Open Access DOI:10.23937/2643-4474/1710081
Spontaneous Intracerebral Hemorrhage in Pediatric Patients with Hemophilia A: Case Report and Review of Perioperative Management of Clotting Factor Concentrates
Omar Akel, MBS, Blake Taylor, MD, Omar Ashraf, Fareed Jumah, MD, Bharath Raju, MD, Priyank Khandelwal, MD, Margaret Pain, MD, Stephen Johnson, MD, Anil Nanda, MD, Sudipta Roychowdhury, MD and Gaurav Gupta, MD
Article Type: Case Report and Review Article | First Published: September 26, 2021
Intracerebral hemorrhage (ICH) is the leading cause of death in patients with hemophilia. The incidence of ICH is up to 50 times greater than that of the general population, and most frequently occurs in children less than two years of age and among those with the severe forms of the disease. The ideal perioperative management of this patient population, however, remains unclear. A 9-month-old boy with a known history of hemophilia A (HA) presented to the emergency department with lethargy, anor...
Open Access DOI:10.23937/2643-4474/1710080
Cerebral Infarction from Compression of the Internal Carotid Artery - A Rare Presentation of Pituitary Apoplexy
Kali Uppalapati, Narindra Ramnarine, FRCS and Panduranga Seetahal-Maraj
Article Type: Case Report | First Published: September 20, 2021
Cerebral infarction caused by Pituitary Apoplexy is a rare phenomenon with less than 30 reported cases in literature. We report this rare phenomenon in a 42-year-old female, who was diagnosed and underwent urgent trans-sphenoidal decompression of the sella. A 42-year-old female presented with sudden onset of headaches, left hemiplegia and bitemporal hemianopia. Radiological investigations revealed right anterior circulation infarction from mechanical obstruction of the right internal carotid art...
Open Access DOI:10.23937/2643-4474/1710078
Bilateral Dumbbell Cervical Spinal Ganglioneuromas Associated with Neurofibromatosis Type 1
Panduranga Seetahal-Maraj, MRCS, Nadeem Hosein, FRCP, Patrick Knight, FRCS and Narindra Ramnarine, FRCS
Article Type: Case Report | First Published: September 15, 2021
Ganglioneuromas of the cervical spine are rare lesions. There are only 6 documented cases in the existing literature that are associated with neurofibromatosis type 1, in which all patients presented with tetraparesis. We present a case of a young female with NF1, who developed bilateral upper limb paresthesia after a minor fall. Her neurological examination was consistent with cervical myelopathy, with long tract signs evident but no loss of power. MRI of the cervical spine showed bilateral dum...
Open Access DOI:10.23937/2643-4474/1710076
Pedicle Screws Fixation of Thoraco-Lumbar Fractures Experience in Qatar
Abdulnasser Alyafei, Ghanem Al Sulaiti, Nissar Shaikh, Sirajelddin Belkhair, Ahmed Quateen, Surya Batas, Aisha AL Kubaisi, Ghaya AL Rumahi, Alaalden, Husham Abdul Rahman, Ahmed Own, Ali Raza and Hassan AL Thani
Article Type: Orginal Research | First Published: September 03, 2021
Thoracolumbar injury is one of the most common spine injuries. The injury manifesting as neurologic deficit usually requires surgery because of the underlying spinal instability and/or neural compression. The objectives of surgical treatment are to restore the biomechanical stability of the spine and/or to achieve neural decompression. The aim of the study was to evaluate short-term outcomes in patients with symptomatic vertebral injury, underwent posterior instrumentation surgery in the acute s...
Open Access DOI:10.23937/2643-4474/1710077
The Successful Use of Dual Flow Diverters in the Treatment of a Fusiform Middle Cerebral Artery Aneurysm
Panduranga Seetahal-Maraj, MRCS, Narindra Ramnarine, FRCS and Yourki Pierri Tairouz Zeitoune, MD
Article Type: Case Report | First Published: September 04, 2021
The management of fusiform anterior circulation aneurysms has been controversial, due to the rare nature of such lesions. They provide a unique management challenge compared to saccular aneurysms, and a variety of microsurgical techniques have been attempted in the past, with varying success rates. Fusiform middle cerebral artery aneurysms can be fraught with morbidity and even mortality, if perforator ischaemia results from intervention. In this neuroendovascular era, flow diverters have shown ...
Open Access DOI:10.23937/2643-4474/1710075
Management of Severe Traumatic Brain Injury in Children by Decompressive Craniectomy: Technical Note and Therapy Concepts
Hejazi N, MD and Al-Kassab M, MD
Article Type: Review Article | First Published: July 28, 2021
The goal of this study was to evaluate the therapeutic role of decompressive craniectomy for severe brain injury in children. Between 1993 and 2020 we treated 37 children with severe brain injury (Glasgow Coma Scores lower than 8) and primary intracranial pressure of 30 mmHg or higher. In all cases follow up data could be obtained. Mean age was 6.5 years (range 2 years - 16 years). Initial computerized tomography scans of all patients demonstrated diffuse brain injury with generalized brain swel...
Open Access DOI:10.23937/2643-4474/1710074
Resolution of Posterior Fossa Extradural Haematoma by Conservative Treatment: A Case Report
Krishan Kumar Sharma and Asgar Ali
Article Type: Case Report | First Published: July 28, 2021
Surgical intervention in posterior fossa extradural haematoma (PFEDH) carries very good results. But there are no defined indications for surgical evacuation when patient is asymptomatic and normal neurologically, even in the guidelines for surgical management of traumatic brain injury by ‘the brain trauma foundation & the congress of neurological surgeons’. Haematoma volume > 10 ml, haematoma thickness > 15 mm, perimesencephalic cisterns obliteration, fourth ventricle displacement and hydro...
Open Access DOI:10.23937/2643-4474/1710073
Decompressive Surgery for Craniovertebral Foramen Magnum Stenosis with Medullary Compression in Paediatric Skeletal Dysplasia Syndromes
Cristiano Antunes, Paulo Pereira, Daniela Alves, Rui Vaz and Josue Pereira
Article Type: Case Reports and Case Series | First Published: July 23, 2021
More than 450 skeletal dysplasias have been described including Achondroplasia. Due to defective ossification of the occipital bone and upper cervical spine, neural structures may be compressed, causing increased morbidity/mortality during childhood, mainly from sleep apnoea and other respiration abnormalities, myelopathy, syringomyelia, hydrocephalus, and even sudden infant death. This highlights the importance of early and effective treatment of craniovertebral stenosis in infants with skeleta...