ABSTRACT
The authors describe a simple modification of the traditional muscle-packing technique to seal exposed frontal air sinus during neurosurgical, ENT and facio-maxillary trauma and elective procedures. Oxidised cellulose hammock is used to effectively hold the muscle piece in place to seal the sinus.
Subject(s)
Cellulose, Oxidized/therapeutic use , Frontal Sinus/surgery , Otorhinolaryngologic Surgical Procedures/methods , Temporal Muscle/transplantation , Facial Injuries/surgery , Humans , Plastic Surgery Procedures/methods , Transplantation, AutologousABSTRACT
In paediatric practice, head injury is a major public health hazard that places considerable demand on health services. It accounts for almost one third of all accidental deaths and for up to two thirds of all trauma deaths in hospital. Common house-hold objects are at times a source of penetrating head injuries in children. These include electric plugs, golf clubs, toys, nails, etc. Fortunately less than 10% of these eventually lead to permanent brain injury. We report a rare case of penetrating head injury caused by a dart.
Subject(s)
Accidents, Home , Foreign Bodies/surgery , Head Injuries, Penetrating/etiology , Head Injuries, Penetrating/surgery , Play and Playthings , Child , Humans , MaleABSTRACT
During microvascular decompression procedure for trigeminal neuralgia, surgical attention is mainly focused at the neurovascular conflict at trigeminal root entry zone. However, many major complications of this surgery are often related to venous structures in the posterior fossa, including the venous sinuses and the superior petrosal vein(s). The author reviews surgical anatomy of the superior petrosal vein, highlights important surgical steps related to its microsurgical dissection and discusses avoidance of complications, as well as their management during microvascular decompressive surgery in this region. The discussion is mainly focused on the surgical anatomy of the superior petrosal vein along with its significance during surgery and not on the neurovascular relationships of the trigeminal nerve or aetio-pathogenesis of trigeminal neuralgia.
Subject(s)
Decompression, Surgical/methods , Petrous Bone/blood supply , Trigeminal Neuralgia/surgery , Decompression, Surgical/instrumentation , Humans , Intracranial Hemorrhages/prevention & control , Intracranial Hemorrhages/surgery , Microcirculation/surgery , Veins/anatomy & histology , Veins/surgeryABSTRACT
A rare case of glioblastoma with isolated cutaneous metastasis adjacent to the scar site is described. Its pathogenesis and clinical significance are discussed.
Subject(s)
Brain Neoplasms/pathology , Glioblastoma/secondary , Head and Neck Neoplasms/secondary , Scalp , Skin Neoplasms/secondary , Brain Neoplasms/surgery , Cicatrix/pathology , Craniotomy/adverse effects , Fatal Outcome , Glioblastoma/surgery , Humans , Male , Middle Aged , Scalp/pathologyABSTRACT
A rare case of unilateral benign essential tremor is presented that responded to surgical excision of a posterior fossa arachnoid cyst.
Subject(s)
Arachnoid Cysts/complications , Essential Tremor/etiology , Adult , Arachnoid Cysts/diagnosis , Arachnoid Cysts/surgery , Cranial Fossa, Posterior , Female , Humans , Magnetic Resonance Imaging , Treatment OutcomeABSTRACT
We report a rare case of paraparesis caused by thoracic spinal epidural lipomatosis in a female patient who did not have any recognized predisposing factor for this condition.
Subject(s)
Lipomatosis/pathology , Spinal Cord Diseases/pathology , Adult , Epidural Space , Female , Humans , Lipomatosis/complications , Lipomatosis/surgery , Magnetic Resonance Imaging/methods , Paraparesis/etiology , Paraparesis/pathology , Paraparesis/surgery , Spinal Cord Diseases/complications , Spinal Cord Diseases/surgery , Thoracic Vertebrae , Treatment OutcomeABSTRACT
A rare case of vesical calculi complicating the procedure of ventriculo-vesical shunt is presented. In addition to highlighting technical difficulties in placing shunt catheters into the urinary system, the potential complications are discussed. We consider this route of cerebrospinal fluid(CSF) diversion less physiological compared with the peritoneal, pleural or the venous sites, and discourage use of the urinary bladder as the drainage site for the shunting of CSF.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Urinary Bladder Calculi/etiology , Adult , Cerebrospinal Fluid Shunts/instrumentation , Equipment Failure , Humans , MaleABSTRACT
Two rare cases of akinetic mutism induced by aneurysmal subarachnoid haemorrhage are reported. The literature is reviewed, the possible pathophysiological mechanism of akinetic mutism is considered and the association between these two conditions is explored with an attempt to address the roles of medical treatment and surgery and to discuss prognosis.
Subject(s)
Akinetic Mutism/etiology , Subarachnoid Hemorrhage/complications , Adult , Akinetic Mutism/diagnostic imaging , Akinetic Mutism/surgery , Brain/diagnostic imaging , Cerebral Angiography , Female , Humans , Intracranial Aneurysm/complications , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/surgery , Subarachnoid Hemorrhage/diagnostic imaging , Subarachnoid Hemorrhage/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Wrapping or coating of ruptured cerebral aneurysms was an acceptable method of surgical treatment until the 1980s. Occasionally, patients still present with a re-bleed. Management of these patients can be challenging. The author describes his experience of surgically treating ruptured aneurysms that have been previously wrapped. Technical issues in the surgical treatment are discussed with three illustrative cases of aneurysms at different locations encountered from 1999 to 2003. Despite operative difficulties satisfactory surgical results can be accomplished in the majority of these cases.
Subject(s)
Intracranial Aneurysm/surgery , Intracranial Hemorrhages/surgery , Aneurysm, Ruptured/pathology , Aneurysm, Ruptured/surgery , Bandages , Humans , Intracranial Aneurysm/pathology , Intracranial Hemorrhages/pathology , Recurrence , Reoperation , Retrospective StudiesABSTRACT
Isolated conjugate gaze palsy following unilateral frontal lobe surgery is uncommon. When it does occur, usually it recovers within hours. We report a case of isolated conjugate gaze palsy which persisted for four weeks post-operatively before recovery commenced.
Subject(s)
Brain Neoplasms/surgery , Oligodendroglioma/surgery , Ophthalmoplegia/etiology , Postoperative Complications , Brain Neoplasms/pathology , Frontal Lobe , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Oligodendroglioma/pathologyABSTRACT
A case of sphenoid wing meningioma mimicking the presentation of a transient ischaemic attack (TIA) is described. Based on findings from neuroimaging in this case, possible explanations of the mechanism of this uncommon presentation of meningiomas are discussed and the literature is reviewed.
Subject(s)
Ischemic Attack, Transient/etiology , Meningeal Neoplasms/complications , Meningioma/complications , Aged , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
A case of recurrent intracranial abscess at the initial site after a latency of 16 years is presented. The causes and possible mechanisms of recurrence are discussed.
Subject(s)
Brain Abscess/drug therapy , Aged , Anti-Bacterial Agents/therapeutic use , Brain Abscess/diagnostic imaging , Brain Abscess/etiology , Confusion/etiology , Headache/etiology , Humans , Male , Paresis/etiology , Recurrence , Speech Disorders/etiology , Tomography, X-Ray Computed/methodsABSTRACT
A 34-year-old female patient presented with an intracranial subarachnoid hemorrhage and was found to have a dural arteriovenous fistula at the site of previous cervical meningocele repair. Subsequent occlusion was achieved with endovascular embolization. To our knowledge, the phenomenon of the development of a spinal dural fistula at the site of a meningocele repair has not been recorded before.
Subject(s)
Arteriovenous Fistula/etiology , Arteriovenous Fistula/surgery , Meningocele/surgery , Postoperative Complications , Adult , Arteriovenous Fistula/pathology , Cerebral Angiography , Dura Mater/blood supply , Female , Humans , Spinal Cord/blood supply , Subarachnoid Hemorrhage/etiology , Subarachnoid Hemorrhage/pathology , Subarachnoid Hemorrhage/surgerySubject(s)
Arterial Occlusive Diseases/complications , Carotid Artery Diseases/complications , Carotid Artery, Internal , Intracranial Aneurysm/complications , Posterior Cerebral Artery , Aged , Arterial Occlusive Diseases/diagnostic imaging , Carotid Artery Diseases/diagnostic imaging , Carotid Artery, Internal/diagnostic imaging , Cerebral Angiography , Humans , Intracranial Aneurysm/diagnostic imaging , Male , Posterior Cerebral Artery/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
The authors report a rare case of aneurysmal haemorrhage that presented with Terson's syndrome without any classical features of subarachnoid haemorrhage. The mechanism of this phenomenon is discussed and the importance of its identification is highlighted.
Subject(s)
Aneurysm, Ruptured/complications , Intracranial Aneurysm/complications , Vision Disorders/etiology , Vitreous Hemorrhage/etiology , Female , Humans , Middle Aged , Rupture, Spontaneous/complications , SyndromeABSTRACT
We report a case of malignant fibrosarcoma involving the brachial plexus presenting in childhood. Primary malignant tumours of the brachial plexus are rare entities. In particular, fibrosarcoma of the brachial plexus occurring in a child has not been previously reported. Dilemmas in resolving the management and long-term consequences of this condition are discussed.
Subject(s)
Brachial Plexus Neuropathies/surgery , Fibrosarcoma/surgery , Arm , Brachial Plexus Neuropathies/diagnostic imaging , Child , Female , Fibrosarcoma/diagnostic imaging , Follow-Up Studies , Humans , Neurosurgical Procedures/methods , Paralysis/etiology , Postoperative Complications , Tomography, X-Ray ComputedABSTRACT
The authors present four patients with a history of high dose cranial irradiation, who were diagnosed years later to have symptomatic meningiomas requiring surgical management. Relevant literature pertaining to these rare tumours is reviewed and their unusual characteristics highlighted. Their aetio-pathogenesis and management strategies are discussed.