In the following patient, a giant shenoid wing meningioma resulted in occlusion of both supraclinoid ICAs, similar to a Moya-Moya pattern. Therefore, the primary method of reconstitution is via leptomeningeal PCA-MCA (purple arrows) and PCA-ACA (light blue arrows) collaterals, the posterior to anterior pericalossal (yellow) anastomosis, and left more than right middle meningeal artery auto-synangioses with the MCA territory on the left (motor strip, purple oval) and right MMA to left ACA territory as well (white arrows). Notice meningioma tumor blush (orange oval)
Patients with mitral stenosis do not tolerate significant increases in heart rate, or tachycardia. On the other hand, tachycardia is common during cesarean section performed under general anesthesia, either during the induction or surgical stress. To avoid sharp changes in heart rate cesarean section is best performed under epidural anesthesia. The onset of epidural block is relatively slow, between ten and twenty minutes, and vasodilatation can be counteracted by administering vasoconstrictors, drugs that increase vascular tone. Analgesia achieved by epidural block is superior to that of general anesthesia, and as the result hemodynamic parameters remain stable during surgery, and the chance of adverse effects of anesthesia is reduced.
It is characterized by the presence of an oculomotor nerve (CN III) palsy and cerebellar ataxia including tremor and involuntary choreoathetotic movements. Neuroanatomical structures affected include CNIII nucleus, Red nucleus , corticospinal tracts , brachium conjunctivum , and the superior cerebellar peduncle decussation. It has a very similar cause, morphology and signs and symptoms to Weber's syndrome ; the main difference between the two being that Weber's is more associated with hemiplegia (. paralysis), and Benedikt's with hemiataxia (. disturbed coordination of movements). It is also similar to Claude's syndrome , but is distinguishable in that Benedikt's has more predominant tremor and choreoathetotic movements while Claude's is more marked by the ataxia.