Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Dec 2013
Case ReportsAkinetic mutism and parkinsonism due to subdural and intraventricular tension pneumocephalus.
Pneumocephalus may occur after intracranial surgery and is most often asymptomatic. It is usually associated with posterior fossa surgery. ⋯ As an emergency treatment, air was exchanged with saline via the drainage, which then was removed and a subduro-peritoneal shunt was implanted. The condition described here requires immediate attention and appropriate treatment.
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J Neurol Surg A Cent Eur Neurosurg · Dec 2013
Case ReportsRuptured Rathke cleft cyst mimicking pituitary apoplexy.
Rathke cleft cysts (RCCs) are benign cystic lesions of the sellar and suprasellar region that are asymptomatic in most cases. Occasionally, compression of the optic pathway and hypothalamo-pituitary structures may cause clinical symptoms, such as headaches, visual deficits and endocrinopathies. ⋯ In retrospect, clinical symptoms, intraoperative appearance, and histologic examination were compatible with the diagnosis of nonhemorrhagic rupture of an RCC. Thus, the clinical presentation of "Rathke cleft cyst apoplexy" is not necessarily caused by hemorrhage.
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J Neurol Surg A Cent Eur Neurosurg · Dec 2013
Case ReportsAcute onset of hemiparesis after gamma knife radiosurgery for arteriovenous malformation caused by hyperacute thrombosis of draining vein: a case report.
Complications after gamma knife radiosurgery (GKRS) have been attributed most commonly to radiation-induced damage to the brain. Early occlusion of the draining veins has been postulated as one of the rare causes of complications after GKRS, which often occurs at or beyond 6 months after GKRS. ⋯ Early draining vein occlusion is an important cause of postradiosurgery complications, and it can rarely occur within days.
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J Neurol Surg A Cent Eur Neurosurg · Dec 2013
Case ReportsSimultaneous rupture of two middle cerebral artery aneurysms presented with two aneurysm-associated intracerebral hemorrhages.
Simultaneous rupture of more than one intracranial aneurysm is a rare event and difficult to diagnose. In this case report, we present the case of a patient with a simultaneous rupture of two middle cerebral artery (MCA) aneurysms with two separately localized aneurysm-associated intracerebral hemorrhages (ICH). Initially, the patient presented with headache and neck stiffness as well as progressive decrease of consciousness. ⋯ Rupture of both aneurysms was confirmed during surgery, and both aneurysms were clipped microsurgically without complications. Although rupture of one aneurysm in patients with multiple aneurysms is the most common event, this case indicates that simultaneous rupture should be kept in mind in patients with multiple aneurysms. In patients with multiple aneurysms, the identification of the ruptured aneurysm(s) is necessary to avoid leaving a ruptured aneurysm untreated.
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J Neurol Surg A Cent Eur Neurosurg · Dec 2013
Case ReportsGigantism treated by pure endoscopic endonasal approach in a case of McCune-Albright syndrome with sphenoid fibrous dysplasia: a case report.
McCune-Albright syndrome (MAS) is an uncommon polyostotic manifestation of fibrous dysplasia in association with at least one endocrinopathy that is mostly associated with precocious puberty and hyperpigmented skin macules named café-au-lait spots. We present an atypical manifestation of McCune-Albright syndrome in a 19-year-old man with the uncommon association of polyostotic fibrous dysplasia and gigantism in the absence of café-au-lait spots and precocious puberty. ⋯ Magnetic resonance imaging (MRI) found a right stalk shift of the pituitary with a 20 mm pituitary adenoma. We describe the diagnostic and endoscopic endonasal transsphenoidal approach for excision of the tumor.