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    Iatrogenic Cerebrospinal Fluid Oculorrhea
    (LIPPINCOTT WILLIAMS & WILKINS, 2014) Chi, Mijung; Kim, H. Jane; Koktekir, Bengu E.; Vagefi, Reza; Kersten, Robert C.
    Cerebrospinal fluid leakage into the orbit (CSF orbitorrhea) or through the orbit to the exterior (CSF oculorrhea) occurs when there is a communication between orbit and subarachnoid space. It has rarely been described. We report a case of CSF oculorrhea following surgery for recurrent sphenoid wing meningioma. A 67-year-old patient who underwent craniotomy for a recurrent sphenoid wing meningioma complained of tearing from the ipsilateral eye. Fluid collection was observed in the right periorbital area contiguous with craniotomy wound. With wide retraction of eyelids, a 1-cm longitudinal full-thickness laceration through the conjunctiva toward the lateral orbital rim was visualized in the area of the lateral canthal tendon. Steady leakage of pink-tinged serous fluid through the forniceal laceration was observed. With a presumed diagnosis of iatrogenic CSF oculorrhea, the patient was treated conservatively with resolution by postoperative day 6.
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    Masson Tumor in the Eyelid
    (LIPPINCOTT WILLIAMS & WILKINS, 2014) Koktekir, Bengu Ekinci; Basham, Ryan; Vagefi, Reza; Kersten, Robert C.
    Intravascular papillary endothelial hyperplasia (Masson tumor) is an uncommon vascular lesion that rarely affects the periorbital region. Differential diagnosis from some malignant periorbital tumors is challenging and depends mostly on histopathologic confirmation. We present a case with elevated, multilobular lower eyelid lesion that turned out to be intravascular papillary endothelial hyperplasia.
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    Orbital Schwannomatosis in the Absence of Neurofibromatosis
    (LIPPINCOTT WILLIAMS & WILKINS, 2014) Koktekir, Bengu Ekinci; Kim, H. Jane; Geske, Mike; Bloomer, Michelle; Vagefi, Reza; Kersten, Robert C.
    Purpose: The aim of this study was to describe 3 cases of primary orbital schwannomatosis without associated systemic neurofibromatosis. Methods: This is a retrospective interventional study of 3 patients who presented with multiple, distinct masses in the orbit (n = 3) as well as in the hemiface (n = 1). The clinical presentation, imaging features, surgical procedures, and outcomes were defined. Results: Two women and a man presented with of exophthalmos and diplopia. Pain was the most prominent complaint in 2 patients. None of the patients had associated systemic neurofibromatosis by history or examination. Radiologic evaluation with computed tomography or magnetic resonance imaging of orbit revealed multiple well-demarcated intraconal and extraconal masses. Masses were excised, and histopathology confirmed all masses to be schwannomas. Postoperative follow-up was uneventful with alleviation of primary complaints in all patients. Conclusions: Multiple orbital schwannomas (primary orbital schwannomatosis) may be observed in patients without systemic association of neurofibromatosis. Management includes surgical excision of the tumors to achieve relief from their mass effects.