Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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This report describes a 66-year-old man who presented with progressive paraparesis after a fall. Magnetic resonance imaging showed an acute spinal hematoma at T11-12 with spinal cord compression. ⋯ To the best of our knowledge, this is the first reported case of traumatic spinal subarachnoid hematoma. We discuss the possible mechanism and our case illustrates an injured radicular vein can be a source of traumatic spinal subarachnoid hematoma.
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A 45-year-old woman with anaplastic astrocytoma was clinically diagnosed with Turcot syndrome, and subsequently developed simultaneous neurocysticercosis and malignant transformation to glioblastoma. The parasitic cysts and glioblastoma were microsurgically removed. Histological examination of surgical specimens revealed neurocysticercosis between the normal brain tissue and glioblastoma. The clinical course and histological findings suggest that the parasitic infection and/or genetic changes contributed to the malignant transformation of the astrocytic tumour.
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Migration of a bullet within the spinal canal after gunshot injury is rare. We report here the case of a penetrating gunshot injury of the lumbar spine at L3 with migration of the bullet within the spinal canal S2. The patient had marked paraparesis (proximal 1/5, distal 0/5 muscle strength) and anaesthesia at L3 and below, and had a hypocompliant, hyper-reflexive bladder with decreased capacity, and absent anal tonus. ⋯ After surgery, we observed an improvement in paraparesis, an increase in bladder capacity and urinary compliance, and improvement in anal tonus. The appropriate course of action in this type of injury remains unclear, because the number of cases described in the literature is not sufficient to provide a basis on which to make a definitive therapeutic decision. We herein review the literature describing cases in which a bullet in the spinal canal has migrated; we describe the treatment used and the outcomes in these cases.
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The extracellular signal-regulated kinase (ERK) pathway, which modulates the activity of many transcriptional factors leading to the proliferation of various cells, is activated in lesions in regions of selective vulnerability after traumatic brain injury (TBI). In the present study, using the ERK inhibitor U0126, we investigated the role of the ERK pathway in histopathological and behavioral outcomes after TBI. Adult male Sprague-Dawley rats, weighing 300-400 g were subjected to lateral fluid percussion brain injury. ⋯ Pretreatment with U0126 significantly reduced both CA3 neuronal damage and contusional lesion volume after injury. In addition, administration of U0126 ameliorated motor function recovery on days 3, 4 and 5 after injury. Therefore, inhibition of ERK phosphorylation could be a potentially effective therapeutic target after TBI.
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The need for repeat angiography in patients with subarachnoid haemorrhage (SAH) who initially present with a negative angiogram is still debated. The aim of this study was to provide a management protocol for 'angiogram-negative SAH'. ⋯ Out of the 143 patients, 103 underwent repeat angiography, and 18 were found to have ruptured aneurysms that were not detected on the initial angiogram (false negative rate: 17.5% overall, 0% in group I, 1.5% in group II, and 45.9% in group III). Repeat angiography should be performed, particularly in patients who have a non-perimesencephalic SAH pattern, for detection of initially unrecognised ruptured aneurysms.