1/39. A case of neurocysticercosis-differential diagnostic aspects.neurocysticercosis is no medical rarity but in non-endemic countries especially, a high degree of physician awareness is necessary for diagnosis. The case of a German female patient who had focal seizures for the first time at the age of 23 caused by a cerebral cyst of cysticercus cellulosae is presented. Only surgical removal and subsequent histological examination allowed diagnosis while diagnostic investigation yielded no pathological findings.- - - - - - - - - - ranking = 1keywords = cyst (Clic here for more details about this article) |
2/39. Fatal secondary increase in serum S-100B protein after severe head injury. Report of three cases.The S-100B protein is a small cytosolic protein that is found in astroglial or schwann cells. It is highly specific for brain tissue and is increasingly being investigated as a diagnostic tool to assess the neurological damage after head injury, stroke, subarachnoid hemorrhage, and cardiopulmonary bypass. The authors report on three patients with severe head injury with otherwise normal cerebral perfusion pressure, SaO2, PaCO2, and controlled intracranial pressure (ICP), in whom a secondary excessive increase in serum S-100B was observed. In all cases, the S-100B increase was followed by an increase in ICP. All three patients died within 72 hours after the excessive increase in S-100B. These findings indicate that major secondary brain damage may occur at a cellular level without being identified by current neuromonitoring techniques.- - - - - - - - - - ranking = 13.249097066583keywords = arachnoid (Clic here for more details about this article) |
3/39. subarachnoid hemorrhage following permissive hypercapnia in a patient with severe acute asthma.In this article, we describe a case of a subarachnoid hemorrhage (SAH) in an acute severe asthma patient following mechanical hypoventilation. A 49-year-old man was admitted to an intensive care Unit with an acute exacerbation of asthma. After 3 days of mechanical ventilation (hypercapnia and normoxaemia), it was noted that his right pupil was fixed, dilated, and unreactive to light. Computed tomography (CT) scan showed localized SAH within the basilar cisterns and diffuse cerebral swelling. On the fourth day, a new CT scan showed hemorrhage resorption and a cerebral swelling decrease. In the following days, the patient's condition continued improving with no detectable neurological deficits. A review of similar published reports showed that all patients performed respiratory acidosis, normoxaemia, and hypercapnia. The most frequent neurological sign was mydriasis, and all subjects showed cerebral edema. Since normoxaemic hypercapnia has been associated with absence, or less cerebral edema, we considered additional factors to explain cerebral edema and intracranial hypertension causes. Thus, intrathoracic pressures due to patient's efforts by forcibly exhaling, or during mechanical ventilation, would further increase intracranial pressure by limiting cerebral venous drainage. This case emphasizes the fact that patients with acute severe asthma who have developed profoundly hypercarbic without hypoxia before or during mechanical ventilation, may have raised critical intracranial pressure.- - - - - - - - - - ranking = 66.245485332913keywords = arachnoid (Clic here for more details about this article) |
4/39. Right temporal lobe glioblastoma presenting in the left orbit. Case report.Dissemination of gliomas outside the central nervous system without preceding neurosurgery is a rare phenomenon. Glial neoplasms presenting as bone lesions are even more rare. A case of glioblastoma multiforme (GBM) with initial presentation in the orbit following a single generalized seizure is described. Signs of intracranial hypertension resulted from subarachnoid tumor invasion. The patient was treated with whole-dose radiation therapy but survived for only 6 months following the initial presentation. An autopsy revealed a right temporal GBM with extensive subarachnoid spread and invasion in the left orbit and skull base. The literature on dissemination of primary tumors of the brain is reviewed.- - - - - - - - - - ranking = 26.498194133165keywords = arachnoid (Clic here for more details about this article) |
5/39. Anomalous optic disc elevation associated with ultrasonographic evidence of increased subarachnoid fluid.The presence of increased subarachnoid fluid around the optic nerve as measured by ultrasound has been shown to be associated with elevated intracranial pressure, as well as a number of other conditions. This finding has proved useful for distinguishing optic disc elevation secondary to papilledema from disc elevation attributable to other causes. This report describes a patient with anomalous optic disc elevation and increased subarachnoid fluid around the optic nerve.- - - - - - - - - - ranking = 79.494582399496keywords = arachnoid (Clic here for more details about this article) |
6/39. Acoustic schwannoma and arachnoid cyst colocated in the cerebellopontine angle--case report.A 50-year-old female presented with a right acoustic schwannoma colocated with a cerebellopontine angle arachnoid cyst. The arachnoid cyst was distinct from the arachnoid cap surrounding the acoustic schwannoma. Initial excision of the arachnoid cyst created the space required to excise the schwannoma. The acoustic schwannoma had surprisingly dense adhesions to the brainstem, probably due to the constant pressure exerted by the cyst displacing the tumor towards the brainstem. The acoustic schwannoma was excised by meticulous dissection. Such a coexisting lesion should be suspected when a large cystic collection surrounds an acoustic schwannoma. Initial excision of the arachnoid cyst will prevent excessive cerebellar retraction.- - - - - - - - - - ranking = 178.4589974125keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
7/39. Primary leptomeningeal lymphoma with long-term survival: a case report.Primary leptomeningeal lymphoma (PLML) is a rare disease. The most common presentation is symptoms of increased intracranial pressure. confusion, dysarthria, hearing loss, paraparesis and lumbosacral spinal root symptoms have also been reported. Chemotherapy and radiotherapy have been tried, but its prognosis is usually poor. We experienced a case of PLML with a relatively benign course in an 18-year-old girl. Initial diagnosis was made as idiopathic intracranial hypertension. Lumbosacral shunt was done with good response for 3 years. When headache recurred, she was reevaluated and was correctly diagnosed as PLML.- - - - - - - - - - ranking = 1.2409180259185keywords = leptomeningeal (Clic here for more details about this article) |
8/39. Arachnoid cyst with spontaneous rupture into the subdural space.Spontaneous rupture of an arachnoid cyst into the subdural space is an unusual complication. Only six cases have been reported in the literature. We report here an additional case and review the literature concerning arachnoid cysts. The possible pathogenesis of this condition is discussed.- - - - - - - - - - ranking = 41.80247508648keywords = arachnoid, arachnoid cyst, cyst (Clic here for more details about this article) |
9/39. Diagnostic and surgical strategies for intractable spontaneous intracranial hypotension. Case report.The authors present the case of a 55-year-old man suffering from intractable spontaneous intracranial hypotension, in whom conservative treatment with 19 weeks of bed rest was not effective. In this period the patient twice underwent surgery for bilateral chronic subdural hematoma, a complication of spontaneous intracranial hypotension. Conventional radionuclide cisternography, magnetic resonance imaging, and computerized tomography myelography did not demonstrate cerebrospinal fluid (CSF) leakage. Repeated radionuclide cisternography with the patient in an upright position revealed leakage of the tracer at upper cervical levels. Computerized tomography myelography with breath holding also showed CSF leakage of the contrast medium bilaterally at upper cervical levels. The patient underwent surgery, and bilateral C-2 and C-3 spinal nerve root pouches were sealed off from the subarachnoid space with oxidized cellulose cotton and fibrin glue. Epiarachnoid spaces around the root sleeves were also sealed to ensure complete resolution of the CSF leakage. After the surgery, the patient was completely free of the disease. In the case of intractable persistent spontaneous intracranial hypotension, surgical treatment is preferable to long-term conservative management. To identify CSF leakage, radionuclide cisternography with the patient in the upright position is useful. When obvious leakage is encountered, surgical sealing of the lesion should be performed via a subarachnoid approach.- - - - - - - - - - ranking = 39.747291199748keywords = arachnoid (Clic here for more details about this article) |
10/39. Terson syndrome: a case report suggesting the mechanism of vitreous hemorrhage.OBJECTIVE: To present a patient with Terson syndrome and to propose a mechanism for vitreous hemorrhage. DESIGN: Observational case report. PARTICIPANT: A 50-year-old woman with subarachnoid hemorrhage and unilateral vitreous hemorrhage. methods: Detailed examination with fluorescein angiography and funduscopy. MAIN OUTCOME MEASURES: Site of dye leakage on fluorescein angiography in the eye with vitreous hemorrhage. RESULTS: fluorescein angiography showed the leakage site at the margin of the disc in the eye with vitreous hemorrhage after the vitreous hemorrhage had been removed. CONCLUSIONS: The damage to peripapillary tissues demonstrated by fluorescein leakage suggests that intracranial hypertension affects peripapillary structures through the intervaginal space of the optic nerve sheath.- - - - - - - - - - ranking = 13.249097066583keywords = arachnoid (Clic here for more details about this article) |
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