Medial Sphenoid Ridge Meningiomas: Classification, Microsurgical Anatomy, Operative Nuances, and Long-Term Surgical Outcome in 35 Consecutive Patients

Abstract Objective: On the basis of contemporary multiplanar imaging, microsurgical observations, and long-term follow-up in 60 consecutive patients with sphenoid ridge meningiomas, we propose a modification to Cushing's classification of these tumors. This article will concentrate on patients from this series with global medial sphenoid ridge tumors. Methods: Data were collected prospectively for 35 patients with global meningiomas arising from the medial portion of the sphenoid ridge that were surgically treated between 1982 and 2002. Results: All patients were followed for the entire length of this study (mean, 12.8 yr). The tumor size ranged from 2 to 8 cm (mean, 4.5 cm). Of the 24 patients with purely intradural tumors, four (17%) had Simpson Grade I and 19 had Simpson Grade II resections; 23 (96%) had gross total resections. Of the 11 patients with tumors extending extradurally (i.e., cavernous sinus), one (9%) patient had a Simpson Grade II resection, whereas nine (82%) had Simpson Grade III resections, with the latter being all visible tumor removed except that in the cavernous sinus. One (9%) of these 11 patients had a gross total resection, and 9 (82%) had radical resections, with the latter defined as total removal of all intradural tumor. The overall morbidity rate was 18%. There was no surgical mortality or symptomatic cerebral infarction. Conclusion: An accurate classification of global medial sphenoid meningiomas is mandatory to gain insight into their clinical behavior and for understanding the long-term efficacy and safety of available treatment options. Primary medial sphenoid ridge tumors consistently involve the unilateral arteries of the anterior cerebral circulation, and therefore, the resection of tumor from around these arteries is the most important operative nuance for their safe excision.

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Cuboid nutcracker fracture in a 9-year-old child

BMJ Case Reports ◽

10.1136/bcr-2020-240441 ◽

2021 ◽

Vol 14 (2) ◽

pp. e240441

Author(s):

Tannous Jorge Sassine ◽

Bernardo Barcellos Terra ◽

Vincenzo Giordano ◽

Benno Ejnisman

Keyword(s):

Direct Reduction ◽

Treatment Options ◽

Compression Fracture ◽

Medium Term ◽

Lateral Column ◽

Cuboid Bone ◽

Long Term Follow Up ◽

Type Of Fracture

A 9-year-old girl presented to the emergency department reporting intense pain and inability to bear weight on her left foot after a classmate tripped over it. Imaging studies confirmed a fracture of the cuboid bone due to compression of the lateral column of the foot (also known as nutcracker fracture). The patient was treated surgically, with direct reduction of the compression fracture and definitive fixation with two Kirschner wires. Cuboid nutcracker fracture is rare in children and adolescents, and potential consequences can occur if it is not correctly diagnosed and adequately managed. Literature on this type of fracture is scarce, along with information on treatment options and results over medium-term and long-term follow-up. We describe this case and review the literature on this particular topic.

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Angiolymphoid Hyperplasia with Eosinophilia (Histiocytoid Hemangioma): Evaluation of Treatment Options

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949310200410 ◽

1993 ◽

Vol 102 (4) ◽

pp. 303-308 ◽

Cited By ~ 24

Author(s):

Mack L. Cheney ◽

Samir Bhatt ◽

Paul Googe ◽

Patricia L. Hibberd

Keyword(s):

Treatment Options ◽

Clinical Problem ◽

Radical Excision ◽

Angiolymphoid Hyperplasia With Eosinophilia ◽

Angiolymphoid Hyperplasia ◽

Immunodeficiency Virus ◽

Long Term Follow Up ◽

Proliferative Lesion

Angiolymphoid hyperplasia with eosinophilia is an uncommon benign vascular proliferative lesion of unknown cause. In this report, a case is presented of a patient who was confirmed to be positive for human immunodeficiency virus and in whom the lesion had shown rapid accelerated growth. The case is used to illustrate a variety of therapeutic techniques and to evaluate the effectiveness of the various alternatives in the treatment of this unusual clinical problem. Long-term follow-up after radical excision of the tumor mass is presented.

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RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v7.i12.2019.311 ◽

2020 ◽

Vol 7 (12) ◽

pp. 189-198

Author(s):

Zeynep Başağaoğlu Demirekin ◽

Yavuz Findik ◽

S. Süha Turkaslan ◽

Timuçin Baykul ◽

Merve Erken

Keyword(s):

Treatment Options ◽

Clinical Results ◽

Long Term Results ◽

Retrospective Evaluation ◽

Early Results ◽

Single Crown ◽

Long Term Follow Up ◽

Implant Therapy

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

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Readmission after discharge from a medium secure unit

The Psychiatrist ◽

10.1192/pb.bp.112.039289 ◽

2013 ◽

Vol 37 (4) ◽

pp. 124-129 ◽

Cited By ~ 5

Author(s):

Martin Clarke ◽

Conor Duggan ◽

Clive R. Hollin ◽

Nick Huband ◽

Lucy McCarthy ◽

...

Keyword(s):

Mental Health ◽

Psychiatric Hospital ◽

Psychiatric Hospitals ◽

Patient Treatment ◽

Multiple Sources ◽

Long Term Follow Up ◽

Secure Unit

Aims and methodWe examined readmission to psychiatric hospital of 550 patients discharged from one medium secure unit over 20 years. Multiple sources were used to obtain readmission data.ResultsReadmission was common, particularly to non-secure psychiatric hospitals. At least 339 patients (61.6%) were readmitted to any psychiatric hospital (mean follow-up 9.5 years), with over a third (37.6%) subsequently being readmitted to medium- or high-security or both. Of those discharged directly to the community, having previous in-patient treatment and a Mental Health Act classification of mental illness were associated with shorter time to first readmission.Clinical implicationsThe long-standing nature of disorders is evident in the high rates of readmission overall and the need for readmission to medium and high secure services, suggesting that these patients require long-term follow-up and support from mental health services.

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Paraphimosis revisited: is chronic paraphimosis a predominantly third world condition?

Tropical Doctor ◽

10.1258/td.2007.006212 ◽

2008 ◽

Vol 38 (1) ◽

pp. 40-42 ◽

Cited By ~ 4

Author(s):

M Rangarajan ◽

S M Jayakar

Keyword(s):

Chronic Condition ◽

Third World ◽

New Classification ◽

The Third ◽

Long Term Follow Up ◽

Initial Injury ◽

Acute Condition

Paraphimosis is an acute condition characterized by all the signs of inflammation. Here we describe a ‘chronic’ variant of paraphimosis where patients often present many days after the initial injury. The aim of this study is to identify and possibly classify this new variation of paraphimosis – the chronic condition. We studied 68 patients with this condition between 1997 and 2005. In all, the prepuce was fibrous and bunched up behind the glans penis and, in some cases, with ulcerations. All patients were treated by excision of the fibrous flap and circumcision, under local anaesthesia. Patients were discharged on the same dayon which the excision was done. Follow-up was on the third, seventh and ninetieth days. Long-term follow-up was possible in only 22 patients. This technique of modified circumcision was effective in treating this condition and we think a new classification of paraphimosis is warranted – acute and chronic.

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Therapeutic strategy for pineal parenchymal tumor of intermediate differentiation (PPTID): case report of PPTID with malignant transformation to pineocytoma with leptomeningeal dissemination 6 years after surgery

Journal of Neurosurgery ◽

10.3171/2018.2.jns171876 ◽

2019 ◽

Vol 130 (6) ◽

pp. 2009-2015 ◽

Cited By ~ 1

Author(s):

Toshiaki Bando ◽

Yasushi Ueno ◽

Narihide Shinoda ◽

Yukihiro Imai ◽

Kazuhito Ichikawa ◽

...

Keyword(s):

Tumor Resection ◽

Gamma Knife Radiosurgery ◽

Craniospinal Irradiation ◽

Histopathological Study ◽

Leptomeningeal Dissemination ◽

Who Grade ◽

Lower Extremity Weakness ◽

Long Term Follow Up ◽

Grade Ii

Pineal parenchymal tumor of intermediate differentiation (PPTID) is rare. The WHO first classified PPTID in 2000 as a pineal parenchymal tumor (PPT) with an intermediate prognosis between pineocytoma (PC) and pineoblastoma (PB). It is considered an intermediate-grade tumor and divided into WHO grade II or III.The number of available reports about PPTID is presently limited, and the appropriate management for this tumor has not yet been determined.The authors report a rare case of PC in a 63-year-old woman who presented with lower-extremity weakness and gait disturbance. A pineal mass lesion was detected on MRI. A diagnosis of PC was established after microsurgical gross-total tumor resection, and the patient received no adjuvant therapy after surgery. Two years after surgery, a partial recurrence was recognized and Gamma Knife radiosurgery was performed. Fours years later, the patient developed diffuse leptomeningeal dissemination. She was successfully treated with craniospinal irradiation. Leptomeningeal dissemination may develop 6 years after the initial diagnosis of PC. A histopathological study of the recurrent tumor revealed a malignant change from PC to PPTID.The present case shows the importance of long-term follow-up of patients with PPTs following resection and the efficacy of craniospinal irradiation in the treatment of leptomeningeal dissemination.

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Management and outcome of acute and recurrent pericarditis during pregnancy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2157 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Lotan ◽

Y Wasserstrum ◽

E Itelman ◽

M Nir-Simchen ◽

M Arad ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Q Fever ◽

Treatment Options ◽

Subsequent Treatment ◽

High Recurrence Rate ◽

Recurrent Pericarditis ◽

Long Term Follow Up

Abstract Background Pericarditis in pregnancy is uncommon. Treatment options, including NSAIDs and long term gluco-corticosteroids (CS) have extensive side-effects, while data on the use of Colchicine in pregnant women who suffer from pericarditis is limited. Objective To evaluate the management and outcome of active pericarditis during pregnancy in both acute (AP) and recurrent pericarditis (RP) patients. Methods and results Twelve pregnant women (14 pregnancies) with active pericarditis were followed prospectively in our cardiology-pregnancy clinic; 6 with AP and 8 with RP. Etiology: 11 idiopathic, 2 post-pericardiotomy syndrome and 1 Q fever. Maternal age on presentation was 27±4y vs. 33±3y in RP vs AP respectively. Average gestational age upon diagnosis was lower in RP than in AP (18 weeks, range 6–30 vs 26 weeks, range 5–35). In the RP group, 7/8 women (87%) were treated with CS compared with 2/6 women (33%) in the AP group; 3 women in RP group (37%) failed to respond to subsequent treatment with azathioprine and 1 patient was treated successfully with Anakinra. Colchicine was prescribed in 13/14 (93%) of pregnancies, average colchicine exposure during pregnancy was 25±15 weeks. Recurrence during pregnancy: 6/8 (75%) of RP; 2/6 (33%) of the AP, all of them on CS. All pregnancies culminated in a live birth with a mean gestational age on delivery of 37±1.4 weeks. Average birthweight was 3267±507 grams. There were no fetal anomalies or developmental delays after a mean follow-up of 2.7 years. All newborns and maternal outcomes were normal. On long term follow-up after delivery RP patients treated with colchicine developed less recurrences. Conclusion Active pericarditis is associated with a high recurrence rate during pregnancy despite treatment with CS. Colchicine use in pregnant women with active pericarditis appears to be safe. Funding Acknowledgement Type of funding source: None

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Endovascular treatment of intractable epistaxis - results of a 4-year local audit

South African Journal of Radiology ◽

10.4102/sajr.v8i3.118 ◽

2004 ◽

Vol 8 (3) ◽

pp. 9 ◽

Cited By ~ 2

Author(s):

Ian C Duncan ◽

P.A. Fourie ◽

C.E. Le Grange ◽

H.A. Van der Walt

Keyword(s):

Success Rate ◽

Morbidity Rate ◽

Hereditary Haemorrhagic Telangiectasia ◽

Artery Ligation ◽

Endovascular Embolisation ◽

Long Term Follow Up ◽

Initial Procedure ◽

Intractable Epistaxis

A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients over a 4-year period at the Unitas Interventional Unit near Pretoria. Long-term follow-up was possible in 36 patients. Three cases were due to trauma and 2 directly related to previous facial surgery, 1 patient had hereditary haemorrhagic telangiectasia (HHT), and the remaining 45 cases (88.2%) were classed as idiopathic. Eight patients (15.7%) had a rebleed between 1 and 33 days after the initial embolisation. Four were re-embolised once, 1 was re-embolised twice (the HHT patient), and 2 underwent additional ethmoid artery ligation (with no further bleeding). This gives a primary short-term success rate (in all 51 cases) of 86.3% and a secondary assisted success rate of 94.1% for embolisation alone. Long-term follow- up was obtained in 36 patients, with 35 (97.2%) reporting no further bleeding after the initial procedure(s). Only the patient with HHT developed multiple recurrent bleeds. The mortality rate was 0%, the major morbidity rate 2% (1 stroke), and the minor morbidity rate 25% (N = 36), which included transient facial pain, headaches and femoral problems related to access. Our results compare favourably with other published series. In conclusion, endovascular embolisation for intractable epistaxis is available locally as an alternative technique for the treatment

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