Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jan 2012
Case ReportsGlioblastoma associated with intratumoral abscess formation. Case report.
A 45-year-old man presented with a rare case of glioblastoma associated with intratumoral abscess formation manifesting as headache and vomiting after an appendectomy. Computed tomography and magnetic resonance imaging demonstrated a ring-enhanced lesion mimicking malignant glioma. ⋯ Histological examination revealed glioblastoma with abscess, and the etiological agent was anaerobic Gram-negative bacilli. The suspected route of microbial migration and colonization in this tumor was bacteremia from appendicitis.
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Neurol. Med. Chir. (Tokyo) · Jan 2012
Case ReportsTuberculum sellae meningioma causing progressive visual impairment during pregnancy. Case report.
A 29-year-old woman in the 17th week of pregnancy presented with blurred vision and visual impairment of both eyes. Magnetic resonance imaging revealed a tuberculum sellae meningioma. ⋯ Her visual acuity and field almost fully recovered immediately after the operation. She delivered a healthy normal baby on the expected day.
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Neurol. Med. Chir. (Tokyo) · Jan 2012
Case ReportsClip blade scissoring with titanium bayonet clip in aneurysm surgery. Two case reports.
Scissoring of the cerebral aneurysm clip blades is a rare but potentially devastating complication of clipping surgery and results in aneurysm neck injury inducing rupture and/or cerebral infarction. Scissoring has been reported using titanium straight clips. Here we present two unusual cases of crossing of the blades of titanium bayonet clips by a scissors-like mechanism during surgery. ⋯ The slipped clip should be removed immediately because the scissor-like deformed aneurysm clip may slip further and result in parent artery stenosis. Scissoring tends to happen in the presence of partial arteriosclerosis of the aneurysm neck. Before a titanium clip is used to treat an aneurysm with partially arteriosclerotic neck, reducing the amount of aneurysm filling by temporary clipping of the main vessel is useful to avoid slippage phenomena.
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Neurol. Med. Chir. (Tokyo) · Jan 2012
Bumping phenomenon during continuous coagulation with bipolar forceps.
During continuous bipolar coagulation, the coagulum sometimes ruptures suddenly and audibly, leading to hemostasis failure and damage to the surrounding tissues. Such coagulum rupture is a phenomenon that is similar to microwave bumping, which occurs because of unequal heat distribution as a result of sudden elevation in temperature. The present study investigated the conditions under which bumping can occur during bipolar coagulation using samples of whole blood. ⋯ Furthermore, bumping during coagulation could be prevented if the tips of the forceps at the coagulation site were repeatedly opened and closed. The bumping phenomenon is influenced by various factors such as heat, electrical power, equipment, and coagulation technique. Neurosurgeons should understand the technical certain aspects of these surgical tools and develop appropriate advanced techniques for temperature control.
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Neurol. Med. Chir. (Tokyo) · Jan 2012
Review Case ReportsNontraumatic cervical disc herniation in a 21-year-old patient with no other underlying disease.
A 21-year-old woman presented with cervical myelopathy due to nontraumatic cervical disc herniation associated with cervical canal stenosis. The patient underwent removal of the herniated disc and anterior fusion with an autogenous iliac crest bone graft. After surgery, the patient showed satisfactory improvement. ⋯ A history of cervical trauma and preexisting fusion of the cervical spine are risk factors for cervical disc herniation. The present case is the youngest known of nontraumatic disc herniation without other underlying disease. Hypermobility due to neck cracking and a relatively narrow spinal canal might have been important in causing cervical myelopathy by disc herniation.