Epidural hematoma of the clivus

✓ This 8-year-old boy presented with a rare case of epidural hematoma of the clivus and atlantoaxial dislocation caused by a hyperflexion injury sustained in a traffic accident. Magnetic resonance (MR) imaging demonstrated an epidural hematoma in the posterior fossa that compressed the pons and medulla. On admission, the patient was confused and had bilateral abducens palsy. He was treated conservatively, and 6 months after admission, the epidural hematoma on the clivus had disappeared on MR imaging and the bilateral abducens palsy was cured. Only two such cases have been reported in the literature. In this report, the authors discuss the mechanism of hematoma formation in this region of the brain.

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Clivus epidural hematoma

Journal of Neurosurgery ◽

10.3171/jns.1990.72.4.0660 ◽

1990 ◽

Vol 72 (4) ◽

pp. 660-662 ◽

Cited By ~ 29

Author(s):

Akihiro Kurosu ◽

Keiichi Amano ◽

Osami Kubo ◽

Hiroshi Himuro ◽

Takeki Nagao ◽

...

Keyword(s):

Traffic Accident ◽

Rare Case ◽

Epidural Hematoma ◽

Similar Case ◽

Content Type ◽

Hyperextension Injury ◽

Fine Print

✓A rare case of epidural hematoma of the clivus is reported in an 11 -year-old girl involved in a traffic accident which caused a severe hyperextension injury. Only one similar case has been reported in the literature. The mechanism for the formation of the hematoma of this region is discussed.

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Bilateral traumatic abducens palsy

Journal of Neurosurgery ◽

10.3171/jns.1971.34.1.0033 ◽

1971 ◽

Vol 34 (1) ◽

pp. 33-37 ◽

Cited By ~ 50

Author(s):

Richard C. Schneider ◽

Frank D. Johnson

Keyword(s):

Cervical Spine ◽

Abducens Nerve ◽

Abducens Palsy ◽

Content Type ◽

Associated Injury ◽

Posterior Direction ◽

Bilateral Abducens Palsy ◽

Bilateral Abducens ◽

Fine Print

✓ Two patients with bilateral abducens palsy are presented. A study of the associated injury to the cervical spine suggests that a severe blow to the head in an upward and posterior direction may produce contusion or avulsion of the abducens nerve by the rigid petrosphenoidal ligament under which it passes.

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Hydrocephalus due to villous hypertrophy of the choroid plexus in the lateral ventricles

Journal of Neurosurgery ◽

10.3171/jns.1994.80.2.0321 ◽

1994 ◽

Vol 80 (2) ◽

pp. 321-323 ◽

Cited By ~ 33

Author(s):

Hirofumi Hirano ◽

Kazuho Hirahara ◽

Tetsuhiko Asakura ◽

Tetsuro Shimozuru ◽

Koki Kadota ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Mental Retardation ◽

Magnetic Resonance ◽

Mr Imaging ◽

Choroid Plexus ◽

Ventriculoperitoneal Shunt ◽

Rare Case ◽

Content Type ◽

Lateral Ventricles ◽

Fine Print

✓ A case is reported of hydrocephalus due to overproduction of cerebrospinal fluid (CSF) caused by villous hypertrophy of the choroid plexus in the lateral ventricles. A 7-year-old girl with mental retardation developed gait disturbance; hydrocephalus and a Dandy-Walker cyst were detected on computerized tomography. She was initially treated with a ventriculoperitoneal shunt; however, shunting failed to control the hydrocephalus. The excessive outflow of CSF suggested choroid plexus abnormality, and magnetic resonance (MR) imaging revealed enlargement of the choroid plexus in both lateral ventricles. The patient was therefore diagnosed as having hydrocephalus induced by overproduction of CSF, which was controlled by resection of the choroid plexus. Histological examination showed the structure typical of normal choroid plexus. This is a rare case of villous hypertrophy of the choroid plexus in which MR imaging assisted in the diagnosis.

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A realistic brain tissue phantom for intraparenchymal infusion studies

Journal of Neurosurgery ◽

10.3171/jns.2004.101.2.0314 ◽

2004 ◽

Vol 101 (2) ◽

pp. 314-322 ◽

Cited By ~ 165

Author(s):

Zhi-Jian Chen ◽

George T. Gillies ◽

William C. Broaddus ◽

Sujit S. Prabhu ◽

Helen Fillmore ◽

...

Keyword(s):

Mr Imaging ◽

Bromophenol Blue ◽

Agarose Gel ◽

Convection Enhanced Delivery ◽

Content Type ◽

Force Profile ◽

The Brain ◽

Fine Print

Object. The goal of this study was to validate a simple, inexpensive, and robust model system to be used as an in vitro surrogate for in vivo brain tissues in preclinical and exploratory studies of infusion-based intraparenchymal drug and cell delivery. Methods. Agarose gels of varying concentrations and porcine brain were tested to determine the infusion characteristics of several different catheters at flow rates of 0.5 and 1 µl per minute by using bromophenol blue (BPB) dye (molecular weight [MW] ∼690) and gadodiamide (MW ∼573). Magnetic resonance (MR) imaging and videomicroscopy were used to measure the distribution of these infusates, with a simultaneous measurement of infusion pressures. In addition, the forces of catheter penetration and movement through gel and brain were measured. Agarose gel at a 0.6% concentration closely resembles in vivo brain with respect to several critical physical characteristics. The ratio of distribution volume to infusion volume of agarose was 10 compared with 7.1 for brain. The infusion pressure of the gel demonstrated profiles similar in configuration and magnitude to those of the brain (plateau pressures 10–20 mm Hg). Gadodiamide infusion in agarose closely resembled that in the brain, as documented using T1-weighted MR imaging. Gadodiamide distribution in agarose gel was virtually identical to that of BPB dye, as documented by MR imaging and videomicroscopy. The force profile for insertion of a silastic catheter into agarose gel was similar in magnitude and configuration to the force profile for insertion into the brain. Careful insertion of the cannula using a stereotactic guide is critical to minimize irregularity and backflow of infusate distribution. Conclusions. Agarose gel (0.6%) is a useful surrogate for in vivo brain in exploratory studies of convection-enhanced delivery.

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Bilateral abducens palsy in closed head injury: A comprehensive review of literature based on a case report

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i10.38006 ◽

2021 ◽

Vol 12 (10) ◽

pp. 164-170

Author(s):

Sandeep B V ◽

Rekha K R ◽

Manpreet Singh Banga ◽

Anantha Kishan ◽

Vittal I Nayak ◽

...

Keyword(s):

Head Injury ◽

Nerve Injury ◽

Nerve Palsy ◽

Closed Head Injury ◽

Abducens Nerve ◽

Nerve Injuries ◽

Abducens Palsy ◽

Closed Head ◽

Bilateral Abducens Palsy ◽

Bilateral Abducens

Isolated bilateral sixth nerve palsies are rare, particularly in the setting of trauma. Most post-head injury cases with bilateral abducens palsy involve either basal skull fractures, particularly clival fractures. We present a case of bilateral abducens palsy after closed head injury in a young male who presented to the emergency department and a comprehensive literature review based on our clinical case. A Medline search for bilateral abducens palsy in closed head injury showed 89 results. Articles were excluded if crush head injury, non-traumatic bilateral abducens nerve palsy, associated vascular malformations were reported. After thorough search and filtering of those articles, fifty-one publications were found which reported and discussed about traumatic bilateral abducens palsy with closed head injury. In these 51 articles, a total of 139 cases were recorded. Several theories have been postulated to explain mechanisms of abducens nerve injury in trauma both in immediate and delayed settings. In our case, patient presented with immediate onset of bilateral abducens palsy. On imaging, clival fracture was seen in CT brain, which can be attributed for the nerve injury. Cases with retroclival extradural haematoma had higher chances of multiple cranial nerve injuries. Cases with multiple basal skull fracture involving petrous temporal bone fracture had higher chances of facial nerve injury. Along with bilateral involvement, the poorer outcome for recovery can be related with the severity of the adduction deficit. Our case showed no improvement in bilateral abduction during follow-up at 6 months. Clinical presentation of traumatic bilateral abducens nerve palsy is rare following closed head trauma and is usually associated with other injuries which are incompatible with life. It can be associated with other nerve injuries depending on basal skull fractures.

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Prenuclear Slowly Progressive Bilateral Abducens Palsy in Marie’s Cerebellar Ataxia

Documenta Ophthalmologica Proceedings Series - Strabismus Symposium Amsterdam, September 3–4, 1981 ◽

10.1007/978-94-009-7997-0_40 ◽

1982 ◽

pp. 263-268 ◽

Cited By ~ 1

Author(s):

T. W. Van Weerden ◽

W. A. Houtman

Keyword(s):

Cerebellar Ataxia ◽

Abducens Palsy ◽

Bilateral Abducens Palsy ◽

Bilateral Abducens

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Infectious meningitis mimicking recurrent medulloblastoma on magnetic resonance imaging

Journal of Neurosurgery ◽

10.3171/jns.1999.91.3.0499 ◽

1999 ◽

Vol 91 (3) ◽

pp. 499-502 ◽

Cited By ~ 7

Author(s):

Maryam Fouladi ◽

Richard Heideman ◽

James W. Langston ◽

Larry E. Kun ◽

Stephen J. Thompson ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Magnetic Resonance ◽

Mr Imaging ◽

Recurrent Disease ◽

Laboratory Data ◽

Resonance Imaging ◽

Content Type ◽

Routine Surveillance ◽

Brain And Spinal Cord ◽

The Brain

✓ This report and the accompanying review of the literature address the challenges, when using surveillance magnetic resonance (MR) imaging, of establishing the origin of newly detected central nervous system lesions. Routine surveillance MR imaging in a 16-year-old boy, whose medulloblastoma had been successfully treated, demonstrated asymptomatic nodular leptomeningeal enhancement of the brain and spinal cord, which was consistent with recurrent disease. Examination of the cerebrospinal fluid, however, led to the diagnosis of bacterial meningitis. Two weeks after completion of antibiotic therapy, the original MR imaging findings were seen to have resolved. This case illustrates the importance of considering clinical and laboratory data, including results from a complete examination of the cerebrospinal fluid, when interpreting the origin of new lesions revealed by MR imaging.

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Sparganosis of the brain

Journal of Neurosurgery ◽

10.3171/jns.1989.71.2.0287 ◽

1989 ◽

Vol 71 (2) ◽

pp. 287-289 ◽

Cited By ~ 20

Author(s):

Shigetaka Anegawa ◽

Takashi Hayashi ◽

Katsuyasu Ozuru ◽

Shinken Kuramoto ◽

Kenichi Nishimura ◽

...

Keyword(s):

Rare Case ◽

Clinical Symptoms ◽

Parasitic Infection ◽

Diagnostic Evaluation ◽

Content Type ◽

Multiple Lesions ◽

Cerebral Sparganosis ◽

The Brain ◽

Fine Print

✓ A rare case of cerebral sparganosis occurring in a 7-year-old boy is reported. Since his clinical symptoms fluctuated and diagnostic evaluation demonstrated multiple lesions, he was examined for a parasitic infection. Emphasis is placed on the difficulties involved in diagnosing cerebral sparganosis.

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Multiple giant hydatid cysts of the brain

Journal of Neurosurgery ◽

10.3171/jns.1982.57.3.0413 ◽

1982 ◽

Vol 57 (3) ◽

pp. 413-415 ◽

Cited By ~ 41

Author(s):

Ajay Sharma ◽

Jacob Abraham

Keyword(s):

Computerized Tomography ◽

Hydatid Disease ◽

Rare Case ◽

The Body ◽

Hydatid Cysts ◽

Content Type ◽

Multiple Primary ◽

The Right ◽

The Brain ◽

Fine Print

✓ A rare case of multiple primary hydatid cysts of the brain is reported in a 9-year-old girl. There were five cysts, occupying most of the right supratentorial region. The biggest cyst measured 9 cm across, while the smallest one was 4.5 cm in diameter. The diagnosis was based on computerized tomography findings. The patient did not have any evidence of hydatid disease elsewhere in the body. The delivery of all the cysts resulted in the dramatic neurological recovery of this patient.

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