ABSTRACT
We reviewed the cases of 75 patients who underwent an extended subcranial approach to the anterior skull base for treatment of various tumors (35 patients), repair of craniofacial trauma injury (33 patients), or cerebrospinal fluid leakage (10 patients). Preoperative evaluation and surgical procedures were reassessed. Significant complications in the oncology group consisted of one hematoma requiring aspiration, 2 cases of transient pneumocephalus, 2 osteocutaneous fistulae and 2 epiphoras. In the trauma group, one patient died from intracerebral damage, 2 presented with transient pneumocephalus, 5 with telecanthus and 5 with enophthalmy. The most frequent late complication in all three groups was anosmia. Based on this review, we feel that this technique is a safe and effective procedure for the surgical treatment of various pathological conditions involving the anterior skull base.
Subject(s)
Brain Neoplasms/surgery , Cerebrospinal Fluid Rhinorrhea/surgery , Frontal Bone/injuries , Frontal Bone/surgery , Skull Base/injuries , Skull Base/surgery , Skull Fractures/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , History, 17th Century , Humans , Male , Neurosurgical Procedures/methods , Retrospective StudiesABSTRACT
BACKGROUND: Cutaneous drug reactions are attributed usually to one culprit drug, however, some CDRs may be associated with drug interactions. OBJECTIVES: To present a case series of four patients with phenytoin-induced severe CDRs, including toxic epidermal necrolysis (2 patients), exanthematous eruption (1 patient) and hypersensitivity syndrome (1 patient). In all patients the reactions appeared following the combined intake of phenytoin, corticosteroids and H2-blockers. CONCLUSIONS: Our case series may imply the role of drug interactions between phenytoin, corticosteroids and H2-blockers in the induction of severe CDRs.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Drug Eruptions/etiology , Histamine H2 Antagonists/pharmacology , Phenytoin/adverse effects , Administration, Topical , Adult , Drug Synergism , Female , Glucocorticoids , Humans , Male , Middle Aged , Phenytoin/pharmacologyABSTRACT
A 5-year-old child with the unusual association of late-onset diencephalic cachexia and pituitary insufficiency is described. At operation a suprasellar epidermoid cyst was found and excised. This curable tumor should be added in the differential diagnosis of diencephalic syndrome.
