Pub Date : 2023-03-16DOI: 10.33962/roneuro-2023-001
Bica Dorin, Ion Poeata
Glioblastoma (GBM) is one of the most dreadful human cancers having a literature-reported median of life of 14 months with maximal treatment. The correct diagnosis is of crucial importance for the best chances of treatment. Misdiagnosis is uncommon, but seen in daily practice, and leads to important delays for patients. This paper will discuss the delays found in glioblastoma diagnosis in a series of 60 newly diagnosed patients. Four out of 60 patients had a delay of more than 6 weeks of treatment initiation, as at first imaging, GBM was not suspected as a diagnosis.
{"title":"Pitfalls in the diagnosis of glioblastoma","authors":"Bica Dorin, Ion Poeata","doi":"10.33962/roneuro-2023-001","DOIUrl":"https://doi.org/10.33962/roneuro-2023-001","url":null,"abstract":"Glioblastoma (GBM) is one of the most dreadful human cancers having a literature-reported median of life of 14 months with maximal treatment. The correct diagnosis is of crucial importance for the best chances of treatment. Misdiagnosis is uncommon, but seen in daily practice, and leads to important delays for patients. This paper will discuss the delays found in glioblastoma diagnosis in a series of 60 newly diagnosed patients. Four out of 60 patients had a delay of more than 6 weeks of treatment initiation, as at first imaging, GBM was not suspected as a diagnosis.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135553986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-16DOI: 10.33962/roneuro-2023-002
Silvia Danu
Neurosurgery is a high-risk speciality, so the Patient Safety Culture should become a priority to improve patient safety and the quality of medical care. The purpose of the study was to explore the perception of Patient Safety Culture (PSC) among the staff in the neurosurgical departments of the Republic of Moldova. A cross-sectional study was conducted in neurosurgical departments using the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics were carried out, comprising the Cronbach "?" coefficient, frequency of positive answers (PPRs), and level of minimum and maximum of 95% confidential interval. PPRs by question and dimension were analysed overall and classified according to the Harrington scale. Medical staff from five hospitals voluntarily participated in the study. Most of the respondents rated the patient's safety grade as excellent and very good. The value of the frequency of positive responses to the dimensions of the survey varies between 37.3% (nonpunitive response to error) and 85.0% (teamwork within units). The dimensions with the highest score of the PPRs stand out: „teamwork within units”, „organizational learning- continuous improvement” and „supervisor/manager expectations and actions promoting patient safety”. The dimension with a high score of PPRs was „feedback and communication about error”. The dimensions with a satisfactory score of the PPRs were „handoffs and transitions”, „frequency of events reported”, „management support for patient safety”, „teamwork across units”, „communication openness”, „overall perceptions on patient safety”, „non-punitive response to errors” and „staffing”. For the first time in the Republic of Moldova, the perception of patient safety culture in neurosurgery departments was studied. The results reflect the positive attitude of the staff towards most dimensions of the patient safety culture. The study made it possible to highlight the strong and vulnerable points of the patient safety culture in neurosurgical departments from Moldova.
{"title":"The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova","authors":"Silvia Danu","doi":"10.33962/roneuro-2023-002","DOIUrl":"https://doi.org/10.33962/roneuro-2023-002","url":null,"abstract":"Neurosurgery is a high-risk speciality, so the Patient Safety Culture should become a priority to improve patient safety and the quality of medical care. The purpose of the study was to explore the perception of Patient Safety Culture (PSC) among the staff in the neurosurgical departments of the Republic of Moldova. \u0000A cross-sectional study was conducted in neurosurgical departments using the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics were carried out, comprising the Cronbach \"?\" coefficient, frequency of positive answers (PPRs), and level of minimum and maximum of 95% confidential interval. PPRs by question and dimension were analysed overall and classified according to the Harrington scale. \u0000Medical staff from five hospitals voluntarily participated in the study. Most of the respondents rated the patient's safety grade as excellent and very good. The value of the frequency of positive responses to the dimensions of the survey varies between 37.3% (nonpunitive response to error) and 85.0% (teamwork within units). The dimensions with the highest score of the PPRs stand out: „teamwork within units”, „organizational learning- continuous improvement” and „supervisor/manager expectations and actions promoting patient safety”. The dimension with a high score of PPRs was „feedback and communication about error”. The dimensions with a satisfactory score of the PPRs were „handoffs and transitions”, „frequency of events reported”, „management support for patient safety”, „teamwork across units”, „communication openness”, „overall perceptions on patient safety”, „non-punitive response to errors” and „staffing”. \u0000For the first time in the Republic of Moldova, the perception of patient safety culture in neurosurgery departments was studied. The results reflect the positive attitude of the staff towards most dimensions of the patient safety culture. The study made it possible to highlight the strong and vulnerable points of the patient safety culture in neurosurgical departments from Moldova.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135553988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-16DOI: 10.33962/roneuro-2023-017
Rajneesh Misra, Sushil Kumar, Sandeep Sharma
Aim: Reporting a rare case of mature cystic teratoma of spinal cord in an adult
Background: Teratomas of the central nervous system are rare lesions accounting for less than 0.5-2% of all CNS tumors. Most of these are found in pediatric age group and favor sellar - suprasellar, pineal and sacro-coccygeal regions. Their occurrence in spinal cord in an adult is incredibly rare.
Case presentation: A 22-year-old male presented with low back ache and weakness of both lower limbs. Clinical examination and radiological workup revealed presence of a cystic lesion causing diffuse enlargement of the cord from L1 to L5-S1. Histo-pathological examination of the excised lesion revealed it to be teratoma.
Conclusion and clinical significance: Mature teratoma of the spinal cord in adults is extremely rare occurrence. However, this diagnosis should be kept in mind when evaluating a cystic lesion of cord even in adults. Maximal safe resection of the lesion results in prolonged deficit-free survival.
{"title":"Mature cystic teratoma of spinal cord in an adult","authors":"Rajneesh Misra, Sushil Kumar, Sandeep Sharma","doi":"10.33962/roneuro-2023-017","DOIUrl":"https://doi.org/10.33962/roneuro-2023-017","url":null,"abstract":"Aim: Reporting a rare case of mature cystic teratoma of spinal cord in an adult
 Background: Teratomas of the central nervous system are rare lesions accounting for less than 0.5-2% of all CNS tumors. Most of these are found in pediatric age group and favor sellar - suprasellar, pineal and sacro-coccygeal regions. Their occurrence in spinal cord in an adult is incredibly rare.
 Case presentation: A 22-year-old male presented with low back ache and weakness of both lower limbs. Clinical examination and radiological workup revealed presence of a cystic lesion causing diffuse enlargement of the cord from L1 to L5-S1. Histo-pathological examination of the excised lesion revealed it to be teratoma.
 Conclusion and clinical significance: Mature teratoma of the spinal cord in adults is extremely rare occurrence. However, this diagnosis should be kept in mind when evaluating a cystic lesion of cord even in adults. Maximal safe resection of the lesion results in prolonged deficit-free survival.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135553987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-16DOI: 10.33962/roneuro-2023-018
Rasha A. Al-Youzbaki, Emad Hazim Mahmoud, Zahraa A. Alsubaihawi, Mohammed A. Almeran, Saja A. Albanaa, Samer S. Hoz
Introduction: Currarino Syndrome (CS) is a rare entity characterized by a triad of sacral agenesis, anorectal malformations, and pre-sacral masses. CS is typically diagnosed during the first decade of life.
Case Description: We present a rare case of incomplete Currarino syndrome manifesting in a 36-year-old lady who presented with back pain, urinary retention, anal paresthesia, and lower limb weakness. The patient underwent multiple laminectomies and partial resection of an epidermoid cyst and regained function.
Conclusion: Although rare, the possibility of Currarino syndrome should be entertained in adult patients with lower lumbosacral symptoms and a pre-sacral mass. A thorough physical examination and strategic pre-operative planning are mandatory to maximize patient outcomes.
{"title":"Incomplete Currarino triad in an adult woman","authors":"Rasha A. Al-Youzbaki, Emad Hazim Mahmoud, Zahraa A. Alsubaihawi, Mohammed A. Almeran, Saja A. Albanaa, Samer S. Hoz","doi":"10.33962/roneuro-2023-018","DOIUrl":"https://doi.org/10.33962/roneuro-2023-018","url":null,"abstract":"Introduction: Currarino Syndrome (CS) is a rare entity characterized by a triad of sacral agenesis, anorectal malformations, and pre-sacral masses. CS is typically diagnosed during the first decade of life.
 Case Description: We present a rare case of incomplete Currarino syndrome manifesting in a 36-year-old lady who presented with back pain, urinary retention, anal paresthesia, and lower limb weakness. The patient underwent multiple laminectomies and partial resection of an epidermoid cyst and regained function.
 Conclusion: Although rare, the possibility of Currarino syndrome should be entertained in adult patients with lower lumbosacral symptoms and a pre-sacral mass. A thorough physical examination and strategic pre-operative planning are mandatory to maximize patient outcomes.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135553989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-005
Sofia Ramos Soares, Alexandre Lacerda, Júlia Richard Gondim Bezerra Cavalcanti, Thiago Gomes Martins, Giacomo De Freitas Souza, Jim Umberto Cantisani Neto
Introduction. Infectious spondylodiscitis has an incidence of 0.21-3.6%. The best intervention should be individualized, using antibiotics only or combining them with stabilizing surgeries. Case presentation. A 38-year-old man presented with lumbosciatalgia, severe pain and inability to ambulate. Magnetic resonance imaging (MRI) of the lumbar spine showed L5-S1 extruded disc herniation and the patient underwent endoscopic microdiscectomy with complete remission of symptoms. After two weeks, he reported severe low back pain and a return of difficulty to walk. Laboratory tests showed an increase in CRP and ESR. MRI showed signs of lumbar spondylodiscitis. The patient started on broad-spectrum intravenous antibiotic therapy. He evolved with improvement in laboratory parameters and maintenance of low back pain. Due to the failure of conservative treatment, anterior approach arthrodesis (ALIF) was chosen, with the complete improvement of the low back pain and the return of the ability to walk. Discussion. Postoperative spondylodiscitis’ frequency depends on the invasiveness of the operation and the type of surgery performed. The most likely source of infection is direct inoculation by virulent pathogens during surgery. A diagnosis delay of more than two months is considered a risk factor for generating adverse results. A Conservative approach is indicated for the patient who is neurologically intact and with minimal bone destruction. Surgical indications are the presence of neurological deficits, intraspinal abscesses, extensive bone destruction, and failure of conservative management. ALIF is supported in the literature because it allows wide exposure of the entire disc space through efficient access to the spine with the complete evacuation of the disc, avoiding dissection of perineural scar tissue and preserving the articular facets. Conclusion. Early diagnosis and treatment are crucial, although there is still no consensus about the best treatment approach. The use of a titanium cage with a bioglass graft had a good response in pain and infection control in our case.
{"title":"Anterior approach arthrodesis - ALIF with use of a titanium cage for treatment of postoperative spondylodiscitis after lumbar microdiscectomy","authors":"Sofia Ramos Soares, Alexandre Lacerda, Júlia Richard Gondim Bezerra Cavalcanti, Thiago Gomes Martins, Giacomo De Freitas Souza, Jim Umberto Cantisani Neto","doi":"10.33962/roneuro-2023-005","DOIUrl":"https://doi.org/10.33962/roneuro-2023-005","url":null,"abstract":"Introduction. Infectious spondylodiscitis has an incidence of 0.21-3.6%. The best intervention should be individualized, using antibiotics only or combining them with stabilizing surgeries. Case presentation. A 38-year-old man presented with lumbosciatalgia, severe pain and inability to ambulate. Magnetic resonance imaging (MRI) of the lumbar spine showed L5-S1 extruded disc herniation and the patient underwent endoscopic microdiscectomy with complete remission of symptoms. After two weeks, he reported severe low back pain and a return of difficulty to walk. Laboratory tests showed an increase in CRP and ESR. MRI showed signs of lumbar spondylodiscitis. The patient started on broad-spectrum intravenous antibiotic therapy. He evolved with improvement in laboratory parameters and maintenance of low back pain. Due to the failure of conservative treatment, anterior approach arthrodesis (ALIF) was chosen, with the complete improvement of the low back pain and the return of the ability to walk. Discussion. Postoperative spondylodiscitis’ frequency depends on the invasiveness of the operation and the type of surgery performed. The most likely source of infection is direct inoculation by virulent pathogens during surgery. A diagnosis delay of more than two months is considered a risk factor for generating adverse results. A Conservative approach is indicated for the patient who is neurologically intact and with minimal bone destruction. Surgical indications are the presence of neurological deficits, intraspinal abscesses, extensive bone destruction, and failure of conservative management. ALIF is supported in the literature because it allows wide exposure of the entire disc space through efficient access to the spine with the complete evacuation of the disc, avoiding dissection of perineural scar tissue and preserving the articular facets. Conclusion. Early diagnosis and treatment are crucial, although there is still no consensus about the best treatment approach. The use of a titanium cage with a bioglass graft had a good response in pain and infection control in our case.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135747674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-021
Ahtesham Khizar
To acquire a wide range of technical skills, neurosurgeons undergo extensive and drawn-out training. Additionally, neurosurgery necessitates a significant amount of preoperative, intraoperative, and postoperative clinical data collection, decision-making, care, and recovery. The significance of artificial intelligence in neurosurgery has significantly increased during the past ten years. The potential of artificial intelligence to improve diagnostic and prognostic outcomes in neurosurgery is quite promising. It is important to clinical therapy because it helps neurosurgeons make crucial decisions during surgical interventions to improve patient outcomes and it enhances their abilities to give patients the finest interventional and non-interventional care possible. Furthermore, the acquisition, processing, and storage of clinical and experimental data are all greatly influenced by artificial intelligence. Its application in neurosurgery can lower surgical care expenses and offer top-notch medical treatment to a larger population. This article examines the use of artificial intelligence in preoperative, intraoperative, and postoperative care for both interventional and non-interventional aspects of neurosurgery, including diagnosis, clinical decision-making, surgical operation, prognosis, data collection, and research in the field.
{"title":"An insight into artificial intelligence and its role in neurosurgery","authors":"Ahtesham Khizar","doi":"10.33962/roneuro-2023-021","DOIUrl":"https://doi.org/10.33962/roneuro-2023-021","url":null,"abstract":"To acquire a wide range of technical skills, neurosurgeons undergo extensive and drawn-out training. Additionally, neurosurgery necessitates a significant amount of preoperative, intraoperative, and postoperative clinical data collection, decision-making, care, and recovery. The significance of artificial intelligence in neurosurgery has significantly increased during the past ten years. The potential of artificial intelligence to improve diagnostic and prognostic outcomes in neurosurgery is quite promising. It is important to clinical therapy because it helps neurosurgeons make crucial decisions during surgical interventions to improve patient outcomes and it enhances their abilities to give patients the finest interventional and non-interventional care possible. Furthermore, the acquisition, processing, and storage of clinical and experimental data are all greatly influenced by artificial intelligence. Its application in neurosurgery can lower surgical care expenses and offer top-notch medical treatment to a larger population. This article examines the use of artificial intelligence in preoperative, intraoperative, and postoperative care for both interventional and non-interventional aspects of neurosurgery, including diagnosis, clinical decision-making, surgical operation, prognosis, data collection, and research in the field.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135748417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-009
Anand Sharma, A. Shukla, Avinash Sharma
Multidirectional migration of bullets has been reported infrequently in the literature. The Surgical retrieval of an intracranial migrating bullet is suggested because of its capacity to produce an additional neurological deficit. Intraoperative image guidance using the C arm is indicated in all intracranial migrating metallic foreign bodies following gunshot injury. A rare case of migrating bullet fragment in its trajectory with the migration of metallic fragment in both cerebral hemispheres is reported, and relevant literature is reviewed.
{"title":"Wandering intracranial bullet","authors":"Anand Sharma, A. Shukla, Avinash Sharma","doi":"10.33962/roneuro-2023-009","DOIUrl":"https://doi.org/10.33962/roneuro-2023-009","url":null,"abstract":"Multidirectional migration of bullets has been reported infrequently in the literature. The Surgical retrieval of an intracranial migrating bullet is suggested because of its capacity to produce an additional neurological deficit. Intraoperative image guidance using the C arm is indicated in all intracranial migrating metallic foreign bodies following gunshot injury. A rare case of migrating bullet fragment in its trajectory with the migration of metallic fragment in both cerebral hemispheres is reported, and relevant literature is reviewed.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135748420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-010
Mamadou Bata Dianka, Farida Abdoulkader Guedi, Djama Houssein Omar, Goumaneh Omar Houssein, Filsan Omar Ali
The cavernoma is a vascular malformation made of well-circumscribed agglomeration of pseudo-capillaries. Bone marrow localization is rare and accounts for about 5% of spinal cord vascular lesions. Clinical symptomatology is marked by progressive bone marrow compression syndrome. The diagnosis is strongly evoked in magnetic resonance imaging and confirmed by histology. The management is essentially surgical. We report a case of bone marrow cavernoma in a 38-year-old man seen in consultation, paraplegic for 2 weeks. The spinal cord MRI revealed a lesion opposite D11, evoking a cavernoma. The patient was operated on with total removal of the lesion; histology confirmed the diagnosis of cavernoma. The immediate post-operative follow-up was marked by the partial recovery of the deficit. We discuss, through this clinical case, the clinical, radiological and especially therapeutic aspects of the medullary cavernoma.
{"title":"Intramedullary cavernoma","authors":"Mamadou Bata Dianka, Farida Abdoulkader Guedi, Djama Houssein Omar, Goumaneh Omar Houssein, Filsan Omar Ali","doi":"10.33962/roneuro-2023-010","DOIUrl":"https://doi.org/10.33962/roneuro-2023-010","url":null,"abstract":"The cavernoma is a vascular malformation made of well-circumscribed agglomeration of pseudo-capillaries. Bone marrow localization is rare and accounts for about 5% of spinal cord vascular lesions. Clinical symptomatology is marked by progressive bone marrow compression syndrome. The diagnosis is strongly evoked in magnetic resonance imaging and confirmed by histology. The management is essentially surgical. We report a case of bone marrow cavernoma in a 38-year-old man seen in consultation, paraplegic for 2 weeks. The spinal cord MRI revealed a lesion opposite D11, evoking a cavernoma. The patient was operated on with total removal of the lesion; histology confirmed the diagnosis of cavernoma. The immediate post-operative follow-up was marked by the partial recovery of the deficit. We discuss, through this clinical case, the clinical, radiological and especially therapeutic aspects of the medullary cavernoma.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135747675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-011
Adnan Khaliq, Ahtesham Khizar
Background. Common peroneal nerve (CPN) injuries are generally common but they are uncommon due to gunshot injuries and are associated with poor motor outcomes. Managing neuroma-in-continuity is still challenging because there are currently no accepted standards for deciding on the most effective course of treatment or estimating the time needed for repair. Treatment options for a neuroma-in-continuity include neurolysis, neuroma resection with interposition, end-to-side nerve grafting, and bypass grafting. Case presentation. A 40-year-old man presented with findings of complete right foot drop due to an 8-month-old firearm injury to his right distal thigh. Following baseline investigations, imaging, and anaesthesia fitness, he underwent surgical exploration under general anaesthesia. A neuroma-in-continuity was found in the CPN, resected, and an end-to-end nerve repair was performed. Along with the neuroma-in-continuity, a bullet fragment was also removed. The neurological status remained unchanged postoperatively. Conclusion. Regardless of the cause of the lesion, patients should be urged to seek surgical therapy if there is no spontaneous recovery within four months after the CPN injury. Sharp injuries and knee dislocations have a better chance of recovery than crush injuries and gunshot wounds.
{"title":"Common peroneal neuroma in continuity with complete foot drop secondary to a bullet fragment injury","authors":"Adnan Khaliq, Ahtesham Khizar","doi":"10.33962/roneuro-2023-011","DOIUrl":"https://doi.org/10.33962/roneuro-2023-011","url":null,"abstract":"Background. Common peroneal nerve (CPN) injuries are generally common but they are uncommon due to gunshot injuries and are associated with poor motor outcomes. Managing neuroma-in-continuity is still challenging because there are currently no accepted standards for deciding on the most effective course of treatment or estimating the time needed for repair. Treatment options for a neuroma-in-continuity include neurolysis, neuroma resection with interposition, end-to-side nerve grafting, and bypass grafting. Case presentation. A 40-year-old man presented with findings of complete right foot drop due to an 8-month-old firearm injury to his right distal thigh. Following baseline investigations, imaging, and anaesthesia fitness, he underwent surgical exploration under general anaesthesia. A neuroma-in-continuity was found in the CPN, resected, and an end-to-end nerve repair was performed. Along with the neuroma-in-continuity, a bullet fragment was also removed. The neurological status remained unchanged postoperatively. Conclusion. Regardless of the cause of the lesion, patients should be urged to seek surgical therapy if there is no spontaneous recovery within four months after the CPN injury. Sharp injuries and knee dislocations have a better chance of recovery than crush injuries and gunshot wounds.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135748418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-15DOI: 10.33962/roneuro-2023-012
Hrushikesh Kharosekar, Mayuresh Hinduja, Vernon Velho, Laxmikant Bhople
Rosai Dorfman disease is a self-limiting disease usually affecting the lymph nodes. Intracranial lesions are seen in less than 5% of cases. Isolated intracranial RDD without nodal involvement is rare, only 70 cases have been reported to date. Skull base lesions are seen in only 7 cases, petro clival RDD. Clionoidal lesions of RDD have not been reported in the literature, we report a rare case of bilateral Clionoidal lesions of RDD presenting with bilateral blindness in a young male.
{"title":"Bilateral clinoidal Rosai Dorfman disease mimicking meningioma – a rare cause of bilateral blindness","authors":"Hrushikesh Kharosekar, Mayuresh Hinduja, Vernon Velho, Laxmikant Bhople","doi":"10.33962/roneuro-2023-012","DOIUrl":"https://doi.org/10.33962/roneuro-2023-012","url":null,"abstract":"Rosai Dorfman disease is a self-limiting disease usually affecting the lymph nodes. Intracranial lesions are seen in less than 5% of cases. Isolated intracranial RDD without nodal involvement is rare, only 70 cases have been reported to date. Skull base lesions are seen in only 7 cases, petro clival RDD. Clionoidal lesions of RDD have not been reported in the literature, we report a rare case of bilateral Clionoidal lesions of RDD presenting with bilateral blindness in a young male.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135748422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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