1/201. Contralateral deafness following unilateral suboccipital brain tumor surgery in a patient with large vestibular aqueduct--case report.A 68-year-old female developed contralateral deafness following extirpation of a left cerebellopontine angle epidermoid cyst. Computed tomography showed that large vestibular aqueduct was present. This unusual complication may have been caused by an abrupt pressure change after cerebrospinal fluid release, which was transmitted through the large vestibular aqueduct and resulted in cochlear damage.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/201. Infantile hiv encephalopathy associated with cerebral and cerebellar telangiectases.We describe a paediatric case of hiv encephalopathy associated with cerebral and cerebellar telangiectases. Although immunohistochemistry failed to show hiv in the walls of dilated blood vessels, or in their vicinity, brain capillary telangiectases might be an additional complication indirectly related to paediatric hiv infection.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
3/201. Infratentorial subdural empyema, pituitary abscess, and septic cavernous sinus thrombophlebitis secondary to paranasal sinusitis: case report.OBJECTIVE AND IMPORTANCE: Infratentorial empyema, pituitary abscess, and septic cavernous sinus thrombophlebitis are all rare and potentially lethal conditions. The occurrence of all three in a single patient has not previously been described. We present such a case occurring in a young, otherwise healthy man. CLINICAL PRESENTATION: A 26-year-old man with a remote history of sinusitis developed rapidly progressive headache, fever, right eye pain, swelling, proptosis, and visual impairment. magnetic resonance imaging demonstrated diffuse pansinusitis, including sphenoid sinusitis, and extension of inflammation and infection into the adjacent cavernous sinuses, pituitary gland, and posterior fossa. INTERVENTION: Urgent drainage of the ethmoid and maxillary sinuses was performed; pus was not identified. The patient continued to deteriorate clinically with worsening of visual acuity. Computed tomography of the head performed the next day revealed worsening hydrocephalus and an enlarging posterior fossa subdural empyema. Urgent ventricular drainage and evacuation of the empyema was performed, and subsequently, the patient's clinical course improved. The microbiology results revealed alpha hemolytic streptococcus and coagulase-negative staphylococcus species. The patient survived but during the follow-up period had a blind right eye and pituitary insufficiency. CONCLUSION: Paranasal sinusitis can have devastating intracranial sequelae. Involvement of the adjacent pituitary gland and cavernous sinuses can result in serious neurological morbidity or mortality, and retrograde spread of infection through the basal venous system can result in subdural or parenchymal brain involvement. A high index of suspicion and aggressive medical and surgical treatment are crucial for patient survival, but the morbidity rate remains high. Our patient survived but lost anterior pituitary function and vision in his right eye.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
4/201. Posterior fossa ischemia and bilateral vertebral artery hypoplasia.OBJECTIVE: To discuss cerebellar infarct in a patient with bilateral hypoplasia of the vertebral arteries. CLINICAL FEATURES: A 67-year-old woman suffered neck pain and headaches immediately after a minor motor vehicle accident. Fracture and dislocation were radiographically ruled out. Within a few days, the patient began to experience symptoms of vertigo and dizziness. Computed tomography scanning of the brain revealed a cerebellar infarct, and an angiogram of the vertebral arteries demonstrated bilateral hypoplasia. INTERVENTION AND OUTCOME: The cerebellar infarct created mild, stable symptoms, and the patient was monitored closely in a hospital setting until the risk of possible complications was negligible. After an uncomplicated and full recovery, the patient was given recommendations regarding critical neck positions to decrease the potential for further ischemic events. CONCLUSION: Cerebellar infarcts are rare and may be associated with rare vascular anomalies.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
5/201. Cerebellar hemorrhage after supratentorial surgery for treatment of epilepsy: report of three cases.OBJECTIVE AND IMPORTANCE: We report three cases of cerebellar hemorrhage complicating supratentorial craniotomies for the treatment of epilepsy. In a literature review, we identified only four similar cases of cerebellar hemorrhage after temporal lobectomy for the treatment of epilepsy. CLINICAL PRESENTATION AND RESULTS: Three young and otherwise healthy patients underwent frontal, occipital, and temporal resections for the treatment of refractory epilepsy. The hemorrhage manifested as peduncular tremor, ataxia, and decerebrate posturing presenting early in the postoperative period. The diagnosis was established by computed tomography and/or magnetic resonance imaging. Benign outcomes were observed for all patients. CONCLUSION: Based on the available data, it is our opinion that brain dislocation resulting from excessive intraoperative cerebrospinal fluid drainage is a possible mechanism for this rare complication of supratentorial craniotomy. The overdrainage seems to be less hazardous when the procedure is performed for the removal of space-occupying mass lesions. In contrast, the resection of nonexpanding tissues, such as in lobectomies for the treatment of epilepsy, may be an additional risk factor, because the incidence of this complication seems to be higher in these situations.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
6/201. Palatal myoclonus--a case report.Palatal myoclonus is usually due to a brainstem or cerebellar lesion disrupting the dentato-rubro-olivary pathway. Rarely it may be caused by a cortical lesion. The precipitating factor in 70% of all cases is an infarct. We describe an unusual case of a patient with palatal myoclonus who had an old ipsilateral cerebellar infarct and a new contralateral subcortical (corona radiata) infarct. We postulate that the new infarct caused disinhibition of the old cerebellar infarct, resulting in palatal myoclonus. magnetic resonance imaging (MRI) of the brain did not show any hypertrophy of the inferior olivary nucleus. Her myoclonus proved refractory to clonazepam, valproate and phenytoin.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
7/201. Postoperative brainstem high intensity is correlated with poor outcomes for patients with spontaneous cerebellar hemorrhage.OBJECTIVE: The outcomes for patients with cerebellar hemorrhage are thought to be influenced by anatomic damage to the brainstem. In this study, we investigated the magnetic resonance imaging findings in the brainstem, to examine the relationship between the degree of brainstem damage and the outcomes for patients with spontaneous cerebellar hemorrhage who are in poor-grade condition. methods: The results for 31 patients with spontaneous cerebellar hemorrhage, with Glasgow coma Scale scores of 8 or less at admission, who underwent magnetic resonance imaging examinations were reviewed. All patients underwent surgical intervention. The patients were divided into two groups according to their glasgow outcome scale scores at the time of discharge, i.e., patients who experienced good recoveries or exhibited moderate disabilities (Group I, n = 8) and patients who exhibited severe disabilities, were in a persistent vegetative state, or had died (Group II, n = 23). We investigated obliteration of the fourth ventricle and the perimesencephalic cistern and the presence of hydrocephalus in initial computed tomographic scans and the presence of areas of high signal intensity in the brainstem in T2-weighted images. RESULTS: Eight patients experienced good outcomes, and 23 patients experienced poor outcomes. The overall mortality rate was 32.3%. There were no significant differences between groups with respect to computed tomographic findings such as hematoma size, but the incidence of high signal intensities in the pons and midbrain in T2-weighted images for Group II was significantly higher than that for Group I (P < 0.01). CONCLUSION: magnetic resonance imaging clearly demonstrated brainstem damage, and high signal intensity in the brainstem was a significant prognostic factor for determining outcomes for patients with spontaneous cerebellar hemorrhage who were in poor-grade condition.- - - - - - - - - - ranking = 2.75keywords = brain (Clic here for more details about this article) |
8/201. Acute cerebellitis with near-fatal cerebellar swelling and benign outcome under conservative treatment with high dose steroids.Acute cerebellar swelling is an emergency because of brainstem compression as well as upward or downward cerebellar herniation. Few childhood cases are on record, with fatal outcome in three out of six. We report a girl with probable Epstein-Barr virus-associated cerebellar swelling who recovered completely with steroid treatment after a stormy course. review of the literature showed that all three patients, including our own, who recovered fully, received high-dose steroids in contrast to none of the four patients who died or survived with sequelae. neuroimaging and evoked potential studies are useful for early diagnosis and disease monitoring. We conclude that for the time being high-dose steroid treatment is advocated in patients with acute infectious or parainfectious cerebellar swelling.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
9/201. Therapeutic effectiveness of acetazolamide in hindbrain hernia headache.A 43-year-old man had been suffering from exertional headache for 10 years. Sagittal sections on magnetic resonance imaging showed a Chiari type 1 malformation and a cerebellar arachnoid cyst. This syndrome, named hindbrain hernia headache, disappeared with oral acetazolamide. This treatment should be tried in patients with hindbrain hernia headache prior to considering surgical decompression of the foramen magnum.- - - - - - - - - - ranking = 1.5keywords = brain (Clic here for more details about this article) |
10/201. Auditory brainstem response and temporal bone pathology findings in a brain-dead infant.The criteria for assessing adult brain death have been already established, but those for infant brain death have not been yet established in japan. We report auditory brainstem response (ABR) and postmortem pathology of the temporal bone and brain of a brain-dead 9-month-old female. During the comatose state, her ABR showed only waves I and II bilaterally. autopsy revealed the presence of a left cerebellar astrocytoma, herniation and anoxic encephalopathy. The pathological examination of the temporal bone revealed the destruction of the inner ear particularly on the left side. In the auditory pathway of brain-dead patients, degeneration occurs first in the cerebrum, followed by the cochlear nerve. Thus, ABR is one of the useful means to assess brain death even in infants.- - - - - - - - - - ranking = 3.75keywords = brain (Clic here for more details about this article) |
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