scholarly journals Pilocytic astrocytoma mimicking craniopharyngioma: a case series

2012 ◽  
Vol 94 (3) ◽  
pp. e125-e128 ◽  
Author(s):  
JRA Skipworth ◽  
CS Hill ◽  
T Jones ◽  
J Foster ◽  
I Chopra ◽  
...  
Keyword(s):  
Pilocytic Astrocytoma ◽  
Brain Tumours ◽  
Case Series ◽  
Operative Management ◽  
Diagnostic Pitfall ◽  
Case Basis

Although they are one of the most common brain tumours in childhood, piiocytic astrocytomas are rare in adulthood. We report a series of three piiocytic astrocytomas presenting as an intra/suprasellar mass in the fourth to sixth decades of life. All three radiologically mimicked the appearance of a craniopharyngioma, thus representing a potential radiological and diagnostic pitfall. In this series all three patients underwent successful operative management and have remained well throughout follow-up. The majority of information concerning piiocytic astrocytomas is derived from paediatric populations and so only limited and often conflicting data exist for piiocytic astrocytomas developing in adulthood. Decisions regarding treatment of piiocytic astrocytomas in adults must be made on a multidisciplinary, case-by-case basis.

Operative Outcomes of Grade 3 Turf Toe Injuries in Competitive Football Players

2018 ◽  
Vol 39 (9) ◽  
pp. 1076-1081 ◽  
Author(s):  
Kenneth Smith ◽  
Norman Waldrop
Keyword(s):  
Range Of Motion ◽  
Operative Procedure ◽  
Case Series ◽  
Operative Management ◽  
Return To Play ◽  
First Metatarsophalangeal Joint ◽  
Operative Outcomes ◽  
Turf Toe ◽  
Grade 3

Background: Turf toe is a term used to describe a hyperextension injury to the first metatarsophalangeal joint. Although the vast majority of turf toe injuries can be treated successfully without operative intervention, there are instances where surgery is required to allow the athlete to return to play. Although there is a plethora of literature on turf toe injuries and nonoperative management, there are currently few reports on operative outcomes in athletes. Methods: We obtained all cases of turf toe repair according to the ICD-10 procedural code. The inclusion criteria included: age greater than 16, turf toe injury requiring operative management and at least a varsity level high school football player. The charts were reviewed for age, BMI, level of competition, injury mechanism, football position, setting of injury and playing surface. In addition, we recorded the specifics of the operative procedure, a listing of all injured structures, the implants used and the great toe range of motion at final follow-up visit. The AOFAS Hallux score and VAS was used postoperatively as our outcome measures. Our patient population included 15 patients. The average follow-up time was 27.5 months. Results: The average patient was 19.3 years old with a body mass index of 32.3. The average playing time missed was 16.5 weeks. The average dorsiflexion range of motion at the final follow-up was 42.3 degrees. At final follow-up, the average AOFAS Hallux score was 91.3. The average VAS pain score was 0.7 at rest and 0.8 with physical activity. Conclusion: Complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. This study represents the largest cohort of operatively treated grade 3 turf toe injuries in the literature and demonstrates that good clinical outcomes were achieved with operative repair. Level of Evidence: Level IV, case series

Long-Term Follow-up of Arthroscopic Treatment of Lateral Epicondylitis

2008 ◽  
Vol 36 (2) ◽  
pp. 254-260 ◽  
Author(s):  
Champ L. Baker ◽  
Champ L. Baker
Keyword(s):  
Case Series ◽  
Lateral Epicondylitis ◽  
Operative Management ◽  
High Rate ◽  
Functional Score ◽  
Level Of Evidence ◽  
Long Term Follow Up ◽  
The Mean

Background In a previously published report of the authors’ arthroscopic technique of operative management of recalcitrant lateral epicondylitis, they demonstrated short-term success with the procedure in their patients. Hypothesis Arthroscopic management of patients with lateral epicondylitis can produce clinical improvement and have successful long-term outcomes. Study Design Case series; Level of evidence, 4. Methods Forty patients (42 elbows) with lateral epicondylitis who had not responded to nonoperative management were treated with arthroscopic resection of pathologic tissue. Thirty of these patients (30 elbows) were located for extended follow-up. At a mean follow-up of 130 months (range, 106–173 months), patients were asked to use a numeric scale to rate their elbow pain from 0 (no pain) to 10 (severe pain). Patients were also asked to rate their elbows according to the functional portion of the Mayo Clinic Elbow Performance Index. Results The mean pain score at rest was 0; with activities of daily living, 1.0; and with work or sports, 1.9. The mean functional score was 11.7 out of a possible 12 points. No patient required further surgery or repeat injections after surgery. One patient continued to wear a counterforce brace with heavy activities. Twenty-three patients (77%) stated they were “much better,” 6 patients (20%) stated they were “better,” and 1 patient (3%) stated he was the same. Twenty-six patients (87%) were satisfied, and 28 patients (93%) stated they would have the surgery again if needed. Conclusion Arthroscopic removal of pathologic tendinosis tissue is a reliable treatment for recalcitrant lateral epicondylitis. The early high rate of success in patients was maintained at long-term follow-up.

scholarly journals Operative And Non-operative Management Of Osteochondritis Dissecans In The Knee Of Skeletally Immature Patients: Rates Of Persistent Knee Pain, Osteoarthritis, And Arthroplasty At Mean 14- Years Follow-up

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0012
Author(s):  
Mario Hevesi ◽  
Thomas L. Sanders ◽  
Ayoosh Pareek ◽  
Todd Milbrandt ◽  
Bruce A. Levy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Pain ◽  
Case Series ◽  
Female Gender ◽  
Operative Management ◽  
Skeletally Immature ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Operative Notes

Objectives: The purpose of this study was to report long-term follow-up of skeletally immature OCD lesions treated operatively and non-operatively and determine risk factors for persistent knee pain at final follow-up. Methods: A large, geographic database of over 500,000 patients was reviewed in this case series to identify and confirm patients with OCD of the knee. Presenting radiographs and MRI were reviewed. Clinical course including operative management, persistent knee pain, and conversion to TKA were obtained and analyzed through review of clinical and operative notes. Results: 95 skeletally immature patients (70 males, 25 females) with OCD lesions diagnosed at a mean age of 13 years (range: 7-16) were followed for a mean of 14 years (range: 2-40). 53 patients (56%) were treated operatively and 42 patients (44%) were treated non-operatively. At final follow up, 13 patients with a mean age of 30 years noted persistent knee pain, 8 (15%) treated operatively versus 5 (12%) treated non-operatively. Risk factors for knee pain were female gender, patellar lesion location, and unstable lesions (Table 1). Four patients (8%) treated operatively and two (5%) treated non-operatively developed symptomatic osteoarthritis at a mean of 28.6 years following diagnosis. One patient treated operatively and two treated non-operatively converted to TKA at a mean of 37 years following diagnosis. Mean age at TKA was 52 years, significantly younger than that observed for primary TKA at our institution (p = 0.004). Conclusion: Patients with skeletally immature OCD lesions have an estimated 14% rate of persistent knee pain, 6% risk of symptomatic osteoarthritis, and 3% risk of conversion to TKA at a mean of 14 years following time of diagnosis. Female patients, patellar lesions, and unstable lesions demonstrated increased risk of persistent knee pain at final follow-up. Patients with OCD of the knee convert to TKA at a significantly younger age than that of the general primary TKA population. [Table: see text]

Transosseous Repair of Patellar Sleeve Fractures: A Case Series and Surgical Technique Guide

2021 ◽  
Author(s):  
Crystal A. Perkins ◽  
Anthony C. Egger ◽  
S. Clifton Willimon
Keyword(s):  
Surgical Technique ◽  
Chart Review ◽  
Surgical Repair ◽  
Case Series ◽  
Operative Management ◽  
Suture Repair ◽  
Sleeve Fracture ◽  
Transosseous Repair ◽  
Extensor Lag

AbstractThe purpose of this study is to describe the surgical technique and outcomes of transosseous repair of patellar sleeve fractures in a pediatric cohort. A retrospective review was performed on patients younger than 16 years undergoing transosseous repair of distal patellar sleeve fractures. A chart review was performed on demographics, surgical repair technique, and postoperative care. Primary outcomes included intact extensor mechanism function and range of motion (ROM) at final follow-up. In this study, 20 patients, 17 males and 3 females, with a mean age of 11.7 years were included. ROM was initiated at a median of 27.5 days following surgery. All patients had a healed patellar sleeve fracture and intact extensor function at final follow-up. Final mean knee ROM among the 18 patients with minimum 3-month follow-up was 132 degrees. Thirteen patients (72%) achieved full ROM (≥ 130 degrees) and 5 patients (28%) achieved less than 130 degrees knee flexion. Duration of initial immobilization was found to be the only variable strongly associated with final postoperative ROM. Mean duration of immobilization for patients achieving ≥ 130 degrees was 24 days versus 44 days in those patients achieving < 130 degrees, p = 0.009. All patients who began knee ROM within 21 days of surgery obtained full knee ROM. No patients experienced construct failure or extensor lag. Operative management of displaced patellar sleeve fractures with anatomic transosseous suture repair of the sleeve fracture, brief immobilization no more than 21 days, and initiation range of early ROM results in excellent outcomes.

scholarly journals Subconjunctival Bevacizumab Injection in Glaucoma Filtering Surgery: A Case Control Series

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jing Wang ◽  
Paul Harasymowycz
Keyword(s):  
Case Series ◽  
Glaucoma Surgery ◽  
Operative Management ◽  
Control Group ◽  
Filtering Surgery ◽  
Control Series ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Control Group Group

Aims. To describe the use of subconjunctival bevacizumab (SCB) injection in the combined cataract and glaucoma filtering surgery (GFS). Methods. Retrospective comparative case series. Thirty eyes of twenty-eight patients who had GFS followed by SCB injection as part of post-operative management were included (Group SCB). The types of GFS included trabeculectomy and non-penetrating glaucoma surgery (NPGS) with mitomycin-C. Outcome measures included the reduction of intraocular pressure (IOP) and medications. Age-matched patients who had the same types of surgery without SCB were selected as a control group (Group C). Results. The types of GFS were: combined cataract surgery and NPGS (SCB: 20; C: 24), phacotrabeculectomy (SCB: 6; C: 3), NPGS (SCB: 3; C: 2) and trabeculectomy alone (SCB: 1; C: 1). The average follow-up time was 16.9 (±8.2) months in the SCB group and 19.6 (±11.5) months in the controls. 1.25 mg of bevacizumab was injected on average 14.1 (range: 3–42) days post-GFS. The mean IOP decreased from 21.9 (±9.8) to 11.9 (±4.7) mmHg in the controls and from 19.6 (±8.9) to 14.0 (±4.7) mmHg in the SCB group. There was no statistically significant difference between the two groups (P=0.11). Complications included three cases of branch vein occlusion in the SCB group. Conclusions. SCB did not result in better outcome in term of IOP reduction. Clinicians should monitor its side effects in glaucoma patients.

scholarly journals Optimising outcomes in the management of spontaneous cerebrospinal fluid rhinorrhoea

2013 ◽  
Vol 51 (3) ◽  
pp. 268-274
Author(s):  
J.S Virk ◽  
B. Elmiyeh ◽  
C. Stamatoglou ◽  
H.A. Saleh
Keyword(s):  
Body Mass Index ◽  
Cerebrospinal Fluid ◽  
Body Mass ◽  
Surgical Approach ◽  
Case Series ◽  
Operative Management ◽  
Csf Leak ◽  
Tertiary Referral Centre ◽  
Csf Rhinorrhoea

Background: To describe our experience of the management of spontaneous cerebrospinal fluid (CSF) rhinorrhoea in a large case series focusing on surgical approach, peri-operative management and outcomes; to evaluate the efficacy of endoscopic CSF leak repairs. Methodology: Retrospective chart review was performed for all patients with spontaneous CSF rhinorrhoea managed from 2003 to 2011 at a tertiary referral centre. Data regarding demographics, presentation, site of leak, peri-operative management, surgical approach, body mass index (BMI), follow up and success rates was collated. Results: Thirty-six patients were identified: 9 male and 27 female with a mean age of 50.4 years. Eight patients had previous failed repairs in other units. Success rate after first surgery was 89 % and after second surgery was 100 %. Four patients had recurrences, 3 underwent successful revisions and the fourth had complete cessation of the leak after gastric bypass surgery and weight reduction. All failures were before 2004 prior to instigation of an anatomic three-layered repair with no further failures in the following 7 years. Mean follow up was 21.5 months. Mean body mass index was 34.0 kg/m2. Fifty percent of spontaneous leaks were from the cribriform plate, 22 % sphenoid, 14 % ethmoid and 14 % frontal sinus. Conclusion: Endoscopic CSF fistula closure has become the gold standard of care. In order to optimise the outcome, we recommend a multidisciplinary approach to manage the associated idiopathic intracranial hypertension and an anatomic three-layered closure technique for recalcitrant cases.

Isolated Intermetatarsal Ligament Release as Primary Operative Management for Morton’s Neuroma: Short-term Results

2020 ◽  
pp. 193864002095785
Author(s):  
Mohamed Abdelaziz Elghazy ◽  
Kathryn C. Whitelaw ◽  
Gregory R. Waryasz ◽  
Daniel Guss ◽  
Anne H. Johnson ◽  
...  
Keyword(s):  
Case Series ◽  
Operative Management ◽  
Pain Scale ◽  
Morton’S Neuroma ◽  
Short Term ◽  
Level Of Evidence ◽  
Symptom Exacerbation ◽  
Morton's Neuroma ◽  
Neuroma Formation

Background Although the precise pathoetiology of Morton’s neuroma remains unclear, chronic nerve entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional operative management entails neuroma excision but risks unpredictable formation of stump neuroma. Materials and methods Medical records were examined for adult patients who failed at least 3 months of conservative treatment for symptomatic and recalcitrant Morton’s neuroma and who then underwent isolated IML decompression without neuroma resection. Results A total of 12 patients underwent isolated IML decompression for Morton’s neuroma with an average follow-up of 13.5 months. Visual Analog Pain Scale averaged 6.4 ± 1.8 (4-9) preoperatively and decreased to an average of 2 ± 2.1 (0-7) at final follow-up (P = .002). All patients reported significant improvement. Conclusion Isolated IML release of chronically symptomatic Morton’s neuroma shows promising short-term results regarding pain relief, with no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation. Level of Evidence: Level IV: Case series

scholarly journals Case series of scar endometriosis- post caeserean section: A diagnostic pitfall

2021 ◽  
Vol 8 (4) ◽  
pp. 454-456
Author(s):  
Shilpi Singh ◽  
Mahfrid Dharwadkar
Keyword(s):  
Imaging Techniques ◽  
Case Series ◽  
Rare Condition ◽  
Surgical Excision ◽  
Scar Endometriosis ◽  
Diagnostic Pitfall ◽  
Local Site ◽  
Surgical Conditions ◽  
Median Interval

The presence and growth of ectopic functional endometrial tissue outside the uterus is called endometriosis among which scar endometriosis is rare and difficult to diagnose. It occurs as a result of obstetrical and gynecological surgeries and can be confused with other surgical conditions. We reviewed the case records of patients with the diagnosis of scar endometriosis seen in our hospital from 2015 to 2018. We found six patients of scar endometriosis. The median age of the patients was 28.5 years (range 20-31 years) and median interval from symptoms to treatment was 4 years (range 2-6 years). Four patients had first presented to either the surgery or dermatology physicians. The most common complain being cyclical pain and swelling at local site. Patients underwent wide excision of the mass with no recurrence of symptoms at a follow up ranging from 9 months to 12 years. Confirmation of the diagnosis is histopathology with wide surgical excision being the treatment of choice. We have discussed the pathogenesis, diagnosis and treatment of this condition. Imaging techniques and FNAC are indicated towards better diagnostic approach and avoid confusion with other conditions. Medical treatment is helpful in selected cases only. After studying and presenting this paper we would like to highlight on such a rare condition and prevent its misdiagnosis.

Over-All Accuracy of 99mTc-Pertechnetate Brain Scanning for Brain Tumours – Study of 471 Patients

1978 ◽  
Vol 17 (06) ◽  
pp. 249-253
Author(s):  
E. Pétursson ◽  
B. Sigurbjörnsson ◽  
D. Davidsson ◽  
O.G. Björnsson
Keyword(s):  
Brain Metastases ◽  
Brain Tumours ◽  
True Negative ◽  
Diagnostic Reliability ◽  
Radioisotope Scanning ◽  
Primary Brain Tumours ◽  
99Mtc Pertechnetate

A 3-year follow-up and re-evaluation of all scans on all patients referred for brain scanning in Iceland during 1 year was performed in order to assess the diagnostic reliability of radioisotope scanning for brain tumours. The study included 471 patients. Of these 25 had primary brain tumours and 7 brain metastases. Scans were positive and correctly interpreted in68 % of the patients with primary brain tumours and in 3 of the 7 patients with metastases. The over-all accuracy of brain scanning for brain tumours defined as the total number of correct positive scans and correct negative scans versus total number of scans examined was 96%, this figure being mainly influenced by the high number of true negative scans.

Effect of Isolated Medial Patellofemoral Ligament Reconstruction in Patellofemoral Instability Regardless of Predisposing Factors

2020 ◽  
Author(s):  
Jae Ik Lee ◽  
Mohd Shahrul Azuan Jaffar ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Case Series ◽  
Patellofemoral Instability ◽  
International Knee Documentation Committee ◽  
Predisposing Factors ◽  
Mpfl Reconstruction ◽  
Patellar Tilt ◽  
Case Series Study

AbstractThe purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.

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