Acta neurochirurgica
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Acta neurochirurgica · Apr 2005
Review Case ReportsSpinal intramedullary ependymal cyst: a case report and review of the literature.
We report a rare case of spinal intramedullary ependymal cyst in a 44-year-old female and reviewed 12 cases reported in the literature. The patient presented with slowly progressive lower limb paresis. She underwent biopsy of the cyst wall and placement of a cysto-subarachnoid shunt with complete recovery at the follow-up examination 18 months after surgery. This is a benign lesion and appropriate management should be performed at an early stage of the disease.
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Acta neurochirurgica · Apr 2005
Case ReportsEsophageal perforation complicating with spinal epidural abscess, iatrogenic or secondary to first thoracic spine fracture?
A 49-year-old drunken man was involved in a motorbike crash. He presented with cervical spine injury and multiple limbs fracture. Neuro-imaging demonstrated disruption of the C5-6 anterior longitudinal ligament, herniation of C3-4 and C5-6 discs, and Th1 compression fracture. ⋯ After proper management and rehabilitation, he achieved good recovery one year later at follow-up. We report the unique case of Th1 fracture with esophageal perforation complicated with spinal epidural abscess. The possible mechanism and the controversy concerning therapy for esophageal perforation are discussed.
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Acta neurochirurgica · Apr 2005
Case ReportsCranio-cervical stabilization of traumatic atlanto-occipital dislocation with minimal resultant neurological deficit.
Our purpose is to describe a case of atlanto-occipital dislocation and discuss treatment approaches to minimize subsequent neurological deficits. Traumatic atlanto-occipital dislocation, has traditionally been considered rare and lethal, due to resulting high levels of spinal cord injury. Outcomes are generally expected to be poor. ⋯ Motor strength and sensation remained intact following surgery. One-week post-operation, the patient was ambulating 140 feet, conversationally appropriate, and had a GCS of 15. This case illustrates the possibility for neurosurgical intervention of cranio-cervical dislocations to achieve optimal outcome and demonstrates that survival from this injury is not only conceivable, but recovery of function is also possible.