Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Pregnancy and puerperium raise the risk of thrombotic events, and these risks are likely to be increased in women who are carriers of thrombophilic gene polymorphisms. Prothrombin G20210A variant is reported to be the second most frequent prothrombotic polymorphism in Caucasians. Our aim was to determine the prevalence of this variant in south Indian women and examine its association with cerebral venous and sinus thrombosis occurring during puerperium. ⋯ The prothrombin G20210A variant was not detected in either the CVT patients or the healthy control subjects. Our study on a large series of patients with puerperal CVT shows that the prothrombin G20210A variant is not present in south Indian women and is not associated with puerperal CVT. This study also highlights the fact that there are racial differences in the risk factors for thrombosis, which should be considered when investigating these patients.
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We report an unusual case of epidural hematoma secondary to the use of a three-point skull-fixation device. Initially, a posterior-fossa brain tumor with hydrocephalus was diagnosed in a 15-year-old boy. Midline suboccipital craniectomy was performed with the patient placed in the prone position. A Mayfield (Ohio Medical Instrument Co., Cincinnati, OH, USA) skull clamp was used for fixation of the head during the surgical procedure, following which, a huge epidural hematoma developed within 6 hours of surgery, due to skull penetration and fracture at one of the clamp's pin sites located proximate to the coronal suture.
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Terminal syringomyelia occurs in approximately 25% of patients with occult spinal dysraphism. Congenital spinal dermal sinus is an uncommon form of occult spinal dysraphism. This case report highlights the rare association of terminal syringomyelia communicating with a spinal dermal sinus, resulting in an unique clinical presentation. The clinical, radiological and surgical findings of this unusual case are reported.
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Case Reports
Symptomatic tension pneumocephalus: an unusual post-operative complication of posterior spinal surgery.
Pneumocephalus is a rare, but serious complication of spinal surgery and its management and physiology is not widely recognized. Symptomatic tension pneumocephalus secondary to iatrogenic cerebrospinal fluid (CSF) leak after surgical intervention, and drainage with a vacuum suction device, has not been previously reported. We report a patient who underwent intervertebral disc surgery who developed pneumoencephalus after drainage with a vacuum suction device. ⋯ The condition was resolved by discontinuation of the suction drainage, bed rest and hyperhydration. Thus, spinal drainage may predispose to entry of air intracranially and pneumocephalus. It is important to be aware of this serious post-operative complication in patients with a CSF fistula.
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To assess the surgical and hardware complications in 26 consecutive patients with movement disorders undergoing subthalamic deep brain stimulation (STN-DBS) in early practice at our institute. ⋯ The associated morbidity is significant in STN-DBS. The use of MER may improve the clinical outcome while decreasing the morbidity.