal bone of a 20-year-old female. The lesion was first noted after a fall, and grew steadily in size following further head injury during pregnancy. Initial plain radiography demonstrated an area of radiolucency, with subsequent cross-sectional imaging rev...
journal_title:Acta neurochirurgica
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doi:10.1007/s00701-016-3024-9
更新日期:2017-02-01 00:00:00
abstract::Changes of plasma thromboxane level in subarachnoid haemorrhage (SAH) were studied clinically and experimentally using 11-dehydro-thromboxane B2 (11 DTX) as a measuring index. 11 DTX is a major long-lived metabolite formed from thromboxane (TX) B2, and is said to be a more reliable parameter for detecting TXA2 product...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403202
更新日期:1991-01-01 00:00:00
abstract:INTRODUCTION:Intraoperative detection of residual tumor remains an important challenge in surgery to treat gliomas. New developments in optical techniques offer non-invasive high-resolution imaging that may integrate well into the workflow of neurosurgical operations. Using an intracranial glioma model, we have recentl...
journal_title:Acta neurochirurgica
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doi:10.1007/s00701-009-0248-y
更新日期:2009-05-01 00:00:00
abstract::Early onset "juvenile type" Parkinson's disease is commonly associated with disabling bilateral levodopa-induced dyskinesias. We report here a successful contemporaneous bilateral postero-ventral pallidotomy performed on a 46-year-old male with juvenile type Parkinson's and associated levodopa incited symmetric dyskin...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808622
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Patients with intervertebral disc herniation undergo surgical removal of herniated disc material in cases of persisting symptoms and/or neurologic deficits. While motor deficits often prompt surgery, little is known about the optimal timing of surgery in these cases. The aim of this study was to prospectivel...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04614-0
更新日期:2021-01-01 00:00:00
abstract::The mechanisms by which mexiletine exerts its effects in increasing myocardial circulation, and smooth muscle perfusion and alleviating diabetic neuropathic pain have been widely discussed. The purpose of this study was to examine the protective effect of this compound in ischemia/reperfusion-induced cerebral injury f...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200023
更新日期:2002-02-01 00:00:00
abstract::In the present note, the cause of root compression in cases with degenerative lumbar spondylolisthesis is discussed in order to clarify the best method of surgery and to avoid iatrogenic damage of the cauda equina if a transpedicular fusion is going to be performed. The root compression is due to osteophytes growing o...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02187192
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The exact aetiology, growth and rupture of intracranial aneurysms is unclear. In this study we investigated a possible association between intracranial aneurysm rupture and polymorphism of the endothelial nitric oxide synthase gene G894T. METHODS:Endothelial nitric oxide synthase gene polymorphism of 53 pat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1467-8
更新日期:2008-01-01 00:00:00
abstract::Twenty operated cases of angiographically unrecognized microaneurysm (AUM) have been analysed with special reference to intra-operative observations and clipping-technique. Among the patients with intracranial aneurysms that the authors' facility has operated upon, the incidence of asymptomatic incidental AUM that was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808877
更新日期:1997-01-01 00:00:00
abstract:INTRODUCTION:To report the incidence, treatment and outcome of occipital condyle fractures (OCFs) based on the experience of a single neurosurgical department over a period of two years. MATERIAL AND METHODS:From April 1999 to April 2001, ten cases of OCFs were identified in 110 cervical traumas observed over a period...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-004-0289-1
更新日期:2004-08-01 00:00:00
abstract::Intracranial meningiomas are characteristically benign tumours with a tendency to recur following surgical resection. Our group is investigating the pathogenesis of meningioma recurrence. In our initial studies we identified two cases of dural "tails" associated with intracranial meningiomas. Gadolinium-enhanced magne...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401115
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:Spontaneous posterior interosseous nerve palsy is a rare condition. Entrapment is mostly at level of the arcade of Frohse, and a few cases of distal entrapment have been described. METHODS:A case of entrapment distal to the arcade of Frohse is described here. Cases of distal entrapment have been reviewed ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-018-3615-8
更新日期:2018-09-01 00:00:00
abstract::Two cases of primary extraosseous intradural spinal Ewing's sarcoma are reported with a review of the current literature. This rare neoplasm shares features with cerebral primitive neuroectodermal tumors, complicating a correct diagnosis. Gross total resection seems to be the main treatment, although adjuvant therapie...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-013-1739-4
更新日期:2013-07-01 00:00:00
abstract::Changes in vestibulospinal evoked potentials (VsEP) and motor evoked potentials (MEP) were examined in 10 cats before and after two different weight-dropping spinal cord injuries. In six animals somatosensory evoked potentials (SEP) were also monitored. The recordings were done from epidural spinal cord electrodes. Be...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01410530
更新日期:1989-01-01 00:00:00
abstract::Aneurysms of the vertebro-basilar junction area have been considered the most difficult to be surgically treated because of their deep location, the proximity of the brain stem and the cranial nerves. However, at present, new endovascular techniques and new transbasal surgical approaches offer valuable management stra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02747192
更新日期:1997-01-01 00:00:00
abstract::We investigated the characteristic features of intramedullary spinal cord tumour associated with neurofibromatosis type 1 (NF-1). We have experienced 44 cases of pathologically confirmed intramedullary spinal cord tumour. Diagnosis of NF-1 was done according to the criteria set by the National Institute of Health Cons...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/BF01411560
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:To investigate the natural history and the growth rate of spheno-orbital meningiomas (SOMs). METHODS:Ninety patients with a diagnosis of SOM were included, and patient charts and imaging were evaluated. In a subset of 32 patients, volumetric studies were performed. RESULTS:The median follow-up for the enti...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0878-0
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the pattern of disc herniation and to investigate the associated symptoms in cases of isthmic spondylolisthesis. It is well known that the pathogenesis of degenerative spondylolisthesis associates with disc degeneration, followed by facet laxity and ligamentum flavum...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0411-5
更新日期:2009-11-01 00:00:00
abstract::The effects of thromboxane A2 synthetase inhibitor and hyperdynamic therapy on delayed cerebral ischaemia following aneurysmal subarachnoid haemorrhage were evaluated in a series of twenty eight patients, who underwent aneurysmal clipping with 72 hours after subarachnoid haemorrhage. Postoperatively, 13 patients were ...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/BF01401822
更新日期:1993-01-01 00:00:00
abstract::In fifteen cases of brain stem lesions caused by basal tumours, operations, injuries, arteriosclerosis or multiple sclerosis, a paradoxical activity of jaw closing muscles during jaw opening was observed. This inverse activity was the cause of severe trismus in 8 cases. It is the manifestation of a faulty programming ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403831
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:Juxtafacet cysts (JFCs) of the subaxial cervical spine are rare causes of neurological deficits. Their imaging characteristics, relationship to segmental instability, and potential for inducing acute symptomatic deterioration have only been described in a few case reports and small case series. The objective...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-012-1549-0
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:We report 24 patients with a traumatic acute subdural haematoma of the posterior fossa managed between 1997 and 1999 at 8 Italian neurosurgical centres. METHOD:Each centre provided data about patients' clinico-radiological findings, management, and outcomes, which were retrospectively reviewed. FINDINGS:A ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-003-0150-y
更新日期:2003-12-01 00:00:00
abstract::We previously showed that a canine basilar artery manifested tonic and potent, protein kinase C (PKC)-dependent contractions when nitric oxide (NO) was inhibited. We also reported a linear correlation between chronological changes in the angiographic severity of vasospasm, enhanced PKC, and attenuated guanosine, 13',1...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050215
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Multiple intracranial aneurysms (MIAs) are associated with poorer outcomes after rupture than are single intracranial aneurysms (SIAs). Although the risk factors for intracranial aneurysm rupture have been widely investigated, few studies have focused on MIAs. Thus, the present study aimed to determine wheth...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2826-0
更新日期:2016-07-01 00:00:00
abstract::Incomplete cerebral ischaemia of 10 to 60 minutes duration was performed by reducing the perfusion pressure of completely isolated canine heads at brain temperatures of 37 and 32 degrees C. Complete cerebral ischaemia of the same duration was performed by complete stopping of the perfusion. The latency of recovery of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02074501
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach. METHODS:The aim of the transethmoidal-paraseptal approach is to create sufficient space within...
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pub_type: 杂志文章
doi:10.1007/s00701-017-3075-6
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Schwannomas occur sporadically or in association with neurofibromatosis 2 (NF2), an autosomal dominant disorder, which predisposes to multiple schwannomas, meningiomas and spinal ependymomas, with bilateral vestibular schwannomas as the classic hallmark. As NF2 and sporadic schwannomas differ in some respect...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010070036
更新日期:2000-01-01 00:00:00
abstract::Quantitative isotope ventriculography (QIV) has been suggested as a method for diagnosing hydrocephalus and predicting the results of CSF shunt insertion. However, the physiological significance of this and other tracer clearance studies is questionable. Using a simplified mathematical model for tracer clearance follo...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808440
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Intraoperative fluorescence angiography with indocyanine green (ICG) as a tracer has recently been introduced as a novel technique for neurosurgery. We evaluated the feasibility and efficacy of near-infrared (NIR) indocyanine green (ICG) videoangiography for patients undergoing carotid endarterectomy (CEA). ...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-011-1018-1
更新日期:2011-08-01 00:00:00