British journal of neurosurgery
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Case Reports
Delayed cervical spinal cord tethering following tonsillar resection for Chiari malformation.
Although tethering of the spinal cord in the lumbosacral region, particularly following repair of congenital anomalies, such as myelomeningocele, is a well-known phenomenon, only sporadic reports of tethering along the rest of the neuraxis, including the hindbrain, cervical and thoracic spinal cord have been documented. In this report, we describe a woman who developed symptoms related to tethering of the cervical spinal cord 5 years after suboccipital decompressive surgery of the posterior fossa for Chiari I malformation. The authors discuss the diagnosis, treatment, and postoperative course of this entity.
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Historical Article
Mind on Canvas: anatomy, signs and neurosurgery in art.
Throughout the ages, art and neuroscience have had a delicate yet definite relationship with reciprocal influence. By virtue of their superior power of observation, artists have often preserved neurological signs through detailed brush strokes or meticulous carvings long before it is described in scientific literature. ⋯ In this article we begin by giving a brief introduction to the general relationship between neuroscience and art as depicted in paintings and drawings, and describe the artistic tendencies of the early neuroanatomists. We aim to highlight the existence of neurosurgical themes within paintings and drawings from different eras.
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Case Reports
Pelvic teratoma with extensive spinal involvement in a neonate: an important differential diagnosis.
A 6-week-old girl presented with an abdominal mass and spinal cord compression. Clinical and radiological features indicated a diagnosis of congenital neuroblastoma. Histology revealed a diagnosis of germ cell tumour after therapy for neuroblastoma had been commenced. This is, to the authors' knowledge, the first reported case of paediatric dumbbell retroperitoneal teratoma.
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Review Case Reports
An unusual presentation of thoracic cord compression by a dorsal arachnoid cyst in a 14-month-old boy. A discussion of the case and review of the literature.
Spinal arachnoid cysts are a rare cause of spinal cord compression in children and presenting symptoms may be subtle. We present a neurologically intact 14-month-old boy who presented with pain and postural irritability from a thoracic arachnoid cyst.
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A simple way of evaluating surgical outcomes is to compare mortality and morbidity. Such comparisons may be misleading without a proper case mix. The POSSUM scoring system was developed to overcome this problem. ⋯ The difference between observed and predicted deaths at different risk levels was not significant with P-POSSUM (p = 0.424) and was significantly different with POSSUM score (p < 0.001). P-POSSUM scoring system was highly accurate in predicting the overall mortality in neurosurgical patients. In contrast, POSSUM score was not useful for prediction of mortality.