Fig. 1 T 1 -weighted magnetic resonance imageswith gadolinium (A: axial section, B: sagittal section) demonstrating a subfrontal tumor with homogeneous enhancement in the left anterior cranial fossa.
191Neurol Med Chir (Tokyo) 44, 191¿194, 2004 Olfactory Groove Schwannoma
AbstractA 30-year-old man presented with a 2-year history of intermittent headache. No neurological deficit was detected. Computed tomography (CT) and magnetic resonance imaging showed a tumor with a diameter of 2.5 cm in the left anterior skull base associated with bone scalloping on three-dimensional CT. Angiography showed a hypovascular tumor. Craniotomy demonstrated a tumor in the region of the left olfactory groove attached to the anterior part of the cribriform plate. The histological diagnosis was schwannoma. Schwannoma arising from near the olfactory groove is rare, with only 13 other cases reported. The precise origin of these tumors is not well understood, but the tumor in this case probably arose from the fila olfactoria, because the olfactory bulb was involved in the tumor, whereas the olfactory tract remained intact.
The successful obliteration of torcular dural arteriovenous fistula (DAVF) with a diffuse shunt in the affected sinus may require complex treatment strategies. Therapeutic goals include the preservation of normal venous drainage and complete obliteration of shunt flow. The authors report the case of a torcular DAVF. The treatment of this type of AVF may require a combined approach with transarterial and transvenous embolization, open surgery, or radiosurgery and is associated with many problems. Stent placement and angioplasty in the affected sinus result in compression of the fistulous dural wall of the sinus and decrease shunt flow. In cases in which there is a diffuse shunt in the affected sinus and no evident shunt point, such as in AVFs involving venous pouches and parasinuses, sealing the fistula orifice with self-expandable stents and angioplasty (balloon inflation) is considered the best treatment option to preserve normal cerebral venous sinus drainage and obliterate shunt flow. In such cases, the authors recommend using one or more self-expandable and closed-cell stents and using angioplasty to avoid endoleakage into the gap between the stent graft and the vessel wall.
The findings of carotid ultrasonography and BB-MRI are closely associated with the CEA specimen's morphology. Ultrasonography alone is insufficient to diagnose the plaque type accurately in some patients. Employing both carotid US and BB-MRI is useful for evaluating the characteristics of carotid plaque.
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