ABSTRACT
Silver-Russell syndrome is a rare genetically heterogeneous disorder in which patients demonstrate intrauterine and postnatal growth retardation, triangular facies, excessive sweating during early childhood, late closure of the anterior fontanelle and skeletal asymmetry. An association with malignancy exists and only one previous intracranial tumour has been reported, a craniopharyngioma. We report the first case of Silver-Russell syndrome associated with a supratentorial juvenile pilocytic astrocytoma.
Subject(s)
Astrocytoma/complications , Chromosome Disorders/complications , Fetal Growth Retardation , Headache Disorders/etiology , Adult , Astrocytoma/diagnosis , Astrocytoma/surgery , Female , Humans , Magnetic Resonance Imaging, Interventional/methods , Syndrome , Treatment OutcomeABSTRACT
STUDY DESIGN: Case report. OBJECTIVES: Successful excision of the mass and identification of the causative agent by histologic and microbiologic studies. SUMMARY OF BACKGROUND DATA: Spinal pain, caused by an infective mass, developed in a 39-year-old man 3 months after an epidural injection for low back pain. METHODS: Exploratory surgery was performed to remove the mass, and histologic and microbiologic studies were conducted. RESULTS: The inflammatory mass was excised successfully, and several specimens were examined for bacteriologic presence. Histologic examination of the excised specimen showed chronic granulomatous inflammation, and subsequent microbiologic studies cultured an acid- and alcohol-fast bacillus that was later identified as Mycobacterium fortuitum. CONCLUSION: A review of the literature shows that this is a particularly uncommon micro-organism.
Subject(s)
Injections, Epidural/adverse effects , Mycobacterium Infections, Nontuberculous/etiology , Mycobacterium fortuitum/isolation & purification , Spinal Diseases/etiology , Adult , Anesthesia, Spinal , Anti-Bacterial Agents , Drug Therapy, Combination/therapeutic use , Humans , Iatrogenic Disease , Laminectomy , Low Back Pain/therapy , Magnetic Resonance Imaging , Male , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology , Spinal Diseases/drug therapy , Spinal Diseases/microbiologyABSTRACT
Two patients who appeared to have suffered from intracranial haemorrhage are presented. Their clinical histories and computed tomographic scans were supportive of the diagnosis of intracranial haemorrhage. However, both patients were found to have infected cerebrospinal fluid.
Subject(s)
Cerebral Hemorrhage/diagnostic imaging , Cerebral Ventriculography , Encephalitis/diagnostic imaging , Meningitis/diagnostic imaging , Streptococcal Infections/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Diagnosis, Differential , Encephalitis/cerebrospinal fluid , Female , Humans , Male , Meningitis/cerebrospinal fluid , Streptococcal Infections/cerebrospinal fluidABSTRACT
The prevalence of skin reactions associated with surgical scrub-up among a representative sample of theatre personnel in Scotland was 37.2 per cent. Only 5 per cent of the sample had severe symptoms as judged by the necessity to consult a dermatologist. A skin reaction following surgical scrub-up is most likely to be due to a drying effect from frequent scrubs, and moisturizing creams are effective in controlling symptoms in up to 25 per cent of those developing reactions. Individuals who have other allergic symptoms appear more likely to develop skin reactions than those with no other allergic symptoms. These individuals may benefit from regular use of hand creams or using a scrub routine which causes less trauma to their skin as a prophylactic measure.
