World Neurosurg
-
Pituitary apoplexy is a rare complication of the initial administration of leuprolide acetate. ⋯ Clinicians should be aware of this rare but known complication of leuprolide injection so that prompt diagnosis and treatment initiation are performed in patients with leuprolide-associated pituitary apoplexy.
-
Therapeutic decompressive craniectomy (TDC) controls increased intracranial pressure (ICP). Its role was controversial until its successful introduction to treat malignant middle cerebral artery ischemia. However, standardization of size and site of TDC remains controversial. This study was designed to evaluate whether size and site matter in TDC. ⋯ The size of a TDC is very important in reducing increased ICP. The size should be tailored to the level of increased ICP and the likelihood of further brain swelling postoperatively. A smaller TDC should be located more anteriorly to control increased ICP. Although location is not as important when increased ICP is >30 mm Hg and TDC size ≥8.3 cm is required.
-
Intracranial extraskeletal mesenchymal chondrosarcomas (MCSs) are rare tumors accounting for <0.16% of intracranial tumors. They are usually described as occurring in the age group of 20-30 years and are commonly found in the frontoparietal region arising from the falx and surrounding dura. We describe 3 cases at varying ages, locations, and outcomes. ⋯ Intracranial MCSs are rare malignant tumors with poor prognosis. Because of their rarity, it may not be considered as a differential diagnosis and it is often misdiagnosed radiologically, but the importance lies in the need of radical excision. The potential effect of postoperative radiotherapy and chemotherapy is controversial. This article sheds some light on variable prognosis of this tumor.
-
Multiple osseous loose bodies in the lumbar spine have never been reported. We describe a rare surgical case of multiple osseous loose bodies associated with lumbar isthmic spondylolisthesis. ⋯ We described the first instance of multiple loose bodies in the spinal canal with lumbar canal stenosis. It is presumed that long standing minor trauma due to dynamic instability with a trend of hyperossification induced secondary synovial osteochondromatosis forming multiple loose bodies.
-
To evaluate the cerebral and hemodynamic effects of low-dose intramuscular diclofenac sodium (DCFS) administered for fever control in patients with acute brain injury in the intensive care unit. ⋯ Low-dose intramuscular DCFS administration for fever control in patients with acute brain injury is effective but also exposes patients to potentially deleterious hypotensive episodes that must be diagnosed and treated expeditiously to prevent further damage to the injured brain.