Postoperative Contralateral Supra- and Infratentorial Acute Epidural Hematoma after Decompressive Surgery for an Acute Subdural Hematoma: A Case Report

A postoperative contralateral supra- and infratentorial epidural hematoma after decompressive surgery is an extremely rare event. We describe a 38-year-old male with a contralateral supra- and infratentorial acute epidural hematoma just after decompressive surgery for an acute subdural hematoma. A contralateral skull fracture involving a lambdoidal suture and an intraoperative brain protrusion may be warning signs. The mechanisms, along with relevant literature, are discussed.

Clinical Characteristics and Outcome Predictor of Hypertensive Intracerebral Hemorrhage in the Very Elderly / 대한뇌혈관외과학회지

OBJECTIVE: We investigated clinical characteristics and independent outcome predictors of hypertensive intracerebral hemorrhage(ICH) in the very elderly patients. METHODS: From January 2001 to December 2005, we analyzed retrospectively 28 very elderly patients(> or = 80 years) with hypertensive ICH admitted to our neurosurgical department. As a control group, 200 younger patients( or = 80 years than in the control group(35.7% vs. 19.0%, respectively, p = 0.005). By multivariate analysis, in ICH patients > or = 80 years, only coma(Glasgow coma scale score < or = 8) was independently associated with 30-day mortality(odds rati[OR]25.5, 95% confidence interva[CI]2.36 - 275.74, p < 0.001). CONCLUSION: Our result suggests that the very elderly patients with hypertensive ICH may present some different clinical characteristics from those in their younger counterparts.

Vertebral Metastasis from Squamous Cell Carcinoma of the Anal Canal

Distant metastasis of squamous cell carcinoma from the anal canal is an uncommon event. However, hematogenous spread to the vertebrae may occur in the course of this disease. The route of metastasis from the anal canal seems to be Batson's vertebral venous system. A 52-year-old female patient presented with lower back and right leg pain of one-week history. She has undergone radiotherapy and chemotherapy for squamous cell carcinoma of the anal canal and then was followed by surgical resection. Three months later, magnetic resonance images of the lumbar spine disclosed a well-enhanced mass of L5 vertebral body compressing the thecal sac. Surgical decompression and biopsy were performed. Histopathological study confirmed carcinoma of the squamous cell origin. We report a rare case of vertebral metastasis from squamous cell carcinoma of the anal canal with a pertinent review of literature.