ABSTRACT
We report a case of 50-year-old man who was presented with recurrent episodes of left sided hemiparesis. CT scan and MRI brain revealed a large intraventricular fatty lesion. Histopathological examination showed a picture of angiolipoma.
Subject(s)
Angiolipoma/diagnosis , Cerebral Ventricle Neoplasms/diagnosis , Paresis/diagnosis , Angiolipoma/diagnostic imaging , Angiolipoma/surgery , Cerebral Ventricle Neoplasms/diagnostic imaging , Cerebral Ventricle Neoplasms/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Recurrence, Local , Paresis/etiology , Paresis/physiopathology , RadiographyABSTRACT
A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.
Subject(s)
Angiomatosis/therapy , Embolization, Therapeutic/methods , Hemangioma, Cavernous/therapy , Laminectomy/methods , Skin Diseases, Vascular/therapy , Spinal Cord Neoplasms/therapy , Adult , Angiomatosis/complications , Angiomatosis/pathology , Diagnosis, Differential , Follow-Up Studies , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/pathology , Humans , Lumbar Vertebrae , Magnetic Resonance Imaging , Male , Skin Diseases, Vascular/complications , Skin Diseases, Vascular/pathology , Spinal Cord Neoplasms/complications , Spinal Cord Neoplasms/pathology , Syndrome , Thoracic VertebraeABSTRACT
Two rare cases of intractable epilepsy caused by Dysembryoplastic Neuroepithelial Tumours (DNET) are reported and their different management discussed. The first case required vagal nerve stimulation and radiosurgery while the later was operated with the help of neuronavigation. Both had good outcome according to Engel classification after a one year follow up.
Subject(s)
Brain Neoplasms/complications , Brain Neoplasms/surgery , Epilepsy, Temporal Lobe/etiology , Epilepsy, Temporal Lobe/surgery , Neuroectodermal Tumors, Primitive/complications , Neuroectodermal Tumors, Primitive/surgery , Adolescent , Female , Humans , Male , Radiosurgery , Treatment OutcomeABSTRACT
Giant nerve sheath tumour is a rare tumour originating from the nerve sheath. It differs from the conventional nerve sheath tumour only by the size these tumours can reach. There are two main type of tumours that occur in the nerve sheath which include neurofibroma and schwannoma. The current views are that schwannomas arise from the progenitor of the schwann cell. Whereas the neurofibroma series probably arise from a mesenchymal origin closer to a fibroblast. We report on six cases of nerve sheath tumour that occur in the spinal and paraspinal region that presented to us over a 5 year period.
Subject(s)
Neurilemmoma/pathology , Neurofibroma/pathology , Spinal Cord Neoplasms/pathology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Neurilemmoma/surgery , Neurofibroma/surgery , Spinal Cord Neoplasms/surgeryABSTRACT
The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.2 ml) made into a double lumen intraventricular balloon catheter. The objective of this study was thus to determine the effectiveness of the decompressive craniectomy done on the worst brain site with regard to compliance (Cl), pressure volume index (PVI), jugular oximetry (SjVo2), autoregulation abnormalties, brain tissue oxygen (TiO2) and cerebral blood flow (CBF). This is a prospective cohort study of 17 patients who were enrolled after consent and approval of the ethics committee between the beginning of the year 2001 and end of the year 2002. For pre and post assessment on compliance and PVI, all 12 patients who survived were reported to become normal after decompressive craniectomy. There is no significant association between pre and post craniectomy assessment in jugular oxymetry (p > 0.05), autoregulation (p > 0.05), intracranial brain oxymetry (p = 0.125) and cerebral blood flow (p = 0.375). Compliance and PVI improved dramatically in all alive patients who received decompressive craniectomy. Compliance and PVI monitoring may be crucial in improving the outcome of severe head injured patients after decompressive craniectomy.
