scholarly journals Resection of a lateral supratentorial endodermal cyst complicated by postoperative seizures: A case report

2019 ◽  
Vol 10 ◽  
pp. 141
Author(s):  
Keisuke Nagata ◽  
Satoshi Kiyofuji ◽  
Munehiro Yokoyama ◽  
Shigeo Sora
Keyword(s):  
Antiepileptic Drugs ◽  
Brain Cortex ◽  
Surgical Intervention ◽  
Histopathological Examination ◽  
Neurological Deficits ◽  
Preoperative Administration ◽  
Endodermal Cyst ◽  
Chemical Irritation ◽  
Clonic Seizures ◽  
Mild Impairment

Background: Endodermal cysts are uncommon cystic lesions usually located at the ventral aspects of the spine. A lateral supratentorial location of such cysts is extremely rare. A unique case of a lateral supratentorial endodermal cyst that required surgical intervention due to uncal herniation, complicated with postoperative seizures, is presented. Case Description: A 48-year-old man presented with transient motor aphasia and diplopia. Magnetic resonance imaging showed a cystic lesion occupying the left frontal and temporal convexity with midline shift and uncal herniation. Cyst resection was performed, and cyst contents with mucous-like components were aspirated. Histopathological examination showed an endodermal cyst. The patient showed no neurological deficits immediately after surgery but developed tonic-clonic seizures 9 h after surgery. Sedation and intubation were required to control the seizures. After administering multiple antiepileptic drugs, he was extubated on the 5th day after surgery. He was discharged home in a month with mild impairment in dexterity of his right hand. Conclusions: Surgical intervention for endodermal cysts can be complicated by postoperative seizures caused by chemical irritation of brain cortex due to spillage of cyst contents. It is important to irrigate the cyst wall very well intraoperatively and pay attention not to spill the cyst fluid to unaffected locations. Preoperative administration of antiepileptic drugs should also be considered if endodermal cysts, not simple arachnoid cysts, are suspected preoperatively.

scholarly journals Preoperative silk suture embolization of cerebral and dural arteriovenous malformations

2001 ◽  
Vol 11 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Amir R. Dehdashti ◽  
Michel Muster ◽  
Alain Reverdin ◽  
Nicolas De Tribolet ◽  
Daniel A. Ruefenacht
Keyword(s):  
Arteriovenous Malformations ◽  
Histopathological Examination ◽  
Adverse Outcomes ◽  
Neurological Deficits ◽  
Grading System ◽  
Silk Suture ◽  
Long Term Follow Up ◽  
Feeding Vessels ◽  
A Minor ◽  
Proximal Occlusion

Object The aim of this study was to evaluate the use of silk sutures as a medical implant when applied for the embolization of cerebral and dural arteriovenous malformations (AVMs). The facility of surgery and the clinical significance of complications related to preoperative silk suture embolization were evaluated immediately after surgery and at long-term follow up. Methods Thirty-four patients harboring 29 cerebral and five dural AVMs underwent embolization in which silk alone or in association with other agents was used. Medical and radiological records obtained in these 34 patients were reviewed retrospectively. The cerebral AVMs were classified according to the Spetzler–Martin grading system and the dural AVMs to the Djindjian grading system. The facility of the resection and the adverse outcomes, including new neurological deficits, hemorrhage, and fever, as well as histopathological evidence of vessel inflammatory changes, were determined in each case. In all 23 surgical cases, the AVM could be easily manipulated and excised. New temporary neurological deficits occurred in three patients. A high Spetzler–Martin grade was not associated with a higher incidence of new neurological deficits. One delayed-onset hemorrhage was detected after embolization. Fever was present in 24% of the patients. No sign of significant vasculitis or perivascular inflammation was found on radiological or histopathological examination. Conclusions Silk sutures are safe embolic agents especially for proximal occlusion of AVM feeding vessels. New permanent neurological deficits were not encountered in this series. Fever was considered to be a minor, temporary side effect of silk suture embolization.

Advantages and limitations of the use of tractography and fMRI in the treatment of anaplastic glioma

2021 ◽  
pp. 32-42
Author(s):  
Igor Aleksandrovich Medyanik ◽  
Simon Quarteng Badu
Keyword(s):  
Neurological Disorders ◽  
Preoperative Diagnosis ◽  
Surgical Intervention ◽  
Complete Resection ◽  
Anaplastic Glioma ◽  
Neurological Deficits ◽  
Neural Pathways ◽  
Histological Subtype ◽  
Group A ◽  
Group B

The possibility of using only tractography as a preoperative diagnosis of anaplastic glioma is limited due to its inability to show the exact functional location of the tumor; therefore, the combination of tractography and fMRI seems to be a more promising complex diagnostic method. In neurooncology, complete resection without or with minimal neurological deficit is the goal of surgical intervention. The aim of the study was to investigate the advantages and limitations of the use of tractography and fMRI in the treatment of anaplastic glioma compared to standard CT or MRI. The study involved 48 patients who were divided into two groups based on the use of fMRI and tractography: group A (24 patients) and without it — group B (24 patients). The groups were compared in terms of age, sex, histological subtype of anaplastic glioma, degree of resection, postoperative complications, and dynamics of neurological disorders. The combination of fMRI and tractography is the best preoperative diagnosis, it is safe and allows localizing neural pathways, preserve them during surgery, and reduce postoperative neurological deficits.

What is the onset mechanism of internal hernia after vertebral body fracture? A case of internal hernia secondary to traumatic vertebral fracture

2021 ◽  
Vol 14 (9) ◽  
pp. e241005
Author(s):  
Akiyo Matsumoto ◽  
Takahiko Akao ◽  
Hiroshi Matsumoto ◽  
Naoki Kobayashi ◽  
Makoto Kamiya
Keyword(s):  
Internal Hernia ◽  
Histopathological Examination ◽  
Lumbar Vertebra ◽  
The Body ◽  
Neurological Deficits ◽  
Disc Space ◽  
Ileal Loop ◽  
Body Fracture ◽  
Enhanced Ct

A 67-year-old man who had been pinned between a basket crane and a tree complained of severe pain in his lower back and a decreased appetite. Laparotomy after decompressing the gastrointestinal tract revealed incarceration of an ileal loop within a fractured third lumbar vertebra. The damaged bowel was resected, and an end-to-end anastomosis was performed. Once the patient’s condition had stabilised, posterior lumbar fixation was performed. There were no abdominal complications or lower limb neurological deficits during the follow-up period. Enhanced CT and MRI had been helpful in making the diagnoses. Histopathological examination revealed the aetiology of the traumatic incarceration: the intestine had been pinched as the disc space closed, and the body attempted to return to its original state by exerting countertraction.

scholarly journals Progressive Scoliosis and Syringomyelia - Questions of Surgical Approach

Folia Medica ◽  
2018 ◽  
Vol 60 (2) ◽  
pp. 261-269 ◽  
Author(s):  
Mikhail Mikhaylovskiy ◽  
Vyacheslav Stupak ◽  
Vadim Belozerov ◽  
Nikolay Fomichev ◽  
Anatoliy Lutsik ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Surgical Correction ◽  
Neurological Deficits ◽  
Spinal Deformities ◽  
Loss Of Correction ◽  
Scoliotic Deformity ◽  
Scoliosis Correction ◽  
The Moment ◽  
Comparison Of The Results

Abstract Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.

scholarly journals The lateral infratrigeminal transpontine window to deep pontine lesions

2015 ◽  
Vol 123 (3) ◽  
pp. 699-710 ◽  
Author(s):  
Paolo Ferroli ◽  
Marco Schiariti ◽  
Roberto Cordella ◽  
Carlo Boffano ◽  
Simone Nava ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Intervention ◽  
Neurological Deficits ◽  
Critical Area ◽  
Surgical Indications ◽  
Surgical Strategies ◽  
Csf Leakage ◽  
New Knowledge ◽  
Pontine Lesion

OBJECT Surgery of brainstem lesions is increasingly performed despite the fact that surgical indications and techniques continue to be debated. The deep pons, in particular, continues to be a critical area in which the specific risks related to different surgical strategies continue to be examined. With the intention of bringing new knowledge into this important arena, the authors systematically examined the results of brainstem surgeries that have been performed through the lateral infratrigeminal transpontine window. METHODS Between 1990 and 2013, 29 consecutive patients underwent surgery through this window for either biopsy sampling or for removal of a deep pontine lesion. All of this work was performed at the Department of Neurosurgery of the Istituto Nazionale Neurologico "Carlo Besta", in Milan, Italy. A retrospective analysis of the findings was conducted with the intention of bringing further clarity to this important surgical strategy. RESULTS The lateral infratrigeminal transpontine window was exposed through 4 different approaches: 1) classic retrosigmoid (15 cases), 2) minimally invasive keyhole retrosigmoid (10 cases), 3) translabyrinthine (1 case), and 4) combined petrosal (3 cases). No deaths occurred during the entire clinical study. The surgical complications that were observed included hydrocephalus (2 cases) and CSF leakage (1 case). In 6 (20.7%) of 29 patients the authors encountered new neurological deficits during the immediate postoperative period. All 6 of these patients had undergone lesion removal. In only 2 of these 6 patients were permanent sequelae observed at 3 months follow-up. These findings show that 93% of the patients studied did not report any permanent worsening of their neurological condition after this surgical intervention. CONCLUSIONS This retrospective study supports the idea that the lateral infratrigeminal transpontine window is both a low-risk and safe corridor for either biopsy sampling or for removal of deep pontine lesions.

scholarly journals Dorsal Spinal Intradural Intramedullary Epidermoid Cyst: A Rare Case Report and Review of Literature

2019 ◽  
Vol 10 (02) ◽  
pp. 352-354 ◽  
Author(s):  
Siddartha Reddy Musali ◽  
Imran Mohammed ◽  
Prakash Rao Gollapudi ◽  
Sai Kumar Maley
Keyword(s):  
Epidermoid Cyst ◽  
Histopathological Examination ◽  
Neurological Deficits ◽  
Benign Tumors ◽  
Dermal Sinus ◽  
Epidermoid Cysts ◽  
Rare Case Report ◽  
Intracranial Lesions ◽  
Intradural Extramedullary ◽  
Dorsal Spinal

ABSTRACTEpidermoid cysts are commonly seen intracranial lesions but their occurrence in the spine is rare. They account for <1% of all the benign tumors of the spine. These are benign epithelial-lined cysts filled with keratin. They are classified into two types: congenital or acquired. Congenital epidermoid cysts are more commonly associated with spinal dysraphic states such as syringomyelia, dermal sinus and spina bifida whereas the acquired cysts are associated with repeated lumbar punctures. Based on the location, they can be extradural, intradural, extramedullary, or intramedullary. Most of the epidermoids are intradural extramedullary. Intramedullary epidermoid cysts are very uncommon. We report a case of a 6-year-old female patient with dorsal epidermoid cyst with neurological deficits. Magnetic resonance imaging of the spine showed a well-defined lesion from D9 to D12 which was hypointense on T1W1 and heterogeneously hyperintense on T2W2. Surgery was performed to excise the lesion and to decompress the spinal cord. Histopathological examination of the excised lesion confirmed it as an epidermoid cyst.

scholarly journals Bruises around the umbilicus in an infant

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
Sam Hassan ◽  
Ghassan Nakib ◽  
Mary J. Saviour
Keyword(s):  
Silver Nitrate ◽  
Topical Application ◽  
Congenital Abnormality ◽  
Surgical Intervention ◽  
Histopathological Examination ◽  
Pancreatic Tissue ◽  
Duct Cyst ◽  
Omphalomesenteric Duct ◽  
Common Causes ◽  
First Time

The most common causes of umbilical discharge in infancy are infection and umbilical granuloma that may be treated by antibiotics and topical application of silver nitrate subsequently. If the umbilical discharge persists or if there is any abnormal discoloration around the umbilicus, it is important to investigate for underlying congenital abnormality that may be cured by surgical intervention. Unusual presentation of omphalomesenteric duct cyst has been reported in literature. We report, for the first time as far as our search is concerned, a case of a 16-month-old infant who presented initially with persistent umbilical discharge and finally with bruising around the umbilicus in keeping with Cullen’s sign. A diagnosis of omphalomesenteric duct cyst containing pancreatic tissue was made on histopathological examination. This case emphasizes that, a persistent umbilical discharge and or discoloration around the umbilicus should be further investigated and an omphalomesenteric duct cyst can present as Cullen’s sign.

scholarly journals Formation of a meningoencephalocele after removal of a frontal lobe meningioma by transfrontal craniotomy in a cat

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692095719
Author(s):  
Christian Günther ◽  
Katrin M Beckmann ◽  
Frank Steffen
Keyword(s):  
Frontal Lobe ◽  
Postoperative Recovery ◽  
Neurological Deficits ◽  
Anatomical Landmarks ◽  
En Bloc ◽  
Case Summary ◽  
Clonic Seizures ◽  
Definition Of ◽  
Neurological Progression

Case summary A 10-year-old castrated male domestic shorthair cat was referred for surgical treatment of a left-sided frontal lobe meningioma diagnosed by CT. Clinically, the cat had generalised tonic–clonic seizures, which reduced in frequency after treatment was started with prednisolone. After definition of the anatomical landmarks of the feline skull, a bilateral transfrontal craniotomy allowed en bloc removal of the meningioma. While postoperative recovery was uneventful, right-sided proprioceptive deficits were still present 6 months after surgery. MRI detected a probable meningoencephalocele herniating through the surgical bone defect in the frontal sinus. Because of the mild neurological deficits and good quality of life, the meningoencephalocele was not treated. Thirty-one months after meningioma removal the cat was alive without further neurological progression. Relevance and novel information To our knowledge, this is the first report to describe, in detail, the technique of transfrontal craniotomy in cats. Iatrogenic meningoencephalocele is a complication that has not previously been described after meningioma removal in cats, and should be considered as a potential complication after craniotomy.

scholarly journals Conservative Treatment of Acute Spontaneous Spinal Epidural Hematoma

1998 ◽  
Vol 25 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Peter A. Pahapill ◽  
Stephen P. Lownie
Keyword(s):  
Epidural Hematoma ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Operative Therapy ◽  
Complete Recovery ◽  
Neurological Deficits ◽  
Spinal Epidural Hematoma ◽  
Spontaneous Spinal Epidural Hematoma ◽  
Spinal Epidural ◽  
Sustained Recovery

ABSTRACT:Background:In cases of acute spontaneous spinal epidural hematoma producing neurological deficits, emergency surgical evacuation is the standard treatment.Methods:Such a case is presented in which complete resolution of neurological deficits occurred without surgical intervention.Results:This is the fifth reported case of complete recovery in a patient managed conservatively. In most reports, significant and sustained neurological recovery had occurred within 12 hours of impairment of walking.Conclusion:In cases of acute spontaneous spinal epidural hematoma in which neurological deterioration is followed by early and sustained recovery, non-operative therapy may be considered.

scholarly journals Prevalence of brachiocephalous arteries lesions at acute aortic dissection of type A

2020 ◽  
pp. 84-87
Author(s):  
R. K. Dzhordzhikiya ◽  
R. V. Akhmetzyanov ◽  
R. R. Kamaltdinov ◽  
L. M. Mirolyubov
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Surgical Intervention ◽  
Neurological Deficits ◽  
Acute Cerebral Ischemia ◽  
Ischemic Attack ◽  
The Right ◽  
Neck Vessels ◽  
Ischemic Events ◽  
Brachiocephalic Arteries

Acute aortic dissection is a highly disabling disease, due to severe neurological deficits caused by damage to the brachiocephalous arteries. The study enrolled 92 patients, 74% of them were men and 26% women. Everybody underwent extracranial duplex scanning and/or multispiral computer tomography of neck vessels. The narrowing of the true lumen by 60% and either the occurrence of a stroke or a transient ischemic attack  against  the background of the involvement of brachiocephalous arteries in the process  of  delamination was considered to be a significant defeat. Brachiocephalic stem was the most frequently involved (52.1%). Significant lesions were more often identified in the right common carotid artery (10.8%). Higher lethality (33%) was found in the group where brachiocephalous arteries were intervened than in the group of non-operated arteries (24%) (p = 0.048). In the first group ischemic events were revealed only before and during the surgical intervention, in the second group - only in the postoperative period. Interventions on brachiocephalic arteries in acute aortic dissection are associated with higher lethality and occurrence of ischemic events. A classification taking into account pathogenetic mechanisms of acute cerebral ischemia in case of brachiocephalous artery damage has been proposed.

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