ABSTRACT
A 42-year-old male was admitted to our clinic on May 4, 1980, because of slight neck stiffness, quadriparesis and urinary difficulty. On admission, neurological examination revealed alert mental state, slight neck stiffness, quadriparesis and loss of pain and temperature sense below the level of C3 sensory dermatome. All deep tendon reflexes were hyperactive and Babinski's sign was positive. Roentgenographic examination of the cervical spine showed widened interpedicular distance at C5 to C7 in A-P view. Myelogram disclosed widening of the dye column at C4 to T1 vertebral level, suggesting intramedullary tumor. Laminectomy was performed from the C5 to T2. The cord appeared to be widened and swollen at the C6-7 segment level. 1ml of yellowish pus was aspirated from the distended spinal cord at the C6 level. Mid-line posterior myelotomy was performed and hard cavity wall was visible. Upon incision of cavity wall, about 5ml of yellowish purulent pus exuded, allowing the cord to become "flaccid". The abscess cavity was irrigated with saline and penicillin solutions and a small rubber drain catheter was placed in the abscess cavity. The organism from the abscess was identified as Staphylococcus aureus. Postoperative course was uneventful. Antibiotic therapy was continued for four weeks after operation. The patient's condition was much improved and he could walk with assistance on discharge time.
Subject(s)
Adult , Humans , Male , Abscess , Catheters , Laminectomy , Neck , Neurologic Examination , Penicillins , Quadriplegia , Reflex, Babinski , Reflex, Stretch , Rubber , Spinal Cord , Spine , Staphylococcus aureus , Suppuration , ThermosensingABSTRACT
Variable manifestations of neurofibromatosis are properly defined as a hereditary, harmatomatous disorder, probably of neural crest origin, involving not only neuroectoderm and mesoderm but also endoderm, with the potential of appearing in any organ system of the body. Recently, we have experienced 3 cases of neurofibromatosis, one case associated with glioblastoma multiforme in left frontal lobe, another case associated with multiple neurofibromas in thoracic region and cauda equina, the third case associated with retroperitoneal neurofibroma and dural ectasia.
Subject(s)
Cauda Equina , Dilatation, Pathologic , Endoderm , Frontal Lobe , Glioblastoma , Mesoderm , Neural Crest , Neural Plate , Neurofibroma , NeurofibromatosesABSTRACT
A seventeen-year-old boy who had progressive visual disturbance and exophthalomos of the left side for several years, was admitted with complaints of headache and visual disturbance of the right eye. On admission, physical and neurological examinations were normal except remained thoracotomy scar on the right chest for removal of the mediastinal neurilemmoma. Ophthalmological examinations were as follows;Visual acuity was only light perception on the left and 20/40 on the right, exophthalmometry disclosed 17 mm on the left, 12 mm on the right, the fundoscopic examination revealed marked optic atrophy on the left eye. The superior oblique and lateral rectus muscles of the left eye were paralyzed. Plain skull X-ray showed hyperostosis of the anterior clinoid process and lesser wing of the sphenoid bone on the left side. Optic foramen view showed relative normal shape and size of both optic foramina, but marked hyperostosis of the left one was seen. CT scan showed increased density of round tumor mass on the left retrobulbar area and irregular shaped tumor attached to the anterior clinoid process and lesser wing of the sphenoid bone of the left side, which were strongly enhanced by contrast media. The left fronto-temporal craniotomy was performed. The yellowish-brown-colored nodular tumor was found in the parasellar region and lesser wing of the sphenoid bone of the left side. Under the operating microscope, removal of the tumor mass with left optic nerve resection was carried out. Post-operative course was uneventful and discharged on 20 th hospital day after the enucleation of the left eyeball by ophthalmologist.