Pub Date : 2021-10-07DOI: 10.33962/roneuro-2021-047
Branko Đurović, D. Radulović, M. Jokovic, I. Cvrkota, M. Đurović, Nemanja Jovanović, V. Aleksić
Myopericytoma is a benign, soft tissue tumor probably derived from perivascular myoid cells. They are usually found in subcutaneous tissues in the extremities. Intracranial localization of myopericitoma is exceedingly uncommon. We report a 43 years old male patient with incidentally found myopericitoma of the posterior fossa. Patient was operated and tumor was completely removed. Patient was subsequently diagnosed with acquired immunodeficiency syndrome due to human immunodeficiency virus infection. One year after operation tumor showed no signs of recurrence, but patient developed progressive symptoms of AIDS and started highly active antiretroviral therapy (HAART). Connection of intracranial myopericitoma appearance and HIV/AIDS has been reported before, but clear connection is yet to be elucidated.
{"title":"Intracranial myopericitoma","authors":"Branko Đurović, D. Radulović, M. Jokovic, I. Cvrkota, M. Đurović, Nemanja Jovanović, V. Aleksić","doi":"10.33962/roneuro-2021-047","DOIUrl":"https://doi.org/10.33962/roneuro-2021-047","url":null,"abstract":"Myopericytoma is a benign, soft tissue tumor probably derived from perivascular myoid cells. They are usually found in subcutaneous tissues in the extremities. Intracranial localization of myopericitoma is exceedingly uncommon. We report a 43 years old male patient with incidentally found myopericitoma of the posterior fossa. Patient was operated and tumor was completely removed. Patient was subsequently diagnosed with acquired immunodeficiency syndrome due to human immunodeficiency virus infection. One year after operation tumor showed no signs of recurrence, but patient developed progressive symptoms of AIDS and started highly active antiretroviral therapy (HAART). Connection of intracranial myopericitoma appearance and HIV/AIDS has been reported before, but clear connection is yet to be elucidated.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45890570","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 : 2021-10-07DOI: 10.33962/roneuro-2021-044
I. Lozada‐Martínez, A. Galeano-Buelvas, A. C. Pearson-Arrieta, O. J. Díaz-Castillo, M. G. Ortega-Sierra, J. Robledo-Arias, J. Serna-Trejos, Julio César Mantilla-Pardo, D. A. Betancourt-Cundar, Randy Eliecer Frias-Bechara, Harold Yesid Mendez-Martinez, L. Moscote-Salazar
The "Talk and Die" Syndrome is described as the clinical deterioration following a mild to moderate traumatic brain injury. In the face of this event, individuals are able to articulate recognizable words and then deteriorate within 48 hours of the injury. This syndrome represents a major public health challenge due to its high morbidity and mortality rate; it develops from an intracranial haemorrhage causing an increase in intracranial pressure and leading the person to a neurological crisis with focal signs, coma and later death.
{"title":"Talk and Die Syndrome","authors":"I. Lozada‐Martínez, A. Galeano-Buelvas, A. C. Pearson-Arrieta, O. J. Díaz-Castillo, M. G. Ortega-Sierra, J. Robledo-Arias, J. Serna-Trejos, Julio César Mantilla-Pardo, D. A. Betancourt-Cundar, Randy Eliecer Frias-Bechara, Harold Yesid Mendez-Martinez, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-044","DOIUrl":"https://doi.org/10.33962/roneuro-2021-044","url":null,"abstract":"The \"Talk and Die\" Syndrome is described as the clinical deterioration following a mild to moderate traumatic brain injury. In the face of this event, individuals are able to articulate recognizable words and then deteriorate within 48 hours of the injury. This syndrome represents a major public health challenge due to its high morbidity and mortality rate; it develops from an intracranial haemorrhage causing an increase in intracranial pressure and leading the person to a neurological crisis with focal signs, coma and later death.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41750981","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 : 2021-10-07DOI: 10.33962/roneuro-2021-042
G. Iacob
Introduction: Aqueduct stenosis (AS) in old people is a rare pathological entity. I report a case of a 66 years old woman with severe ataxia, cognitive deterioration, loss of sphincters control (gatism). Clinical, neuro-radiologic and therapeutic considerations are discussed. Case presentation: A 66 years old woman with a 6 months history of mild cerebral trauma by car accident without losing consciousness, present 2 months before hospitalization severe ataxia, cognitive disorders, gatism. At the time of trauma, brain scanner performed in another institution showed minimal fronto-basal cerebral contusions and blood collection around the brain stem. One month after a new unenhanced brain scan all previous lesions are gone. At admission, an abnormal enlargement of lateral and third ventricles are remarked both on unenhanced CT and MRI scan of the brain explained by cerebral aqueductal stenosis. Ventricular open pressure was 350 mm H2O. A ventriculoperitoneal shunt with a variable pressure valve was installed. The surgery went uneventful and the patient recovered as expected. 6-month follow-up visit the patient was symptom-free, with a fine intellectual recovery.
{"title":"Active hydrocephalus with aqueduct stenosis to an old woman","authors":"G. Iacob","doi":"10.33962/roneuro-2021-042","DOIUrl":"https://doi.org/10.33962/roneuro-2021-042","url":null,"abstract":"Introduction: Aqueduct stenosis (AS) in old people is a rare pathological entity. I report a case of a 66 years old woman with severe ataxia, cognitive deterioration, loss of sphincters control (gatism). Clinical, neuro-radiologic and therapeutic considerations are discussed. \u0000Case presentation: A 66 years old woman with a 6 months history of mild cerebral trauma by car accident without losing consciousness, present 2 months before hospitalization severe ataxia, cognitive disorders, gatism. At the time of trauma, brain scanner performed in another institution showed minimal fronto-basal cerebral contusions and blood collection around the brain stem. One month after a new unenhanced brain scan all previous lesions are gone. At admission, an abnormal enlargement of lateral and third ventricles are remarked both on unenhanced CT and MRI scan of the brain explained by cerebral aqueductal stenosis. Ventricular open pressure was 350 mm H2O. A ventriculoperitoneal shunt with a variable pressure valve was installed. The surgery went uneventful and the patient recovered as expected. 6-month follow-up visit the patient was symptom-free, with a fine intellectual recovery.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49204731","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 : 2021-10-07DOI: 10.33962/roneuro-2021-046
Zahraa F. Al-Sharshahi, Samer S. Hoz, Mustafa M. Altaweel
This paper is intended as an illustrative teaching case. It gives a porotype case of a patient with subarachnoid haemorrhage and multiple intracranial aneurysms, where the CT data is non-conclusive as to the source of haemorrhage. The paper then discusses the diagnostic challenges and management pearls, pertaining to such scenarios. The paper concludes with a few “take-home points” that summarise the criteria to be applied in such cases.
{"title":"Multiple intracranial aneurysms in subarachnoid haemorrhage. Which one has bled?","authors":"Zahraa F. Al-Sharshahi, Samer S. Hoz, Mustafa M. Altaweel","doi":"10.33962/roneuro-2021-046","DOIUrl":"https://doi.org/10.33962/roneuro-2021-046","url":null,"abstract":"This paper is intended as an illustrative teaching case. It gives a porotype case of a patient with subarachnoid haemorrhage and multiple intracranial aneurysms, where the CT data is non-conclusive as to the source of haemorrhage. The paper then discusses the diagnostic challenges and management pearls, pertaining to such scenarios. The paper concludes with a few “take-home points” that summarise the criteria to be applied in such cases.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42801282","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 : 2021-10-07DOI: 10.33962/roneuro-2021-057
Samer S. Hoz, Aktham O. Al-Khafaji, Zahraa F. Al-Sharshahi, M. Alrawi
Background: Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by bilateral stenosis starting at the supraclinoid internal carotid artery (ICA), with the development of a collateral network of vessels. It is an established cause of stroke in the pediatric age group. Despite its increasing prevalence in various parts of the world, it remains largely underrecognized in the Middle East, particularly in Iraq. This is the first case of MMD in an Iraqi patient undergoing surgery. Case description: A 12-year-old boy presents with a 3-months history of progressive behavioural changes. MRI revealed diffuse infarcts of different ages. MRA and CT angiography revealed extensive asymmetrical steno-occlusive changes of the supraclinoid ICAs extending into the anterior and middle cerebral arteries, with the development of a collateral network in the basal ganglia. Indirect revascularization of the right side by encephaloduroarteriomyosynangiosis (EDAMS) was performed. The clinical status of the patient improved during the follow-up and the MRA showed a re-establishment of the blood flow to the MCA. Conclusion: MMD should be recognized as a cause of stroke or recurrent TIAs in the Iraqi population, particularly in pediatric patients. EDAMS is an effective revascularization procedure with good results in pediatric patients.
{"title":"Indirect revascularization in an Iraqi child with Moyamoya Disease","authors":"Samer S. Hoz, Aktham O. Al-Khafaji, Zahraa F. Al-Sharshahi, M. Alrawi","doi":"10.33962/roneuro-2021-057","DOIUrl":"https://doi.org/10.33962/roneuro-2021-057","url":null,"abstract":"Background: Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by bilateral stenosis starting at the supraclinoid internal carotid artery (ICA), with the development of a collateral network of vessels. It is an established cause of stroke in the pediatric age group. Despite its increasing prevalence in various parts of the world, it remains largely underrecognized in the Middle East, particularly in Iraq. This is the first case of MMD in an Iraqi patient undergoing surgery. \u0000Case description: A 12-year-old boy presents with a 3-months history of progressive behavioural changes. MRI revealed diffuse infarcts of different ages. MRA and CT angiography revealed extensive asymmetrical steno-occlusive changes of the supraclinoid ICAs extending into the anterior and middle cerebral arteries, with the development of a collateral network in the basal ganglia. Indirect revascularization of the right side by encephaloduroarteriomyosynangiosis (EDAMS) was performed. The clinical status of the patient improved during the follow-up and the MRA showed a re-establishment of the blood flow to the MCA. \u0000Conclusion: MMD should be recognized as a cause of stroke or recurrent TIAs in the Iraqi population, particularly in pediatric patients. EDAMS is an effective revascularization procedure with good results in pediatric patients.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49396340","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 : 2021-10-07DOI: 10.33962/roneuro-2021-043
A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, I. Poeată
Migration of coils represents one of the most challenging complications of endovascular management of cerebral aneurysms with a potentially catastrophic result. In this article, we present the successful management of a coil migration during the endovascular occlusion of an anterior communicating artery aneurysm. A stent fixation technique was used with good vascular repermeabilisation. The reported frequency, risk factors and management strategies are also discussed.
{"title":"Particular management strategy for intraprocedural coil migration during endovascular treatment of intracranial aneurysm","authors":"A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, I. Poeată","doi":"10.33962/roneuro-2021-043","DOIUrl":"https://doi.org/10.33962/roneuro-2021-043","url":null,"abstract":"Migration of coils represents one of the most challenging complications of endovascular management of cerebral aneurysms with a potentially catastrophic result. In this article, we present the successful management of a coil migration during the endovascular occlusion of an anterior communicating artery aneurysm. A stent fixation technique was used with good vascular repermeabilisation. The reported frequency, risk factors and management strategies are also discussed.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49510494","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 : 2021-09-20DOI: 10.21203/rs.3.rs-915673/v1
D. Shankar, Deepak Kumar Singh, V. Chand, Mohammad Kaif
Background Primary Intracranial Malignant Melanoma (PIMM) is a very rare neoplasm and account for 1% of all melanomas and 0.1% of all intracranial tumors. It carries a poor prognosis with overall poor survival. Case Presentation: We here present a case of PIMM in a 35-year-old male presenting with sign and symptoms of a left cerebellar hemisphere tumor with leptomeningeal spread. Conclusions Diagnosis on mere imaging findings of an intracranial melanoma is a daunting task. Multimodality treatment with surgery followed by chemotherapy and radiotherapy have proved to be effective in improving clinical outcome in these patients.
{"title":"Primary Intracranial Malignant Melanoma: A Case Report And Review Of Literature","authors":"D. Shankar, Deepak Kumar Singh, V. Chand, Mohammad Kaif","doi":"10.21203/rs.3.rs-915673/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-915673/v1","url":null,"abstract":"\u0000 Background\u0000\u0000Primary Intracranial Malignant Melanoma (PIMM) is a very rare neoplasm and account for 1% of all melanomas and 0.1% of all intracranial tumors. It carries a poor prognosis with overall poor survival.\u0000Case Presentation:\u0000\u0000We here present a case of PIMM in a 35-year-old male presenting with sign and symptoms of a left cerebellar hemisphere tumor with leptomeningeal spread.\u0000Conclusions\u0000\u0000Diagnosis on mere imaging findings of an intracranial melanoma is a daunting task. Multimodality treatment with surgery followed by chemotherapy and radiotherapy have proved to be effective in improving clinical outcome in these patients.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42725583","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 : 2021-09-15DOI: 10.33962/roneuro-2021-053
Abdulrahman Al-Mirza, Omar Al-Taei, T. Al-Saadi
Background: The spinal injury in an elderly patient is associated with higher mortality and an increased frequency of life-threatening complications and specifically spinal cord injuries. The aim of this study is to study the prevalence of geriatric spinal neurosurgical conditions in the Neurosurgical Department at Khoula Hospital, Muscat, Sultanate of Oman. Results: 171 patients were admitted due to spinal pathologies, which will be the main focus of the present study with an average age of 70.7 years. The male-to-female ratio was (1.5:1). Degenerative conditions were the most common spinal diagnosis (90.6%) followed by traumatic accidents (2.9%). Most of the patients underwent surgical intervention (78.9%). The majority of the patients (91.2%) of the patients stayed in the hospital for less than 15 days. There was a significant difference between the age of patients above and below 75 years the gender (p=0.003) and between the length of stay and type of intervention (P<0.005). Conclusion: Spinal cord-related pathologies are a growing cause of mortality and morbidity worldwide, because of the increasing number of elderly people due to an increasingly rising life span worldwide. In the present study, degenerative conditions were the most common spinal diagnosis followed by traumatic accidents.
{"title":"Spinal conditions in geriatric patients in developing countries","authors":"Abdulrahman Al-Mirza, Omar Al-Taei, T. Al-Saadi","doi":"10.33962/roneuro-2021-053","DOIUrl":"https://doi.org/10.33962/roneuro-2021-053","url":null,"abstract":"Background: The spinal injury in an elderly patient is associated with higher mortality and an increased frequency of life-threatening complications and specifically spinal cord injuries. The aim of this study is to study the prevalence of geriatric spinal neurosurgical conditions in the Neurosurgical Department at Khoula Hospital, Muscat, Sultanate of Oman.\u0000Results: 171 patients were admitted due to spinal pathologies, which will be the main focus of the present study with an average age of 70.7 years. The male-to-female ratio was (1.5:1). Degenerative conditions were the most common spinal diagnosis (90.6%) followed by traumatic accidents (2.9%). Most of the patients underwent surgical intervention (78.9%). The majority of the patients (91.2%) of the patients stayed in the hospital for less than 15 days. There was a significant difference between the age of patients above and below 75 years the gender (p=0.003) and between the length of stay and type of intervention (P<0.005).\u0000Conclusion: Spinal cord-related pathologies are a growing cause of mortality and morbidity worldwide, because of the increasing number of elderly people due to an increasingly rising life span worldwide. In the present study, degenerative conditions were the most common spinal diagnosis followed by traumatic accidents.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46285640","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 : 2021-09-15DOI: 10.33962/roneuro-2021-060
Ebtesam Abdulla, H. Luther, T. Shah, N. Chandran
Background: Basal ganglia germinomas (BGGs) represent a diagnostic and management neurosurgical dilemma. Because of the rarity of these tumors in adults, the management strategies are not well defined. Case description: A 24-year-old man was presented with progressive left-sided hemiparesis. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a heterogeneous lesion with few microcystic nodules, seen involving the right basal ganglia with calcification. A stereotactic brain biopsy (SBB) was obtained. Histopathology revealed BGG. The patient received whole-brain radiation therapy (WBRT) and reported marked improvement in symptoms with no recurrence during a follow-up period of four years. Conclusion: BGG should be considered a part of the differential diagnosis in young adults presented with hemiparesis and a heterogeneous lesion in the basal ganglia. Standard recommendations for the management of such rare lesions in adults are needed.
{"title":"A rare occurrence of primary basal ganglia germinoma in an adult patient","authors":"Ebtesam Abdulla, H. Luther, T. Shah, N. Chandran","doi":"10.33962/roneuro-2021-060","DOIUrl":"https://doi.org/10.33962/roneuro-2021-060","url":null,"abstract":"Background: Basal ganglia germinomas (BGGs) represent a diagnostic and management neurosurgical dilemma. Because of the rarity of these tumors in adults, the management strategies are not well defined. \u0000Case description: A 24-year-old man was presented with progressive left-sided hemiparesis. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a heterogeneous lesion with few microcystic nodules, seen involving the right basal ganglia with calcification. A stereotactic brain biopsy (SBB) was obtained. Histopathology revealed BGG. The patient received whole-brain radiation therapy (WBRT) and reported marked improvement in symptoms with no recurrence during a follow-up period of four years.\u0000Conclusion: BGG should be considered a part of the differential diagnosis in young adults presented with hemiparesis and a heterogeneous lesion in the basal ganglia. Standard recommendations for the management of such rare lesions in adults are needed.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43243023","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 : 2021-09-15DOI: 10.33962/roneuro-2021-061
A. Kumar A., Geetha Gopal K.
Introduction: Intracranial epidermoid cysts are congenital inclusion tumours. Cerebellopontine angle and parasellar locations are the common locations. This is a report of an intrasellar epidermoid cyst with haemorrhage, which is rare. Case report: A 70-year-old female presented with bifrontal headache, vertigo, and nasal discharge. Contrast-enhanced Magnetic resonance imaging[MRI] showed heterogeneously enhancing lesion in sella turcica. Internal hemorrhagic foci were seen. Computed tomography[CT] scan showed a slightly hyperdense tumour of sella. Transnasal transsphenoidal excision was done. Hemorrhagic and colloid material came out. Histopathological examination showed cyst lined by stratified squamous epithelium with keratohyalin granules and keratin flakes, suggestive of an epidermoid cyst. Discussion: Usually epidermoid cyst is hypodense in CT scan. But hyperdensity can occur due to calcification of keratinized debris, increased protein content, and recurrent haemorrhage. Enhancement with gadolinium in MRI is mild and in cyst wall. Haemorrhage and enhancement are probably due to foreign body granulation tissue developing from leakage.
{"title":"A case of sellar epidermoid tumour with haemorrhage","authors":"A. Kumar A., Geetha Gopal K.","doi":"10.33962/roneuro-2021-061","DOIUrl":"https://doi.org/10.33962/roneuro-2021-061","url":null,"abstract":"Introduction: Intracranial epidermoid cysts are congenital inclusion tumours. Cerebellopontine angle and parasellar locations are the common locations. This is a report of an intrasellar epidermoid cyst with haemorrhage, which is rare.\u0000Case report: A 70-year-old female presented with bifrontal headache, vertigo, and nasal discharge. Contrast-enhanced Magnetic resonance imaging[MRI] showed heterogeneously enhancing lesion in sella turcica. Internal hemorrhagic foci were seen. Computed tomography[CT] scan showed a slightly hyperdense tumour of sella. Transnasal transsphenoidal excision was done. Hemorrhagic and colloid material came out. Histopathological examination showed cyst lined by stratified squamous epithelium with keratohyalin granules and keratin flakes, suggestive of an epidermoid cyst.\u0000Discussion: Usually epidermoid cyst is hypodense in CT scan. But hyperdensity can occur due to calcification of keratinized debris, increased protein content, and recurrent haemorrhage. Enhancement with gadolinium in MRI is mild and in cyst wall. Haemorrhage and enhancement are probably due to foreign body granulation tissue developing from leakage.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44417622","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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