scholarly journals Symptomatic cerebral vasospasm in the setting of carmustine wafer placement for glioblastoma: A case presentation and review of literature

2020 ◽  
Vol 11 ◽  
pp. 168 ◽  
Author(s):  
Maheen Qamar Khan ◽  
Cristian Cirjan ◽  
Nabiha Quadri ◽  
Georgios Alexopoulos ◽  
Jeroen Coppens

Background: Gliadel placement in glioblastoma resection, particularly with concurrent chemoradiation, has demonstrated an improvement in survival. There have been several reported adverse effects, some of which lend to significantly increased morbidity and mortality. With only two other cases described in literature, cerebral vasospasm secondary to carmustine-impregnated wafers is an extremely rare side effect. Case Description: We report the case of a 51-year-old female who presented with the left lower limb paresis 8 days after high-grade glioma resection provoked by carmustine wafer placement. Conclusion: We urge surgeons to reconsider placement of carmustine wafers in nations where the surgical resection cavity includes exposed large cerebral vasculature. We also propose the early identification of this devastating complication in the postoperative period by maintaining a high clinical suspicion and prompt utilization of computed tomography and digital subtraction angiography in the management and treatment of these patients accordingly.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsuyoshi Murata ◽  
Yuta Endo ◽  
Shigenori Furukawa ◽  
Atsushi Ono ◽  
Yuichiroh Kiko ◽  
...  

Abstract Background Ovarian abscesses, which occur mostly in sexually active women via recurrent salpingitis, occur rarely in virginal adolescent girls. Here, we present a case of an ovarian abscess in a virginal adolescent girl who was diagnosed and treated by laparoscopy. Case presentation A 13-year-old healthy girl presented with fever lasting for a month without abdominal pain. Computed tomography scan and magnetic resonance imaging indicated a right ovarian abscess. Laparoscopic surgery revealed a right ovarian abscess with intact uterus and fallopian tubes. The abscess was caused by Staphylococcus aureus. The patient recovered completely after excision of the abscess, followed by antibiotic treatment. Conclusions Ovarian abscess may occur in virginal adolescent girls; Staphylococcus aureus, an uncommon species causing ovarian abscess, may cause the infection.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Karim M. Eltawil ◽  
Carly Whalen ◽  
Bryce Knapp

Abstract Background Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin occurring most often in the visceral pleura, however, it has been described in almost every anatomic location of the human body. While most SFTs have a benign behavior, they can potentially be locally aggressive and demonstrate a malignant behavior. Case presentation A 63 year-old male patient presented with lower abdominal pain and nausea and was noted on CT to have a large, heterogeneous lower abdominal mass with no evidence of metastatic disease. A surgical resection was performed and the mass appeared to be connected to the greater omentum with a vascular pedicle. It was not invading any intra-abdominal or pelvic organs. Pathology revealed an SFT of omental origin. The mitotic count was less than 4 per 10 high-power fields and all pathologic characteristics did not meet the criteria for a malignant SFT. Conclusions We report an extremely rare case of SFT originating from the greater omentum. A multidisciplinary team approach was followed to plan the patient’s management strategy.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahana Perveen ◽  
Karmaine A. Millington ◽  
Suchitra Acharya ◽  
Amit Grag ◽  
Vita Boyar

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Anup Singh ◽  
Vaisakh Kuzhikkali ◽  
Arvind Kumar Kairo

Abstract Background Head and neck is a relatively common site of occurrence for the peripheral nerve sheath tumors, and majority of these tumors are seen involving neck, involving vagus nerve, and cervical sympathetic chain. Schwannomas involving mobile tongue are rarely encountered, especially in the pediatric population Case presentation We present a case of recurrent tongue schwannoma in a 13-year-old female successfully managed with transoral excision. At a follow-up of 3 years, no recurrence is observed. Conclusion Surgical excision is the recommended modality of treatment for lingual schwannomas, and when excised adequately, recurrences are not expected. A clear margin of surrounding normal tissue should be aimed for to avoid possible recurrence.


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