ABSTRACT
Bleeding after surgery for chronic subdural hematoma far from the operative site is a rare phenomenon with possibly serious consequences. We report a case of combined epidural and intracerebral hemorrhage immediately after evacuation of bilateral chronic subdural hematoma. The epidural hematoma was evacuated by emergency craniotomy, but the deep parenchymal hematoma was treated conservatively. The patient recovered progressively with a good outcome. Approximately 30 cases of chronic subdural hematomas complicated by intracerebral hematoma were previously reported, but only seven cases of epidural hematoma. These complications could be avoided if slow, gradual decompression is used during surgery. Clinicians should suspect its occurrence without delay when a postoperative neurological deterioration is demonstrated. Possible mechanisms are discussed.
Subject(s)
Hematoma, Epidural, Cranial/diagnostic imaging , Hematoma, Epidural, Cranial/surgery , Parietal Lobe/diagnostic imaging , Aged , Cognition Disorders , Craniotomy , Diabetes Complications/diagnostic imaging , Humans , Male , Paresis/etiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Cystic schwannoma is highly unusual and intraspinal involvement seems to be even more rare. We report a case of intradural lumbar-cystic schwannoma in a 50-year-old man who presented with chronic low-back pain and sciatalgia, which were initially related to a bulging disc. Diagnosis of a tumor origin was suspected two years later on MRI as a hemangioblastoma. The lesion was histologically confirmed to be a schwannoma. Only eight cases of spinal schwannoma with large cyst have been previously reported. Cystic schwannoma should be considered in the differential diagnosis of lumbar intradural-cystic lesion.
Subject(s)
Cauda Equina/pathology , Cauda Equina/surgery , Hemangioblastoma/pathology , Neurilemmoma/pathology , Neurilemmoma/surgery , Neurosurgical Procedures , Peripheral Nervous System Neoplasms/pathology , Diagnosis, Differential , Hemangioblastoma/diagnosis , Humans , Laminectomy , Magnetic Resonance Imaging , Male , Middle Aged , Peripheral Nervous System Neoplasms/surgeryABSTRACT
BACKGROUND: A rare case of intradiploic epidermoid cyst of the occipital bone is described and recent literature, which emphasizes the radiological evaluation and surgical treatment of this lesion is reviewed. CASE DESCRIPTION: A 56-year-old female patient complained of headache and occasional episodes of vertigo for one year. Computed tomographic scan and magnetic resonance imaging were performed. The patient underwent occipital right craniotomy followed by total removal of the cyst and its capsule. RESULT: The postoperative course was uneventful and the patient was discharged 4 days later. CONCLUSION: A review of the literature shows that intradiploic epidermoid cyst of the occipital bone is rare. Correct radiological assessment and complete excision of this lesion and its capsule provides complete recovery.
Subject(s)
Epidermal Cyst/surgery , Occipital Bone/surgery , Skull Neoplasms/surgery , Craniotomy , Diagnosis, Differential , Epidermal Cyst/diagnostic imaging , Epidermal Cyst/pathology , Female , Granuloma/pathology , Headache/etiology , Humans , Magnetic Resonance Imaging , Middle Aged , Neurosurgical Procedures , Occipital Bone/diagnostic imaging , Occipital Bone/pathology , Skull Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Vertigo/etiologyABSTRACT
Mesenchymal chondrosarcoma is a highly malignant and extremely rare tumor of the orbit: only 18 cases have been reported to date. We report a case of spheno-orbital mesenchymal chondrosarcoma in a 36-year-old woman presented with a 4-month history of progressive left exophthalmia and temporal mass. A CT-scan of the orbit and MRI showed a spheno-orbital mass, with temporal fossa extension, fed by the internal maxillary artery visible on cerebral angiography. Surgery via a transcranial, left frontotemporozygomatic approach after selective embolization enabled subtotal removal. Definitive histologic examination revealed mesenchymal chondrosarcoma. Postoperatively, exophthalmia spectacularly regressed. We report our clinical findings and present a review of the literature.
Subject(s)
Bone Neoplasms/surgery , Chondrosarcoma/surgery , Skull/surgery , Adult , Bone Neoplasms/diagnostic imaging , Chondrosarcoma/diagnostic imaging , Chondrosarcoma/radiotherapy , Combined Modality Therapy , Exophthalmos/etiology , Female , Humans , Magnetic Resonance Imaging , Radiotherapy/methods , Skull/diagnostic imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Intraosseous cavernous hemangiomas are a rare finding in the calvarium. It is a benign tumors arising from the intrinsic vasculature of the bone. We report one case observed in a 31 year-old female, presented with a progressive left parietal mass. A plain X-ray of the skull and cranial CT-scan showed a osteolytic lesion in the left parietal bone. Surgery consisted of total resection of the lesion and cranioplasty. The postoperative course was uneventful. Histological study revealed a cavernous hemangioma of the diploe. In view of this observation and the literature review, clinical; radiological and therapeutic aspect of this rare entity are discussed.
