Late-onset spinal accessory nerve palsy after traffic accident: case report.

An injury to the spinal accessory nerve is mostly reported after surgical procedures performed in the posterior triangle of the neck. In addition, it may be caused by fractures in the jugular foramina, traumas or skull base tumors. Clinically, paralysis of the trapezius muscle leads to weakness, downward rotation of the scapulae and falling down of the shoulder girdle. A 38- year-old male with left shoulder pain, scapular deviation and weakness in the left upper extremity, whose symptoms developed over a two-year period following a traffic accident, is presented herein. In the electromyography (EMG) study, partial spinal accessory nerve palsy was detected. The patient was treated conservatively for the nerve palsy since the time elapsed rendered surgical intervention inappropriate. We report a case in which spinal accessory nerve palsy developed two years after a traffic accident. Accessory nerve injury following a traffic accident is very uncommon.

Chronic subdural hematoma after endoscopic third ventriculostomy: a case report and literature review.

Chronic subdural hematoma is a very rarely observed complication after endoscopic third ventriculostomy (ETV). A 21-year-old male patient was admitted to our clinic with complaining of headache, weakness and tremor. The fundoscopic examination revealed slightly indistinct border of the papilla and neurological examination findings were normal. The cranial computed tomographic (CT) and magnetic resonance imaging (MRI) findings demonstrated three-ventricular hydrocephalus due to aqueductal stenosis and ETV was performed. The symptoms got better after the operation. At 1½ month postoperatively the patient reapplied to our clinic with a symptom of severe headache. Cranial BT imaging demonstrated enlargement of subdural hematoma. The hematoma was treated by burr-hole evacuation and drainage and totally disappeared in the postoperative period. The follow-up CT scan was evaluated as normal. Nowadays, ETV is accepted as a safe and an alternative method for the treatment of obstructive hydrocephalus instead of shunt operation. Chronic subdural hematoma is a rarely observed complication after ETV.

Lumbar epidural capillary hemangioma presenting as lumbar disc herniation disease: case report.

STUDY DESIGN: A case of lumbar spinal epidural hemangioma is presented. OBJECTIVE: To present the first reported lumbar spinal epidural hemangioma patient clinically mimicking the lumbar disc herniation disease. SUMMARY OF BACKGROUND DATA: Capillary hemangiomas are benign endothelial cell neoplasms that are believed to be hamartomatous proliferations of vascular endothelial cells. The occurrence of spinal epidural capillary hemangiomas is exceedingly rare. There are only 3 reported epidurally located cases of capillary hemangiomas in the spinal channel in literature. Lumbar spinal epidural capillary hemangioma in a patient has not been previously reported. METHODS: Radiologic features, pathology, and clinical course were documented. RESULTS: L4 hypoesthesia and back pain of the patient was caused by an epidurally located capillary hemangioma. The neurologic symptoms of the patient were markedly improved after surgery. CONCLUSION: We have reported for the first lumbar epidural capillary hemangioma patient in literature. These lesions are benign and surgical treatment is curative.

Brucella-related cerebral aneurysms/subarachnoidal hemorrhage: a short review featuring a case report.

Brucellosis is a multisystem disease that may present with a large spectrum of clinical manifestations. Only five cases of intracranial aneurysm formation and/or subarachnoidal hemorrhage associated with brucellosis have been reported. In this paper, we take the opportunity to review these reports and present a new case of basilar artery aneurysm and subarachnoidal hemorrhage due to brucellosis.

Multilevel cervical fusion without plates, screws or autogenous iliac crest bone graft.

OBJECTIVE: This prospective study was performed to evaluate the safety and efficacy of polyetheretherketone (PEEK) cages packed with demineralized bone matrix (DBM) mixed with autologous blood and curettage microchip material for treatment of multilevel cervical disc disease and spondylosis without the use of plates, screws or autogenous iliac crest bone graft. MATERIAL AND METHODS: Sixteen patients underwent multilevel anterior cervical discectomy and fusion (ACDF) for a total of 42 levels. Minimum follow-up was 18 months. Neurological outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scoring system; cervical lordosis and cervical fusion status was assessed on X-ray. Statistical analysis was performed to compare preoperative and postoperative scores using a dependent t-test (P<0.05). RESULTS: Eight patients underwent two-level, six underwent three-level and two underwent four-level operations. The fusion rate was 90.5% and non-fusion rate was 9.5%, but reoperation was not required for these patients in the follow-up period. Cervical lordosis was preserved and neurological status was improved. No cage migration or cage failure occured. CONCLUSION: ACDF using PEEK cages packed with DBM is a safe and efficient method for treatment of multilevel cervical disc disease and spondylosis. It preserves cervical lordosis and obviates the complications related to iliac crest graft harvest and screw-plate fixation.