Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Neurenteric cysts are rare congenital, benign, endodermal lesions of the central nervous system that occur mainly in the spinal canal. Intracranial neurenteric cysts are rare; the posterior fossa being the most common site. ⋯ A search of the literature revealed no other extradural supratentorial neurenteric cyst. We present a patient with an extradural giant neurenteric cyst that occupied both the supratentorial and infratentorial compartments, further highlighting the heterogeneity of this rare intracranial lesion and emphasizing the need to consider this in the differential diagnosis of cystic intracranial brain lesions.
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Case Reports
Trigeminocardiac reflex: a cause of sudden asystole during cerebellopontine angle surgery.
We present a patient with an unusual, exaggerated trigeminocardiac reflex response during surgery for vestibular schwannoma and its successful management.
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Temporal lobe epilepsy (TLE) is conventionally surgically treated by anterior temporal lobectomy. Temporal disconnection surgery has been proposed to minimize the complications associated with standard temporal lobectomy with comparable seizure control. We report a patient with seizures secondary to hippocampal herniation treated successfully with lateral temporal lobectomy and hippocampal disconnection.
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Both transthoracic (TTE) and transoesophageal (TOE) echocardiography are used routinely to investigate ischaemic stroke. We retrospectively assessed the incidence of abnormalities on TTE/TOE and whether an abnormal TTE/TOE result could have been predicted on the basis of ancillary tests and clinical cardiological examination. Data from 428 patients were analysed. ⋯ A significant correlation was found between clinical cardiac disease, stroke subtype and the diagnostic yield of TTE. We conclude that the vast majority of abnormal findings occur in patients who already have clinical evidence of cardiac disease. This suggests that the use of these tests should not be "routine", but determined on an individual patient basis.
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There is much interest in the use of decompressive craniectomy for intracranial hypertension. Whilst technically straightforward, the procedure is not without significant complications. A retrospective analysis was undertaken of 41 patients who had had a decompressive craniectomy for severe head injury in the years 2006 and 2007 at the two major hospitals in Western Australia, Sir Charles Gairdner Hospital and Royal Perth Hospital. ⋯ Syndrome of the trephined occurred in three (7%) of those patients whose bone flap had significantly resorbed. Two deaths (5.5%) occurred as a direct complication of the craniectomy or cranioplasty procedure. I attempted to define what may be regarded as a complication of the decompressive procedure rather than what may be a consequence of the primary pathological process of traumatic brain injury.