ABSTRACT
Granulocytic sarcoma (GS) is a tumour formed by myeloid precursors in an extramedullary site and is associated with myeloid leukaemias and other myeloproliferative disorders. We present a patient with symptoms of cauda equina compression where MRI of the spine showed extradural lesions at S1 and L3 levels. This patient had normal bone marrow and peripheral blood for a further 6 weeks from onset of symptoms. Such aleukaemic presentations of GS are rare and have potential for misdiagnosis and delay in treatment. Therefore we recommended early open biopsy of such tumours.
Subject(s)
Cauda Equina , Leukemia, Monocytic, Acute/diagnosis , Nerve Compression Syndromes/diagnosis , Adult , Biopsy, Needle , Bone Marrow/pathology , Diagnosis, Differential , Fatal Outcome , Humans , Leukemia, Monocytic, Acute/therapy , Magnetic Resonance Imaging , Male , Reoperation , Tomography, X-Ray ComputedABSTRACT
Oxidized cellulose (Surgicel) has been used as a haemostatic agent in neurosurgery for five decades. Complications have been few. Two cases are reported of granulomatous reaction to oxidised cellulose two months and twelve months after removal of intracranial meningiomas. Both appeared as contrast enhancing space occupying lesions on CT scan and were taken for recurrence of the tumour.
Subject(s)
Cellulose, Oxidized/adverse effects , Foreign Bodies/etiology , Granuloma/diagnosis , Foreign Bodies/surgery , Granuloma/etiology , Granuloma/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
The effect of isoflurane on intraventricular pressure (IVP) was examined during nitrous oxide with fentanyl anaesthesia in patients undergoing craniotomy during normocapnia or hypocapnia. Hypocapnic patients (n = 30, PaCO2 3.3 (0.1) kPa) were allocated to three groups (A, B, C; n = 10 each) according to the inspired concentration of isoflurane (1%, 1.5%, 2%). Normocapnic patients (n = 10, PaCO2 4.7 (0.1) kPa) received an inspired concentration of 1% isoflurane (group D). In patients in groups C and D, IVP increased significantly in response to isoflurane (P less than 0.01). In groups A and B, IVP did not change significantly (P greater than 0.05). Mean arterial pressure and cerebral perfusion pressure decreased significantly (P less than 0.001) in all groups in response to isoflurane.