Delayed brain abscess related to a retained foreign body with culture of Clostridium bifermentans

1986 ◽  
Vol 64 (5) ◽  
pp. 813-815 ◽  
Author(s):  
Terrence L. Pencek ◽  
Kim J. Burchiel
Keyword(s):  
Foreign Body ◽  
Brain Abscess ◽  
Surgical Management ◽  
Foreign Bodies ◽  
Intracranial Abscess ◽  
Content Type ◽  
Retained Foreign Body ◽  
Organism Growth ◽  
Clostridium Bifermentans ◽  
Fine Print

✓ Although it is well documented that retained foreign bodies are associated with delayed intracranial abscess, there are few reports of anaerobic organism growth. A case is presented in which a left parieto-occipital abscess surrounded a metallic fragment implanted when a mortar shell exploded in Vietnam 15 years before. The diagnostic evaluation and surgical management of this case are presented.

Juxtapontine abscess around a retained wooden fragment following a penetrating eye injury: surgical management via a transtentorial approach

2012 ◽  
Vol 9 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Sunil K. Gupta ◽  
Alok A. Umredkar
Keyword(s):  
Foreign Body ◽  
Brain Abscess ◽  
Surgical Management ◽  
Penetrating Injury ◽  
Eye Injury ◽  
Retained Foreign Body ◽  
Penetrating Eye Injury ◽  
Wooden Foreign Body ◽  
Transtentorial Approach

Penetrating injury through the orbit with a retained intracranial wooden foreign body is rare. The authors report the case of a child with a juxtapontine brain abscess secondary to a retained foreign body. The pitfalls in diagnosis and the surgical management for removal of the wooden fragment and drainage of the abscess are discussed.

Intracranial foreign bodies: backfire

1973 ◽  
Vol 38 (1) ◽  
pp. 96-98
Author(s):  
B. A. Rocha Campos ◽  
N. Ballalai ◽  
J. Portugal Pinto
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Cranial Cavity ◽  
Content Type ◽  
Fine Print

✓ The authors report 14 cases of a foreign body that penetrated the cranial cavity due to backfire of an over-charged, home-filled metallic cartridge.

Brain abscess related to metal fragments 47 years after head injury

2000 ◽  
Vol 93 (3) ◽  
pp. 477-479 ◽  
Author(s):  
June-Ho Lee ◽  
Dong Gyu Kim
Keyword(s):  
Brain Abscess ◽  
Foreign Bodies ◽  
Korean War ◽  
Content Type ◽  
Generalized Seizures ◽  
Personality Changes ◽  
The Korean War ◽  
The Right ◽  
Explosion Injury ◽  
Fine Print

✓ The authors report a case of symptomatic brain abscess in a 51-year-old man who presented with personality changes and generalized seizures. He had survived a grenade explosion injury during the Korean War 47 years previously. Computerized tomography scanning revealed multiple conglomerate rim-enhancing lesions and metallic foreign bodies in the right frontal lobe. The mass was totally removed and Pseudomonas aeruginosa was isolated from microbial cultures.Retained foreign bodies in the brain, whether bone or metal, should be removed at the time of injury if at all possible. If this cannot be accomplished, patients with such retained foreign bodies should be carefully monitored for life.

Use of centrifuge in the treatment of an intraventricular metallic foreign body

1971 ◽  
Vol 34 (6) ◽  
pp. 800-804 ◽  
Author(s):  
James W. Markham ◽  
Seymour Stein ◽  
Ralph Pelligra ◽  
Philipp Lippe ◽  
Jack Noyes
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Metallic Foreign Body ◽  
Fixed Position ◽  
Content Type ◽  
Bullet Fragment ◽  
Motion Simulator ◽  
Left Lateral Ventricle ◽  
Fine Print

✓ A bullet fragment within the ventricular system was immobilized by use of centrifugation in a 5°-of-freedom-of-motion simulator at 4 to 6 G's. Transient cardiovascular changes occurred, but there were no ill effects clinically. The bullet fragment was immobilized within the ependyma of the left lateral ventricle and has remained in a fixed position during a 22-month follow-up period. A brief review of the treatment of intraventricular foreign bodies is included.

Penetrating intracranial wood wounds: clinical limitations of computerized tomography

1988 ◽  
Vol 68 (5) ◽  
pp. 752-756 ◽  
Author(s):  
James E. Hansen ◽  
Steven K. Gudeman ◽  
Richard C. Holgate ◽  
Richard A. Saunders
Keyword(s):  
Foreign Body ◽  
Computerized Tomography ◽  
Case History ◽  
Foreign Bodies ◽  
Content Type ◽  
History Of ◽  
Wooden Foreign Body ◽  
Type Of Injury ◽  
Different Sources ◽  
Fine Print

✓ The case history of a patient with a periorbital penetrating wooden foreign body is presented. The computerized tomography (CT) densities of several different sources of wood were compared using an experimental model. The clinical usefulness and practical limitations of CT in the evaluation of intracranial foreign bodies is discussed, and the management of this type of injury is reviewed.

Bacteriology of intracranial abscess in children

1981 ◽  
Vol 54 (4) ◽  
pp. 484-488 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Anaerobic Bacteria ◽  
Subdural Empyema ◽  
Intracranial Abscess ◽  
Gram Positive ◽  
Temporal Area ◽  
Content Type ◽  
Gram Positive Cocci ◽  
Fine Print

✓ The bacteriological and clinical findings in 19 pediatric patients with intracranial abscess are presented. Ten children presented with subdural empyema and nine had brain abscess. Sinusitis was present in 14 children, and dental abscess in two. The abscess was located in the frontal and parietal area in seven instances each, and in the temporal area in five. Anaerobic organisms alone were recovered in 12 (63%) of the patients (including eight with subdural empyema and four with brain abscess), aerobic bacteria alone were present in two children (11%), and mixed aerobic and anaerobic bacteria were present in five (26%) patients. There were 43 anaerobic isolates (2.3 per specimen). The predominant anaerobes were anaerobic Gram-positive cocci (16 isolates); Bacteroides sp. (10, including two B. fragilis); Fusobacterium sp. (nine isolates); and Actinomyces sp. (five isolates). A total of eight aerobic isolates (0.4 per specimen), including five Gram-positive cocci and three Haemophilus sp., were recovered. Antimicrobial therapy was administered to all patients. Five patients, four with sinusitis and subdural empyema and one with sinusitis and brain abscess, did not respond to antimicrobial therapy and aspiration of the abscess, and required surgical drainage of their inflamed sinuses. These findings indicate the major role of anaerobic organisms in the polymicrobial etiology of intracranial abscess in children.

Microvascular patch technique with and without Silastic T-tube bypass

1984 ◽  
Vol 60 (2) ◽  
pp. 287-295 ◽  
Author(s):  
Peter C. Haines ◽  
R. M. Peardon Donaghy
Keyword(s):  
Foreign Body ◽  
Suture Material ◽  
Vascular Occlusion ◽  
Current Data ◽  
Content Type ◽  
Small Vessels ◽  
T Tube ◽  
Patch Closure ◽  
Patch Technique ◽  
Fine Print

✓ Poor patency results in the surgery of small vessels operated on between 1959 to 1964 was demonstrated to be in part due to the long period of occlusion of the operated vessel during surgery and the presence of a foreign body (suture) in the lumen of the vessel postoperatively. New suture techniques and T-tube bypass were introduced at that time. New experimental data have not been extensively sought since that time. To provide further current data regarding the above observations, 110 arterial vessels (60 carotid arteries 1.1 to 1.3 mm in outside diameter (OD) and 50 femoral arteries 0.6 to 0.7 mm OD) were operated on in rats to compare the bypass versus non-bypass and vein patch closure techniques. In 1-mm vessels, patency rates 1 month after surgery were 100% regardless of the use of bypass or type of closure. Improved visualization, better suture material, and improved surgical skill were probably chiefly responsible for this success. The success rate was not as encouraging, however, in vessels of 0.6 mm OD. The following points are brought out: 1) The presence of the bypass causes damage to the intima in 0.6 mm OD vessels and should not be used. Smaller bypasses do not conduct blood well. 2) Bypass is not required in 1-mm vessels as the patency rate is satisfactory and not altered by its use. 3) The major indication for T-tube bypass is in vessels of 1 mm OD and larger, that nourish tissue which would be damaged by vascular occlusion for 20 to 40 minutes. 4) Foreign body (suture) in the lumen is poorly tolerated in 0.6 mm vessels, but can be tolerated more easily in larger vessels. 5) Techniques that limit the amount of suture material in the lumen are indicated in 0.6-mm vessels. 6) After 1 month, suture material has an epithelial covering and if patency has been maintained for that period of time it is likely to remain.

Surgical management of spinal cord hemangioblastomas in patients with von Hippel—Lindau disease

2003 ◽  
Vol 98 (1) ◽  
pp. 106-116 ◽  
Author(s):  
Russell R. Lonser ◽  
Robert J. Weil ◽  
John E. Wanebo ◽  
Hetty L. Devroom ◽  
Edward H. Oldfield
Keyword(s):  
Spinal Cord ◽  
Surgical Management ◽  
Postoperative Outcome ◽  
Tumor Location ◽  
Neurological Dysfunction ◽  
Autosomal Dominant Disorder ◽  
Content Type ◽  
Von Hippel Lindau ◽  
Vhl Disease ◽  
Fine Print

Object. Von Hippel—Lindau (VHL) disease is an autosomal-dominant disorder frequently associated with hemangioblastomas of the spinal cord. Because of the slow progression, protean nature, and high frequency of multiple spinal hemangioblastomas associated with VHL disease, the surgical management of these lesions is complex. Because prior reports have not identified the factors that predict which patients with spinal cord hemangioblastomas need surgery or what outcomes of this procedure should be expected, the authors have reviewed a series of patients with VHL disease who underwent resection of spinal hemangioblastomas at a single institution to identify features that might guide surgical management of these patients. Methods. Forty-four consecutive patients with VHL disease (26 men and 18 women) who underwent 55 operations with resection of 86 spinal cord hemangioblastomas (mean age at surgery 34 years; range 20–58 years) at the National Institutes of Health were included in this study (mean clinical follow up 44 months). Patient examination, review of hospital charts, operative findings, and magnetic resonance imaging studies were used to analyze surgical management and its outcome. To evaluate the clinical course, clinical grades were assigned to patients before and after surgery. Preoperative neurological status, tumor size, and tumor location were predictive of postoperative outcome. Patients with no or minimal preoperative neurological dysfunction, with lesions smaller than 500 mm3, and with dorsal lesions were more likely to have no or minimal neurological impairment. Syrinx resolution was the result of tumor removal and was not influenced by whether the syrinx cavity was entered. Conclusions. Spinal cord hemangioblastomas can be safely removed in the majority of patients with VHL disease. Generally in these patients, hemangioblastomas of the spinal cord should be removed when they produce symptoms or signs.

scholarly journals Accuracy of ultrasonography in detecting radiolucent soft-tissue foreign bodies

2014 ◽  
Vol 24 (02) ◽  
pp. 196-200
Author(s):  
Morteza Tahmasebi ◽  
Hamdollah Zareizadeh ◽  
Azim Motamedfar
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
High Frequency ◽  
Foreign Bodies ◽  
Linear Array ◽  
Foreign Body Removal ◽  
Retained Foreign Body ◽  
Array Transducer ◽  
Highly Sensitive ◽  
Objective Detection

Abstract Background and Objective: Detection of radiolucent soft-tissue foreign bodies is a challenging problem, which is especially further complicated when retained foreign body is highly suggested by clinicians but radiography is negative. So, blind exploration is sometimes hazardous for patients. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft-tissue foreign bodies in the extremities. Materials and Methods: From November 2011 to January 2012, patients with clinically suspected radiolucent soft-tissue foreign body and negative radiography were evaluated by USG with a 12-MHz linear array transducer. The patients with positive clinical and USG examination were included in our study and underwent exploration or USG removal. Results: Fifty-one patients underwent foreign body removal under ultrasonography-guided or surgical exploration and 47 patients had foreign body (31, 12, 3, and 1 case had thorn, wood, glass, and plastic, respectively). Ultrasound was positive in 50 patients. USG falsely predicted the presence of foreign body in four cases and was falsely negative in one of the cases. Accuracy, sensitivity, and positive predictive value were determined as 90.2%, 97.9%, and 92%, respectively. Conclusions: The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which are difficult to be visualized by routine radiography.

Surgical management and outcome in patients with radial nerve lesions

2001 ◽  
Vol 95 (4) ◽  
pp. 573-583 ◽  
Author(s):  
Daniel H. Kim ◽  
Andrew C. Kam ◽  
Padmavathi Chandika ◽  
Robert L. Tiel ◽  
David G. Kline
Keyword(s):  
Surgical Management ◽  
Radial Nerve ◽  
Gunshot Wounds ◽  
Suture Repair ◽  
Content Type ◽  
Louisiana State University ◽  
Internal Neurolysis ◽  
End To End ◽  
Grade 3 ◽  
Fine Print

Object. The goal of this paper was to review surgical management and outcomes in patients treated for radial nerve (RN) lesions at Louisiana State University Health Sciences over a period of 30 years. Methods. Two hundred sixty patients with RN injuries were evaluated. The most common mechanisms of injuries involving the RN included fracture of the humerus, laceration, blunt contusions, and gunshot wounds. One hundred and eighty patients (69%) underwent surgery. Lesions not in continuity required primary or secondary end-to-end suture repairs or graft repairs. With the use of direct intraoperative nerve action potential recording, RN injuries in which the lesion was in continuity required external or internal neurolysis or resection of the lesion followed by end-to-end suture or graft repair. A minimum of 1.5 years follow-up review was available in 90% of the patients who underwent surgery. Motor function recovery to Grade 3 or better was observed in 10 (91%) of 11 patients who underwent primary suture repair, 25 (83%) of 30 who underwent secondary suture repair, 43 (80%) of 54 who received graft repair, and 63 (98%) of 64 in whom neurolysis was performed. Sixteen (71%) of 21 patients with superficial sensory RN injury achieved satisfactory pain relief after complete resection of a neuroma or neurolysis. Conclusions. This study clearly demonstrates that excellent functional recovery can be achieved with proper surgical management of RN injuries.

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