ABSTRACT
Seventeen cases of aneurysmal bone cyst of the spine are reported. Clinical manifestations, methods of investigation, differential diagnosis, treatment, and pathogenesis are discussed. The condition is essentially a benign lesion, affects a young age group, and grows rapidly, often producing a paravertebral mass. Occasionally it becomes acutely exacerbated, causing irreversible damage to the spinal cord. For these reasons, prompt diagnosis and timely treatment are important. Excision of the lesion is the treatment of choice but, if not feasible, thorough curettage and radiotherapy not exceeding 2000 rads are indicated. With a two-stage operation, excision of the lesion is often possible, and the stability of the vertebral column is assured with bone-graft fusions.
Subject(s)
Bone Cysts/surgery , Adolescent , Adult , Bone Cysts/diagnosis , Bone Cysts/etiology , Child , Diagnosis, Differential , Female , Humans , Male , RecurrenceABSTRACT
Aneurysmal bone cysts rarely affect the skull. Thirty-six cases including four reported in this paper are reviewed. The condition usually affects children and young adults and progresses rapidly. It may result in raised intracranial or intraorbital pressure. Complete excision of the mass is the treatment of choice, but if not feasible curettage followed by low dose radiotherapy is effective. As the prognosis in this condition is good, prompt diagnosis and early treatment are of utmost importance.
Subject(s)
Bone Cysts/pathology , Skull , Adolescent , Adult , Bone Cysts/diagnostic imaging , Bone Cysts/surgery , Female , Humans , Male , RadiographyABSTRACT
Polyostotic fibrous dysplasia affects many bones of the skeleton and usually on one side only. In monostotic variety only one bone is affected. The condition which usually starts in early childhood is at first active, gradually becomes quiescent and finally with termination of skeletal growth becomes inactive and ceases to grow. These stages can be seen histologically as well as radiologically. The main feature is increasing calcification of the mass. In half of our cases there was an intracranial mass with signs of raised intracranial or intra-orbital pressure. In all of these cases the mass originated from the base of skull. Those growing from the vault of the skull grew outward. Pathogenesis, diagnosis and treatment are discussed.
Subject(s)
Fibrous Dysplasia of Bone/diagnosis , Fibrous Dysplasia, Monostotic/diagnosis , Skull , Adolescent , Adult , Child , Diagnosis, Differential , Female , Fibrous Dysplasia, Monostotic/diagnostic imaging , Fibrous Dysplasia, Monostotic/pathology , Fibrous Dysplasia, Monostotic/surgery , Humans , Male , Radiography , Skull/diagnostic imaging , Skull/pathology , Skull/surgeryABSTRACT
This study is based on 28 personal cases. Twenty seven cases of infantile hemiplegia and one case of Stürge-Weber syndrome, with uncontrollable epilepsy and severe behaviour disturbance, were subjected to hemispherectomy. Any evidence of a defect in the other hemisphere was a contraindication to operation. In nine cases the left cerebral hemisphere was removed. Following the operation, epilepsy and behavior disturbances were abolished in nearly all of the cases. In those with left hemispherectomy there was no speech disturbance before or after the operation. It is postulated that at birth all cerebral functions including consciousness, speech, and movement are bilaterally represented, but to unequal degrees. With training and education these functions become more lateralized. Thus, we can explain the greater plasticity of the brain in childhood.
Subject(s)
Angiomatosis/surgery , Brain/surgery , Child Behavior Disorders/therapy , Epilepsy/surgery , Hemiplegia/surgery , Sturge-Weber Syndrome/surgery , Adolescent , Adult , Child , Child, Preschool , Humans , Movement , Postoperative Complications , Sensation , Speech , SyndromeABSTRACT
Three new cases of intracranial sewing needles are reported and are reviewed with 10 other published cases. These needles must have been introduced in infancy before the closure of fontanelles. The intention, at least in most cases, has been infanticide. Except in one case which the mother reported and two cases found at necropsy, the others were diagnosed by skull radiography. Headache and epilepsy were the main symptoms and they often appeared when the patient had reached adulthood. Removal of the needles lessened the symptoms.
Subject(s)
Brain , Foreign Bodies/diagnosis , Needles , Adult , Brain Injuries/etiology , Foreign Bodies/complications , Foreign Bodies/surgery , Humans , Infant , Infanticide , Iran , MaleABSTRACT
From among 1500 patients who underwent computerized tomography (CT) during an 18-month period, five cases of hydatid disease of the brain were diagnosed. The preoperative diagnosis is of paramount importance as the cyst has to be removed unruptured. The CT features of this condition are practically pathognomonic. The authors discuss the CT findings in these cases and differential diagnosis with other cystic lesions of the brain. The help that this safe and sure method of investigation gives to attain preoperative diagnosis is emphasized.
