scholarly journals Head, chest and limbs mine-explosive wounds

Author(s):  
A. N. Tulupov ◽  
V. A. Manukovskiy ◽  
V. E. Savello ◽  
G. M. Besaev ◽  
A. E. Demko ◽  
...  

The article presents the experience of treating wounded K., 29 years old, who, as a result of the suicide bombing of a homemade shell-free explosive device in a moving car of the St. Petersburg Metro 03.04.2017 received a severe mine-explosive combined wound to the head, chest and limbs with a fragmented blind skull. The trauma was accompanied by brain damage, a fracture of the cranial vault bones, lungs contusion, and fragmented fracture of the right tibia bones. The patient underwent sequential bifrontal decompressive craniotomy, external fixation of the right shin bones fractures, blocked intramedullary osteosynthesis of the latter, dura mater plasty, cranioplasty with a titanium plate after its computer modeling. The complex treatment allowed the patient to be discharged from the hospital after 4 months in a satisfactory condition.

1926 ◽  
Vol 22 (12) ◽  
pp. 1405-1405

Dr. Bronnikov reported a case of Jackson's epilepsy treated operatively. A patient after being wounded with a hammer of the parietal bone first suffered paralysis of the right arm and difficulty in speaking, and after 2 months he had epileptiform seizures every 6 days. In the 4th month, he underwent surgery to remove fragments of the internal lamina pressing on the dura mater, and the defect was closed with a piece of fascia lata with fatty tissue. The patient was demonstrated 3 months after the operation; he had no seizures, his speech was normal, and his hand function had been restored.


2015 ◽  
Vol 123 (6) ◽  
pp. 1566-1568 ◽  
Author(s):  
Mentor Petrela ◽  
Arben Rroji ◽  
Eugen Enesi ◽  
Artur Xhumari ◽  
Artid Lame

The authors report a complication of catheter ablation that, to their knowledge, has never been previously reported. A 63-year-old man had undergone successful transvenous catheter thermoablation for atrial fibrillation. The patient remained well until 3 days prior to further admission when he noticed itching in the right frontal area of his scalp. On palpating his scalp, he discovered a metallic body projecting out of it and he proceeded to extract 20 cm of wire from his head. The following day a progressive left hemiplegia developed, and the patient experienced a deteriorating level of consciousness. A CT scan of the brain showed a right frontotemporal intraparenchymal hemorrhage and revealed a metallic structure in the middle of the hematoma. The hematoma was evacuated and a decompressive craniotomy was performed. The guidewire was identified, but it was only possible to extract part of it. It was covered by fibrous tissue, secondary to inflammatory reaction. To the authors’ knowledge, this is the first report of guidewire-induced brain hemorrhage. The guidewire apparently had not been removed and had spontaneously migrated from the heart to the brain and beyond to the scalp where it then exited the patient’s head. The patient had been well before he attempted to pull out the wire. Earlier identification of the iatrogenic complication of a retained guidewire might have prevented the fatal outcome in this case.


2020 ◽  
Vol 18 ◽  
pp. 205873922092685
Author(s):  
Yunna Yang ◽  
Zheng Gu ◽  
Yinglun Song

Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eiichiro Amano ◽  
Keisuke Uchida ◽  
Tasuku Ishihara ◽  
Shinichi Otsu ◽  
Akira Machida ◽  
...  

Abstract Background Hypertrophic pachymeningitis (HP) is a rare disorder that involves localized or diffuse thickening of the dura mater. HP is associated with various inflammatory, infectious, and malignant diseases, such as rheumatic arthritis, sarcoidosis, anti-neutrophil cytoplasmic antibody-associated vasculitis, IgG4-related disorders, syphilis, tuberculosis, bacterial and fungal infections, cancer, and idiopathic diseases, when evaluation fails to reveal a cause. Among them, chronic infection with Propionibacterium acnes is a rare etiology of HP, and its pathology remains unclear. Case presentation An 80-year-old man having refractory otitis media with effusion of the right ear presented with progressive right-sided headache and nausea. Post-contrast brain magnetic resonance imaging revealed right mastoiditis and remarkable thickening of the dura mater and enhancement of pia mater extending from the right middle cranial fossa to the temporal lobe. HP secondary to middle ear infection was suspected, and a biopsy of the right mastoid was performed. An anaerobic culture of the biopsied right mastoid showed the growth of P. acnes, and histopathological examination using P. acnes-specific monoclonal antibody (PAB antibody) revealed the infiltration of inflammatory cells with P. acnes. Moreover, using PAB antibody, P. acnes was detected in the biopsy specimen of the thickening dura mater. No granulomas were identified in either specimen. HP was resolved with long-term administration of antibiotics and steroids. Conclusion This is the first documentation of pathologically demonstrated chronic HP associated with P. acnes infection followed by refractory otitis media. This report showed that chronic latent P. acnes infection induces chronic inflammation.


1997 ◽  
Vol 78 (1) ◽  
pp. 214-228 ◽  
Author(s):  
Andrew D. McClellan ◽  
André Hagevik

McClellan, Andrew D. and André Hagevik. Descending control of turning locomotor activity in larval lamprey: neurophysiology and computer modeling. J. Neurophysiol. 78: 214–228, 1997. The purpose of the present study was to examine the mechanisms that produce natural spontaneous turning maneuvers in larval lamprey. During swimming, spontaneous turning movements began with a larger-than-normal bending of the head to one side. Subsequently, undulations propagated down the body with greater amplitude on the side ipsilateral to the turn. During turning to one side, which usually occurred within one cycle, the amplitude and duration of ipsilateral muscle burst activity as well as overall cycle time increased significantly with increasing turn angle. In in vitro brain/spinal cord preparations, brief electrical stimulation applied to the left side of the oral hood at the onset of locomotor burst activity on the right side of the spinal cord produced turninglike motor activity. During the perturbed cycle, the duration and amplitude of the burst on the right as well as cycle time were significantly larger than during preceding control cycles. In several lower vertebrates, unilateral stimulation in brain stem locomotor regions elicits asymmetric, turninglike locomotor activity. In the lamprey, unilateral chemical microstimulation in brain stem locomotor regions elicited continuous asymmetric locomotor activity, but there was little change in cycle time, as occurs during the single turning cycles in whole animals. The descending mechanisms responsible for producing turning locomotor activity were examined with the use of a computer model consisting of left and right phase oscillators in the spinal cord that were coupled by net reciprocal inhibition. With relatively weak reciprocal coupling, a brief unilateral descending excitatory input to one oscillator produced effects ipsilaterally, but there was little effect on the contralateral oscillator. Turninglike patterns could be produced by each of the following modifications of the model: 1) unilateral descending input and relatively strong reciprocal coupling; 2) unilateral descending input that phase shifted as well as increased the amplitude of the waveform generated by an oscillator on one side; and 3) brief descending modulatory inputs that excited the oscillator on one side and inhibited the contralateral oscillator. In all three cases, there was an increase in “burst” duration ipsilateral to the excitatory input and an increase in cycle time, similar to turning locomotor activity in whole animals. It is likely that turning maneuvers are mediated by descending modulatory inputs primarily to the spinal oscillator networks, which control the timing of burst activity, but perhaps also to motoneurons for axial musculature.


2012 ◽  
Vol 10 (1) ◽  
pp. 67-70 ◽  
Author(s):  
Ravishankar S. Goel ◽  
Rashim Kataria ◽  
Virendra D. Sinha ◽  
Ashok Gupta ◽  
Simran Singh ◽  
...  

Craniocerebral maduromycetoma is extremely rare; only 2 cases have been reported so far. The authors report a case of maduromycetoma in a 17-year-old girl from a rural background in the state of Rajasthan, India, with involvement of the right parietal cortex, overlying bone, and subcutaneous tissue. The mass was totally excised, along with the involved dura mater, bone, and scalp. She was given antifungal drugs in the postoperative period. The patient responded very well to the treatment, and there were no signs of recurrence at the 6-month follow-up visit. The clinical features, imaging and histopathological investigations, and management of this rare entity are discussed, and the available literature is reviewed.


1973 ◽  
Vol 39 (2) ◽  
pp. 261-264 ◽  
Author(s):  
P. G. Lynch ◽  
E. Uriburu

✓ A case is recorded in which a solitary cartilage containing mesenchymal tumor arising from the dura mater over the convexity of the right cerebral hemisphere was successfully removed. The tumor was composed of mesenchymal tissue in which there were several large islands of typical cartilage, sometimes calcified. Suggestions are made as to the possible classifications of this unusual tumor.


2021 ◽  
Vol XII (2) ◽  
pp. 197-208
Author(s):  
G. A. Dedov

28 / VII. The patient died at 6.30 am. Opening 28 / VII. Great emaciation; stiffness is poorly expressed; on the sacrum and on the right trochanter bedsores. The bones of the cranial vault are thickened, diple is almost absent. Dura mater is spliced ​​in some places with the inner surface of the vault and with the pia mater. The last one is thickened, cloudy (milky stripes), it is removed from the surface of the brain with great difficulty. Brain weight 1397.0; its substance is edematous; the cortical substance is anemic, atrophied; the lateral ventricles are dilated with a large amount of serous fluid. In the internal organs, except for the expansion of the lower lobes of both lungs, no pathological changes were noted.


2018 ◽  
Vol 22 (4) ◽  
pp. 183-185
Author(s):  
Luciele Stochero ◽  
Luciele Zibetti Alberton ◽  
Sofia Bezerra ◽  
Rui D'Ávila ◽  
Alice Becker Teixeira ◽  
...  

Dura mater grafts are commonly applied in neurosurgery. The bovine pericardium is safe and associated with rare complications. We report a case of a patient presenting with tuberculum sellae meningioma and unusual complication after frontotemporal duroplasty using bovine pericardium. After two days of good postoperative evolution, the patient presents with neurological worsening and CT scan shows intraparenchymal hematoma on the right, with perilesional edema, requiring surgery to drain and replace the pericardium of a fascia lata graft. with good postoperative evolution. Pediculated pericranium, temporal fascia and fascia lata are the most effective and safe choice to replace the dura mater. Among heterologous grafts, bovine pericardium is associated with few complications. However, complications such as inflammationand infection are related to the substance glutaraldehyde, present in such graft.


2020 ◽  
Vol 22 (1) ◽  
pp. 77-82
Author(s):  
A. A. Bimurzin ◽  
A. V. Kalinovsky

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.


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