Intraorbital arteriovenous malformations (AVMs) are extremely rare, and their actual prevalence is unknown. There is no consensus regarding the best treatment options, and the treatment is usually challenging, involving endovascular and other surgical procedures. Herein, we report the case of a patient diagnosed with an intraorbital AVM, presenting with thrombosis and hemorrhage, with rapidly progressive proptosis, chemosis, ophthalmoparesis, and vision loss. Treatment was performed with a transorbital puncture targeting a venous aneurysm of the superior ophthalmic vein, and closure of the AVM was possible with the use of coils and Onyx. We obtained anatomical occlusion of the lesion, and the patient showed progressive improvement of chemosis, vision acuity, and ophthalmoparesis. At six-month’ follow-up, only mild proptosis was noted, and a control digital subtraction angiography confirmed complete closure of the AVM, with no residual lesion. To date, this is the first case of an intraorbital AVM treated with transorbital direct puncture.
Symptomatic cavernous malformations in the ventral region of the pons are difficult to access surgically. The authors present a case of a 46-year-old woman with a 10-year history of sudden and transitory diplopia and right hemiparesis, followed by five more episodes of mild right hemiparesis. Brain MRI showed a 2.6-cm cavernous malformation in the pons with an exophytic portion in the prepontine cistern. The patient underwent an endoscopic endonasal transclival approach for a complete resection of the lesion. CSF leak was noted and corrected on the sixth postoperative day. The patient progressed with complete motor deficit recovery.The video can be found here: https://youtu.be/ePgpyij2Wpo.
Embora o acometimento do nervo fibular seja uma das neuropatias mais comuns nos membros inferiores, a lesão bilateral ainda é pouco citada na literatura. Apresentamos uma mulher jovem com doença de nervo fibular comum pouco tempo após a descompressão cirúrgica bem sucedida no membro contralateral. O principal achado é o déficit motor, com a típica marcha escarvante. A eletroneuromiografia continua sendo a propedêutica ideal, considerando atualmente novas modalidades em estudo. Mesmo que em diferentes apresentações, até o momento, a descompressão cirúrgica do nervo fibular parece ser a modalidade terapêutica de melhor resultado.
Introdução: A radiculopatia, causada pelo Loop da artéria vertebral, é uma entidade rara, tendo como uma das opções de tratamento a descompressão cirúrgica do forame vertebral. Objetivo: Revisar literatura e demonstrar técnica cirúrgica empregada em uma paciente de 50 anos, a qual não obteve melhora com tratamento conservador. Conclusão: Um método indicado, quando o paciente não apresenta melhora com o método conservador, é a descompressão cirúrgica.
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