Isolated chorda tympani injury following petrous temporal fracture.

Petrous temporal fractures account for nearly a fifth of all skull base fractures but are associated with taste disturbance in only 2% of cases. Chorda tympani injuries almost invariably occur in association with other nerve injuries. We present a rare case of an isolated chorda tympani injury associated with a petrous temporal fracture. Our observations suggest that the gustatory fibres in this nerve are segregated into groups subserving different taste modalities.

Ganglioglioma with anaplastic recurrence of the neuronal element following radiotherapy.

Gangliogliomas are rare tumours in adults representing between 0.5% and 1% of all neuroepithelial tumours. They are of mixed cellularity comprised both of a neuronal and a glial population. Although malignant transformation is rare, and this mostly occurs in the glial element, we present a case of malignant neuroblastomatous transformation of a ganglioglioma. This is only the second ever case to our knowledge in the literature reporting the participation of the neuronal element in the malignant transformation of a ganglioglioma. In contrast with the previous published case, our patient has received post-operative therapeutic radiotherapy. The related literature is reviewed and the oncogenic role of therapeutic irradiation is discussed.

Postoperative cervical cord compression induced by hydrogel (DuraSeal): a possible complication.

STUDY DESIGN: A retrospective case report. OBJECTIVE: To raise the issue of DuraSeal for dural tear repair; to raise the issue of the potential for fatal consequences, if not considered to be an issue around and after surgery; and to illustrate this with a case. SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid leak is a potential complication of spinal, and posterior fossa surgery. Leakage may be caused by inadvertent dural tears during decompressive laminectomy or extradural spinal approaches, for spinal surgery. We present the case of a complication as a result of repair for dural tear with hydrogel. METHODS: History, focused neurologic examination with pre- and postoperative magnetic resonance scan images. RESULTS: C5-C6 anterior cervical discectomy, and fusion with a standard commercial PEEK space cage. Intraoperatively there was a small cerebrospinal leak when excising the posterior longitudinal ligament. Surgicel and DuraSeal were used to seal this. The patient developed a quadriparesis after surgery which was a result of expansion of the hydrogel seen on MRI and at re-exploration. CONCLUSION: Hydrogel is now described for the second time to cause potentially fatal expansion.

Recurrent carpal tunnel syndrome owing to an implantation epidermoid cyst after carpal tunnel decompression: case report.

OBJECTIVE: Implantation epidermoid cysts have been reported after a variety of surgical procedures. Although carpal tunnel surgery is the most common peripheral nerve operation, there have been no previous reports of these cysts after carpal tunnel decompression. We present a case of an implantation epidermoid cyst after carpal tunnel surgery. CLINICAL PRESENTATION: A 41-year-old man presented with recurrence of carpal tunnel syndrome and an enlarging mass at the site of his previous carpal tunnel decompression. INTERVENTION: The operation site was re-explored, and a subcutaneous mass was removed. This was histologically shown to be an implantation epidermoid cyst. CONCLUSION: The possibility of an implanted epidermoid cyst should be considered in any patient who presents with a recurrence of carpal tunnel symptoms and a mass at the site of the previous operation. It is possible that the occurrence of these cysts may be related to the use of polyglactin sutures for wound closure. In this case, the result of surgery was excellent.

CSF diversion in benign intracranial hypertension using a lumbo-atrial shunt.

An obese woman with benign intracranial hypertension had been managed for several years with lumbo-peritoneal shunting. Following a bilopancreatic procedure performed for management of her obesity dense peritoneal adhesions caused repeated shunt failure. The shunt system was successfully converted to a lumbo-atrial system.