1/15. Verruciform xanthoma in association with milroy disease and leaky capillary syndrome.An 18-year-old Caucasian boy with Milroy disease involving the right leg presented with erythematous, smooth-topped, waxy papules on the dorsum of his right foot. A 12-year-old Caucasian girl with leaky capillary syndrome presented with hemorrhagic verrucous papules on the dorsum of the toes of both feet. Histopathologic analysis revealed changes consistent with xanthoma. Both patients were treated with leg compression, curettage, and electrodesiccation. Although similar papules have been described in the setting of lymphedema from other causes, this is the first report of verruciform xanthoma associated with Milroy disease or leaky capillary syndrome.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/15. Successful surgical management of a case of spontaneous epidural hematoma of the spine during pregnancy.BACKGROUND CONTEXT: A spontaneous epidural hematoma of the spine occurring during pregnancy is extremely rare. The development of a significant neurologic deficit may be rapid. Therefore, the neurosurgeon should be aware of the presentation, diagnosis and treatment options available. PURPOSE: The authors report a case of a spontaneous epidural hematoma of the spine during the third trimester of pregnancy, which was successfully managed with surgical evacuation. The case is unique in that the patient demonstrated a subacute presentation. STUDY DESIGN: The authors report a case of a 27-year-old primagravada presented with the subacute onset of progressive paraparesis. She became nonambulatory before admission. A magnetic resonance imaging study (MRI) demonstrated ventral epidural compression in the upper thoracic region. methods: A retrospective review of a case of spontaneous epidural hematoma of the spine during pregnancy was performed. The inpatient and outpatient charts were used to gather clinical information of the case, and the pertinent radiographs and images were reviewed. RESULTS: An urgent cesarean section was performed followed by evacuation of the epidural hematoma. The decompression was performed by means of a thoracic laminectomy with partial facetectomy. The patient had a prompt return of neurologic function. CONCLUSION: Spontaneous epidural hematoma of the spine should be suspected in the setting of acute back or neck pain with or without an associated progressive neurologic deficit. spine surgeons and obstetricians should also recognize that a spinal epidural hematoma during pregnancy may also present subacutely, as illustrated in our case. Prompt diagnosis may be made with MRI, and evacuation of the hematoma should be performed, ideally before the onset of neurologic signs or symptoms. The prognosis for return of neurologic function is good after urgent evacuation.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
3/15. Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: a case report.Traumatic anterior dislocation of the hip joint in children is rare, and only one case with ipsilateral femoral fracture has been reported in japan. We report a case of such dislocation and a review of the literature. The patient was a 31-month-old girl who was injured in a car accident while asleep on a tilted front passenger seat. Radiographic examination showed dislocation of the right obturator foramen and transverse fracture of the ipsilateral femoral shaft. The dislocation of the right hip was easily reduced without anaesthesia during radiography. We applied Bryant traction after reduction for 4 weeks, followed by cast application for 3 weeks. walking with support and full weightbearing were permitted 14 weeks and 16 weeks after the injury, respectively. radiography at 4.5 years after the injury showed a mildly enlarged right femoral head and femur overgrowth of approximately 8 mm. magnetic resonance imaging showed no evidence of suspected avascular necrosis of the femoral head. The patient has no subjective or objective symptoms, and is able to engage in all usual activities. The detailed mechanism of the injury is unknown. We assume that the lower leg was dislocated through abduction during flexion, or abducent, external flexion, considering that the child was sleeping at the time of the accident. Since she was hurled to the back seat, it was assumed that strong external force was vertically added to the femur, which caused the abducent force.- - - - - - - - - - ranking = 32.250092819485keywords = fracture (Clic here for more details about this article) |
4/15. Spinal chronic subdural hematoma in a patient with ventriculo-peritoneal shunting after a minor trauma.STUDY DESIGN: Case report and review of literature. OBJECTIVES: Intracranial chronic subdural hematoma (SDH) is a well-recognized complication of ventriculoperitoneal (VP) shunt. Spinal chronic SDH is very rarely associated with VP shunt. SETTING: Kaohsiung Medical University Hospital, Kaohsiung, taiwan. CASE REPORT: We describe a spinal chronic SDH, developing after a minor trauma, in a patient who underwent a VP shunt surgery for hydrocephalus 6 months previously. A good outcome was achieved after decompressive surgery. CONCLUSION: Spinal chronic SDH should be considered in the diagnosis of progressive spinal compression, especially in the patients with VP shunt after minor trauma.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
5/15. Postpartum sacral fracture presenting as lumbar radiculopathy: a case report.Although rare, sacral stress fractures may occur in pregnant women, and osteoporosis of pregnancy is a poorly understood entity. We present the case of a young, postpartum, recreational runner who developed low back pain (LBP) and radicular symptoms suggestive of L5 radiculopathy found to be secondary to sacral stress fracture. The patient had a good clinical outcome after several months and was able to resume her normal activities. This case illustrates that clinicians should have a high index of suspicion for sacral stress fracture in athletic pregnant or postpartum women presenting with LBP and/or lumbar radiculopathy. Also included are a brief review of osteoporosis in pregnancy and guidelines on the diagnosis and management of sacral stress fractures.- - - - - - - - - - ranking = 43.000123759313keywords = fracture (Clic here for more details about this article) |
6/15. Thrombosed giant intracavernous aneurysm with subsequent spontaneous ipsilateral carotid artery occlusion.We report a case of a 47-year-old man with a giant thrombosed aneurysm of the right cavernous internal carotid artery who initially presented with headache, double vision and trigeminal numbness. He experienced subsequent asymtomatic proximal occlusion of the parent vessel, revealed by follow-up angiography. This case illustrates the possibility that a giant thrombosed aneurysm may exert enough compression upon the parent vessel to induce flow stasis with resultant intraluminal thrombosis progressing to occlude the entire parent artery.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/15. Avulsion fractures of the lesser tuberosity of the humerus in adolescents: review of the literature and case report.Isolated fracture of the lesser tuberosity is an unusual phenomenon in children and adolescents. These injuries are difficult to diagnose acutely and often present as chronic shoulder pain. In this study, we report on 1 case of a displaced lesser tuberosity apophysis avulsion fracture in an adolescent treated with open reduction and internal fixation, as well as a review of the literature. A 14-year-old adolescent male presented to the senior surgeon complaining of left shoulder pain and weakness 10 days after a wrestling injury. He was diagnosed with a displaced, isolated fracture of the lesser tuberosity apophysis for which he underwent open reduction and internal fixation. A combination of sutures passed through drill holes in the proximal humerus and bioabsorbable suture tacks were used to anatomically fix the lesser tuberosity fragment and subscapularis tendon. Postoperatively, he underwent a progressive physical therapy regimen. At 4 months follow-up, he had full range of motion, complete return of strength, and returned to competitive athletics. We report here on the successful surgical treatment of a fracture of the lesser tuberosity apophysis in an adolescent.- - - - - - - - - - ranking = 43.000123759313keywords = fracture (Clic here for more details about this article) |
8/15. Broken stent in oesophageal malignancy: a rare complication.Metallic expandable stents are used increasingly for palliative treatment of inoperable malignant tumours of oesophagus to improve dysphagia. We report a rare case of oesophageal stent fracture that was broken and left in situ within the stomach uneventfully until the end of the patient's life after the application of another stent.- - - - - - - - - - ranking = 5.3750154699141keywords = fracture (Clic here for more details about this article) |
9/15. Spinal extradural meningeal cyst with spinal stenosis.STUDY DESIGN: Case report. OBJECTIVE: To present a rare pathology causing a common disease. SETTING: spine unit of the orthopaedic surgery department of a university hospital in berlin/germany. CASE REPORT: A 39-year-old female with an intraspinal extradural arachnoid cyst of the lumbar spine presented with intermittent radiating lumbar pain. The magnetic resonance imaging (MRI) showed a dorsal spinal extradural arachnoid cyst at L3/4. After wide laminotomy L3, operative cyst resection and stabilisation at L3/4 by posterior lumbar interbody fusion (PLIF), major symptom relief occurred. CONCLUSION: Spinal extradural arachnoid cysts are a rare entity causing low back pain and intermittent radicular syndromes. They can be caused by arachnoid herniation through dural weak spots which are hereditary or occur after trauma. A ball-valve mechanism promotes growth. The main diagnostic tool for spinal extradural cysts is the MRI scan. Additionally, myelography is helpful to demonstrate fluid communication. Complete surgical removal of the cyst should be attempted to reduce risk of recurrence. If extensive decompression is needed for the surgical approach causing segmental instability, interbody fusion is recommended. The outcome depends on age, duration and degree of neurological damage.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
10/15. Amyand's hernia presenting as neonatal testicular ischaemia.Testicular ischaemia presenting in the neonatal period is most often attributable to neonatal torsion. We present an unusual case of a male neonate who presented with acute appendicitis within a patent processus vaginalis, causing cord compression and consequent testicular ischaemia.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
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