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1.
Ann Med Surg (Lond) ; 85(6): 2977-2980, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37363535

RESUMO

Glioblastoma is the most common primary malignant brain tumor in adults. It is enhanced by the abnormal proliferation of central nervous system cells called astrocytes. Microvascular endothelial proliferation is one of the criteria for a histological diagnosis. Hypervascular glioblastoma simulating an arteriovenous malformation is an involuntary manifestation and constitutes a rare entity. Case presentation: The authors report a case of a 44-year-old patient with no history followed. Symptoms began 6 months ago with the gradual onset of headaches without vomiting or seizures associated with a drop in normal visual acuity without neurological deficit. Cerebral imaging including cerebral angiography concluding with a right parieto-occipital cerebral process probably associated with an arteriovenous malformation. Clinical discussion: The management was surgical by biopsy after a right parieto-occipital bone flap concluding in glioblastoma. The patient needs chemotherapy and radiotherapy sessions with good clinical evolution. Conclusion: The coexistence of an arteriovenous malformation and glioblastoma remains an association whose pathophysiology still remains to be explored.

2.
Ann Med Surg (Lond) ; 79: 104006, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35860133

RESUMO

Kernohan Woltman Notch Phenomenon (KWNP) is caused by a supratentorial lesion pressing the contralateral cerebral peduncle against the free edge of the tentorium of the cerebellum. It is manifested by neurological signs of ipsilateral localization; cerebral MRI is the most sensitive examination for KWNP. Our patient is a 50-year-old woman, operated in 2011 for aortic and mitral valve replacement by mechanical prosthesis, under oral anticoagulant, consults for headaches evolving for 20 days without any notion of head trauma with installation of a progressively worsening left hemibody deficit. Glasgow coma scale was 14 (E3 V5 M6) with left anisocoria 4mm left/2mm right with left hemiplegia. CT shows a chronic left hemispheric subdural hematoma 13.5mm thick with subfalcorial and ipsilateral temporal involvement of the deficit. The cardiovascular examination as well as the biological assessment was unremarkable. The patient was operated on with a total recovery in 12 days, the anticoagulant is resumed on day 20 postoperatively, with close monitoring. KWNP may contribute to misdiagnosis in patients with bilateral corticospinal tract lesions, and anticoagulation poses a problem in stopping and restarting treatment due to the risk of bleeding on one side and thrombosis on the other side.

3.
Ann Med Surg (Lond) ; 79: 103984, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35860163

RESUMO

Primary Dural lymphoma (PDL) is a rare pathology that occurs in immunocompetent patients. In such cases, these lesions may mimic more common intracranial tumors. We present the case of a patient who presented an intra cranial hypertension syndrome; the brain MRI showed a tissular mass that we took for a meningioma; upon surgical intervention, an occult mass was discovered. Major excision and immunohistochemistry demonstrated PDL. Our case report highlights the rarity of these pathology and the importance of combined surgery and medical treatment, as the latter can be treated with chemoradiation with good clinical outcomes.

4.
Ann Med Surg (Lond) ; 78: 103806, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35734744

RESUMO

Cerebral hydatid cyst is rare (2%), and mainly affects children. We report 2 cases aged 5 years. The clinical symptomatology was dominated by intracranial hypertension syndrome and motor deficit in both cases. One patient presented a generalized tonic-clonic seizure, the second one presented a left central facial palsy. The diagnosis was made in both cases by brain CT scan and one patient underwent brain MRI. A radiological workup to look for extra-cerebral localization was performed for all patients, which was normal. The treatment was surgical for both patients (D'ARANA-INIGUEZ hydro pulsion technique) with simple after-effects. The postoperative CT scan showed a residual cavity. All our patients were put under antiparasitic treatment with Albendazole.

5.
Ann Med Surg (Lond) ; 75: 103458, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35386769

RESUMO

Otogenic frontal abscess is an uncommon location of otogenic abscess of the brain and constitutes less than 5%. And the orbital extension is even more exceptional. An 11-year-old child, presenting with a two-week-long history of an acute otitis badly treated. Admitted for headaches, fever, vomiting and left eyelid swelling. The preoperative CT scan revealed a left frontal epidural abscess associated to a sub-periosteal Abscess. The patient was operated on. A supraorbital incision through the eyebrows allowed the evacuation of the periorbital abscess and the cerebral empyema through a trephine hole. The patient received probabilistic intravenous antibiotic therapy with ceftriaxon, aminoglycoside and metronidazole. Then relay per os. Postoperative recovery was marked by disappearance of headaches at postoperative Day two and the periorbital edema at day six. The patient was discharged home at postoperative week four with oral antibiotic therapy. Three months postoperative months follow-up CT scan revealed a total radiological cleaning. Otogenic frontal abscess associated to orbital Abscess is extremely rare and should be considered in front of ophthalmological signs. The management is multidisciplinary, and the entry point treatment mustn't be forgotten.

6.
Ann Med Surg (Lond) ; 73: 103157, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34950477

RESUMO

Electrification accidents is a serious pathology due to the passage of an electric current through the body. The clinical manifestation is mainly represented by skin lesions with burners of different degrees however all the tissues of the body can be affected. The cerebral manifestation is a rare entity described in the literature. In this paper, we report the case of a patient with an electrocution accident manifested by an extradural hematoma who has not encountered a similar case described in the literature. We therefore present this case which poses a poorly understood pathophysiological problem.

7.
Ann Med Surg (Lond) ; 63: 102161, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33664947

RESUMO

This paper presents the case of an 18-year-old woman in the 31st week of pregnancy complaining for 8 months a several episodes of vomiting and headache the neurological examination revealed muscle power was 3/5 on left side. The cerebral MRI revealed an intracranial hydatid cyst. The cyst was surgically removed under general anesthesia and put it on albendazole, the diagnosis has been confirmed by the histopathological examination. The patient gave a healthy baby 1 month later without any incident. No primary focus was found in the lungs, liver, or other organs. Primary cerebral hydatid cyst during pregnancy can be successfully treated by surgical and medical intervention, vomiting in a pregnant woman should be investigated to rule out other differential diagnosis.

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