No shinkei geka. Neurological surgery
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Review Case Reports
[Acute epidural hematoma of the posterior fossa caused by forehead impact].
A rare case of acute epidural hematoma of the posterior fossa caused by forehead impact is reported. This 36-year-old man fell from a truck and hit his face. He was conscious and was brought to our center 30 minutes after the injury. ⋯ Opening of the dura revealed contusion in the occipital lobe. He died on the 17th postoperative day. The possible mechanism in the production of the posterior fossa hematoma in this case is discussed.
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The outcome of a consecutive series of 28 patients with giant aneurysm who had been followed without surgery from one month to 12 years after the diagnosis was made, are presented with reviewing their radiological and clinical features. Symptoms and signs were directly or indirectly attributable to the intracranial mass effect and nine patients (32%) presented subarachnoid hemorrhage. ⋯ The mortality rate in 28 cases for the above follow up period was 46% (13 in 28 cases) and major morbidity occurred in 11% (3 in 28 cases). The above outcome of non operated giant aneurysm cases may justify the surgical management of the giant aneurysm, but as the intracavernous giant aneurysm and thrombosed giant aneurysm are relatively harmless, surgical indication should be carefully decided, especially in the older patients.
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Review Case Reports
[Intracranial meningioma of an infant: a case report].
An 11-month-old male infant with intracranial meningioma is presented. Intracranial meningiomas in infancy under the age of 1 year are extremely rare, and only 22 cases have been reported previously. The authors reviewed the clinical and pathological findings of these meningiomas including our case. ⋯ Histological diagnosis was of fibroblastic meningioma. He was discharged two weeks after the operation without any neurological deficits. Several characteristic features of meningiomas in infant under 1 year old were drawn from the review of literature in comparison with those of meningiomas in adult. 1) Predominant sex was male (16/23). 2) All meningiomas developed in the supra-tentorium. 3) Eight of 18 tumors being described did not have the dural attachment. 4) Nine of 16 tumors showed cyst formation. 5) The most cases were histologically diagnosed benign (17 of 22), and 15 cases was fibroblastic meningioma.