Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report.

Occipital neuralgia is a paroxysmal jabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation in the affected area. Occipital nerve block is a common diagnostic and therapeutic tool used in the course of occipital neuralgia and is considered a safe treatment with few localized adverse events. Occipital nerve block is also indicated for cervicogenic and cluster headache and is often used as a rescue treatment for headaches not responding to conventional therapies. We describe a case of epidural abscess formation 16 days following occipital nerve block in a patient with no underlying medical conditions. This case report emphasizes the importance of strict aseptic technique to reduce infection rates in patients undergoing this procedure, despite the overall safety of occipital nerve block. Clinicians must remain aware of acute and late complications arising postprocedure for the safe practice of this technique.

La névralgie occipitale est une douleur lancinante paroxystique dans la distribution des nerfs du grand ou du petit occipital qui s'accompagne d'une diminution des sensations dans la zone affectée. Le bloc du nerf occipital, un outil diagnostique et thérapeutique communément utilisé dans le cadre d'une névralgie occipitale, est considéré comme un traitement sécuritaire qui n'entraine que peu d'effets indésirables localisés. Le bloc du nerf occipital, également indiqué pour traiter la céphalée cervicogénique et la céphalée vasculaire de Horton, est souvent utilisé en tant que traitement de secours pour les céphalées qui ne répondent pas aux thérapies conventionnelles. Nous décrivons un cas de formation d'un abcès épidural 16 jours après le bloc du nerf occipital chez un patient sans affection médicale sous-jacente. L'étude de cas met l'accent sur l'importance d'une stricte conformité aux techniques d'asepsie afin de réduire les taux d'infection chez les patients soumis à cette procédure, malgré le caractère sécuritaire du bloc du nerf occipital. Les cliniciens doivent demeurer vigilants quant aux complications aigues et tardives qui peuvent survenir après la procédure afin d'appliquer cette technique de manière sécuritaire.

Dopamine neurons implanted into people with Parkinson's disease survive without pathology for 14 years.

Postmortem analysis of five subjects with Parkinson's disease 9-14 years after transplantation of fetal midbrain cell suspensions revealed surviving grafts that included dopamine and serotonin neurons without pathology. These findings are important for the understanding of the etiopathogenesis of midbrain dopamine neuron degeneration and future use of cell replacement therapies.

Fourth ventricular neurocytoma: case report and review of the literature.

OBJECTIVES: Central neurocytoma is a tumour that typically occurs in young adults in close association with the lateral and third ventricles of the cerebrum. METHODS: We report the unusual case of a central neurocytoma that developed in the fourth ventricle of a 59-year-old woman and metastasized to the upper cervical canal. Subtotal excision and adjuvant radiotherapy were used to treat the lesion. Microscopic evaluation, discussion of the pathologic differential diagnosis and theories of the histogenesis of the tumour are presented. RESULTS AND CONCLUSIONS: Fourth ventricular neurocytoma is rare and has only been reported twice previously. It appears most likely that this tumour arises from subependymal progenitor cell lines.

Cavernous malformation of the hypoglossal nerve: case report and review of the literature.

OBJECTIVE: To describe a patient who presented with a hypoglossal nerve palsy caused by a cavernous malformation, review the literature on cavernous malformations associated with cranial nerves and the differential diagnosis of hypoglossal palsy. RESULTS: Partial resection of the lesion was achieved and the diagnosis of cavernous malformation proven histologically. CONCLUSIONS: Involvement of a cranial nerve by a cavernous malformation is very uncommon and the facial nerve is the example most frequently reported. This case report adds another possible site for this rare occurrence.