scholarly journals Surgical treatment of Lhermitte–Duclos disease (dysplastic gangliocytoma of the cerebellum)

2020 ◽  
Vol 22 (1) ◽  
pp. 77-82
Author(s):  
A. A. Bimurzin ◽  
A. V. Kalinovsky
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Right Hemisphere ◽  
Surgical Removal ◽  
Study Objective ◽  
Dysplastic Gangliocytoma ◽  
Satisfactory Condition ◽  
Suboccipital Craniotomy ◽  
Intact Brain ◽  
The Right

The study objective is to describe a clinical case of a rare disorder of the cerebellum, Lhermitte–Duclos disease.Clinical case. The Federal Neurosurgical Center (Novosibirsk) admitted a male patient, 40 years old. Medical history showed that in 2017 he underwent ventriculoperitoneal shunt due to hypertensive hydrocephalus syndrome caused by space-occupying mass of the right hemisphere of the cerebellum. In June of 2017, the patient was consulted by a neurosurgeon. Later, an increase in the mass, partial atrophy of the optic disks were observed. Due to the patient’s complaints of headache, ataxia, vertigo, as well as insufficient effect of the shunt, microsurgical removal of the space-occupying mass in the cerebellum by right paramedian suboccipital craniotomy was performed. Gangliocytoma removal was performed under constant neurophysiological control which allowed to fully resect the gangliocytoma inside intact brain tissue. Histological and immunohistological examinations allowed to diagnose grade I dysplastic gangliocytoma of the cerebellum (Lhermitte–Duclos disease). In the postoperative period, brain symptoms regressed fully, vestibulocerebellar syndrome persisted. The patient was discharged in satisfactory condition. No negative dynamics were observed in 7 months of follow-up.Conclusion. Due to the rareness of Lhermitte–Duclos disease, currently there are no established approaches to treatment, however, in symptomatic course there are indications for surgical removal of the gangliocytoma. Radicality of resection should be correlated with the risk of neurological defects. In our case, surgical treatment allowed to improve the patient’s condition, prevent further progression of the gangliocytoma and obtain an accurate histological diagnosis.

scholarly journals Carotid chemodectoma in the otorhinolaryngological practice: a clinical case

2020 ◽  
Vol 27 (2) ◽  
pp. 135-143
Author(s):  
A. N. Vachev ◽  
O. V. Dmitriev ◽  
O. V. Zeleva ◽  
P. M. Zelter
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Blood Loss ◽  
Clinical Case ◽  
Interdisciplinary Approach ◽  
Complete Recovery ◽  
Peritonsillar Abscess ◽  
Surgical Removal ◽  
The Right

Aim. To describe a clinical case of carotid chemodectoma in a patient seeking treatment from an otorhinolaryngologist.Results. A 79-year-old woman complained of sore throat and difficulty swallowing. Mesopharyngoscopy revealed a significant asymmetry of the pharynx on the right with a sagging soft palate. Computed tomography revealed the asymmetry of the pharynx on the right due to compression from outside. An irregularly shaped formation intensely accumulating contrast medium was detected in the periopharyngeal space on the right, near the bifurcation of the carotid artery. Carotid chemodectoma was suspected. The patient underwent surgical removal of the chemodectoma followed by the autoarterial reconstruction of the carotid artery on the right. The postoperative period was uneventful.Conclusion. The management of patients with carotid chemodectoma requires an interdisciplinary approach with participation of vascular surgeons, otorhinolaryngologists and radiologists. This approach ensures timely surgical treatment leading to complete recovery without neurological consequences and profuse blood loss. The disease can be mistaken for a peritonsillar abscess with the possibility of serious complications during surgical treatment.

Vocal Reaction Times to Tachistoscopically Presented High- and Low-Frequency Verbs: Some Evidence for Selective Minor Hemisphere Linguistic Analysis

1988 ◽  
Vol 66 (3) ◽  
pp. 803-810 ◽  
Author(s):  
Michael P. Rastatter ◽  
Catherine Loren
Keyword(s):  
Visual Field ◽  
High Frequency ◽  
Right Hemisphere ◽  
Visual Fields ◽  
Reaction Times ◽  
Low Frequency ◽  
Normal Subjects ◽  
Right Visual Field ◽  
Intact Brain ◽  
The Right

The current study investigated the capacity of the right hemisphere to process verbs using a paradigm proven reliable for predicting differential, minor hemisphere lexical analysis in the normal, intact brain. Vocal reaction times of normal subjects were measured to unilaterally presented verbs of high and of low frequency. A significant interaction was noted between the stimulus items and visual fields. Post hoc tests showed that vocal reaction times to verbs of high frequency were significantly faster following right visual-field presentations (right hemisphere). No significant differences in vocal reaction time occurred between the two visual fields for the verbs of low frequency. Also, significant differences were observed between the two types of verbs following left visual-field presentation but not the right. These results were interpreted to suggest that right-hemispheric analysis was restricted to the verbs of high frequency in the presence of a dominant left hemisphere.

scholarly journals Surgical treatment of retroperitoneal neuroblastoma in a 14-month-old child

2021 ◽  
Vol 25 (1) ◽  
pp. 61-67
Author(s):  
M. N. Sukhov ◽  
A. G. Narbutov ◽  
I. P. Lyvina ◽  
I. A. Bryzzheva ◽  
M. V. Isaeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Nursery School ◽  
Disease Recurrence ◽  
Surgical Removal ◽  
Anatomical Location ◽  
Good State ◽  
Staging Systems ◽  
Tumor In Childhood ◽  
The Right

Introduction. Neuroblastoma is the most common malignant embryonic extracranial solid tumor in childhood having a high mortality rate. While treating neuroblastoma, it is extremely important to follow international protocols with their staging systems and groups of risk. Surgical treatment is a compulsory approach, but in some cases it is extremely difficult, and it involves significant risks. However, in some cases, radical removal of the tumor can cure patients without chemotherapy.Material and methods. The article presents a clinical case of 14-month-old child with neuroblastoma of stage 3 and difficult anatomical location after 2 courses of polychemotherapy by NB-2004 protocol. The child had subradical resection of an extensive tumor in the retroperitoneal space and nephrectomy on the right. The authors also describe specific moments during surgery, problems which their faced during child’s treatment as well as follow-up examinations in the postoperative period.Results. Follow-up examinations did not reveal any signs of disease recurrence. Catamnesis lasted for 56 months. The child is in a good state; she is active, attends a nursery school.Conclusion. The discussed case demonstrates that a successful radical surgical removal of neuroblastoma of difficult anatomic location may have good outcomes without adjuvant postoperative therapy.

scholarly journals Renal Cancer with Tumor Thrombus of the Inferior Vena Cava and the Right Atrium

2020 ◽  
Vol 13 (3) ◽  
pp. 214-226
Author(s):  
Yulia Aleksandrovna Stepanova ◽  
Aleksandr Anatolevich Gritskevch ◽  
Amiran Shotaevich Revishvili ◽  
Madina Valerevna Kadirova ◽  
Egor Sergeyevich Malyshenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Kidney Cancer ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Clinical Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Radical Treatment ◽  
The Right

ntroduction. A distinctive feature of kidney cancer is a frequent, compared with other tumors, spread of the tumor through the venous collectors (in the renal and inferior vena cava up to the right atrium), along the path of least resistance to invasive growth.The aim of the study was to present a clinical case of radical treatment of kidney cancer involving extensive IVC thrombosis.Materials and methods. The study describes a clinical case of radical treatment of patient M. with kidney cancer involving extensive IVC thrombosis, extending to the right atrium (written informed consent for patient information and images to be published was obtained prior to the study). During preoperative examination, the patient was diagnosed with renal cell carcinoma with non-occlusive hypervascular tumor thrombus of the renal vein, the inferior vena cava and the right atrium based on the findings of ultrasound examination (transabdominal and transthoracic, and transesophageal), multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).Results and discussion. Surgical treatment remains the main method of treatment of renal cell cancer, moreover, the inferior vena cava thrombosis cannot serve as a cause for refusing surgical treatment. The thrombus spreading along the venous collectors is an important factor in determining the tactics of surgical treatment. The length of the tumor thrombus, as well as the degree of its fixation and ingrowth into the vein wall is of great significance for planning surgical techniques and predicting clinical outcomes. Based on various methods of radiological examination, patient M. was diagnosed with cancer of the right kidney, 3 stage T3cNxM0, IVC tumor thrombus, paraneoplastic syndrome (hyperthermia), right-sided nephrectomy with aortocaval lymphadenectomy, thrombectomy from the IVC, vascular isolation of the liver, resection of the IVC, thrombectomy from the right atrium combined with cardiopulmonary bypass.Conclusion. Despite the technical complexity of nephrectomy with thrombectomy from the IVC, especially in the presence of a massive supradiaphragmatic thrombus, these interventions have no alternatives if a radical treatment is to be achieved. Step-by-step support using radiological methods of investigation is an important aspect of patients preparation; this allowing determining the exact volume of the damage and non-invasively assessing clinical outcomes of surgical treatment.

scholarly journals Acute Hematogenous Osteomyelitis of the Rib in 14 Years Old Child: Clinical Case

2021 ◽  
Vol 20 (2) ◽  
pp. 144-148
Author(s):  
Vasily P. Gavrilyuk ◽  
Elena V. Donskaya ◽  
Maria I. Statina ◽  
D. A. Severinov ◽  
Margarita V. Dovbnya
Keyword(s):  
Clinical Case ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Final Diagnosis ◽  
Intercostal Space ◽  
Local Form ◽  
Satisfactory Condition ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
The Right

Background. Rib osteomyelitis is extremely rare in childhood. This localization of purulent focus represents only 1% of all osteomyelitis cases. The typical manifestations of ribs osteomyelitis are fever, chest or back pain. However, these clinical signs are not always present, and the disease can manifest in other way.Clinical Case Description. Mother with 14 years old child K. have applied to the regional children's hospital admission department. The child had complains of right upper quadrant abdominal pain and in right part of the chest, difficulty in breathing. The disease began 2 days before admission with fatigue, weakness, and pyretic fever (39 °C). Complaints remained over time. The patient was hospitalized with the diagnosis: “Chest impact injury with severe pain syndrome? Right lung contusion?". The ultrasound examination of pleural cavities and the right anterior chest surface has revealed osteomyelitic phlegmon in VII intercostal space on the 3rd day of hospitalization. It was lanced and drained under general anesthesia, about 7 ml of liquid pus were obtained. The child received treatment according to clinical guidelines for the management of patients with such nosology. The final diagnosis was: «Acute hematogenous osteomyelitis of the VII rib, local form. Osteomyelitic phlegmon of VII intercostal space. Right pneumonitis. Bilateral mild hydrothorax». The boy was discharged on the 10th day since surgery in satisfactory condition.Conclusion. The described clinical case is interesting for pediatric surgeons, traumatologists, infectious disease specialist. Particular attention should be paid to the clinical features of the disease and anamnestic information in such unclear clinical cases. It will allow to exclude traumatic injuries and assume the local inflammatory process.

scholarly journals Surgical treatment of frontopolar artery aneurysm: a case report

2019 ◽  
Vol 21 (1) ◽  
pp. 60-65
Author(s):  
V. A. Lukyanchikov ◽  
I. V. Senko ◽  
M. M. Idalov ◽  
R. M. Umarov ◽  
M. M. Yusupova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Intracerebral Hemorrhage ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Stiff Neck ◽  
Focal Neurological Deficit ◽  
Study Objective ◽  
Grade 3 ◽  
The Right

The study objective is to describe the results of surgical treatment of a patient with frontopolar artery aneurysm rupture. Materials and methods. A 22-year-old female patient in grave condition (Hunt and Hess grade 3, Glasgow coma score 14) was admitted to the Department of Neurosurgery on day 5 after hemorrhage. The patient presented with headache, nausea, weakness, and stiff neck. However, no hemodynamic, respiratory, motor, or sensitive disorders were observed. Computed tomography of the brain revealed a 35 cm3 intracerebral hemorrhage in the projection of the interhemispheric fissure and frontal lobes without transverse or axial dislocation. Computed tomography angiography demonstrated a distal aneurysm of the right frontopolar artery. Results. The patient underwent emergency osteoplastic craniotomy in the right pterional region followed by aneurysm excision and removal of intracerebral hemorrhage. The postoperative period was uneventful (Glasgow outcome score 5). The patient was discharged on day 14 postoperatively with no signs of focal neurological deficit. Conclusion. Thorough preoperative examination of patients with lobar hemorrhages prevents severe complications during surgery, such as uncontrolled intraoperative bleeding.

scholarly journals A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

2021 ◽  
Vol 25 (2) ◽  
pp. 80
Author(s):  
K. A. Petlin ◽  
E. A. Kosovskikh ◽  
B. N. Kozlov ◽  
V. A. Tomilin
Keyword(s):  
Surgical Treatment ◽  
Coronary Sinus ◽  
Conflict Of Interest ◽  
Right Atrium ◽  
Clinical Case ◽  
Surgical Care ◽  
Right Atrial ◽  
Stab Wounds ◽  
Pseudo Aneurysm ◽  
The Right

<p>Chest injury is an acute, extremely life-threatening condition. Among penetrating heart wounds, approximately 85% are stab wounds. In the case of stab and cut injuries, the lethality, according to various sources, reaches 90% and directly depends on the time of delivery of the victim to the hospital. In the overwhelming majority of cases, emergency operations for stab wounds of the chest are conducted in general surgical hospitals. As a rule, when providing emergency surgical care, only superficial heart wounds are sutured, excluding the correction of damage to the intra-cardiac structures. Aorto-right atrial fistula is a rather rare clinical condition that is formed due to the action of a traumatic factor and is characterised by the formation of a communication between the aorta and the right atrium with the discharge of arterial blood into the venous system. Considering that this pathology is accompanied by an increase in pressure in the right atrium, signs of stagnation are found in the systemic circulation, followed by compensatory dilatation of the right atrium and then dilatation of the right ventricle. The only effective method to treat this problem is surgery.<br />The presented clinical case demonstrates the surgical treatment of chronic post-traumatic aorto-right atrial fistula, pseudo-aneurysm between the non-coronary sinus and the right atrium and pseudo-aneurysm of the left coronary sinus 2 years after the stab wound. Echocardiography performed after surgery indicated a positive trend, i.e., a decrease in the size of the right- and left-sided heart and normalisation of pressure in the pulmonary artery. No inter-chamber shunts were found. This case shows that clinicians must remember that after providing emergency surgical care to patients with penetrating chest wounds, it is necessary to conduct an additional examination of the heart after stabilisation of the condition to detect hidden damage to the intra-cardiac structures.</p><p>Received 2 February 2021. Revised 2 March 2021. Accepted 3 March 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals COMPLETE THORACIC ESOPHAGUS OBLITERATION: CLINICAL CASE REPORT

2021 ◽  
Vol 74 (1) ◽  
pp. 155-160
Author(s):  
Serhii O. Savvi ◽  
Alla Yu. Korolevska ◽  
Serhii Yu. Bityak ◽  
Yevhen A. Novikov
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Esophageal Stricture ◽  
Clinical Case ◽  
Middle Colic Artery ◽  
Thoracic Esophagus ◽  
Colic Artery ◽  
Treatment Results ◽  
Food Passage ◽  
The Right

Using the example of a clinical case, to present the management features of a patient with complete esophageal obliteration as a chemical burn result, the surgical intervention features in case of a non-standard situation during the operation, and the treatment results analyze. It was described a clinical case of 41-year-old patient with thoracic esophagus obliteration due to extended post-burn cicatricial esophageal stricture, dysphagia of IV degree in very severe general condition. Stamm-Senn-Kader’s gastrostomy was performed as a first step of surgical treatment. Angiography and embolization of the right colic artery and it’s branches was performed in 8 months while preserving the middle colic artery. In 20 days the cologastroanastomosis and feeding colostomy on the right chest wall were performed. In 10 days after the colostomy was disattached from the chest wall, the end-to-side esophagocoloanastomosis was performed intrapleurally. In one month after the third surgery and restoration of the food passage by the natural way, closure of the contact gastrostomy was performed. During the observation over the patient (8 years) the postoperative complications were not observed. The patient survived. The proposed staged surgical treatment tactics of patients with complete esophageal obliteration due to post-burn esophageal stricture, dysphagia of IV degree presents effective treatment results and a significant improvement in the patient’s life quality.

Neuronal Plasticity in the Associative Visual Cortex of the Cat after Callosatomy

Perception ◽  
1997 ◽  
Vol 26 (1_suppl) ◽  
pp. 151-151
Author(s):  
I M Gabibov ◽  
V F Strohm ◽  
S D Solnushkin
Keyword(s):  
Visual Cortex ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Single Cells ◽  
Area 17 ◽  
Large Numbers ◽  
Area 7 ◽  
Intact Brain ◽  
The Right ◽  
Short Time

Changes in receptive field (RF) properties and connectivity of neurons in cat associative visual cortex were studied after callosatomy. Callosatomy and skull trepanation at area 21 were performed in cats weighing 2.5 – 4 kg (with nembutal 40 mg kg−1). A total of 120 neurons in area 21 were studied. In experiments performed a short time after the operation, RF sizes were found to be smaller on average, and more equal between the two hemispheres compared with intact brains [mean RF sizes previously found in intact brains: 39 deg (left hemisphere) and 28 deg (right hemisphere); after operation: 23 (left hemisphere) and 24 deg (right hemisphere)]. At this stage, all investigated neurons lacked ipsilateral input and were selective for the orientation of the stimulus, whereas we have previously found that 70% of the neurons in the left and 30% of the neurons in the right hemisphere of the intact brain are not selective for orientation. Two months after the operation, RF sizes had increased, associated with the appearance of extensive inhibitory zones including input from the ipsilateral hemifield (in 40% of the neurons). Connectivity was studied by injecting horseradish peroxidase (HRP) in area 21. In intact animals, this has been found to result in a characteristic pattern of staining of neurons in area 17 in groups of 2 – 15. In animals studied two months after callosatomy, the resulting HRP staining in area 17 was more uniform. Further, in area 7 of operated animals large numbers of cells were stained, compared with only single cells in intact brains. More than 20% of the stained area 7 neurons of operated animals were inhibitory interneurons, which might correlate with the large inhibitory zones apparent in area 21 RFs. We conclude that extensive compensatory reorganisations occur in the associative visual cortex after callosatomy, involving changing connections in at least areas 7 and 17.

Giant dermoid cyst of the brain: a clinical case and literature review

2021 ◽  
pp. 209-223
Author(s):  
Sergey Evgenievich Zuev ◽  
Andrey Anatolievich Grin ◽  
Aleksey Sergeevich Tokarev ◽  
Evdokimova Olga Liverievna Evdokimova Olga Liverievna
Keyword(s):  
Surgical Treatment ◽  
Dermoid Cyst ◽  
Clinical Case ◽  
Clinical Status ◽  
Systematic Analysis ◽  
Study Objective ◽  
Disease Outcomes ◽  
The Brain ◽  
Frequent Localization

The study objective to present a clinical case of patient with a giant brain dermoid cyst, as well as to analyze the literature data about this problem. Clinical case. The patient, 48 years old, with a giant dermoid cyst, complaints of headache, oculomotor disorders, underwent total microsurgical excision. In the long-term period after surgery, a complete resolution of neurological disorders was achieved, with a control MRI after 9 months, no recurrence of the disease was detected. Literature analysis. The analysis of the literature data was published during the thirty years from 1977 to 2017 revealed descriptions of intracranial dermoid cysts in 69 patients, determined the most frequent localization of cysts, the clinical status of the disease, outcomes of surgical treatment and prognosis of the disease. Results. The work demonstrates the results of surgical treatment of a dermoid cyst of the brain and a systematic analysis of the scientific medical literature data on this disease.

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