scholarly journals Chronic epidural hematoma presenting with diplopia

2021 ◽  
Vol 12 ◽  
pp. 420
Author(s):  
Jaims Lim ◽  
Steven B. Housley ◽  
Douglas Drumsta ◽  
Richard M. Spiro
Keyword(s):  
Complete Resolution ◽  
Epidural Hematoma ◽  
Brain Injuries ◽  
Mass Effect ◽  
Brain Parenchyma ◽  
Complete Resection ◽  
Surgical Evacuation ◽  
Significant Mass Effect ◽  
Significant Mass ◽  
Inflammatory Tissue

Background: Epidural hematomas are common intracranial pathologies secondary to traumatic brain injuries and are associated with overlying skull fractures up to 85% of the time. Although many require immediate surgical evacuation, some are observed for stability and followed up conservatively with serial imaging or enlarge slowly overtime, similar to chronic subdural hematomas. Those in the latter category may present with vague symptoms such as diplopia or headache and are often found on routine outpatient evaluation. When concerning findings such as significant mass effect are present, surgical evacuation is necessary. Case Description: Here, we present the case of a 32-year-old man who presented with diplopia 6 weeks after experiencing head trauma and was found to have a chronic epidural hematoma. On resection, thick, inflammatory tissue was observed and carefully resected, revealing normal dura underneath. Six weeks after evacuation of the hematoma, the patient had near-complete resolution of his diplopia and complete resolution of his epidural hematoma. Conclusion: Given the consistency and nature of the fibrous material observed intraoperatively in this case, near-complete resection of the tissue was likely necessary to help facilitate adequate reexpansion of brain parenchyma and improve clinical outcomes.

scholarly journals Kernohan-Woltman notch phenomenon and intention tremors in case of chronic subdural hematoma

2014 ◽  
Vol 21 (1) ◽  
pp. 109-112
Author(s):  
P. Sasikala ◽  
Bindu Menon ◽  
Amit Agarwal
Keyword(s):  
Ct Scan ◽  
Movement Disorders ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Mass Effect ◽  
Midline Shift ◽  
Rare Presentation ◽  
Surgical Evacuation ◽  
Significant Mass Effect ◽  
Significant Mass

Abstract Movement disorders are atypical and rare presentation of chronic subdural hematomas. We report a case of 60 year man who presented with intention tremors and altered sensorium. The patient had Kernohan-Woltman notch phenomenon on clinical examination. CT scan brain showed a large left fronto-temporo-parietal chronic subdural hematoma with significant mass effect and midline shift. His symptoms relieved completely after surgical evacuation of the hematoma.

Embolization of the middle meningeal artery for the treatment of epidural hematoma

2009 ◽  
Vol 110 (6) ◽  
pp. 1247-1249 ◽  
Author(s):  
Ian B. Ross
Keyword(s):  
Epidural Hematoma ◽  
Mass Effect ◽  
Middle Meningeal Artery ◽  
Embolization Therapy ◽  
Clot Removal ◽  
Meningeal Arteries ◽  
Endovascular Technology ◽  
Significant Mass Effect ◽  
Meningeal Artery ◽  
Significant Mass

Epidural hematomas (EDHs) are sometimes treated nonoperatively. Decision making, however, is not always perfect, and some hematomas chosen for observation later deteriorate and require surgical clot removal. With the current endovascular technology it is possible to embolize meningeal arteries to stop epidural bleeding. In this study, the author presents his experience in the treatment of a patient with a troublesome postoperative EDH successfully controlled with embolization therapy. This treatment is also useful in posttraumatic EDH and may obviate the need for surgery in some patients with EDHs who present early after injury and without significant mass effect.

scholarly journals Delayed neurological deterioration due to progressive pneumocephalus

2015 ◽  
Vol 22 (1) ◽  
pp. 128-131
Author(s):  
Amit Agrawal ◽  
S. Satish Kumar ◽  
Umamaheswara Reddy V.
Keyword(s):  
Ct Scan ◽  
Clinical Presentation ◽  
Mass Effect ◽  
Neurological Status ◽  
Tension Pneumocephalus ◽  
Delayed Neurological Deterioration ◽  
Mass Lesions ◽  
Multiple Episodes ◽  
Significant Mass Effect ◽  
Significant Mass

Abstract Pneumocephalus can develop immediately following head trauma or clinical presentation may be delayed for days. We report a case of 35 year male whose initial CT scan brain plain small specks of pneumocephalus in left para-sellar region. However the next day he was complaining of severe headache and had multiple episodes of vomiting. Repeat CT scan showed increase in the size of pneumocephalus including appearance of intraventricular air with mild cerebral edema. The patient recovered well with conservative management. The present case is a gentle reminder that in a subgroup of head injury patients, intracranial air can produce significant mass effect leading to tension pneumocephalus which can can behave like other intracranial mass lesions and causes worsening of the neurological status of these patients.

STEREODYNAMICS, MASS EFFECT AND DOCKING FROM O(3P) + HD → OH + D AT Ecol = 0.4–1.0eV AND O(3P) + HD → OD + H AT Ecol = 0.5–1.0eV

2013 ◽  
Vol 12 (01) ◽  
pp. 1250104 ◽  
Author(s):  
VICTOR WEI-KEH (WU) CHAO
Keyword(s):  
Angular Momentum ◽  
Relative Velocity ◽  
Mass Effect ◽  
Dihedral Angles ◽  
Angular Momentum Vector ◽  
Momentum Vector ◽  
Docking Mechanism ◽  
Drug Modification ◽  
Significant Mass Effect ◽  
Significant Mass

Quasiclassical Trajectory (QCT) calculation for O(3P) + HD → OH + D and O(3P) + HD → OD + H at E col = 0.4–1.0 eV and 0.5–1.0 eV, respectively, on the lowest PES 1 3A″ of Kuppermann et al. has been done. Distribution p(ϑr) of azimuthal angles between the relative velocity k of the reactants and rotational angular momentum vector j′ of either OH or OD , p(φr) of polar as well as dihedral angles correlating k - k′ -j′, p(ϑr, φr), and PDDCS dependent upon the scattering angle ϑt of either OH , or OD between k and k′ of the reactants and products, respectively, are presented and discussed. The stereodynamics and isotopic mass effects at the smallest possible collision energies 0.4 eV and 0.5 eV for OH and OD , respectively, are significantly different. The significant mass effect with quotient 1/2 of H/D, at the corresponding collision threshold may be applied for the investigation of docking mechanism, drug modification and delivery.

scholarly journals Massive thoracic ganglioneuroma with significant mass effect on left hemithorax

2018 ◽  
pp. bcr-2017-222250 ◽  
Author(s):  
Jacob T Lambdin ◽  
Kyongjune B Lee ◽  
Gregory Trachiotis ◽  
Carlose Picone
Keyword(s):  
Mass Effect ◽  
Left Hemithorax ◽  
Significant Mass Effect ◽  
Significant Mass

Spontaneous Thrombosis of an Intracranial Giant Aneurysm

1999 ◽  
Vol 5 (4) ◽  
pp. 327-332 ◽  
Author(s):  
G. Warschewske ◽  
G. Benndorf ◽  
Th. Lehmann ◽  
W. Lanksch
Keyword(s):  
Giant Aneurysm ◽  
Mass Effect ◽  
Anterior Communicating Artery ◽  
Complete Disappearance ◽  
Spontaneous Thrombosis ◽  
Short Period ◽  
Clinical Consequences ◽  
Slow Blood Flow ◽  
Significant Mass Effect ◽  
Significant Mass

Spontaneous thrombosis in giant aneurysms is known, whereas complete occlusion of such aneurysms in a short period of time is rarely reported. We present the case of a 50-year-old man with a giant anuersym arising from the anterior communicating artery (ACA) producing significant mass effect with clinical consequences. The digital subtraction arteriogram (DSA) showed a patent lumen of about 20 mm and a very small neck leading to extremely slow blood flow inside the sac and stagnation of contrast. During catheterization for endovascular occlusion four weeks later, the arteriogram revealed complete disappearance of the aneurysm, while the patient remained clinically stable. The patient was operated upon and the thrombosed sac was removed with no complications. He was discharged one week later and recovered completely from his symptoms within three months.

scholarly journals Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation

2020 ◽  
Vol 4 (4) ◽  
pp. 634-635
Author(s):  
Taofiq Oyedokun ◽  
Kevin Durr
Keyword(s):  
Upper Airway ◽  
Mass Effect ◽  
Endoscopic Examination ◽  
Past Medical History ◽  
Fatal Complication ◽  
Case Presentation ◽  
History Of ◽  
Retropharyngeal Hematoma ◽  
Significant Mass Effect ◽  
Significant Mass

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.

scholarly journals Rare case of giant pediatric cavernous angioma of the temporal lobe: A case report and review of the literature

2020 ◽  
Vol 11 ◽  
pp. 7
Author(s):  
Fahd Derkaoui Hassani ◽  
Claire Karekezi ◽  
Najia El Abbadi
Keyword(s):  
Temporal Lobe ◽  
Cavernous Angioma ◽  
Mass Effect ◽  
Cavernous Malformations ◽  
Perilesional Edema ◽  
The Central Nervous System ◽  
The Brain ◽  
Underlying Pathology ◽  
Significant Mass Effect ◽  
Significant Mass

Background: Giant cavernous malformations of the central nervous system are quite rare. They are more common in children and may be misdiagnosed as other intracranial neoplasms. Here, we presented a very rare giant cavernous angioma mimicking a neoplastic temporal lobe lesion in an 18-month-old male. Case Description: An 18-month-old male presented with two initial seizures. Although the clinical examination was normal, the computed tomography (CT) scan showed a large left temporal mass (66 mm diameter) exerting significant mass effect and midline shift. The brain magnetic resonance (MR) imaging demonstrated a large left temporal heterogeneously enhancing lesion with significant perilesional edema and mass effect. The patient underwent gross total removal of the lesion that proved to be an intracranial cavernous angioma. Postoperatively, he did well, exhibiting no residual neurological deficit, and has remained lesion and seizure-free. Conclusion: This and 12 other cases in the literature focus on intracranial cavernous angiomas that could have been readily misdiagnosed as tumors. It confirms why obtaining appropriate preoperative MR and CT studies, followed by surgical intervention, is essential to confirm the correct underlying pathology and appropriately and optimally treat the patient.

scholarly journals Massive Temporalis Muscle Swelling after Decompressive Craniectomy: Case Report

2020 ◽  
Vol 2 (3) ◽  
pp. 32-34
Author(s):  
Dinesh Kumar Thapa ◽  
Pankaj Raj Nepal ◽  
Robin Bhattarai ◽  
Jagat Narayan Rajbanshi ◽  
Navin Kumar Yadav
Keyword(s):  
Case Report ◽  
Decompressive Craniectomy ◽  
Surgical Procedure ◽  
Mass Effect ◽  
Brain Herniation ◽  
Midline Shift ◽  
Brain Swelling ◽  
Temporalis Muscle ◽  
Significant Mass Effect ◽  
Significant Mass

 Background: Decompressive Craniectomy is a surgical procedure in neurosurgery to handle brain swelling subsequent to trauma, vascular insult, or tumor. There are different techniques and measurements of decompressive craniectomy performed worldwide. We follow the regular trauma flap involving fronto-temporo-parietal craniectomy. There have been many complications seen in these procedures, like brain herniation, malignant swelling, hydrocephalus, infection, etc. But we have encountered quite rare complications of decompressive craniectomy which had massive swelling of the temporalis muscle leading to significant mass effect and midline shift.

scholarly journals Spectrum of Imaging Findings in Oriental Cerebral Schistosomiasis and Their Categorization by MRI

2020 ◽  
Vol 10 (1) ◽  
pp. 16-26
Author(s):  
Prasanna Ghimire ◽  
Guangyao Wu
Keyword(s):  
Retrospective Review ◽  
Mass Effect ◽  
Cystic Degeneration ◽  
Imaging Findings ◽  
Perilesional Edema ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Mass Lesions ◽  
Significant Mass Effect ◽  
Significant Mass

Introduction: To describe the spectrum of imaging findings in oriental cerebral schistosomiasis and characterizing different stages by MRI.Methods: A retrospective review of the clinical and MRI images of twenty nine pathologically proven cases of neuroschistomiasis was performed. Patients with either absence of complete MR examination, previously treated patients were excluded from the study. MRI images were analyzed and lesions were evaluated for the following parameters - distribution, size, clusterity, perilesional edema, mass effect, intralesional hemorrhage, necrosis, cystic degeneration, any abnormal enhancements, any atypical features as abscess,vasculitis, infarctions, or focal atrophy and encephalomalacia.Results: Lesions were only supratentorial in 25 cases, only infratentorial in 3 cases while were both supratentorial and infratentorial in 1 case. Lesions were unilateral in 26 cases. Significant mass effect was noted in 8 cases. All nodular and mass lesions were hyperintense or isointense in T1WI while all but two lesions were hyperintense in T2WI. Lesions were predominantly as clustered nodules (12 cases). All nodules enhanced homogeneously except three that demonstrated ring like enhancement. Masses were demonstrated either homogeneous (2 cases) or heterogeneous in enhancement (2 cases). Central linear enhancement was noted in 12 cases, leptomeningeal enhancement in 10 cases while gyral enhancement was noted in 1 case.Conclusions: Radiological presentation of neuroschistosomiasis varies at different stages of infection as well as among the asymptomatic groups. Recognition of spectrum of presentation has an implied role in the overall management and outcome in cases

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