Singular case of third ventricle metastasis of colorectal carcinoma--case report.

Third ventricle tumors are uncommon central nervous system lesions and unusual locations for metastatic colorectal cancer. We present a case of a 68 year old woman with a solitary 3rd ventricle lesion found on a computed tomography scan of the brain and the synchronous mass of the right colon. The aim in this case was local control of cerebral lesion with pathological diagnosis. Surgery was followed by a short-term good evolution but with sudden death.

Intraventricular metastatic clear cell renal carcinoma.

BACKGROUND: Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, METHODS AND RESULTS: Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and respiratory condition worsened as a bronchopneumonia lead to patient's death in 12 days after surgery. CONCLUSIONS: Clear cell carcinoma metastasis located in the third ventricle should be taken into consideration for patients presenting a single intraventricular lesion even they have no documented primary malignancy.

The pitfalls of differential diagnosis of lumbar spine epidural lesions--exemplification with two particular cases and a review of the literature.

BACKGROUND AND STUDY AIMS: Lumbar spinal epidural lesions could belong to a wide spectrum of pathologies. However, some cases present with rare conditions that can cause significant neurological deficit and raise serious diagnostic challenges. We present two such cases where the clinical picture and the imaging findings failed to elucidate the actual diagnosis, which came as an intraoperative and pathological surprise. PATIENTS: The first case is that of a 78-years-old male that presented for low back pain, bilateral S1 radicular sciatica, paraparesis, and difficulty walking. The neurologic exam showed the absence of the rotulian reflexes bilaterally, and a partial sensory loss in the crural dermatomes. The MRI showed an epidural mass, contrast enhancing at the L1-L2 level, suggestive for an extraxial tumor. The second case is that of a 62-year-old woman that presented for a hyperalgic sciatica involving the right S1 root with parestesias in the corresponding dermatome. MRI showed a cystic, contrast enhancing lesion in the L5-S1 recess, mimicking a cystic neuroma. Both patients underwent surgery and histopathological exams were performed from the excised pieces. RESULTS: In the first case the surgery resulted in complete removal of the pathological process and histopathological result returned chronic organized hematoma, concordant with the intraoperatory aspect. The evolution was good. In the second case the histopathological result came back as pulpous disk. Again the evolution was good with complete neurological recovery. CONCLUSION: In the presence of an epidural mass with clear clinical symptomatology, rare entities like chronic epidural hematoma or posterior migrated disk material should be always considered as a differential diagnosis in patients with suspicion of extradural chronic compressions. In these cases, only the intraoperatory and histopathological exams can provide a clear diagnosis.

[Statistical data on head trauma with frontal sinus involvement at the Emergency Hospital Clinic "Prof. Dr. Nicolae Oblu", Iasi, Romania]. / Elemente de statistica a traumatismelor craniocerebrale cu implicarea sinusurilor aerice frontale în Spitalul Clinic de Urgenta "Prof. Dr. Nicolae Oblu" Iasi.

UNLABELLED: We present here some interesting points of view concerning head and brain injury with frontal sinus involvement. MATERIAL AND METHODS: In general neurosurgical practice the frontal sinus traumatic involvement is about 3-5 per cent from all head trauma; we proposed to realise a extensive 5 years study to finnaly sumarise the characteristical elements for our geographical area. The amount of patients hospitalized in our clinic was about 80 000 in five years. RESULTS: Concerning our statistical data, there are 677 patients with frontal sinus injury, 490 from this were complicated with brain pathology. CONCLUSIONS: We concluded there are differences between our series and the other studies from developed countries, in our region the domestical (agricultural works) causes are about 10% higher.

[Aneurysmal subarachnoid hemorrhage]. / Hemoragia subarahnoidiana de cauza anevrismala.

Nontraumatic subarachnoid hemorrhage is a neurosurgical emergency characterized by the extravasation of blood into the spaces covering the central nervous system that are filled with cerebrospinal fluid. The leading cause of nontraumatic subarachnoid hemorrhage is rupture of an intracranial aneurysm, which accounts for about 80 percent of cases and has a high rate of death and complications. The management of aneurysmal SAH has changed significantly over the past few years. This change is mostly due to the demonstration of the superiority of early diagnosis, surgical clipping or endovascular embolization of ruptured aneurysms. This superiority derives from the relative safety of early aneurysm occlusion and the major threat of early rebleeding (approximately 25% in three weeks after SAH).

Biphasic calcium sulfate dihydrate/iron-modified alpha-tricalcium phosphate bone cement for spinal applications: in vitro study.

In this study, the cytocompatibility of new 'iron-modified/alpha-tricalcium phosphate (IM/alpha-TCP) and calcium sulfate dihydrate (CSD)' bone cement (IM/alpha-TCP/CSD-BC) intended for spinal applications has been approached. The objective was to investigate by direct-contact osteoblast-like cell cultures (from 1 to 14 days) the in vitro cell adhesion, proliferation, morphology and cytoskeleton organization of MG-63 cells seeded onto the new cements. The results were as follows: (a) quantitative MTT-assay and scanning electron microscopy (SEM) showed that cell adhesion, proliferation and viability were not affected with time by the presence of iron in the cements; (b) double immunofluorescent labeling of F-actin and alpha-tubulin showed a dynamic interaction between the cell and its porous substrates sustaining the locomotion phenomenon on the cements' surface, which favored the colonization, and confirming the biocompatibility of the experimental cements; (c) SEM-cell morphology and cytoskeleton observations also evidenced that MG-63 cells were able to adhere, to spread and to attain normal morphology on the new IM/alpha-TCP/CSD-BC which offered favorable substratum properties for osteoblast-like cells proliferation and differentiation in vitro. The results showed that these new iron-modified cement-like biomaterials have cytocompatible features of interest not only as possible spinal cancellous bone replacement biomaterial but also as bone tissue engineering scaffolds.

Osteogenic biphasic calcium sulphate dihydrate/iron-modified alpha-tricalcium phosphate bone cement for spinal applications: in vivo study.

In this study, the biocompatibility and the osteogenic features of a new iron-modified alpha-tricalcium phosphate (IM/alpha-TCP) and calcium sulphate dihydrate (CSD) biphasic cement (IM/alpha-TCP/CSD-BC) have been investigated in terms of the in vivo cement resorption, bone tissue formation and host tissue response on sheep animal model. Histological evaluation performed on undecalcified cement-bone specimens assessed the in vivo behaviour. It has been shown that the new IM/alpha-TCP/CSD-BC has the ability to produce firm bone binding in vivo (i.e. bioactivity). Qualitative histology proved cement biocompatibility, osteoconduction and favourable resorption, mainly through a macrophage-mediated mechanism. The results showed that the new cements have biocompatible and osteogenic features of interest as possible cancellous bone replacement biomaterial for minimally invasive spinal surgery applications.

[Biomechanical modelling of cerebral aneurysm generation]. / Modelarea biomecanica a generarii anevrismelor cerebrale.

UNLABELLED: The mechanisms of production for these aneurysms were not very well explained, therefore, the paper presents the conditions and steps in this vascular deficiency generation. MATERIAL AND METHODS: The physiological overpressures were evaluated and the role of the compliance and hydraulic strength was determined by using windkessel model. RESULTS: The mathematical model was performed on the internal carotid artery and it reveals the role of blood vessel compliance and the increasing of hydraulic vascular-parietal resistance, caused by the contractile dysfunctions of pre-capillary sphincters during the appearance of sac-like and physiological forms of aneurisms.

Injectable iron-modified apatitic bone cement intended for kyphoplasty: cytocompatibility study.

In this study, the cytocompatibility of human ephitelial (HEp-2) cells cultured on new injectable iron-modified calcium phosphate cements (IM-CPCs) has been investigated in terms of cell adhesion, cell proliferation, and morphology. Quantitative MTT-assay and scanning electron microscopy (SEM) showed that cell adhesion and viability were not affected with culturing time by iron concentration in a dose-dependent manner. SEM-cell morphology showed that HEp-2 cells, seeded on IM-CPCs, were able to adhere, spread, and attain normal morphology. These results showed that the new injectable IM-CPCs have cytocompatible features of interest to the intended kyphophasty application, for the treatment of osteoporotic vertebral compression fractures.

[The measurement of nerve root tensile stress]. / Masurarea tensiunii mecanice de intindere la nivelul unei radacini nervoase.

UNLABELLED: In the majority of the cases sciatica is caused by an intervertebral disc herniation compressing the nerve root. The compression determines an increased tension in the nerve root. We believe that the magnitude of this stress offers more information about the root impairment that the disc displacement measured on MRI images. MATERIAL AND METHODS: We present in this paper an original device which allows for intraoperative root stress analysis. The device consists of a force transducer composed of an elastic element and a displacement limitation. RESULTS: The initial measurements were performed on silicon catheters and human cadavers in two different situations: 1. free nerve root; 2. blocked nerve root. Next step was intraoperative nerve roots tensile stress recording during lumbar disc surgery. Different force values were obtained for the same displacement (3 mm perpendicular on nervous root): F1 = 0.21 N; F2 = 0.78 N. Considering experimental values, the tensile stress inside of a nervous root is determined by using specific mechanical calculations presented in this paper. This is a simple and useful device for rapid intraoperative recording of nerve root mechanical stress.