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MRI and contrast-enhanced magnetic resonance images (CE-MRI) in the initial surgery. (1) and (2): displaying a highly enhanced intracranial lesion. White arrow: intracranial lesion; (3)
Source publication
Staged surgery strategy was preferred for patients with intra-extracranial communicating jugular foramen paraganglioma (IECJFP). A female patient who presented mild tinnitus, headache, and dizziness, together with preoperative related imaging, was diagnosed with a left intra-extracranial communicating jugular foramen lesion in November 2015 and acc...
Contexts in source publication
Context 1
... intracranial lesion was totally removed through the left retrosigmoid approach, then preoperative presentations were relieved without new postoperative complications. Postoperative CE-MRI showed total resection of the intracranial tumor (Figures 1(3), (4)), while the extracranial lesion (Figures 1(5),(6)) employed the "wait and scan" strategy. The pathologic result was paraganglioma [2] (Figure 2(1)) without malignancy, in which chromogranin A (CgA), S100, and Synaptophysin (Syn) were positive immunohistochemically (Figures 2(2), (4)). ...
Context 2
... intracranial lesion was totally removed through the left retrosigmoid approach, then preoperative presentations were relieved without new postoperative complications. Postoperative CE-MRI showed total resection of the intracranial tumor (Figures 1(3), (4)), while the extracranial lesion (Figures 1(5),(6)) employed the "wait and scan" strategy. The pathologic result was paraganglioma [2] (Figure 2(1)) without malignancy, in which chromogranin A (CgA), S100, and Synaptophysin (Syn) were positive immunohistochemically (Figures 2(2), (4)). ...
Context 3
... October 2021, the patient found that the extracranial lesion had enlarged, accompanied by left hearing loss, hoarseness, dysfunctional deglutition, protruding tongue towards left with ipsilateral atrophy, left shoulder muscles paroxysmal contraction, and resistant hypertension. Magnetic resonance images and CE-MRI showed that the extracranial lesion with vascular flow void (Figure 3(1)) in the left jugular foramen became enlarged and highly enhanced (Figures 3(2), (3)). Computed tomography angiography presented that feeding vessels of the extracranial lesion arose from branches of the external carotid artery ( Figures 3(4), (5)), and drainage veins returned to the external jugular vein (Figure 3(6)). ...
Context 4
... blood pressure remained normal without antihypertensive drugs, and critical preoperative lower cranial nerves (LCNs) deficits (dysphagia, dysphonia, abnormal tongue movement, and stimulated shoulder muscles contraction) were relieved. The postoperative CE-MRI displayed that most of the extracranial tumor had been resected, but less residual lesion was detected in the jugular foramen ( Figures 4(1), (3)). Aside from traditional pathologic presentation of PGs in the second surgery, the supplementary SDHB and GATA3 were characteristically positive. ...
Citations
... The retrosigmoid approach (RSA) is one of the most common neurosurgical approaches to the posterolateral skull base [1][2][3]. It provides exposure of the cerebellopontine angle region (CPA) and its surroundings, from Meckel's cave to the jugular foramen [4][5][6]. Postoperative cerebral venous sinus thrombosis (CVST) is a rare but known complication following RSA [7]. ...
Postoperative cerebral venous sinus thrombosis (CVST) is a rare complication of the retrosigmoid approach. To address the lack of literature, we performed a retrospective analysis. The thromboses were divided into those demonstrating radiological (rCVST) and clinical (cCVST) features, the latter diagnosed during hospitalization. We identified the former by a lack of contrast in the sigmoid (SS) or transverse sinuses (TS), and evaluated the closest distance from the craniotomy to quantify sinus exposure. We included 130 patients (males: 52, females: 78) with a median age of 46.0. They had rCVST in 46.9% of cases, most often in the TS (65.6%), and cCVST in 3.1% of cases. Distances to the sinuses were not different regarding the presence of cCVST (p = 0.32 and p = 0.72). The distance to the SS was not different regarding rCVST (p = 0.13). However, lower exposure of the TS correlated with a lower incidence of rCVST (p = 0.009). When surgery was performed on the side of the dominant sinuses, rCVSTs were more frequent (p = 0.042). None of the other examined factors were related to rCVST or cCVST. Surgery on the side of the dominant sinus, and the exposing of them, seems to be related with rCVST. Further prospective studies are needed to identify the risk factors and determine the best management.
