Cases reported "Nervous System Diseases"

Filter by keywords:



Filtering documents. Please wait...

1/71. Neurologic compromise after an isolated laminar fracture of the cervical spine.

    STUDY DESIGN: Report of a rare fracture of the cervical spine. OBJECTIVES: To illustrate the importance of the cervical spinolaminar line in the diagnosis of this unusual injury and to comment on appropriate investigations, management, and outcome. SUMMARY OF BACKGROUND DATA: Laminar fractures of the cervical spine are uncommon and are often missed. They usually occur after a hyperextension injury. It is unusual for these injuries to cause neurologic compromise. The injury reported here differs in that it was a result of direct trauma to the posterior aspect of the neck, and there was a significant neurologic deficit. methods: The clinical findings, roentgenographic appearance, treatment, complications, and follow-up assessment are presented and discussed. RESULTS: Initial neurologic examination revealed a right hemiparesis. Radiographs showed disruption of the spinolaminar line at C5 and a computed tomography scan revealed a fracture of the lamina of C5 with spinal canal encroachment. Management included high-dose corticosteroid administration and a posterior spinal decompression. The patient's initial postoperative course was complicated by acute pulmonary edema, which responded well to intravenous furosemide and ventilation. Follow-up assessment showed significant neurologic improvement. CONCLUSIONS: The satisfactory outcome in the case of this rare injury was the result of a prompt, accurate diagnosis and appropriate management.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

2/71. Halo femoral traction and sliding rods in the treatment of a neurologically compromised congenital scoliosis: technique.

    In severe congenital scoliosis, traction (whether with a halo or instrumental) is known to expose patients to neurologic complications. However, patients with restrictive lung disease may benefit from halo traction during the course of the surgical treatment. The goal of treatment of such deformities is, therefore, twofold: improvement of the respiratory function and avoidance of any neurologic complications. We report our technique to treat a 17-year-old girl with a multi-operated congenital scoliosis of 145 degrees and cor pulmonale. Pre-operative halo gravity traction improved her vital capacity from 560 c.c. to 700 c.c., but led to mild neurologic symptoms (clonus in the legs). To avoid further neurologic compromise, her first surgery consisted of posterior osteotomies and the implantation of two sliding rods connected to loose dominoes without any attempt at correction. Correction was then achieved over a 3-week period with a halofemoral traction. This allowed the two rods to slide while the neurologic status of the patient was monitored. Her definitive surgery consisted of locking the dominoes and the application of a contralateral rod. Satisfactory outcome was achieved for both correction of the deformity (without neurologic sequels) and improvement of her pulmonary function (1200 c.c. at 2 years). This technique using sliding rods in combination with halofemoral traction can be useful in high-risk, very severe congenital scoliosis.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

3/71. Intramedullary neurenteric cysts of the spine. Case report and review of the literature.

    This case of a 68-year-old woman with a low-thoracic intramedullary neurenteric cyst is notable for clinical presentation, cyst location, intraoperative findings, and imaging characteristics. The patient's postoperative course was complicated by neurological deterioration and a neuropathic pain syndrome. Potential causes of these complications are discussed, as are possible ways to reduce the risk of their occurrence.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

4/71. Concepts and data model for a co-operative neurovascular database.

    BACKGROUND: Problems of clinical management of neurovascular diseases are very complex. This is caused by the chronic character of the diseases, a long history of symptoms and diverse treatments. If patients are to benefit from treatment, then treatment decisions have to rely on reliable and accurate knowledge of the natural history of the disease and the various treatments. methods: Recent developments in statistical methodology and experience from electronic patient records are used to establish an information infrastructure based on a centralized register. RESULTS: A protocol to collect data on neurovascular diseases with technical as well as logistical aspects of implementing a database for neurovascular diseases are described. The database is designed as a co-operative tool of audit and research available to co-operating centres. CONCLUSION: When a database is linked to a systematic patient follow-up, it can be used to study prognosis. Careful analysis of patient outcome is valuable for decision-making.
- - - - - - - - - -
ranking = 5
keywords = operative
(Clic here for more details about this article)

5/71. Neurologic deficits after cervical laminectomy in the prone position.

    New neurologic deficits are known to occur after spine surgery. We present four patients with cervical myeloradiculopathy who underwent cervical laminectomy, fusion, or both in the prone position, supported by chest rolls. Three patients were intubated and positioned while awake, whereas the fourth patient was positioned after induction. Surgeries were successfully carried out, except for transient episodes of relative hypotension intraoperatively. On recovery from anesthesia, all patients were noted to have new neurologic deficits. Immediate CT myelography or surgical reexploration was unremarkable. All patients improved gradually with administration of high-dose steroids and induction of hypertension. Use of the prone position with abdominal compression may compromise spinal cord perfusion and lead to spinal cord ischemia. The use of frames that prevent abdominal compression, as well as avoidance of perioperative arterial hypotension, is important in maintaining adequate spinal cord perfusion during and after decompressive spinal cord surgery.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

6/71. Giant frontal mucocele extending into the anterior cranial fossa.

    The authors report a patient with a huge frontal mucocele presenting with transient left hemiparesis. magnetic resonance imaging and computed tomography showed the huge frontal mucocele arising from the frontal sinus extending to the anterior cranial fo ssa. Right middle cerebral artery stenosis was seen on the carotid angiography. The mucocele was treated with Killian's surgery. On the postoperative seventh day, the patient showed massive cerebrospinal fluid leakage that ceased with conservative management. The patient was discharged from the hospital without any neurological deficit. We discuss the clinical symptoms and postoperative course of the huge frontal mucocele with intracranial extension.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

7/71. Neurological deficit after surgery for spinal deformity--the value of normal intra operative wake-up tests in large sagitta curves. A report of two cases from an institution.

    Neurological deficit after surgery for spinal deformity is a rare but devastating complication. Factors that have been associated with a post surgical deficit are congenital curves, large curves, kyphotic deformities, anterior and posterior surgery, ligation of multiple anterior vessels and hypotension; controlled or otherwise. Intra operative wake up tests have been used alone or in combination with spinal cord monitoring: to detect evolving neurological deficit in spinal deformity surgery. Despite these checks, major neurological deficits still occur post surgery. This is a report of two cases with normal intra operative wake up tests, but developed neurological deficit twelve hours after the end of surgery.
- - - - - - - - - -
ranking = 6
keywords = operative
(Clic here for more details about this article)

8/71. Catheter-related epidural abscesses -- don't wait for neurological deficits.

    epidural abscess is a rare but serious complication of epidural anesthesia for peri- and postoperative analgesia. It is feared because of possible persistent neurological deficits. epidural abscess presents mostly with a classic triad of symptoms: back pain, fever and variable neurological signs and symptoms. When neurologic signs or symptoms develop, MRI scanning is the diagnostic procedure of choice. The therapy of choice is intravenous antibiotics for more than 4 weeks with or without a laminectomy or drainage. In the present paper we describe three patients with epidural abscesses presented during a time period of 1 year in our hospital. In each case, patients developed local signs of infection and systemic signs, but no neurological symptoms. Based on these cases and a review of the literature, we propose that MRI scanning should be strongly considered when patients present with systemic and local signs, even in the absence of neurological deficits.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

9/71. Contralateral neurologic deficits following microvascular decompression surgery--a case report.

    Microvascular decompression (MVD) surgery for trigeminal neuralgia (Jannetta operation) is common in our institution, and postoperative complications are uncommon. However, a 46 year-old obese female who underwent MVD surgery for right trigeminal neuralgia suffered from postoperative neurologic deficits consisting of left facial palsy, left total deafness, weakness and numbness of the left arm, and unsteady gait. Here, we bring forth the patient's postoperative events, such as delayed emergence, postoperative convulsions, pneumocephalus, and probable causes of the neurologic deficits for discussion.
- - - - - - - - - -
ranking = 4
keywords = operative
(Clic here for more details about this article)

10/71. Necrotizing neurosarcoidosis of the cranial base resembling an en plaque sphenoid wing meningioma: case report.

    OBJECTIVE AND IMPORTANCE: Necrotizing sarcoid granuloma (NSG) has been recognized as a histological variant of sarcoidosis. Two cases of neurosarcoidosis (NS) with NSG with concomitant systemic disease have been described previously. We present an unusual case of primary NS-NSG that resembled an en plaque cranial base meningioma. CLINICAL PRESENTATION: A 51-year-old man presented with a 3-month history of progressive left visual deterioration and proptosis. brain magnetic resonance imaging demonstrated a large cranial base lesion occupying the left anterior clinoid process and sphenoid wing, extending to the left frontotemporal convexity. A second dura-based lesion was observed in the right parietal convexity. Both lesions enhanced homogeneously after administration of intravenous contrast medium. magnetic resonance imaging characteristics were consistent with a typical clinoidal meningioma with an en plaque extension laterally. INTERVENTION: A left frontotemporal craniotomy with extradural removal of the anterior clinoid process was performed. When the dura was opened, a red fibrous mass was identified. Intraoperative histological analysis revealed the presence of necrotizing and noncaseating granulomas. Postoperatively, cerebrospinal fluid, erythrocyte sedimentation rate, c-reactive protein, and serum and cerebrospinal fluid angiotensin-converting enzyme values were normal. The search for acid-fast bacilli or fungi was negative. A diagnosis of primary NS-NSG was made. The patient began long-term high-dose corticosteroid therapy. One and a half years after surgery, his vision had improved significantly and the lesions were stable as revealed by magnetic resonance imaging. CONCLUSION: The first case of primary NS-NSG in the absence of systemic sarcoidosis is reported. NS should be included in the differential diagnosis of dura-based lesions resembling meningioma.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Nervous System Diseases'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.