Tension Pneumocephalus Causing Cerebral Venous Sinus Thrombosis
Nissar Shaikh, Gulzar Hussain, Adnan Khan, Muhammad Mohsin Khan, Mamdouh Al Mustafa, Moad Ehfeda, Muhammad Zubair and Umais Momin
Article Type: Case Report | First Published: September 13, 2019
A 38-year-old Asian male had craniotomy with excision of a left frontal mass which extended into the lateral ventricles. External ventricular and subdural drains were inserted at the end of the procedure. He received mannitol and furosemide intraoperatively. Immediately after surgery he developed tension pneumocephalus, diabetes insipidus and fever. Two days after surgery, magnetic resonance imaging (MRI) showed transverse, sagittal sinus thrombosis extending into the right internal jugular vein...
Neuropathic Pain in the Distribution of the Dorsal Nerve of the Penis Secondary to a Conus Medullaris Contusion
Hu Liang Low and Ahsan Taqvi
Article Type: Case Report | First Published: September 05, 2019
Post-traumatic conus medullaris syndromes (CMS) such as after L1-burst fractures are uncommon, being encountered in only 1.7% of patients with spinal cord injuries. These injuries are almost invariably associated with bladder, erectile or bowel dysfunction, disturbance of perineal sensation and varying sensorimotor deficits in the legs. To date, there are only 6 reported cases of CMS after a L1-burst fracture without sensory or motor deficits in the lower limbs. In this case report, we describe ...
Acute Intratumoral Hemorrhage of a Brain Glioma during Pregnancy: Case Report and Considerations on the Management Strategy
Andrea Bianco, Riccardo Fornaro, Christian Cossandi, Sara Forgnone, Emanuela Crobeddu and Piergiorgio Car and Gabriele Panzarasa
Article Type: Commentary | First Published: July 05, 2019
Pregnancy can change the behavior of brain gliomas with increased growth rate, increased frequency of seizures, and anaplastic transformation. Very rarely the presentation may be hyperacute due to intratumoral hemorrhage. We report and discuss them a management of the hemorrhagic infarction of a newly diagnosed postcentral anaplastic astrocytoma in a pregnant woman. A first MRI discovered the glioma; two days later, after acute neurological deterioration, a second MRI showed a dramatic increase ...
Caring for Meningiomas: A Multi-Disciplinary Approach
Uri P Hadelsberg, MD and Nevo Margalit, MD
Article Type: Commentary | First Published: June 29, 2019
This patient was admitted to our department and eventually underwent surgery with gross total resection after pre-operative endovascular embolization of the tumor. The patient underwent a successful recovery and was discharged without major neurological deficits to rehab. On follow up the patient is doing well and is back home with her children. On the day of surgery the patient was intubated and underwent cerebral embolization with occlusion of several tumor-feeding arteries. The patient was th...
Multidirectional Spontaneous Migration of Intracranial Bullet: A Case Report and Literature Review
Matías Negrotto, MD, Ramon Figueroa, MD and Katherine Sotomayor, MD
Article Type: Case Report | First Published: June 26, 2019
Although gunshot injury to the head is usually mortal, survivors frequently show retained metal shrapnel or full bullet intracranially. An important though uncommon complication of retained bullet is that of spontaneous migration. A migrating intracranial bullet is a dilemma to neurosurgeons, as its management is challenging, since the removal of a deep-seated bullet may cause additional neurological deficit. Migration of a retained bullet may cause damage to vital structures and cranial nerves,...
Clinical Performance of a Novel Fully Synthetic Dura Substitute
Umang Khandpur, BS, Wilson Z Ray, MD and Matthew R MacEwan, PhD
Article Type: Case Series | First Published: June 17, 2019
A retrospective case series was performed to evaluate the efficacy of a novel, fully synthetic dura substitute. Clinical outcomes (e.g. infectious, reoperation rates, cerebrospinal fluid leak) and surgeon experiences with the dura substitute intraoperatively were collected. All methods were approved by the Institutional Review Board at Washington University School of Medicine....
The Role of Neurosurgery Mission Trips in Third World Countries
Article Type: Review Article | First Published: June 17, 2019
A summary of available data on neurosurgical mission trips has been collected from PubMed and Google Scholar on the following mesh keywords: Neurosurgery trips, mission neurosurgery, and neurosurgery in third world countries. We gathered our information that was closely related to neurosurgical education such as proficiency, equipment, ethics and outcomes....
Psychogenic Hemiplegia after Cervical Spine Discectomies and Fusion
Siavash S Haghighi
Article Type: Case Report | First Published: June 08, 2019
A case report of psychogenic hemiplegia following a two level anterior cervical discectomies and fusion was contradicted by a thorough electrophysiological findings. To report an unusual case of post-operative hemiplegia in spite of normal electrophysiological and noncompromising radiographic findings. Conversion disorder with sensory or motor system symptoms is a subtype which includes symptoms such as impaired motor balance, paraplegia, muscle weakness, and urinary retention....
Delayed Quadriplegia after Cervical Discectomy and Fusion Surgery
Siavash S Haghighi, MD, Bertha Ramirez, MD and Richard Zhang, MD
Article Type: Case Report | First Published: May 08, 2019
Acute or delayed paraplegia or quadriplegia following anterior cervical discectomies and fusion are not common. We report this single case report of delayed quadriplegia following an anterior cervical discectomies and fusion without any change of sensory or motor evoked potentials during the operation. The intraoperative somatosensory (SSEPs) were performed by stimulation of tibial nerves or the median (MN). Motor evoked potentials (TcMEPs) were recorded from intrinsic hand or foot muscles after...
Frequency of Diseases Inducing a Systemic Oxidative Stress in 175 Patients with Intracranial Aneurysms
Thierry Patrice, MD, PhD, Romain Bourcier, MD, Hubert Desal, MD, PhD, Bertrand Rozec, MD, PhD and Yvonnick Blanloeil, MD
Article Type: Case Study | First Published: April 26, 2019
Oxidative stress (OS) could be involved during intracranial aneurysms (ICA) progression but knowledge about comorbidities likely to induce OS is poor. We studied the medical and surgical history of patients with an ICA discovered after a subarachnoidal haemorrhage (SAH) or unruptured (UIA). 175 patients, 58 with a UIA, had been successively recruited from a single centre. Their medical history, comorbidities and treatments had been gathered from hospital files, general practitioners, relatives a...
Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis
Wyatt McGilvery, BS, Marc Eastin, MD, Anish Sen, MD and Maciej Witkos, MS, MD
Article Type: Case Report | First Published: April 05, 2019
The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self manipulation of the patient's own cervical vertebrae. Initial emergency department imaging via cervical X-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc her...
Cerebello-Pontine Angle Glioblastoma with Cervical Spine Metastasis: A Case Report
Giuseppe Mariniello, MD, Carmela Peca, MD, Maria Laura Del Basso De Caro, MD, Sergio Corvino, MD, Valentina Orlando, MD, Elia Guadagno, MD and Francesco Maiuri, MD
Article Type: Case Report | First Published: February 14, 2019
This article reports a left cerebellopontine angle glioblastoma presenting with two week history of rapidly progressive hearing loss and trigeminal pain, treated by subtotal resection and radiotherapy with concomitant and adjuvant temozolomide. At one year, local tumor control and diffuse neoplastic seeding in the cervical spinal cord were evidenced. Glioblastomas involving the cerebellopontine angle are exceptional with only 10 reported cases. The possibility of a glioblastoma should be conside...
Pathology Confirmation of Particle Embolization of Middle Meningeal Artery for Management of Subdural Hematoma
Pouya Entezami, MD, Emad Nourollahzadeh, MD, Adedamola Adepoju, MD, David Michael Jones, MD and John Dalfino, MD
Article Type: Case Report | First Published: February 11, 2019
As our patient population grows older with improved health care technology and resources, chronic subdural hematoma (CSDH) is an increasingly common disease faced by the modern neurosurgeon. Despite good results with burr-hole irrigation and evacuation - the gold standard treatment for CSDH - recurrence rate remains high. Recent advancements in endovascular management of this diagnosis via embolization of the middle meningeal artery (MMA), either alone or in conjunction with surgical evacuation,...
Delayed Revascularization of Basilar Artery Occlusion due to Symptomatic Progression
Pouya Entezami, M Reid Gooch, Emad Nourollahzadeh and John Dalfino
Article Type: Case Report | First Published: January 21, 2019
The basilar artery is the main arterial contributor to the posterior circulation. Interruptions of this flow can cause devastating strokes and neurological demise. While most patients with a basilar artery occlusion suffer from a high rate or morbidity and/or mortality, a small subset survive but have progressive symptomatic decline. Delayed revascularization of these patients with chronic basilar artery occlusions based on symptomatic progression may provide a favorable risk-benefit ratio, but ...