Acta neurochirurgica
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Acta neurochirurgica · May 2005
Comparative StudyIntracranial aneurysms in patients 18 years of age or under, are they different from aneurysms in adult population?
Intracranial aneurysms are extremely uncommon in the first two decades of life. This study was undertaken to assess the clinicoradiological features and surgical outcome of intracranial aneurysms in patients less than or equal to 18 years of age; and, to highlight the differences between these and intracranial aneurysms seen in adult patients. ⋯ In patients under 18 years of age, there was a definite male predominance; a higher incidence of seizures; and, the ICA bifurcation formed the most frequent site of intracranial aneurysms. In adults, AcoA a was the commonest site. Rebleeding and delayed ischaemic deficits were the major causes of morbidity. Favorable outcome after surgery in young patients was better in comparison to their adult counterparts.
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Acta neurochirurgica · May 2005
Immediate open anterior reduction and antero-posterior fixation/fusion for bilateral cervical locked facets.
Bilateral cervical locked facets is a severe traumatic lesion, most frequently resulting in tetraplegia. The common treatment strategy has been an attempt of awake, closed reduction, adding general anesthesia, muscle relaxation and manual traction in difficult cases. In cases of failed closed reduction, open reduction has most commonly been performed by a posterior approach. Patients in the current series have been managed by immediate open anterior reduction and circumferential fixation/fusion. The technique is described and its potential advantages are discussed. ⋯ Immediate open anterior reduction of bilateral cervical locked facets and combined antero-posterior fixation/fusion was safe and reliable. This treatment strategy avoids time loss and patient discomfort from attempted closed reduction by traction, obviates the need for external immobilization, and results in an excellent fusion rate.
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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.