Carotid cavernous fistula subsequent to nasal septoplasty; A case report

Carotid cavernous fistula [CCF] is a rare and lethal condition; it can be spontaneous, traumatic or iatrogenic. This report Presents a case of CCF subsequent to nasal septoplasty who was a 24 years old lady with proptosis and severe decreased visual acuity. After cerebral angiography, trapping and embolization of fistula was performed with good recovery. Like our case, review of articles shows that the patients are signs and symptoms free after embolization

Cryocalcium glue: a new formulation for dural repair augmentation

Cerebrospinal fluid leakage is a major problem in neurosurgical operations. For preventing it, the dural closure should be augmented. Current glues which use for augmentation are prepared with mixing cryoprecipitate, bovine thrombin and calcium gluconate in suitable concentrations which are expensive and unavailable anywhere. A new formulation is introduced here. This is a prospective randomized clinical trial in patients who need dural patch graft by using Cryocalcium glue, mixing the cryoprecipitate, calcium gluconate and patient's own blood as the origin of thrombin, in our operating room. Comparing two groups of cases[1o6] and controls[100], we found overall C.S.F leak 3.8% and 15% respectively, with 3.6%, Zero%, Zero% and 16.7% in supratentorial, infratentorial, skull base and spinal cord operations in cases versus 12%, 20%, 33% and 28.6% in controls respectively. Using Cryocalcium glue for dural closure augmentation was with better results in comparison with control group. In addition in reviewing literature, comparing this new formulation and old fashion of fibrin glue, revealed that the new one, if not better, is similar to the old one in quality point of view

rare case of metastatic renal cell carcinoma in posterior fossa

Renal cell carcinoma [RCC] is a tumor with high degree of potentiality for distant metastasis. Intracranial metastasis is a very rare location for this tumor. Here is presented a 47-year-old female with history of RCC and cerebellar metastasis

use of frozen autogenous bone flap for cranioplasty

The artificial methods of cranioplasty such as using metals or alloplastic materials have some disadvantages, comparning with autogenic bone flaps. We tried to show that the autogenic flaps have less complications when used in cranioplasty. With good sealing of bone flap after extraction and preserving in -70 to -800 C, in Immounology Department, the autogenic bone was fixed in the previous site. From 10 patients, one of them developed infection and osteomyelitic bone was extracted. No bone resorption was detected. Comparing with other studies of autogenous bone flap cranioplasty, we have similar rate of complication. In other studies, the rate of infection was almost equal to our results. So using autogenous bone in our center is advisable

Histological study of nerve endings in ligamentum flavum in patients with discopathy

Background: ligamentum flavum normally has neural ends so it has sensory role and helps to protect vertebral column against different injuries. The aim of this study was to detect the neural ends in ligamentum flavum in patients with discopathy

Methods: samples were taken from ligamentum flavum of the patients with discopathy during surgery. One hundred samples were considered. Five hundred sections were obtained and stained with H and E method and were studied under light microscope

Results: nerve corpuscles were found in none of the sections of the patients

Conclusion: it seems that ligamentum flavum in patients has a loss in the nerve ends that leads to a decrease in proprioceptive information to control nervous system and may injure tissues like cartilage, osseous and fascia

Intradural extramedullary hydatid cyst: report of four cases

Progressive myelopathy was noted in three and an incomplete cauda equina syndrome in a fourth patient with intradural extramedullary hydatid cysts. In three patients the presence of medullary cysts were thought to be "de novo", but in one was a consequence of an intra-operatively ruptured cerebral cyst two years previously. Surgical exploration was modestly successful in relieving the symptoms. In at least three patients there was involvement of lung and liver with multiple cysts