ABSTRACT
Chronic granulomatous CNS infections may be caused by tuberculosis, fungi and rarely by free-living amoeba, especially in immunocompromised individuals. We report a rare, fatal case of granulomatous amoebic encephalitis in an immunocompetent patient mimicking CNS tuberculosis, and review the imageological features and diagnostic tests.
Subject(s)
Acanthamoeba/physiology , Amebiasis/complications , Amebiasis/pathology , Central Nervous System Protozoal Infections/microbiology , Central Nervous System Protozoal Infections/pathology , Adult , Autopsy , Diagnosis, Differential , Fatal Outcome , Humans , Male , Tuberculosis, Central Nervous System/pathologyABSTRACT
BACKGROUND: Cervical degenerative disc disease is a common condition in neurosurgical practice. Elimination of a motion segment through fusion causes the load shift to the adjacent levels leading to disc degeneration. Our hypothesis is that by avoiding excessive dissection of the prevertebral soft tissue and placing anchoring screws away the adjacent endplate, we can reduce the load bearing and degeneration rate. METHODS: This is a prospective randomized control study .The study included 30 consecutive cases requiring single level ACDF, 15 each in conservative and minimal dissection group. MRI evidence of disc degeneration was assessed according to Matsumoto MRI grading system. RESULTS: No significant role of age on ASD was noted (P-0.26). ASD was worse in females than males especially at the inferior level(P- 0.035). ASD was noted to be higher when the patients were operated at C5-6 level (P-0.026). The reduction in VAS was 5.933 in the minimal dissection group which was significantly better than the conventional surgery group(5.14) (P-0.023). The increase in degeneration score was 0.97 & 0.6 at superior and inferior levels respectively in the conventional group and 0.13 & 0.34 in Minimal dissection group. CONCLUSIONS: The minimal soft tissue dissection for single level ACDF with PEEK cage placement appears to have reducing rate of ASD compared to conventional ACDF. Minimal soft tissue dissection has better Postoperative VAS scores.
Subject(s)
Central Nervous System Cysts/complications , Ossification, Heterotopic/etiology , Bone Matrix/pathology , Central Nervous System Cysts/diagnosis , Epithelium/metabolism , Epithelium/pathology , Female , Humans , Keratins/metabolism , Magnetic Resonance Imaging , Middle Aged , Ossification, Heterotopic/pathologyABSTRACT
We report a patient presenting with imageological features of bilateral acute subdural hematomas and subarachnoid hemorrhage, who was subsequently diagnosed as a case of moyamoya disease. Imageological features, source of hemorrhage, literature review, and management are discussed. We report this case in view of its rarity in presentation with these imageological features.
Subject(s)
Cranial Fossa, Posterior/pathology , Dura Mater/pathology , Epidermal Cyst/pathology , Epidural Space/pathology , Cranial Fossa, Posterior/surgery , Dura Mater/surgery , Epidermal Cyst/physiopathology , Epidermal Cyst/surgery , Epidural Space/physiopathology , Epidural Space/surgery , Humans , Male , Young AdultABSTRACT
Neurogenic claudication resulting from focal hypertrophy of the ligamentum flavum in the lumbar spine due to ochronotic deposits has not been reported till date. The authors discuss one such case highlighting the pathogenesis, histological and radiological features. Salient features of management are also emphasized upon.
ABSTRACT
A left frontal intradiploic angioleiomyoma in a 10-year-old girl is presented with a review of the literature. The pathological and differential diagnosis and management of this rare lesion is discussed.