ABSTRACT
Rathke cleft cysts (RCC) are benign cysts derived from remnants of Rathke cleft, and are rarely symptomatic in children. Symptoms due to RCC are associated with mass effect and pituitary hormone deficiencies. Slow growth rate of the cyst makes its incidence increase with aging. Here we report on a seven-year-old girl who presented with central diabetes insipidus (CDI). Her sella MRI revealed a lesion in the sellar region which grew rapidly in follow-up. She underwent microneurosurgical operation and the lesion was totally excised. Pathologic examination revealed RCC with degenerative changes. In her follow-up, growth hormone deficiency developed in addition to arginine vasopressin deficiency. Rapid growth of the cyst is not the usual course of RCC's. Mechanisms regarding the cyst growth are unclear as they are in this case. This is the youngest child to date presenting with central diabetes insipidus due to RCC. Rapid growth of RCC can cause CDI in young children.
Subject(s)
Central Nervous System Cysts/diagnosis , Diabetes Insipidus/diagnosis , Central Nervous System Cysts/complications , Central Nervous System Cysts/surgery , Child , Diabetes Insipidus/etiology , Diabetes Insipidus/surgery , Female , Humans , Magnetic Resonance Imaging , Sella Turcica/pathologyABSTRACT
PURPOSE: Many of the hypotheses have been suggested to explain the mechanism of the secondary effects of traumatic spinal cord injury (TSCI) as follows: ischaemia/reperfusion disability theory, free radicals theory, exitotoxicity theory, immunological destruction theory, apoptosis theory. Recently, free radicals,lipid peroxidation reactions and apoptosis theories have been much more accepted than others. In this study, possible protective effects of the alpha lipoic acid were evaluated in the traumatic spinal cord of rats. METHODS: Using a well characterised weight drop technique, spinal cord contusions were formed to 48 Wistar albino rats at thoracal 810 level. After alpha lipoic acid and methylprednisolone were administered intraperitoneally, the spinal cord tissues were harvested for histopathological and biochemical studies. RESULTS: Histopathological examination results showed that neither methylprednisolone nor alpha lipoic acid can play an act to decrease or block the neural tissue destruction and necrosis in hyperacute and subacute stage of the TSCI in rats. Biochemical study results showed that alpha lipoic acid was much more decreased the lipid peroxidation levels than methylprednisolone in subacute stage. However, none of the agents was changed the myeloperoxidation level in subacute stage. INTERPRETATION: Alpha lipoic acid and methylprednisolone administrations did not alter the onset or degree of necrosis at the zone of the TSCI in rats. On the other hand, alpha lipoic acid is more effective than methylprednisolone treatment for the prevention of lipid peroxidation after spinal cord injury.
Subject(s)
Methylprednisolone/therapeutic use , Neuroprotective Agents/therapeutic use , Spinal Cord Injuries/drug therapy , Thioctic Acid/therapeutic use , Animals , Apoptosis/drug effects , Free Radicals/metabolism , Lipid Peroxidation/drug effects , Male , Rats , Rats, Wistar , Spinal Cord Injuries/metabolism , Spinal Cord Injuries/pathology , Treatment FailureABSTRACT
A unique case of bilateral severe carpal tunnel syndrome due to familial Mediterranean fever is reported. The syndrome was diagnosed by clinical examination and electrophysiological studies. Bilateral transverse carpal ligaments were released and the biopsy specimens revealed systemic type A amyloidosis. Up to our knowledge, the co-existence of bilateral carpal tunnel syndrome and familial Mediterranean fever has not been reported previously in the literature.
Subject(s)
Amyloid Neuropathies/complications , Carpal Tunnel Syndrome/etiology , Familial Mediterranean Fever/complications , Adult , Amyloid Neuropathies/diagnosis , Amyloid Neuropathies/surgery , Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/surgery , Female , HumansABSTRACT
In Type I split cord malformation (SCM) lesions, the osteocartilaginous spur and its dural sleeve are almost always located in the caudal extent of the median cleft. The authors present a case of lumbar myelomeningocele associated with a thoracic Type I SCM in which an osseous septum is uniquely situated in the proximal extent of the median cleft. Split cord malformations are cord-tethering lesions, which may be associated with a myelomeningocele that causes additional tethering, even in the opposite direction; therefore, both lesions should be treated. In view of this unique case, however, the surgical approach used for tethering lesions in such cases of complex spina bifida should perhaps be tailored. Whenever feasible, meticulous preoperative examination of a patient with spina bifida, including entire craniospinal magnetic resonance imaging followed with perioperative dynamic evaluation, is important for the effectiveness and safety of the surgery.
Subject(s)
Meningomyelocele/etiology , Meningomyelocele/surgery , Spinal Dysraphism/complications , Spinal Dysraphism/surgery , Female , Humans , Infant , Magnetic Resonance Imaging , Meningomyelocele/pathology , Spine/abnormalities , Spine/pathologyABSTRACT
INTRODUCTION: Intraventricular hydatid cyst is an extremely rare entity. We report a solitary hydatid cyst in a lateral ventricle. CASE REPORT: A 7-year-old girl had a free floating intraventricular cyst, diagnosed by computerized tomography examination inside the enlarged left lateral ventricle of an associated Dandy Walker malformation. The patient underwent surgery and the cyst was removed. CONCLUSION: To our knowledge, this is the first case report in which the natural developmental phases of an intraventricular hydatid cyst have been observed.
