Acta neurochirurgica
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Acta neurochirurgica · Jan 2000
Review Case ReportsPure acute subdural haematoma without subarachnoid haemorrhage caused by rupture of internal carotid artery aneurysm.
A 52-year-old female presented with disturbance of consciousness and clinical signs of tentorial herniation. Computed tomography showed a pure acute subdural haematoma (SDH) over the left convexity without subarachnoid haemorrhage. Cerebral angiography showed a saccular aneurysm at the junction of the left internal carotid artery and the posterior communicating artery. ⋯ Rupture of an aneurysm adhered to either the dura or falx and located in the subdural space may cause pure SDH. Therefore, ruptured intracranial aneurysm should be considered as a cause of non-traumatic SDH. Immediate removal of the SDH and aneurysmal clipping is recommended in such patients, even those in poor neurological condition.
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Brain stem epidermoid cysts are extremely rare. We describe an unusual case of prepontine epidermoid cyst with a large part of the tumour insinuating itself into the pons. ⋯ Cases reported in the literature either had high mortality/morbidity or were only subtotally removed. Relevant literature is reviewed.
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Acta neurochirurgica · Jan 1999
Review Case ReportsSyringobulbia caused by delayed postoperative tethering of the cervical spinal cord - delayed complication of foramen magnum decompression for Chiari malformation.
Postoperative tethering of the high cervical spinal cord is a rare cause of neurological deterioration after foramen magnum decompression (FMD) with duraplasty for Chiari type I malformation. A review of the literature revealed that only 5 cases have been reported. This entity is not widely known to occur as a complication of the common surgical procedure for Chiari type I malformation. ⋯ Follow-up MR images provided significant information on the cervical spinal cord tethering after FMD with duraplasty for Chiari malformation. We encourage sharp surgical detethering and duraplasty with Gore-Tex to avoid retethering. Early recognition and treatment of this unusual but important complication are emphasized.
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Acta neurochirurgica · Jan 1999
ReviewNon-neoplastic cystic lesions of the sellar region presentation, diagnosis and management of eight cases and review of the literature.
The differential diagnosis of a sellar lesion includes pituitary adenoma, cranio-pharyngioma, tumour cyst, benign cyst, and other less common lesions such as aneurysm, squamous cell carcinoma and metastases. Pure cystic lesions within the sella turcica are not uncommon and may appear clinically and radiologically as pituitary adenoma. Intrasellar cysts are broadly classified as neoplastic or non-neoplastic; the latter may be primary lesions of the pituitary fossa or they may arise from the parasellar region and invade into the sella. ⋯ Investigations included computed tomography scan of the head for all and magnetic resonance imaging for six (75%) patients. Work-up included endocrinological and opthalmological evaluations. All presented with headache; six (75%) had visual acuity change, two (25%) had evidence of visual field defects, four (50%) had optic atrophy on fundoscopy, three (37.5%) had endocrine symptoms and hormone reduction was found in four (50%).
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Acta neurochirurgica · Jan 1998
ReviewMeningioma surgery in the elderly: a case-control study assessing morbidity and mortality.
To assess the morbidity and mortality of meningioma surgery in patients over age 65 and compare our results with matched controls and with the present literature on meningioma surgery in the elderly. ⋯ Our lower morbidity and mortality rates after meningioma surgery in the elderly may be a result of patient selection, surgical technique, or excellent pre- and post-operative care by the resident staff, anesthesiologists, and nurses. It suggests, however, that elderly patients can have meningioma surgery safely.