Asian journal of neurosurgery
-
Case Reports
Impar Ganglion Block with Combination of Neurolysis Drugs and Radiofrequency Thermocoagulation for Perineal Pain.
Since it was first introduced, a variety of modification techniques to block the impar ganglion appear such as transsacrococcygeal ligament technique, sacrococcygeal transdiscal approach, paramedian approach, and a two-needle technique using fluoroscopy or computed tomography scan. For therapeutic purposes, a combination of steroid and local anesthetic, neurolysis agents such as alcohol, phenol, cryolesioning, and heat lesioning using radiofrequency thermocoagulation could be used. Here, we reported a successful outcome in treating chronic perineal pain in a 65-year-old patient using combination of neurolysis agent which was alcohol 96% and radiofrequency thermocoagulation.
-
Case Reports
Scedosporium apiospermum: An Emerging Fatal Cause of Fungal Abscess and Ventriculitis after Near-drowning.
Herein, we describe a fatal case of central nervous system (CNS) pseudallescheriasis following near-drowning. A 13-year-old boy, who had been successfully resuscitated after near-drowning, presented with a transient episode of mental confusion during a hospital stay after recovering from severe aspiration pneumonia and respiratory failure. A magnetic resonance imaging (MRI) scan of the brain showed a small brain abscess in the left basal ganglia and ventriculitis in the left lateral ventricle. ⋯ The patient passed away from sudden septic shock 2 months after identification of the brain abscess and ventriculitis. The patient's diagnosis was delayed because multiple examinations of the cerebrospinal fluid did not show positive cultures and could only be obtained from the aspirates of stereotactic biopsy. Physicians should be aware of CNS pseudallescheriasis associated with near-drowning because of the difficulty of diagnosis and the high mortality rate (70%) owing to poor responses to currently available antifungal agents.
-
Intracranial meningiomas account for 30% of all primary intracranial tumors. Surgical resection remains the mainstay of the treatment for meningiomas. The magnetic resonance of intracranial meningiomas has been largely discussed in many reports of the radiological and neurosurgical literature. To date, a few studies have been attempted to differentiate the tumor characteristics of meningiomas based on magnetic resonance imaging (MRI) studies. ⋯ This study presents a new objective method to measure the consistency of intracranial meningiomas based on a simple algorithmic formula. Such information will aid in planning surgery and assessing the resectability of the tumor. To date, this is the first objective measurement of meningioma consistency based on MRI studies and objective intraoperative evaluation.
-
Coccygodynia refers to a pathological condition in which pain occurs in the coccyx or its immediate vicinity. The pain is usually provoked by sitting or rising from sitting. Several studies have reported good or excellent results after coccygectomy especially in patients who are refractory to conservative treatment. ⋯ Coccygectomy for chronic intractable coccygodynia is simple and effective, with a low complication rate.
-
The role of isocitrate dehydrogenase 1 (IDH1) mutation in brain stem glioma is not clear. To the best of our knowledge, six cases of brain stem gliomas carrying IDH1/2 mutations are currently reported in the literature. One case of diffuse brain stem glioma with IDH1 mutation, which was followed for 2 years, is presented and compared with IDH1 negative tumors. ⋯ The patient underwent adjuvant radiation and chemotherapy. The primary and 2 years' clinical/radiological characteristics did not indicate any significant difference from other cases without IDH1 mutation. the prognostic value of IDH1/2 mutation in brain stem glioma is unclear. Brain stem biopsies may allow determination of a tissue-based tumor diagnosis for further investigations.