ABSTRACT
A case of intracranial chondroma arising from the right parietal bone in a 37-year-old woman is presented. CT and MRI findings as well as the differential diagnosis of the lesion are discussed.
Subject(s)
Chondroma/diagnosis , Frontal Bone , Magnetic Resonance Imaging , Parietal Bone , Skull Neoplasms/diagnosis , Tomography, X-Ray Computed , Adult , Chondroma/diagnostic imaging , Diagnosis, Differential , Female , Humans , Skull Neoplasms/diagnostic imagingABSTRACT
This report describes a patient with sudden sensorineural hearing loss who was found to have a megadolichoectasia vertebrobasilar system that appeared to be causing compression of the ipsilateral facial and vestibulocochlear nerves. The patient was treated conservatively for 4 months, during which time no hearing returned. He then underwent microvascular decompression of the affected nerves. At surgery, marked compression of the cranial nerves VII-VIII complex and the pons was observed. Postoperatively, the patient experienced a gradual return of useful hearing. We suggest that vascular compression may be a rare, but treatable, cause of sensorineural hearing loss.
Subject(s)
Cochlea/surgery , Hearing Loss, Sensorineural/surgery , Vestibulocochlear Nerve/surgery , Audiometry, Pure-Tone , Basilar Artery/physiopathology , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nerve Compression Syndromes/complications , Nerve Compression Syndromes/physiopathology , Nerve Compression Syndromes/surgery , Tomography, X-Ray Computed , Vascular Diseases/complications , Vascular Diseases/diagnosis , Vascular Diseases/physiopathology , Vertebral Artery/physiopathologyABSTRACT
A review of 51 cases referred for evaluation of fetal ventriculomegaly revealed adequate follow-up data in 40 patients. Three of the fetuses were electively aborted and 37 were delivered. There were no cases of death in utero. Of the 37 infants who were delivered, 26 (70%) were treated with shunt placement for neonatal hydrocephalus. The reasons for nontreatment included: inaccurate diagnosis, resolution of hydrocephalus by the time of delivery, neonatal death, and parental wishes. Survival time in the 26 shunt-treated patients ranged from 5 days to 14 years (average 4.25 years); five of these patients died within the first 2 weeks of life. Among the 26 treated patients, satisfactory cognitive ability was found in 10 (38%). Of the seven surviving nontreated infants, satisfactory cognitive ability was demonstrated in six (86%). Children with myelomeningocele displayed cognitive development similar to that in patients without myelomeningocele. The findings suggest that, of patients with in utero diagnosis of ventriculomegaly, approximately one-half survive (4-year average follow-up interval) and 38% of the survivors treated with shunt insertion have normal cognitive development. No subgroup likely to benefit from in utero treatment of ventriculomegaly was identified. Associated central nervous system or systemic malformations were identified in 26 (70%) of the 37 who came to delivery. This community-acquired series, not collected from a high-risk obstetrical-perinatal service, may reflect the general experience of the neurosurgeon consulting in such cases.
Subject(s)
Fetal Diseases/diagnostic imaging , Hydrocephalus/diagnostic imaging , Ultrasonography, Prenatal , Abnormalities, Multiple/diagnostic imaging , Cerebral Ventricles/diagnostic imaging , Cerebrospinal Fluid Shunts/adverse effects , Cerebrospinal Fluid Shunts/mortality , Cognition Disorders/etiology , Cognition Disorders/physiopathology , Diagnosis, Differential , Female , Fetal Diseases/physiopathology , Fetal Diseases/surgery , Follow-Up Studies , Humans , Hydrocephalus/complications , Hydrocephalus/physiopathology , Hydrocephalus/surgery , Meningomyelocele/complications , Meningomyelocele/diagnostic imaging , Meningomyelocele/physiopathology , Monitoring, Physiologic , Peritoneum , Pregnancy , Prognosis , Reoperation , Survival Rate , Treatment OutcomeABSTRACT
Recent advances in neuro-imaging have led to the early diagnosis of increasingly smaller and more deeply-seated tumours. Conventional neurosurgical techniques are often not satisfactory to deal with these lesions. The authors describe their preliminary experience with a prototype neuro-endoscope. The technical characteristics of the instrument and description of its use in performing stereotactic laser tumour resection are provided.
