Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Aug 1993
Case ReportsEndoscopic observation of the syrinx in Chiari malformation--case report.
The cervical syrinx cavity in a 27-year-old male with Chiari 1 malformation was inspected with a flexible small-caliber endoscope during syringo-subarachnoid shunting. A cleft was observed in the midline on the ventral wall of the cavity, from which blood vessels emerged and ran along the wall. ⋯ The endoscope was also used to evaluate whether any obstacles to the passage of a shunt tube were present in the subarachnoid space. Endoscopic observation of the syrinx cavity is helpful in performing the shunt operation.
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Neurol. Med. Chir. (Tokyo) · Jun 1993
Case ReportsFacial schwannoma spreading into the middle cranial fossa and the cerebellopontine angle--case report.
A 53-year-old male presented with hearing impairment and facial nerve paralysis following tinnitus of the right ear. Neuroimaging revealed a tumor extensively damaging the temporal bone, and extending into the middle cranial fossa and cerebellopontine angle. The tumor was removed in a two-stage operation. The histological diagnosis was facial schwannoma.
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Neurol. Med. Chir. (Tokyo) · Jan 1993
Case ReportsHuge subdural empyema with unusual presentation in infant--case report.
An 11-month-old boy presented with a huge subdural empyema in the left hemisphere associated with a subsequent contralateral chronic subdural hematoma. Burr-hole drainage and antibiotic therapy achieved a successful outcome. Subdural empyema may result from hematogenous seeding of infection into a pre-existing chronic subdural hematoma.
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Neurol. Med. Chir. (Tokyo) · Jan 1993
Acute subdural hematoma: severity of injury, surgical intervention, and mortality.
Sixty patients with acute subdural hematoma were treated at Tokyo Metropolitan Hiroo Hospital between 1981 and 1989. The overall mortality was 55% and the functional recovery rate 30%. Thirteen (93%) of 14 patients with a Glasgow Coma Scale (GCS) score of 3 died, while all eight patients with a GCS score of 7 or more achieved functional recovery. ⋯ Four patients with GCS scores of 4-6 died in spite of decompressive craniectomy or craniotomy with duroplasty. The mortality is only influenced by age and type of surgical intervention among patients with GCS scores of 4-6. Shorter time from injury to surgical evacuation does not affect mortality within 10 hours of injury.
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Neurol. Med. Chir. (Tokyo) · Dec 1992
Case ReportsContralateral development of acute subdural hematoma following surgery for chronic subdural hematoma--case report.
An unusual case of acute subdural hematoma developed after drainage of chronic subdural hematoma in a 71-year-old male. The acute subdural hematoma was located over a membranous layer in the subdural space similar to the outer membrane of the chronic subdural hematoma. Intraoperatively, bleeding from the bridging vein and oozing from the superior sagittal sinus were observed. The membranous layer probably separated from the dura mater following decompression after drainage of the contralateral hematoma, and this separation then damaged the bridging vein and superior sagittal sinus, resulting in the acute subdural hematoma.