ABSTRACT
A case of an abscess of the sella turcica discovered during craniotomy for pituitary tumour in a 20-year-old man is presented. The clinical features of this unusual intrasellar lesion are discussed. The importance of early diagnosis, high-dosage antibiotics and surgical intervention in reducing the high mortality associated with abscesses in this location are emphasized. It is suggested that abscess of the sella turcica should be considered in the differential diagnosis of a sella mass in any patient with a recent history of cerebrospinal fluid rhinorrhea, sphenoid sinusitis or meningitis.
Subject(s)
Brain Abscess/diagnosis , Sella Turcica , Adult , Brain Abscess/pathology , Brain Abscess/surgery , Diagnosis, Differential , Humans , MaleABSTRACT
A case of an abscess of the sella turcica discovered during craniotomy for pituitary tumour in a 20-year-old man is presented. The clinical features of this unusual intrasellar lesion are discussed. The importance of early diagnosis, high-dosage antibiotics and surgical intervention in reducing the high mortality associated with abscesses in this location are emphasized. It is suggested that abscess of the sella turcica should be considered in the differential diagnosis of a sella mass in any patient with a recent history of cerebrospinal fluid rhinorrhea, sphenoid sinusitis or meningitis
Subject(s)
Adult , Humans , Male , Brain Abscess/diagnosis , Sella Turcica , Brain Abscess/surgery , Brain Abscess/pathology , Diagnosis, DifferentialSubject(s)
Intracranial Arteriovenous Malformations , Adult , Cerebral Hemorrhage/etiology , Humans , Intracranial Arteriovenous Malformations/complications , Intracranial Arteriovenous Malformations/diagnostic imaging , Male , Papilledema/etiology , Radiography , Radionuclide Imaging , Remission, SpontaneousABSTRACT
Fractures of the sella turcica are rare and are often difficult to diagnose radiologically. They can produce a wide variety of complications, including septic, neuroendocrine, neurovascular and neuroophthalmologic problems. The authors describe the case of a 17-year-old boy with diabetes insipidus and diplopia secondary to a type II fracture of the sella turcica. They emphasize the clinical importance of fractures in the sellar region in view of their proximity to vital structures and they discuss possible mechanisms of causation.
Subject(s)
Diabetes Insipidus/etiology , Diplopia/etiology , Sella Turcica/injuries , Skull Fractures/complications , Adolescent , Craniocerebral Trauma/complications , Humans , Male , Radiography , Sella Turcica/diagnostic imaging , Skull Fractures/diagnostic imaging , Wounds, Nonpenetrating/complicationsSubject(s)
Genes, Dominant , Marfan Syndrome/genetics , Mutation , Neurofibromatosis 1/genetics , Adult , Humans , MaleABSTRACT
Acute haematomyelia, an unrecognized sequela of sudden intracranial hypertension is described in 3 patients with massive intracerebral and intraventricular haemorrhage. The presence of a persistent central canal of the spinal cord in communication with the 4th ventricle and acute functional obstruction of the latter allows CSF and blood to pass down into the spinal cord with subsequent rupture into the cord parenchyma.
Subject(s)
Cerebral Hemorrhage/complications , Hydrocephalus/complications , Spinal Canal , Spinal Cord Diseases/etiology , Adult , Aged , Female , Humans , Hydrocephalus/etiology , Male , Middle Aged , Rupture, Spontaneous , Time FactorsABSTRACT
Fatal gastrointestinal hemorrhage or perforation are important problems in the management of patients in the acute phase of spinal cord injury. This paper describes 3 patients with these conditions, and shows some of the associated hazards, especially the danger of painless penetration, perforation, and peritonitis, plus the increased morbidity of these serious problems in the presence of the neurological sequelae of spinal cord injury. Our experience shows that life-threatening hemorrhage from the gastrointestinal tract occurs in about 2.5% of patients with cord injury, and often occurs during the first few days after the accident. We believe that a high index of suspicion and an aggressive therapeutic approach are necessary to save these patients from the traditionally high mortality associated with massive upper gastrointestinal hemorrhage, especially during this critical period of acute spinal cord injury.
