Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2001
Review Case ReportsOssified thoracic spinal meningioma in childhood: a case report and review of the literature.
Spinal ossified meningiomas are extremely rare. This is a report of a study on a 15-year-old boy with thoracic spinal ossified meningioma. ⋯ Immunohistochemically, Ki 67 antibody was applied but no positive staining was present. The surgical and pathological aspects of spinal ossified meningiomas were reviewed.
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Epidermoid cysts of the spinal cord are very rare tumors. We report a 31 year-old female who presented with a 5 months history of progressive lower extremity weakness and spasticity. Magnetic resonance imaging of the thoracic spine revealed a 2 cm intradural, extramedullary mass at the T4-5 level. ⋯ Intraoperative and final histological examination revealed an epidermoid cyst. Epidermoid cysts must be a consideration for intradural, extramedullary lesions of the spinal cord. Complete surgical resection offers the patient an opportunity for good neurologic outcome.
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Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by abdominal distention and massive colonic dilatation without any mechanical cause of obstruction. Lumbar spine operations can be an etiologic factor. We had a case with Ogilvie's syndrome after cervical discectomy. We also treated successfully this case by parasympathetic agent, neostigmine.
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Clin Neurol Neurosurg · Oct 2001
Case ReportsAcute disseminated encephalomyelitis following aseptic meningoencephalitis.
A previously healthy 50-year-old man developed aseptic meningoencephalitis with clinical manifestations including fever, headache, seizure, Wernicke aphasia, right hemiplegia, and blindness in the left eye. One and one-half months after remission of meningoencephalitis, marked ataxia and psychiatric symptoms became apparent. ⋯ Despite these developments, cerebrospinal fluid findings continued to improve except for excessive content of myelin basic protein. Within 2 weeks, steroid therapy dramatically resolved the ataxic symptoms and disseminated lesions.
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Clin Neurol Neurosurg · Jul 2001
Intra-operative electromyographic monitoring of the lower cranial motor nerves (LCN IX-XII) in skull base surgery.
The functional preservation of lower (motor) cranial nerves (LCN) is endangered during skull base surgery. Intra-operative EMG monitoring of the LCN IX-XII was investigated in 78 patients undergoing 80 operations on various skull base tumors with regard to technical feasibility and clinical efficacy. Ongoing 'spontaneous muscle activity' (SMA) and 'compound muscle action potentials' (CMAP) following supramaximal bipolar stimulation were intra-operatively recorded applying needle electrodes into the soft palate (CN IX: n=76), the vocal cord (CN X: n=72), the trapezius muscle (CN XI: n=18), and the tongue (CN XII: n=71). ⋯ Approximate 'normal' values were calculated and compared to (very few) data so far given in the literature. Electromyographic monitoring proved to be a safe tool for the intra-operative identification and localization of the LCN contributing to their anatomical and functional preservation. The predictive value of standard neurophysiological parameters for functional outcome, however, is limited.