Two Cases of Dorsal Epidural Migration of Lumbar Disk Fragments
This report presents 2 cases of migration of the lumbar disk into the dorsal epidural space. A 65-year-old man complained of sciatica and numbness from the posterior surface of the bilateral thighs. Magnetic resonance imaging (MRI) showed a narrow spinal canal at L3-4. The mass was posterolateral in the epidural space at the L4 level. It was iso-hypointense on T1-weighted images and iso-hyperintense on T2-weigted images. A decompressive lumbar hemilaminectomy was performed. Surgery revealed the mass to be surrounded by a membranous thickened mass of the epidural venous plexus and was dorsal to the dural sac. The mass prove...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Hydatid Disease of the Lumbar Spine: A Report on Pure Spinal Involvement With Hydatid Cysts
We report a 58-year-old male patient with low back pain and urine incontinency. The patient was operated because of extradural lesion with compression effect. The final diagnosis was pure primary hydatid infection. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Literature Review and Clinical Presentation of Pelvic Impalement by Steel Bar Causing Cauda Equina Syndrome
Pelvic-penetrating injuries are rare but often spectacular and constitute formidable management problems. Most of the patients suffered from organ or vascular damages; however, neurological lesion in combination with pelvic impalement was seldom reported. This paper highlights a unique case of pelvic impalement through the sacrum with cauda equina injury. A 50-year-old construction worker was impaled in the pelvis because of an accidental fall on a steel bar. The surgical treatment of the injury and the medical management of complications are described in detail. The patient made a good recovery, although he has functional...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Invasive Fungal Granuloma of the Brain in an Immunocompetent Patient
We present a case of the central nervous system aspergillosis in an immunocompetent patient. A 27-year-old man was admitted to the hospital with complaints of headache and visual disturbance. He was a known case of fungal sinusitis and used to inhale opium. In cranial magnetic resonance imaging, a mass lesion in the right frontal lobe was observed. The pathology result was in favor of the aspergillus infection. The substance abuse by inhalation is considered a possible route of fungal entry, especially in the immunocompetent patient. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Giant Petrous Bone Osteoma Associated With Ipsilateral Clivus Meningioma in an Adult: A Case Report and Review of Literature
Conclusions: This case presents new clinical and radiographic findings associated with a rare lesion. Dependent tumors that one tumor may act as an irritating agent for the local proliferation of the other most likely accounted for this pattern of tumoral linkage. A satisfactory surgical result was achieved through a relatively minimal approach and different strategies. Trigeminal neuralgia, the initial presenting symptom, improved during the follow-up period. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Cystic Papillary Meningioma Recurrence With Extracranial Metastasis After Surgery and Postoperative Radiotherapy: A Case Report
Meningiomas are typically benign tumors, and the papillary variant of meningioma with cyst formation is extremely rare. Here, we describe a female patient with cystic papillary meningioma in the left parietal area with cystic recurrence, brain invasion, and extracranial metastasis after gross total surgical resection and postoperative radiotherapy (RT). The solid metastatic lesion was located in the extradural mater and infiltrated into the skull. Considering the severe malignancy of this disease, gross total resection including removal of the cystic wall and adjuvant postoperative RT were deemed necessary. This is a first...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Subacute Posttraumatic Ascending Myelopathy After Excessive Closed Reduction of Bilateral Cervical Facet Dislocation
We report a case of subacute posttraumatic ascending myelopathy after bilateral cervical facet dislocation. The 57-year-old man had quadriparesis after sustaining a neck injury from a fall. Excessive closed reduction and manipulation of the cervical facet dislocation resulted in worsening motor power of his extremities. Urgent operation and decompression by an anterior approach offered slight improvement of the quadriparesis. However, 3 days after the surgery, myelopathic manifestations including respiratory difficulty became progressive. Magnetic resonance imaging revealed that myelopathy had ascended into the brain stem....
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Acromegaly With an Ectopic Clival Pituitary Adenoma: Case Report and Review of Literature
In this report, we describe the fourth case of ectopic growth hormone (GH)-secreting adenoma in the clivus. A 49-year-old female patient was admitted with acromegaly and blurred vision. Biochemical evaluation revealed a notable elevation in the GH level at >40 ng/mL (normal range, 0.0 to 5.0 ng/mL). A magnetic resonance imaging scan of the pituitary showed a mass below the sellar turcica. The patient underwent an endoscopic transnasal transsphenoidal approach to the sella, and the tumor in the clivus was completely removed. The tumor was separated from the intrasellar contents by intact bone of the sella. Histologic examin...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Dual Microcatheter Technology Treatment of Intraoperative Intracranial Aneurysm Rupture
This article, the authors use the dual micro-catheter technology to filling the aneurysm, to ensure the successful operation and to reduce postoperative sequelae, to achieve better clinical results. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Primary Central Nervous System Lymphoma in Immunocompetent Patient
We report a case of primary central nervous system non-Hodgkin lymphoma (PCNSL) located in the right temporoparietal lobe with destruction of ethmoid and sphenoid bones in healthy immunocompetent adult. PCNSL accounts for (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Plexiform Neurofibroma of the Cauda Equina With Ectopic Bone Formation
Plexiform neurofibroma of the cauda equina is a rare entity. In the literature, only 6 cases of cauda equina involvement with plexiform neurofibroma have been reported. Herein, we report a 28-year-old man with recurrent neurofibroma of the cauda equina complicated with ectopic bone formation, the first case to be reported from the Middle East. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Sudden-onset Neck Pain, Quadriparesis, and Altered Sensorium: An Unusual Presentation of Subarachnoid Hemorrhage
Conclusions: We consider this patient to be the first documented case of transient quadriparesis and global sensory disturbance associated with sudden-onset neck pain secondary to SAH. A high index of suspicion for SAH should be maintained when confronted with patients presenting with sudden-onset neck pain and unusual neurological symptoms. Early consideration, appropriate investigation, and management improves outcome in this potentially devastating condition. (Source: Neurosurgery Quarterly)
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Acute Intracranial Posttraumatic CSF Hypotension in a Child: Case Report on a Difficult Craniofacial Trauma
We report the case of a 12-year-old child involved in an accident during a horse competition, with a severe head trauma, who developed acute intracranial hypotension due to a massive sphenoidal sinus and ethmoidal cerebrospinal fluid leakage. The patient presented with acute loss of vision and brain anoxic ischemic lesions associated with contusions, and internal carotid artery dissection. Anoxic ischemic lesions and carotid artery dissection can be explained by airways obstruction and direct mechanical trauma; however, loss of vision is not clearly related with a direct cause. Three mechanisms can be hypothesized to be re...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
A Spontaneous Ruptured Intracranial Dermoid Cyst in an Older Patient
Dermoid cysts are rare cystic tumors originating from ectodermic cells within the intracranial region. These cysts emerge during closure of the neural tube during embryological development. The symptoms are generally incidental and nonspecific. If rupture occurs, the cyst contents propagate through the subarachnoid space and the ventricular system. The dramatic appearance of subarachnoid and cisternal fat droplets facilitates the diagnosis of dermoid cyst rupture by computer tomography and magnetic resonance imaging. Herein, we present a case of ruptured dermoid cyst in an elderly patient. The patient presented with minor ...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
Renal Cell Carcinoma Lately Metastatic to Cerebral Parenchyma that Causes Intracerebral Hemorrhage
We present a case with renal cell carcinoma metastatic to cerebral parenchyma. A 72-year-old man was admitted to the emergency service of our hospital with sudden loss of consciousness and left-side hemiplegia. His admission blood pressure was 250/130 mm Hg, his Glasgow coma scale was recorded as 10, and his computed tomography scan of the brain without contrast enhancement showed right frontoparietal intracerebral hematoma with a dimension of 8 cm×6.3 cm×7 cm, surrounded by diffuse parenchymal edema and an 18 mm midline shift, and led to a presumed diagnosis of a hypertensive intracerebral hemorrhage. He was taken to th...
Source: Neurosurgery Quarterly - February 1, 2015 Category: Neurosurgery Tags: Case Reports Source Type: research
