scholarly journals Hemiparesis resulting from an unusual C1 fracture: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 449
Author(s):  
Sung-Joo Yuh ◽  
Zhi Wang ◽  
Ghassan Boubez ◽  
Daniel Shedid
Keyword(s):  
Cord Compression ◽  
Surgical Decompression ◽  
Neurological Deficits ◽  
Lateral Mass ◽  
Computed Tomography Scan ◽  
Instrumented Fusion ◽  
Jefferson Fracture ◽  
Type 3 ◽  
Neurologically Intact ◽  
Tomography Scan

Background: Jefferson fractures are burst fractures involving both the anterior and posterior arches of C1. They typically result from axial compression or hyperextension injuries. Most are stable, and neurological deficits are rare. They are often successfully treated with external immobilization, but require surgery (e.g., fusion/ stabilization). Case Description: An 89-year-old male presented with a left-sided hemiplegia following a trivial fall. The cervical computed tomography scan revealed a left-sided displaced comminuted C1 fracture involving the arch and lateral mass. The MR revealed posterior cord compression and focal myelomalacia. Six months following an emergent C1–C3 decompression with occiput to C4 instrumented fusion, the patient was neurologically intact and pain-free. Conclusion: An 89-year-old male presented with a left-sided hemiplegia due to a Type 3/4 C1 Jefferson fracture. Following posterior C1–C3 surgical decompression with C0–C4 instrumented fusion, the patient sustained a complete bilateral motor recovery.

scholarly journals A rare case report of Russell’s viper snakebite with ischemic stroke

2017 ◽  
Vol 25 (2) ◽  
pp. 95-97 ◽  
Author(s):  
VK Pothukuchi ◽  
VR Chepuri ◽  
Kalyani Natta ◽  
Nagaraju Madigani ◽  
Alok Kumar
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Endothelial Damage ◽  
Neurological Deficits ◽  
Computed Tomography Scan ◽  
Rare Case Report ◽  
Russell’S Viper ◽  
The Brain ◽  
Underlying Pathology ◽  
Tomography Scan

Ischemic stroke following snakebite is rare. We report a case of a 55-year-old male who developed headache with expressive aphasia following a Russell’s viper bite. Computed tomography scan of the brain revealed infarcts in bilateral frontal lobes. The possible mechanisms for cerebral infarction in this scenario are discussed, which include disseminated intravascular coagulation, toxin-induced vasculitis, and endothelial damage. In viper bites, whenever there is any central nervous system manifestations or deficits, immediate computed tomography scan of the brain should be taken to delineate the underlying pathology, whether hemorrhagic or ischemic, as treatments differ in both situations. Although ischemic stroke is rare in viper bites, if the treatment is started early, the neurological deficits can be minimized.

scholarly journals Role of Computed Tomography Scan in Non-Localized Headache in Tertiary Hospital of Mid Western Region of Nepal

2017 ◽  
Vol 13 (1) ◽  
pp. 2-4 ◽  
Author(s):  
Prasanna Ghimire ◽  
B. P. Singh ◽  
S. K. Chaturvedi
Keyword(s):  
Computed Tomography ◽  
Tertiary Hospital ◽  
Neurological Deficits ◽  
Computed Tomography Scan ◽  
Medical College ◽  
Health Related ◽  
History Of ◽  
Detailed Assessment ◽  
Age Range ◽  
Tomography Scan

Objective: To investigate the implication of a computed tomography scan for headache with non-localizing sign.Materials and methods: One hundred and thirty six patients with headache having non-localizing signs were included in this prospective study. Patients with age > 11 years, incomplete radiological or clinical data, recent/new onset headache, any immunosuppressive state, neurological deficits at the time of presentation, history of fever, trauma, any previous surgical intervention and any malignancy were excluded from the study.Results: Among the 136 patients, 73% were females and 27% were males with age range of 11- 76 years. Negative computed tomography scan was present in 91 (66.9 %) cases. Positive findings that significantly influenced the management were present in only 6 (4.4%) cases. Conclusion: Computed tomography in headache with non-localizing signs has a poor yield for a significant intracranial pathology. A careful and detailed assessment curtails the need for inadvertent imaging thus reducing the economic burden and health related hazards.Journal of Nepalgunj Medical College Vol.13(1) 2015: 2-4

scholarly journals Extended tulip cervical reduction screws to restore alignment in traumatic atlantoaxial dislocation after type 3 odontoid fracture: illustrative case

2021 ◽  
Vol 2 (15) ◽  
Author(s):  
Christopher F. Dibble ◽  
Saad Javeed ◽  
Justin K. Zhang ◽  
Brenton Pennicooke ◽  
Wilson Z. Ray ◽  
...  
Keyword(s):  
Odontoid Fracture ◽  
Atlantoaxial Subluxation ◽  
Illustrative Case ◽  
Lateral Mass ◽  
Mass Reduction ◽  
Uncommon Presentation ◽  
Cervical Traction ◽  
Spine Surgeon ◽  
Type 3 ◽  
Neurologically Intact

BACKGROUND Traumatic atlantoaxial rotatory subluxation after type 3 odontoid fracture is an uncommon presentation that may require complex intraoperative reduction maneuvers and presents challenges to successful instrumentation and fusion. OBSERVATIONS The authors report a case of a 39-year-old female patient who sustained a type 3 odontoid fracture. She was neurologically intact and managed in a rigid collar. Four months later, she presented again after a second trauma with acute torticollis and type 2 atlantoaxial subluxation, again neurologically intact. Serial cervical traction was placed with minimal radiographic reduction. Ultimately, she underwent intraoperative reduction, instrumentation, and fusion. Freehand C1 lateral mass reduction screws were placed, then C2 translaminar screws, and finally lateral mass screws at C3 and C4. The C2–4 instrumentation was used as bilateral rod anchors to reduce the C1 lateral mass reduction screws engaged onto the subluxated atlantodental complex. As a final step, cortical allograft spacers were inserted at C1–2 under compression to facilitate long-term stability and fusion. LESSONS This is the first description of a technique using extended tulip cervical reduction screws to correct traction-irreducible atlantoaxial subluxation. This case is a demonstration of using intraoperative tools available for the spine surgeon managing complex cervical injuries requiring intraoperative reduction that is resistant to traction reduction.

scholarly journals Per-operative glue embolization with surgical decompression: A multimodality treatment for aggressive vertebral haemangioma

2019 ◽  
Vol 25 (5) ◽  
pp. 570-578 ◽  
Author(s):  
AR Prabhuraj ◽  
Ajit Mishra ◽  
Rakesh Kumar Mishra ◽  
Nupur Pruthi ◽  
Jitender Saini ◽  
...  
Keyword(s):  
Transarterial Embolization ◽  
Treatment Options ◽  
Cord Compression ◽  
Surgical Decompression ◽  
Spinal Needle ◽  
Neurological Deficits ◽  
Percutaneous Injection ◽  
Spinal Stabilization ◽  
Vertebral Haemangioma ◽  
Glue Embolization

Objective The aim of this study is to share our experience in per-operative embolization of aggressive vertebral haemangioma and to compare the surgical outcome with existing modalities of management. Background Vertebral haemangioma accounts for 12% of benign lesions of the vertebral column detected incidentally. Rarely they may enlarge, cause pain and neurological deficit because of spinal cord compression, vertebral body or arch expansion, or pathological fracture. Treatment options for symptomatic vertebral haemangioma include pre-operative transarterial embolization, surgical excision, radiotherapy, and percutaneous injection of alcohol or methyl methacrylate. We present our experience of per-operative glue embolization for aggressive (Enneking stage 3) vertebral haemangiomas. Materials and methods We describe five patients with symptomatic vertebral haemangioma at the dorsal level who underwent per-operative glue embolization. After initial laminectomy, a tumorogram was obtained under fluoroscopic guidance through direct contrast injection via spinal needle inserted through the pedicles of vertebra at the involved level. Varied concentration of glue was injected via the same spinal needle. All patients underwent surgical decompression of the intraspinal epidural component in the same sitting along with posterior spinal stabilization of the adjacent levels in two patients. Results In all five patients, complete embolization of the tumour was possible per-operatively through the transpedicular approach along with adjunctive surgical decompression, and the blood loss was significantly less. Clinical follow-up of these patients at 12–48 months showed reduction in size of the epidural component, relief of cord compression, and significant improvement in their neurological deficits with no recurrence. Conclusion We conclude that per-operative embolization is a safe and efficacious adjunctive procedure with surgical decompression with or without spinal stabilization for the treatment of symptomatic vertebral haemangiomas.

scholarly journals Computed Tomographic Diagnosis of Traumatic Atlanto-occipital Rotatory Luxation and Successful Closed Reduction in a Dog

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e164-e169
Author(s):  
Gordon Lye ◽  
Karl Mathis ◽  
Sarah Hill ◽  
Ryan Cattin ◽  
Angela Hartman
Keyword(s):  
Computed Tomography ◽  
Closed Reduction ◽  
Head Tilt ◽  
Neurological Deficits ◽  
Computed Tomography Scan ◽  
Traumatic Injuries ◽  
Computed Tomographic ◽  
Neurological Signs ◽  
External Trauma ◽  
Tomography Scan

AbstractA 12-year-old, female spayed crossbred dog was presented for traumatic injuries sustained after being hit by a car. The dog was non-ambulatory with a right-sided head tilt on presentation, neurological deficits and signs of external trauma centred on the head. A trauma computed tomography was performed which revealed an atlanto-occipital luxation with narrowing of the vertebral canal. This was treated successfully via closed reduction and confirmed with a repeat computed tomography scan. The dog recovered well following the atlanto-occipital luxation reduction, and was ambulatory the day after the reduction, and neurological signs resolved within 2 days.

scholarly journals Pneumocephalus following Lumbar Spine Surgery: A Rare Cause of Delayed Emergence from Anesthesia

2018 ◽  
Vol 05 (01) ◽  
pp. 30-32
Author(s):  
Ritesh Lamsal ◽  
Rajeeb K. Mishra ◽  
Niraj Kumar
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Neurological Deficits ◽  
Lumbar Spine Surgery ◽  
Computed Tomography Scan ◽  
Delayed Emergence ◽  
Delayed Emergence From Anesthesia ◽  
Tomography Scan

AbstractPneumocephalus is an unusual presentation after lumbar spine surgery. We report the case of a young healthy patient, who had delayed emergence from anesthesia after undergoing an uncomplicated lumbar spine surgery. After shifting to the Intensive Care Unit, the patient had an episode of generalized tonic—clonic seizure. Computed tomography scan revealed the presence of pneumocephalus. The patient was managed conservatively, extubated the following day and discharged with no neurological deficits.

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