Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Case Reports
Tension pneumocephalus following transsphenoid surgery for pituitary adenoma - report of two cases.
Occurrence of symptomatic pneumocephalus following transsphenoid surgery is a rare event. Two cases of symptomatic pneumocephalus were observed in our series of 480 transsphenoidal surgeries. The first case reported presented with a head injury 4 years earlier and had a left frontotemporal haematoma evacuation. ⋯ He developed postoperative CSF rhinorrhea and in spite of conservative therapy, developed progressive visual deterioration necessitating a re-exploration and repair leading to resolution of the neurological deficits. The second case presented with delayed CSF rhinorrhea leading to rapid alteration in sensorium, requiring external ventricular drainage. The leak subsided without any further surgical intervention.
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The implanted peripheral nerve stimulator has a role for pain relief in well-selected patients with pain in a peripheral nerve distribution. We describe an electrode to help simplify the surgical implantation of a peripheral nerve stimulator and also to reduce the possibility of electrode migration following implantation. Design details of the electrode are discussed, as are notes on surgical technique.
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Schwannomas are rare benign tumours of nerve sheath cells of neural crest origin. Often these tumours are solitary and encapsulated. ⋯ We report an extremely rare case of schwannomatosis of the sciatic nerve in a young female and include a comprehensive literature review. Treatment options are discussed.
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Painful neuromas form on cutaneous nerves as a result of trauma, pressure, stretch or entrapment. Since the earliest descriptions of neuromas, proposed treatments have been met with poor results and controversy. ⋯ As veins are readily accessible due to their proximity in the neurovascular bundle, they serve as a ready source for grafting. The advantages include minimisation of trauma to bone and muscle as compared with previous treatment techniques and the relative ease of the method.