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José M. Valdueza - One of the best experts on this subject based on the ideXlab platform.
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serial ultrasound assessment of the Basal Vein of rosenthal in hsv encephalitis
Ultrasound in Medicine and Biology, 2006Co-Authors: Florian Doepp, José M. Valdueza, Stephan J SchreiberAbstract:Herpes simplex virus encephalitis (HSVE) typically affects the baso-temporal brain. The venous blood drainage of this region mainly occurs via the Basal Vein of Rosenthal (BVR), which can easily be monitored by transcranial color-coded duplex sonography (TCCS), and might be a useful parameter for the activity of the disease. Serial blood flow velocity (BFV) measurements of the BVR and the Basal cerebral arteries were performed in five acute HSVE patients by means of transcranial color-coded duplex sonography (TCCS). Remarkable increased BFV of the BVR at the affected side was found in all patients, showing a maximum within the first 8 d of infection followed by a tendency toward normalisation during the next weeks. In comparison, changes of BFV in the Basal cerebral arteries were much more heterogeneous. Our findings suggest that TCCS measurements of the BVR might be used as an additional diagnostic bed-side tool to evaluate patients with HSVE during the acute stage.
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internal jugular Vein valve incompetence and intracranial venous anatomy in transient global amnesia
Journal of Neurology Neurosurgery and Psychiatry, 2005Co-Authors: Stephan J Schreiber, Florian Doepp, Randolf Klingebiel, José M. ValduezaAbstract:Background: Recently a causal relation between internal jugular Vein valve incompetence (IJVVI) and transient global amnesia (TGA) has been suggested. IJVVI is postulated to provoke a transient mesiotemporal ischaemia by venous congestion. This mechanism requires a patent venous pathway from the affected IJV through the transverse sinus, confluens, straight sinus (SS), Vein of Galen into the Basal Vein of Rosenthal and the internal cerebral Veins. Objective: To study IJVVI in TGA patients in relation to the intracranial venous anatomy. Methods: IJVVI was defined if a repeated Valsalva manoeuvre (VM) led to a retrograde jugular flow detected by extracranial duplex ultrasound. Non-contrast venous MR angiography (MRA) was performed to analyse intracranial drainage patterns of the SS in relation to the side of the IJVVI. SS drainage was differentiated into three groups: predominantly right, left, and bilateral drainage. Ultrasound studies were performed in 25 TGA patients and 85 age matched controls. Twenty patients underwent venous MRA. Results: Sixty eight per cent of patients and 33% of controls showed unilateral or bilateral IJVVI (p = 0.0025). In 36% of patients a TGA preceding VM was reported. Drainage pattern of SS and side of IJVVI corresponded in five of eight patients (63%) with VM and four of 12 patients without VM (33%, p = 0.0994). Conclusion: Our study confirms the significantly higher prevalence of IJVVI in TGA patients. However, no specific IJVVI related intracranial venous drainage patterns could be found to further support the hypothesis of a direct causal relation between IJVVI and TGA.
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assessment of normal flow velocity in Basal cerebral Veins a transcranial doppler ultrasound study
Stroke, 1996Co-Authors: José M. Valdueza, Klaus Schmierer, S Mehraein, Karl M. EinhäuplAbstract:Background and Purpose Transcranial Doppler ultrasound has not yet been applied systematically to the analysis of the venous system and cerebrovenous disorders. Assessment of the intracranial venous system, however, would contribute to the understanding of cerebral hemodynamics and thus allow new possibilities for clinical application of the Doppler technique. Therefore, we demonstrated the validity of the transcranial Doppler technique in analyzing the Basal cerebral Veins. Methods Venous transcranial Doppler ultrasound was performed with a range-gated 2-MHz transducer in 60 healthy volunteers and patients without central nervous disorders ranging in age from 10 to 71 years (mean±SD, 41.9±15 years). Results A venous signal away from the probe and adjacent to the posterior cerebral artery, considered to correspond to the Basal Vein of Rosenthal, was found in all subjects on at least one side. Mean blood flow velocity ranged from 4 to 17 cm/s (mean±SD, 10.1±2.3 cm/s). Analysis for age dependency revealed a...
R. Shane Tubbs - One of the best experts on this subject based on the ideXlab platform.
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Direct drainage of the Basal Vein of Rosenthal into the superior petrosal sinus: a literature review.
Anatomy & cell biology, 2020Co-Authors: Santiago Gutierrez, Aaron S. Dumont, R. Shane TubbsAbstract:An adult male was found to have a variation of the left Basal Vein of Rosenthal after presenting with complaints of headache and balance issues. In this case, the Vein drained directly into the left superior petrosal sinus (SPS) instead of the great Vein of Galen. Anatomical variation of the Basal Vein is likely due to embryonic development of the deep cerebral venous system as primitive structures either differentiate regress or further with age. These changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case that shows the Basal Vein drains into the SPS. The normal and variant anatomy of this vessel are discussed.
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Drainage of the Basal Vein of Rosenthal into the confluence of sinuses.
Anatomy & cell biology, 2019Co-Authors: Stephen J. Bordes, Marios Loukas, Skyler Jenkins, Joe Iwanaga, Joel K. Curé, R. Shane TubbsAbstract:An adult female was found to have a variation of the left Basal Vein of Rosenthal after presenting with complaints of headache. The Vein, in this case, drained directly into the confluence of sinuses instead of the great Vein of Galen. Variation of the Basal Vein is likely due to the embryonic development of the deep cerebral venous system as primitive structures either differentiate further or regress with age. Such changes may result in the uncommon presentation seen in this case. To our knowledge, this is the first case reported of the Basal Vein draining into the confluence of sinuses.
Robert F. Spetzler - One of the best experts on this subject based on the ideXlab platform.
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the role of endoscopic assistance in ambient cistern surgery analysis of four surgical approaches
World Neurosurgery, 2015Co-Authors: Eberval Gadelha Figueiredo, Robert F. Spetzler, Albert L. Rhoton, Andre Beerfurlan, Peter Nakaji, Neil R Crawford, Leonardo C Welling, Eduardo Carvalhal Ribas, Manoel Jacobsen Teixeira, Mark C PreulAbstract:Objective We used microscopy with endoscopic assistance to conduct an objective analysis of 4 surgical approaches commonly used in the surgery of the ambient cistern: infratentorial supracerebellar (SC), occipital interhemispheric (OI), subtemporal (ST), and transchoroideal (TC). In addition, we performed a parahippocampalis gyrus resection in the ST context. Methods Each approach (SC, OI, ST, TC) was performed on 3 cadaveric heads (6 sides). After the microscopic anatomic dissection, the 30-degree endoscope was used to explore the exposure. The parahippocampalis gyrus was resected through an ST approach and the exposure was evaluated. The quantitative analysis was based on linear exposure of the vascular structures (linear exposure), such as the posterior choroidal artery (PChA), the P2 and P3 segments of the posterior cerebral artery (PCA) with their branches, the Basal Vein of Rosenthal, and the area of exposure of the ambient cistern region (area of exposure) limited by points on its superior, mesial, and anterior walls. In all cases, a P value of less than 0.05 was considered significant. Results There was a significant difference ( P Conclusions This study demonstrates that endoscope assistance improved exposure of the ambient cistern region when using the ST approach. Endoscopic assistance provided similar surgical exposure compared with ST associated with parahippocampalis resection.
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aberrant venous drainage pattern in a medial sphenoid wing dural arteriovenous fistula a case report and review of the literature
World Neurosurgery, 2013Co-Authors: Joshua W Osbun, Robert F. Spetzler, Cameron G McdougallAbstract:Background Sphenoid wing region dural arteriovenous fistulas (DAVFs) are rare lesions that are typically fed by middle meningeal artery feeders and that drain via the sphenoparietal sinus or middle cerebral Vein. We describe a unique case of a medial sphenoid wing fistula draining exclusively via the Basal Vein of Rosenthal. Methods A 55-year-old man presented with progressive right temporal homonymous hemianopsia. Cerebral angiography revealed a DAVF that rapidly filled into the deep venous system via the Basal Vein of Rosenthal with a large venous varix compressing the optic nerve. The sphenoid wing DAVF was not amenable to endovascular embolization due to direct ophthalmic artery feeders and was therefore treated with surgical obliteration. A right pterional craniotomy with orbitozygomatic osteotomy was performed. Results The fistula was clip ligated, and the venous varix was incised and drained. Intraoperative angiography demonstrated complete obliteration of the fistula. Conclusions Sphenoid wing DAVFs may drain via the deep venous system and have a complex arterial feeding network. Key features of the fistula, including deep venous drainage, presence of venous varices, and retrograde leptomeningeal venous drainage, make this an aggressive lesion with a high risk of rupture based on the available natural history data.
Cameron G Mcdougall - One of the best experts on this subject based on the ideXlab platform.
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aberrant venous drainage pattern in a medial sphenoid wing dural arteriovenous fistula a case report and review of the literature
World Neurosurgery, 2013Co-Authors: Joshua W Osbun, Robert F. Spetzler, Cameron G McdougallAbstract:Background Sphenoid wing region dural arteriovenous fistulas (DAVFs) are rare lesions that are typically fed by middle meningeal artery feeders and that drain via the sphenoparietal sinus or middle cerebral Vein. We describe a unique case of a medial sphenoid wing fistula draining exclusively via the Basal Vein of Rosenthal. Methods A 55-year-old man presented with progressive right temporal homonymous hemianopsia. Cerebral angiography revealed a DAVF that rapidly filled into the deep venous system via the Basal Vein of Rosenthal with a large venous varix compressing the optic nerve. The sphenoid wing DAVF was not amenable to endovascular embolization due to direct ophthalmic artery feeders and was therefore treated with surgical obliteration. A right pterional craniotomy with orbitozygomatic osteotomy was performed. Results The fistula was clip ligated, and the venous varix was incised and drained. Intraoperative angiography demonstrated complete obliteration of the fistula. Conclusions Sphenoid wing DAVFs may drain via the deep venous system and have a complex arterial feeding network. Key features of the fistula, including deep venous drainage, presence of venous varices, and retrograde leptomeningeal venous drainage, make this an aggressive lesion with a high risk of rupture based on the available natural history data.
Shobu Shibata - One of the best experts on this subject based on the ideXlab platform.
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Depicting Cerebral Veins by Three-Dimensional CT Angiography before Surgical Clipping of Aneurysms
2014Co-Authors: Makio Kaminogo, Yoshitaka Matsuo, Minoru Morikawa, Hideki Ishimaru, Tsutomu Yoshioka, Kentaro Hayashi, Naoki Kitagawa, Hideyuki Hayashi, Shobu ShibataAbstract:BACKGROUND AND PURPOSE: Cerebral Veins show wide variation, and unexpected Veins occasionally limit surgical procedures for clipping of cerebral aneurysms. This study was undertaken to assess the utility of three-dimensional CT angiography (3D-CTA) in the evalu-ation of venous anatomy before surgical clipping of cerebral aneurysms. METHODS: 3D-CTA was performed in 19 patients before pterional craniotomy. The venous anatomy visualized by use of 3D-CTA was compared retrospectively with intraoperative findings. RESULTS: 3D-CTA clearly depicted the superficial sylvian Veins (SSVs) in 17 of 19 cases. In three of these 17 cases, 3D-CTA failed to reveal the additional connecting Veins from SSVs to the midportion of the sphenoid wing. 3D-CTA also depicted bridging Veins from: 1) the Basal Vein of Rosenthal to the sphenoparietal sinus (SPS) (three cases); 2) a junction of the anterior cerebral Vein and the deep middle cerebral Vein to the SPS (two cases); 3) the anterior cerebral Vein into the cavernous sinus (one case); and 4) the deep middle cerebral Vein to the cavernous sinus in one case. Surgical findings corresponded well with the angiographic findings. 3D-CTA depicted bridging Veins from the frontal base into the SPS in two cases; retraction of the frontal lobe was severely limited in these cases. 3D-CTA also exhibited anatomic variation of dee
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depicting cerebral Veins by three dimensional ct angiography before surgical clipping of aneurysms
American Journal of Neuroradiology, 2002Co-Authors: Makio Kaminogo, Yoshitaka Matsuo, Minoru Morikawa, Hideki Ishimaru, Tsutomu Yoshioka, Kentaro Hayashi, Naoki Kitagawa, Hideyuki Hayashi, Shobu ShibataAbstract:BACKGROUND AND PURPOSE: Cerebral Veins show wide variation, and unexpected Veins occasionally limit surgical procedures for clipping of cerebral aneurysms. This study was undertaken to assess the utility of three-dimensional CT angiography (3D-CTA) in the evaluation of venous anatomy before surgical clipping of cerebral aneurysms. METHODS: 3D-CTA was performed in 19 patients before pterional craniotomy. The venous anatomy visualized by use of 3D-CTA was compared retrospectively with intraoperative findings. RESULTS: 3D-CTA clearly depicted the superficial sylvian Veins (SSVs) in 17 of 19 cases. In three of these 17 cases, 3D-CTA failed to reveal the additional connecting Veins from SSVs to the midportion of the sphenoid wing. 3D-CTA also depicted bridging Veins from: 1) the Basal Vein of Rosenthal to the sphenoparietal sinus (SPS) (three cases); 2) a junction of the anterior cerebral Vein and the deep middle cerebral Vein to the SPS (two cases); 3) the anterior cerebral Vein into the cavernous sinus (one case); and 4) the deep middle cerebral Vein to the cavernous sinus in one case. Surgical findings corresponded well with the angiographic findings. 3D-CTA depicted bridging Veins from the frontal base into the SPS in two cases; retraction of the frontal lobe was severely limited in these cases. 3D-CTA also exhibited anatomic variation of deep cerebral Veins, which suggests the utility of 3D-CTA in evaluating the risks carried by sacrifice of some bridging Veins. In two patients, aneurysmal dissection was restricted because of adhering Veins. 3D-CTA depicted these cerebral Veins to be lying in contact with the aneurysm. In one case, the contiguous Vein was hidden behind a large middle cerebral artery aneurysm; 3D-CTA was helpful for visualization of this Vein. CONCLUSION: 3D-CTA can clearly depict the venous anatomy of the brain and is useful for surgical planning of a pterional or temporopolar approach for cerebral aneurysms.
