Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Most trigeminal neuralgia is attributable to vascular compression of the root entry zone of the trigeminal nerve at the pons. Only about 5-10% of trigeminal neuralgia cases are caused by direct compression by ipsilateral cerebellopontine angle tumors. Trigeminal neuralgia caused by contralateral posterior fossa tumors are extremely rare. ⋯ This report describes a case of large meningioma in the left occipital region. The patient's right facial pain subsided gradually after tumor excision. This neuralgia is likely due to a displaced adjacent vessel that developed following brainstem distortion by the tumor.
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We present a right-hemispheric stroke patient with complex regional pain syndrome (CRPS). The regional cerebral blow flow (rCBF) as determined using single photon emission computed tomography (SPECT) showed contralateral increase of tracer uptake in the left thalamus accompanied by crossed cerebellar diaschisis (CCD) in the left cerebellum. After rehabilitation, the CRPS in the right upper extremity recovered, although hemiplegia persisted on the left limbs. ⋯ At a 6-month follow-up, the CRPS had not recurred. Our findings show that analysis of rCBF by SPECT is useful for the clinical evaluation and follow-up of CRPS. To the best of our knowledge, this is the first reported case with this particular pattern of symptoms amd symptom resolution.
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We describe for the first time a case of intracranial tuberculoma with adjacent intracerebral inflammatory aneurysms, and include a brief discussion of the developmental mechanism of these pathologies. A 28-year-old woman presented with a history of intermittent seizure attacks. She had been diagnosed as having pulmonary tuberculosis 1 year previously, and had been treated with antituberculosis medications for 9 months. ⋯ At surgery, we were surprised to find multiple small aneurysms in the distal middle cerebral arteries surrounding the mass. The mass was totally removed, and the aneurysms were secured by wrapping and fibrin tissue adhesive. The mass was diagnosed as a tuberculoma, and the aneurysms were suspected of being inflammatory in nature and associated with the patient's tuberculosis.
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Controlled Clinical Trial
Intravenous theophylline decreases post-dural puncture headaches.
Post-dural puncture headache (PDPH) is a common complication of lumbar puncture. As invasive treatments for PDPH have known complications, pharmacologic management may be preferable. The aim of this study was to evaluate and to compare the efficacy of intravenous theophylline treatment for PDPH, in comparison with a placebo. ⋯ Intravenous theophylline infusion is an easy, rapid, minimally invasive, an effective treatment for PDPH. It may be attempted in PDPH patients before invasive techniques are used. To the best of our knowledge, this is the first report on the effect of intravenous infusion of theophylline compared with a placebo in the treatment of PDPH.
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The aim of this study was to identify the risk factors associated with bone grafts infection after cranioplasty. Eighty-four cranioplasties were performed on 75 patients between 2002 and 2006. Cryopreserved bone grafts were used as graft material in group 1 and polymethylmethacrylate (PMMA) was used in group 2. ⋯ Multiple procedures and insufficient time intervals increase the risk of infection. Interrupting the wound healing process may be the cause of infection. PMMA is a safe material for cranioplasty regardless of previous infection.