ABSTRACT
Primary pyogenic abscess in the conus medullaris in a healthy adult has never been reported. An urgent MRI scan with contrast and prompt surgical evacuation may lead to good neurological recovery.
Subject(s)
Abscess/surgery , Paraparesis/microbiology , Spinal Cord Diseases/surgery , Streptococcal Infections/surgery , Abscess/drug therapy , Anti-Bacterial Agents/therapeutic use , Humans , Male , Middle Aged , Spinal Cord Diseases/drug therapy , Streptococcal Infections/drug therapy , Streptococcus intermedius , Streptococcus milleri GroupABSTRACT
The authors report a rare case of a cervical intraosseous schwannoma, which was diagnosed following an incidental history of trauma. This is the first case of an intraosseous schwannoma of the cervical vertebra that was diagnosed using magnetic resonance imaging. The authors discuss the radiological imaging, surgical procedure and review the relevant literature.
Subject(s)
Cervical Vertebrae/pathology , Neurilemmoma/pathology , Spinal Neoplasms/pathology , Accidents, Traffic , Adult , Cervical Vertebrae/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Male , Neurilemmoma/diagnostic imaging , Neurilemmoma/surgery , Orthopedic Procedures/methods , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/surgery , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
The aim of this study was to compare readings of intracranial pressure from a ventricular catheter with those obtained from a Camino catheter-tipped transducer. The Camino transducer was evaluated in two ways: firstly, when it was inserted by a subdural screw, and secondly, when it was inserted into a ventricular catheter using a ventricular monitoring kit. Data were recorded for 376 hours for the subdural screw method and for 486 hours for the ventricular monitoring kit. Average pressure readings were calculated every 5 minutes (10 half-minute values), and regression analysis was performed. For the subdural screw method, the correlation coefficient was 0.945 (gradient, 1.04; intercept, -5.51. The results from the ventricular monitoring kit showed that the correlation coefficient was 0.901 (gradient, 0.93; intercept, -0.92. The correlation between recordings of ventricular fluid pressure and the Camino recordings obtained from both subdural screw insertions and ventricular monitoring kits was good, with the subdural screw method proving more accurate and reliable in clinical use.
Subject(s)
Brain Injuries/physiopathology , Catheterization , Intracranial Pressure , Monitoring, Physiologic/instrumentation , Transducers , Humans , Monitoring, Physiologic/methodsABSTRACT
The aim of the study was to determine whether the extent of ischemia produced by an experimental space-occupying lesion changed between 5 minutes and 4 hours after the production of a lesion. In two groups of rats, a 50-microliter balloon was inflated in the right caudate nucleus. Cerebral blood flow (CBF) was determined by 14C-iodoantipyrine quantitative autoradiography, in Group 1 (n = 6) 5 minutes after inflation and in Group 2 (n = 6) 4 hours later. After 5 minutes of inflation, the mean blood flow in the caudate nucleus was reduced to 65% of the contralateral value and 11.5% of the ipsilateral caudate nucleus had a blood flow of below 25 ml/100 g/minute. After 4 hours of inflation, there was a greater fall in the mean CBF of the ipsilateral caudate nucleus to 30% of the contralateral value, and 38.9% of the ipsilateral caudate nucleus had a CBF of less than 25 ml/100 g/minute. The differences between the two groups were significant (mean CBF, P less than 0.01; CBF less than 25 ml/100 g/minute, P less than 0.02). The results show that the initial ischemic lesion produced by a spontaneous intracerebral space-occupying lesion does not remain static, but progresses with time and is significantly greater after 4 hours than after 5 minutes. Interventions that reduce the progression of ischemia may be beneficial in reducing the ultimate amount of ischemic brain damage.
Subject(s)
Cerebral Hemorrhage/physiopathology , Ischemic Attack, Transient/physiopathology , Animals , Blood Pressure , Cerebral Hemorrhage/complications , Cerebrovascular Circulation , Ischemic Attack, Transient/etiology , Male , Rats , Rats, Inbred StrainsABSTRACT
The effect of pretreatment with the calcium antagonist nimodipine on the pathophysiological events which follow an intracerebral haemorrhage in rats was compared with a similar control group. Cerebral blood flow was higher and the amount of pathologically determined ischaemic damage measured by light microscopy was less in the nimodipine pretreated group. Bloodbrain barrier permeability was increased in the nimodipine group, but there was no evidence of cerebral oedema. Nimodipine appeared to have no effect on the intracranial pressure.
Subject(s)
Cerebral Hemorrhage/drug therapy , Cerebrovascular Circulation/drug effects , Nimodipine/therapeutic use , Animals , Blood-Brain Barrier/drug effects , Brain/pathology , Capillary Permeability/drug effects , Cerebral Hemorrhage/pathology , Intracranial Pressure/drug effects , Male , Oxygen/blood , Rats , Rats, Inbred StrainsABSTRACT
Late pathophysiological events after the production and subsequent removal of an intracerebral mass were investigated using a mechanical microballoon model to simulate intracerebral hemorrhage. Immediately following balloon inflation in the caudate nucleus of rats, there was a significant increase in intracranial pressure to 14 +/- 1 mm Hg (mean +/- standard error of the mean), accompanied by a reduction in cerebral blood flow (CBF) in the ipsilateral frontal cortex, as measured by the hydrogen-clearance technique. Carbon-14-iodoantipyrine autoradiography revealed a significant reduction in the CBF of the ipsilateral caudate nucleus 4 hours after balloon inflation: 31% of the caudate nucleus had a CBF of less than 20 ml X 100 gm-1 X min-1 compared to only 1% in the sham-treated control group (balloon insertion without inflation). The rats with an intracerebral mass exhibited a significant increase in the volume of ischemic damage in the ipsilateral caudate nucleus (17.1% of total volume) compared to only 1.7% in the sham-treated group; however, there was no evidence of cerebral edema. Ischemic damage and reduced CBF persisted for 4 hours after transient inflation of a microballoon in the caudate nucleus. This suggests that ischemic damage occurs at the time of formation of the lesion and is not prevented by its early removal.
Subject(s)
Brain Ischemia/etiology , Cerebral Hemorrhage/physiopathology , Intracranial Pressure , Animals , Brain Edema/etiology , Caudate Nucleus/blood supply , Male , Rats , Time FactorsABSTRACT
The authors report two patients who developed occipito-parietal extradural haematomas following removal of large frontal meningiomas. In both, CT scanning aided diagnosis and subsequent management. Although rare, this complication should be considered when patients deteriorate or fail to improve after removal of frontally situated tumours or inexplicable brain swelling is encountered at the time of original surgery.