scholarly journals Role of early surgical intervention in outcome and prognosis of spontaneous cerebellar hemorrhage with intraventricular extension

2021 ◽  
Vol 3 (01) ◽  
pp. 28-32
Author(s):  
Jemesh Singh Maharjan
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Sudden Onset ◽  
Cerebellar Hemorrhage ◽  
First Case ◽  
Spontaneous Intracranial Hemorrhage ◽  
Poor Outcomes ◽  
The Right ◽  
Early Surgical Intervention

Spontaneous cerebellar hematomas represent 5 to 13% of all cases of spontaneous intracranial hemorrhage. The main controversy involves deciding which cases require surgical evacuation of the hematoma versus other options, such as ventricular drainage only or conservative treatment. Furthermore, because the clinical course is variable in some cases, timing of such treatment should be carefully considered. The duration from the onset of hemorrhage also plays an important role in prognosis and recovery of the patient. Both the clinical presentation and subsequent course vary among cases. Unpredictable rapid deterioration in consciousness levels has been recognized. The majority of patients with such decline in consciousness experience the deterioration primarily within 72 hrs after onset⁠. Acute presentation was observed to be correlated with poor outcomes. In our report, the first case presented with sudden onset of headache in the right frontal region of head with vertigo. He came to hospital within 6 hours of onset. However, the second case had an onset of symptoms around 72 hours before the presentation.

scholarly journals Spontaneous cervical epidural hematoma: Insight into this occurrence with case examples

2021 ◽  
Vol 12 ◽  
pp. 79
Author(s):  
Brian Fiani ◽  
Ryan Jarrah ◽  
Nicholas J. Fiani ◽  
Juliana Runnels
Keyword(s):  
Epidural Hematoma ◽  
Clinical Presentation ◽  
Treatment Algorithm ◽  
Region Of Interest ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Spinal Epidural Hematoma ◽  
Comprehensive Overview ◽  
Case Examples ◽  
First Case

Background: First characterized in the 19th century, spontaneous spinal epidural hematoma (SSEH) is known as the idiopathic accumulation of blood within the spinal canal’s epidural space, causing symptoms varying from general back pain to complete paraplegia. With varying etiologies, a broad spectrum of severity and symptoms, a time-dependent resolution period, and no documented diagnosis or treatment algorithm, SSEH is a commonly misunderstood condition associated with increasing morbidity. While SSEH can occur at any vertebrae level, 16% of all SSEH cases occur in the cervical spine, making it a region of interest to clinicians. Case Description: Herein, the authors present two case examples describing the clinical presentation of SSEH, while also reviewing the literature to provide a comprehensive overview of its presentation, pathology, and treatment. The first case is a patient with nontraumatic sudden onset neck pain with rapidly progressing weakness. The second case is a patient with painless weakness that developed while taking 325 mg of aspirin daily. Conclusion: Clinicians should keep SSEH in their differential diagnosis when seeing patients with nontraumatic sources of weakness in their extremities. The appropriate steps should be followed to diagnose and treat this condition with magnetic resonance imaging and surgical decompression if there are progressive neurological deficits. There is a continued need for more extensive database-driven studies to understand better SSEHs clinical presentation, etiology, and ultimate treatment.

A case of successful surgical treatment of patient with adrenal cyst using 3-d modeling

2020 ◽  
Vol 28 (4) ◽  
pp. 530-535
Author(s):  
Ivan Andreev ◽  
Alexander Kolsanov ◽  
Sergey Katorkin ◽  
Evgeniy Shestakov ◽  
Leonid Lichman
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
3D Modeling ◽  
Clinical Observation ◽  
Preoperative Planning ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Adrenal Cyst ◽  
The Right ◽  
Medical University

Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.

Disrupting the right pars opercularis with electrical stimulation frees the song: case report

2015 ◽  
Vol 123 (6) ◽  
pp. 1401-1404 ◽  
Author(s):  
Guillaume Herbet ◽  
Gilles Lafargue ◽  
Fabien Almairac ◽  
Sylvie Moritz-Gasser ◽  
François Bonnetblanc ◽  
...  
Keyword(s):  
Language Production ◽  
Inferior Frontal Gyrus ◽  
Awake Surgery ◽  
Low Grade ◽  
Speech Impairment ◽  
First Case ◽  
Pars Opercularis ◽  
The Right

The authors report the first case of a strikingly unusual speech impairment evoked by intraoperative electrostimulation in a 36-year-old right-handed patient, a well-trained singer, who underwent awake surgery for a right fronto-temporo-insular low-grade glioma. Functionally disrupting the pars opercularis of the right inferior frontal gyrus led the patient to automatically switch from a speaking to a singing mode of language production. Given the central role of the right pars opercularis in the inhibitory control network, the authors propose that this finding may be interpreted as possible evidence for a competitive and independent neurocognitive subnetwork devoted to the melodically intoned articulation of words (normal language-based vs singing-based) in subjects with high expertise. From a more clinical perspective, such data may have implications for awake neurosurgery, especially to preserve the quality of life for singers.

scholarly journals Microscopic Pulmonary Tumour Embolism: An Unusual Presentation of Thymic Carcinoma

2002 ◽  
Vol 9 (5) ◽  
pp. 347-350 ◽  
Author(s):  
Brita L Sperling ◽  
Donald W Cockcroft ◽  
Rajni Chibbar
Keyword(s):  
Thymic Carcinoma ◽  
Clinical Presentation ◽  
Present Report ◽  
Cor Pulmonale ◽  
Sudden Onset ◽  
Clinical Indication ◽  
Extrinsic Compression ◽  
Occult Malignancy ◽  
Right Pulmonary Artery ◽  
The Right

The present report describes the first reported case of microscopic pulmonary tumour embolism (MPTE) from thymic carcinoma. The carcinoma was discovered during an autopsy in a 55-year-old man who had undergone surgery for a pilonidal sinus two weeks before presentation. Pulmonary thromboembolism was suspected. This case was unusual because MPTE has never before been associated with thymic carcinoma, MPTE was the first clinical indication of an occult malignancy, and the clinical presentation was that of sudden onset of dyspnea associated with acute cor pulmonale. The cause of death was determined to be hypoxia secondary to extrinsic compression of the right pulmonary artery and extensive tumour emboli in the small arteries, arterioles and venules of the pulmonary parenchyma. A review of the clinical presentation and diagnosis of MPTE is included.

scholarly journals Severe Dilatation of Coronary Artery Ostium Complicating Sinus of Valsalva Aneurysm: Differential Diagnosis and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Paul Bamford ◽  
Nicholas Collins
Keyword(s):  
Differential Diagnosis ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Surgical Intervention ◽  
Sinus Of Valsalva ◽  
Sinus Of Valsalva Aneurysm ◽  
Unusual Manifestation ◽  
The Right ◽  
Underlying Pathophysiology

Coronary artery dilatation may be due to various aetiologies including congenital anomalies, atherosclerotic coronary disease, and Kawasakis disease. We describe a case characterised by apparent severe dilatation of the right coronary artery ostium in an asymptomatic male. Subsequent imaging and surgical intervention documented the presence of a sinus of Valsalva aneurysm extending into the ostium of the right coronary artery. This represents an unusual manifestation of a sinus of Valsalva aneurysm. The underlying pathophysiology, differential diagnosis, role of surgical management, and outcomes are discussed.

Cervical Spine Dural Arteriovenous Fistula With Coexisting Spinal Radiculopial Artery Aneurysm Presenting as Subarachnoid Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 259-263 ◽  
Author(s):  
Joshua W. Lucas ◽  
Jesse Jones ◽  
Azadeh Farin ◽  
Paul Kim ◽  
Steven L. Giannotta
Keyword(s):  
Native American ◽  
Cervical Spine ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Artery Aneurysm ◽  
Sudden Onset ◽  
Spinal Dural Arteriovenous Fistula ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE We present a patient with a cervical spine dural arteriovenous fistula associated with a radiculopial artery aneurysm at the same vertebral level presenting with subarachnoid hemorrhage. CLINICAL PRESENTATION A 45-year-old Native American man presented with sudden-onset severe headache, lethargy, and right hemiparesis. Computed tomography (CT) of the head showed subarachnoid hemorrhage and hydrocephalus. A subsequent CT of the neck showed an anterior spinal subdural hematoma from C2 to C4 causing mild cord compression. Carotid and vertebral angiography failed to demonstrate an intracranial aneurysm, but showed a spinal dural arteriovenous fistula originating from the right vertebral artery at the C5 neuroforamen. The severity of the patient's symptoms, atypical for rupture of a dural arteriovenous fistula, prompted more thorough angiographic evaluation. Thus, injection of the right thyrocervical trunk was performed, demonstrating a 4-mm spinal radiculopial artery aneurysm. Following ventriculostomy, a hemilaminectomy from C4 to C7 was performed with disconnection of the fistula from its drainage system. Subsequent resection of the aneurysm, which was determined to be the cause of the hemorrhage, was accomplished. The patient improved neurologically and was discharged to rehabilitation. CONCLUSION Spinal cord aneurysms from a separate vascular distribution may coexist with spinal dural arteriovenous fistulas. In the setting of spinal hemorrhage, especially in situations with an atypical clinical presentation, comprehensive imaging is indicated to rule out such lesions.

An Impacted Malformed Primary Maxillary Central Incisor Diagnosed as a Compound Odontoma.

2008 ◽  
Vol 33 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Dror Aizenbud ◽  
Yael Pery Front
Keyword(s):  
Normal Development ◽  
Surgical Intervention ◽  
Traumatic Injury ◽  
Permanent Tooth ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
History Of ◽  
The Right ◽  
Compound Odontoma ◽  
Early Surgical Intervention

An odontoma is usually found in the surrounding area of the unerupted permanent tooth bud and rarely adjacent to the primary central incisor. This report presents a case of an unerupted malformed primary central incisor, histologically diagnosed as a compound odontoma. A 5.5 year-old healthy boy presented with an unerupted maxillary left primary central incisor and mild gingival buccal swelling. No history of traumatic injury was recorded. Radiological examination revealed a tooth-like mass with a partially developed root and a malformed crown in the area of the left primary central incisor. Delayed development of the successor left permanent incisor in comparison to the right one was noted. The rational for early surgical intervention to enable normal development and eruption of permanent incisors is described. Clinical and radiographic diagnoses as well as several etiological factors and a differential diagnosis are considered and reviewed.

scholarly journals Isolated Gallbladder Rupture Due to Blunt Abdominal Trauma

HPB Surgery ◽  
1989 ◽  
Vol 1 (4) ◽  
pp. 359-362 ◽  
Author(s):  
P. Schachter ◽  
A. Czerniak ◽  
E. Shemesh ◽  
I. Avigad ◽  
G. Lotan ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Traumatic Injury ◽  
Biliary System ◽  
High Morbidity ◽  
Delay In Diagnosis ◽  
Early Surgical Intervention ◽  
Gallbladder Rupture

Traumatic injury to the extrahepatic biliary system is rare and usually diagnosed at laparotomy when it is associated with other visceral injuries. Isolated gallbladder rupture due to blunt abdominal trauma is even rarer. The clinical presentation of gallbladder injury is variable, resulting in a delay in diagnosis and treatment. Awareness to the possibilty of trauma to the extrahepatic biliary system enables early surgical intervention and eliminates the high morbidity associated with delated diagnosis.A 5 year old child with isolated gallbladder rupture caused by blunt abdominal trauma is presented.

scholarly journals A Dire Emergency Case of Stab Injury with Impending Ischemia of Eviscerated Bowel with Colonic Perforation - A Case Report

2021 ◽  
Vol 4 (6) ◽  
pp. 01-02
Author(s):  
Chatterjee S ◽  
M Amir ◽  
Sameer D ◽  
Prathamesh P
Keyword(s):  
Abdominal Trauma ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Colonic Perforation ◽  
Emergency Case ◽  
Penetrating Abdominal Trauma ◽  
Stab Injury ◽  
Ischemic Bowel ◽  
Work Up ◽  
Early Surgical Intervention

Penetrating abdominal trauma is mostly caused by gunshots or stab wounds.1 Management of penetrating abdominal trauma is often challenging and time between the injury and surgical intervention play a pivotal role in such cases depending upon the clinical presentation of the patient.The success rate depends so much on early surgical intervention that one cannot wait for pre-operative work up before taking the patient to operation theatre2. We present a case of stab injury presented with eviscerated ischemic bowel and perforation in transverse colon with mesenteric arterial spurter.

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