Clinical presentation and outcome after anterior cervical discectomy and fusion for degenerative cervical disc disease.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a well-described surgical approach for symptomatic degenerative cervical disc disease which does not respond to conservative management. In the present study, we assessed clinical presentation and outcomes of ACDF. MATERIALS AND METHODS: The present study was conducted from October 1, 2015, to October 31, 2017, in the Department of Neurosurgery, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, among 100 consecutive adult patients who underwent single- or two-level ACDF for degenerative cervical disc disease. RESULTS: The mean age was 47.2 ± 12.8 years (range: 20-74 years). Majority of the patients were male (86/100). Presenting symptoms were neck pain (77%), limb weakness (73%), paresthesias (53%), radicular pain (49%), stiffness in limbs (16%), and bladder involvement (13%). Fusion was done with stand-alone titanium cage/bone graft or titanium cage/bone graft with anterior cervical plate. At the time of discharge, significant improvement in preoperative symptoms (neck pain [47/77-61%], radicular pain [31/49-63%], limb weakness [53/73-72.6%], paresthesias [44/53-83%], stiffness in limbs [13/16-81%], and bladder symptoms [8/13-61%]) was reported by majority of these patients. Majority of these patients also reported improvement in preoperative sensory deficits at the time of discharge. Postoperative complications were hoarseness of voice (22%), dysphagia (16%), deterioration of motor power (8%), and postoperative hematoma (7%). CONCLUSIONS: A significant proportion of patients with degenerative cervical disc disease show remarkable recovery after ACDF.

Pleomorphic xanthoastrocytoma: a new differential diagnosis for a pediatric pineal neoplasm.

The pleomorphic xanthoastrocytoma (PXA) is an infrequently occurring benign astrocytic tumor with a predilection for the temporal and parietal cortices of children and young adults. We describe its occurrence in an unusual location in a 15-year-old boy who presented with raised intracranial pressure of short duration. Imaging showed a 3 × 3.2 × 3.5 cm mass in the pineal region extending into the quadrigeminal cistern. It had a contrast-enhancing solid component and a larger, ventrally located, peripherally enhancing cystic component. Total excision of the lesion was achieved via a modified left Poppen's approach. Histopathology and immunochemistry were suggestive of a PXA. This is the first report in the pediatric literature describing a PXA in the pineal region.

A rare case of intracranial solitary fibrous tumor of meninges: case report.

The authors report a case of intracranial tumor in a 60 year female, previously asymptomatic presenting with altered sensorium following a road traffic accident. Imaging showed a small left frontotemporal contusion along with a large right frontoparietal extra axial mass lesion suggestive of a meningioma. Patient improved significantly after craniotomy and tumour decompression. Histopathology with immunohistochemical analysis however revealed the presence of a solitary fibrous tumor of meninges. The case is reported in view of its rarity, atypical presentation and need to distinguish from meningiomas which they can mimic radiologically.