Study Design. A retrospective radiographic review of all patients treated by a single surgeon with a three-level anterior cervical discectomy and fusion with plate fixation. Objectives. To compare fusion success rates and pseudoarthrosis results with published data for three-level anterior cervical constructs including; anterior cervical discectomy and fusion with plating (ACDFP) and anterior cervical corpectomy with and without plating (ACCP, ACC). Methods. In this study, authors have reviewed a series of 1416 patients done by a single surgeon between May 2001 and February 2008. Of these, 127 patients met standard criteria including a minimum of six months follow up, no previous cervical surgeries, and flexion/extension lateral radiographs. Pseudoarthrosis was defined as abnormal movement between the spinous processes, lucency at the graft vertebral body interface or absence of trabecular bone spanning the complete fused space. Fusion was identified by the absence of abnormal motion of the fused segments on flexion/extension lateral radiographs and the presence of continuous trabecular bone formation at the graft/endplate junction. Results. Of the 127 patients, 124 had successful fusions and 3 had pseudoarthrosis. Three hundred seventy-six out of three-hundred eighty-one (98.7%) levels fused while only five (1.3%) levels developed pseudoarthrosis. Conclusions. This study presents the largest reported series of patients undergoing a three-level ACDFP by a single surgeon with close follow up, and suggests that three-level ACDFP utilizing a standardized modified Smith-Robinson technique has an acceptably high level of fusion in comparison to other modalities.
{"title":"Three-Level Anterior Cervical Discectomy and Fusion with Plate Fixation: Radiographic Results of 127 Patients","authors":"D. Bullard, J. J. souza","doi":"10.5580/87d","DOIUrl":"https://doi.org/10.5580/87d","url":null,"abstract":"Study Design. A retrospective radiographic review of all patients treated by a single surgeon with a three-level anterior cervical discectomy and fusion with plate fixation. Objectives. To compare fusion success rates and pseudoarthrosis results with published data for three-level anterior cervical constructs including; anterior cervical discectomy and fusion with plating (ACDFP) and anterior cervical corpectomy with and without plating (ACCP, ACC). Methods. In this study, authors have reviewed a series of 1416 patients done by a single surgeon between May 2001 and February 2008. Of these, 127 patients met standard criteria including a minimum of six months follow up, no previous cervical surgeries, and flexion/extension lateral radiographs. Pseudoarthrosis was defined as abnormal movement between the spinous processes, lucency at the graft vertebral body interface or absence of trabecular bone spanning the complete fused space. Fusion was identified by the absence of abnormal motion of the fused segments on flexion/extension lateral radiographs and the presence of continuous trabecular bone formation at the graft/endplate junction. Results. Of the 127 patients, 124 had successful fusions and 3 had pseudoarthrosis. Three hundred seventy-six out of three-hundred eighty-one (98.7%) levels fused while only five (1.3%) levels developed pseudoarthrosis. Conclusions. This study presents the largest reported series of patients undergoing a three-level ACDFP by a single surgeon with close follow up, and suggests that three-level ACDFP utilizing a standardized modified Smith-Robinson technique has an acceptably high level of fusion in comparison to other modalities.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123298108","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}
S. Manjeet, S. Siddhartha, Wani H. Iftikhar, Tikoo Agnivesh, M. Farid, Mahajan Nirdosh, S. Dara
This is a 2 years review of traumatic spine injury patients treated at GMC Jammu, a tertiary care health centre, to determine clinico-epidemiological aspects of this injury in Jammu division. The objective of this study was to study the risk factors in traumatic spinal cord injuries and to identify preventable risk factors.
{"title":"Spine injuries in a tertiary health care hospital in Jammu: A Clinico - Epidemiological Study","authors":"S. Manjeet, S. Siddhartha, Wani H. Iftikhar, Tikoo Agnivesh, M. Farid, Mahajan Nirdosh, S. Dara","doi":"10.5580/1890","DOIUrl":"https://doi.org/10.5580/1890","url":null,"abstract":"This is a 2 years review of traumatic spine injury patients treated at GMC Jammu, a tertiary care health centre, to determine clinico-epidemiological aspects of this injury in Jammu division. The objective of this study was to study the risk factors in traumatic spinal cord injuries and to identify preventable risk factors.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130114766","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}
Posterior fossa extradural(PFED) uncommon but potentially fatal condition. Extradural haematomas in the posterior fossa is rare. Extradural haematoma are commonly associated with direct trauma to the temporal bones of the cranium resulting in damage to the middle meningeal artery or its branches. This case describes of an occipital skull fracture with venous sinus bleeding that resulted in a posterior cranial fossa extradural haematoma which was managed conservatively.
{"title":"Posterior cranial fossa extradural haematoma managed conservatively","authors":"B.D.G.S. Jayathilaka, A. Hussain, J. L. Martin","doi":"10.5580/2702","DOIUrl":"https://doi.org/10.5580/2702","url":null,"abstract":"Posterior fossa extradural(PFED) uncommon but potentially fatal condition. Extradural haematomas in the posterior fossa is rare. Extradural haematoma are commonly associated with direct trauma to the temporal bones of the cranium resulting in damage to the middle meningeal artery or its branches. This case describes of an occipital skull fracture with venous sinus bleeding that resulted in a posterior cranial fossa extradural haematoma which was managed conservatively.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121132462","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}
Childhood convulsion with hemiparesis due to schizencephaly is a rare condition. It is a developmental disorder of neuronal migration, characterized by early focal destruction of the germinal matrix and surrounding brain before the cerebral hemispheres are fully formed at 1-5 months of gestation .The lesion is most likely related to multiple aetiologies including genetic, toxic, metabolic, vascular or infectious agents. This case is reported due to its worldwide rarity. INTRODUCTION Schizencephaly, a developmental disorder of neuronal migration is characterized by cleft in cerebral mantle, which communicates between the subarachnoid space laterally and ventricular system medially. This disorder was originally described by Wadsworth and Yakolev. 1 Their original work describes schizencephaly to result from failure of normal migration of primitive normoblasts resulting in cerebral cleft .The cardinal neuropathological features are і) Hemispheric cleft іі) communication of subarachnoid space with lateral ventricle medially ііі) Infolding of grey matter along the cleft iv) Multiple associated intracranial malformations including polymicrigyria, absent septum pellucidum, optic nerve hypoplasia. The presentation and outcome are variable i.e. hemiparesis, developmental delay, microcephaly, mental retardation and most patients have seizures. CASE REPORT A 2 year aged female child was admitted in paediatric neurosurgery ward of CM Hospital Dhaka with complain of repeated episode of convulsion since birth and weakness in right upper and lower limbs since two months of age. She was symptomatically treated with anticonvulsant sodium valproate. The child was delivered full term normally at home with unremarkable antenatal maternal history. She cried soon after birth and there were no postnatal complications. There is no history of consanguineous marriage. On physical examination child had normocephaly, no dysmorphism of face. Anterior fontanelle was normal. Sutures were widely normal. There was a global delay in the developmental milestones. Muscle tone of the right upper and lower limbs showed spasticity with 4/5 power grade with normal reflexes. Vitals were normal. Anthropometric measurements of weight and length were within normal limits. The child was admitted with provisional diagnosis of Cerebral palsy. Investigations done revealed normal Hb, Tc, Dc. EEG showed abnormal record with seizure pattern. CT scan showedSCHIZENCEPHALY. Figure 1 Fig: CT scan of brain to show schizenencephaly Thus the diagnosis was established with the help of CT scan report. The option of treatment with prognosis was explained to the parents. She eventually underwent cystoperitonreal shunt. Postoperative recovery was uneventful except an episode of seizure that was managed by sodium valproate. Childhood convulsion and hemiparesis due to schizencephaly-a case report 2 of 3 Counseling was given and physiotherapy was advised. Anticonvulsant was continued. DISCUSSION Schizencephaly
{"title":"Childhood convulsion and hemiparesis due to schizencephaly-a case report","authors":"M. Salek, H. Alam, M. Islam, Zaman","doi":"10.5580/2203","DOIUrl":"https://doi.org/10.5580/2203","url":null,"abstract":"Childhood convulsion with hemiparesis due to schizencephaly is a rare condition. It is a developmental disorder of neuronal migration, characterized by early focal destruction of the germinal matrix and surrounding brain before the cerebral hemispheres are fully formed at 1-5 months of gestation .The lesion is most likely related to multiple aetiologies including genetic, toxic, metabolic, vascular or infectious agents. This case is reported due to its worldwide rarity. INTRODUCTION Schizencephaly, a developmental disorder of neuronal migration is characterized by cleft in cerebral mantle, which communicates between the subarachnoid space laterally and ventricular system medially. This disorder was originally described by Wadsworth and Yakolev. 1 Their original work describes schizencephaly to result from failure of normal migration of primitive normoblasts resulting in cerebral cleft .The cardinal neuropathological features are і) Hemispheric cleft іі) communication of subarachnoid space with lateral ventricle medially ііі) Infolding of grey matter along the cleft iv) Multiple associated intracranial malformations including polymicrigyria, absent septum pellucidum, optic nerve hypoplasia. The presentation and outcome are variable i.e. hemiparesis, developmental delay, microcephaly, mental retardation and most patients have seizures. CASE REPORT A 2 year aged female child was admitted in paediatric neurosurgery ward of CM Hospital Dhaka with complain of repeated episode of convulsion since birth and weakness in right upper and lower limbs since two months of age. She was symptomatically treated with anticonvulsant sodium valproate. The child was delivered full term normally at home with unremarkable antenatal maternal history. She cried soon after birth and there were no postnatal complications. There is no history of consanguineous marriage. On physical examination child had normocephaly, no dysmorphism of face. Anterior fontanelle was normal. Sutures were widely normal. There was a global delay in the developmental milestones. Muscle tone of the right upper and lower limbs showed spasticity with 4/5 power grade with normal reflexes. Vitals were normal. Anthropometric measurements of weight and length were within normal limits. The child was admitted with provisional diagnosis of Cerebral palsy. Investigations done revealed normal Hb, Tc, Dc. EEG showed abnormal record with seizure pattern. CT scan showedSCHIZENCEPHALY. Figure 1 Fig: CT scan of brain to show schizenencephaly Thus the diagnosis was established with the help of CT scan report. The option of treatment with prognosis was explained to the parents. She eventually underwent cystoperitonreal shunt. Postoperative recovery was uneventful except an episode of seizure that was managed by sodium valproate. Childhood convulsion and hemiparesis due to schizencephaly-a case report 2 of 3 Counseling was given and physiotherapy was advised. Anticonvulsant was continued. DISCUSSION Schizencephaly ","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128405554","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}
Parkinsonism has been well-documented in patients with communicating hydrocephalus, but it is an uncommon complication of shunting for obstructive hydrocephalus secondary to aqueductal stenosis. Although a number of hypotheses regarding anatomical and pathophysiological clues to this are proposed, its exact mechanism remains unclear. The author presents a unique case of parkinsonism after shunting for hydrocephalus due to aqueductal stenosis with Chiari malformation. Suboccipital craniectomy and duraplasty followed by ventriculoperitoneal shunting was performed, parkinsonian symptoms developed after the shunt revision, and short-term levodopa therapy resulted in complete recovery.
{"title":"Parkinsonism after Shunting for Hydrocephalus Secondary to Aqueductal Stenosis with Chiari Malformation","authors":"M. Turgut","doi":"10.5580/1c07","DOIUrl":"https://doi.org/10.5580/1c07","url":null,"abstract":"Parkinsonism has been well-documented in patients with communicating hydrocephalus, but it is an uncommon complication of shunting for obstructive hydrocephalus secondary to aqueductal stenosis. Although a number of hypotheses regarding anatomical and pathophysiological clues to this are proposed, its exact mechanism remains unclear. The author presents a unique case of parkinsonism after shunting for hydrocephalus due to aqueductal stenosis with Chiari malformation. Suboccipital craniectomy and duraplasty followed by ventriculoperitoneal shunting was performed, parkinsonian symptoms developed after the shunt revision, and short-term levodopa therapy resulted in complete recovery.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128509585","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}
Cerebral venous sinus thrombosis is an uncommon condition which remains a diagnostic challenge for the clinician and radiologist. The wide spectrum of clinical and radiological manifestations can result in delayed or misdiagnosis. The authors present the case of a 50-year-old woman with headaches following an episode of mastoiditis. CT imaging revealed temporal ring-enhancing lesions which were thought to represent cerebral abscess formation and the patient proceeded to image-guided aspiration. MR venography, biopsy and histological examination confirmed the diagnosis of hemorrhagic infarction secondary to transverse sinus thrombosis.
{"title":"Hemorrhagic infarction due to transverse sinus thrombosis mimicking cerebral abscesses","authors":"N. Barua, M. Bradley, Nitin Patel","doi":"10.5580/2662","DOIUrl":"https://doi.org/10.5580/2662","url":null,"abstract":"Cerebral venous sinus thrombosis is an uncommon condition which remains a diagnostic challenge for the clinician and radiologist. The wide spectrum of clinical and radiological manifestations can result in delayed or misdiagnosis. The authors present the case of a 50-year-old woman with headaches following an episode of mastoiditis. CT imaging revealed temporal ring-enhancing lesions which were thought to represent cerebral abscess formation and the patient proceeded to image-guided aspiration. MR venography, biopsy and histological examination confirmed the diagnosis of hemorrhagic infarction secondary to transverse sinus thrombosis.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131960876","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}
A young male developed sudden weakness of both lower limbs with D8 sensory level.MR imaging revealed extradural lesion at D5-6.Laminectomy revealed brown colored highly vascular circumscribed lesion arising from D5 extradural nerve root. Lesion was excised completely and histopathology confirmed it to be arteriovenous malfomation
{"title":"Exradural Arterio-Venous Malformation Arising From Dorsal Nerve Mimicking A Tumor : A Case Report","authors":"Sushil Kumar, P. Abbey, D. Jha, V. Mishra","doi":"10.5580/2179","DOIUrl":"https://doi.org/10.5580/2179","url":null,"abstract":"A young male developed sudden weakness of both lower limbs with D8 sensory level.MR imaging revealed extradural lesion at D5-6.Laminectomy revealed brown colored highly vascular circumscribed lesion arising from D5 extradural nerve root. Lesion was excised completely and histopathology confirmed it to be arteriovenous malfomation","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115142668","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}
Posterior spinal tuberculosis is rare. A case of posterior spinal tuberculosis with large abscess without any neurological deficit was managed conservatively. He was relieved of pain and swelling subsided completely on anti-tubercular drugs
{"title":"conservative treatment of large tubercular abscess arising from spinous process and laminae","authors":"Sushil Kumar, P. Abbey, V. Jaiswal","doi":"10.5580/165b","DOIUrl":"https://doi.org/10.5580/165b","url":null,"abstract":"Posterior spinal tuberculosis is rare. A case of posterior spinal tuberculosis with large abscess without any neurological deficit was managed conservatively. He was relieved of pain and swelling subsided completely on anti-tubercular drugs","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116587449","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}
A. Gupta, B. Walia, A. Wani, A. Jha, S. Vaishya, Vipul Gupta
Giant cell tumour is one of the rare tumors of the sphenoid bone .The tumour usually has delayed presentation due to late onset of symptoms .The excision is relatively difficult due to narrow corridors available for surgery. We have described here our experience with use of Le Fort 2 osteotomy in removal of the tumour .Despite having adequate corridor, we could not achieve total excision and had to administer adjuvant therapy for control of disease.
巨细胞瘤是一种罕见的蝶骨肿瘤，由于出现症状较晚，肿瘤通常延迟出现，由于手术通道狭窄，切除相对困难。我们在此描述了我们使用Le Fort 2型截骨术切除肿瘤的经验。尽管有足够的通道，但我们无法实现完全切除，必须进行辅助治疗以控制疾病。
{"title":"Giant cell tumour of the sphenoid bone – Lefort 2 approach for surgery","authors":"A. Gupta, B. Walia, A. Wani, A. Jha, S. Vaishya, Vipul Gupta","doi":"10.5580/1ee4","DOIUrl":"https://doi.org/10.5580/1ee4","url":null,"abstract":"Giant cell tumour is one of the rare tumors of the sphenoid bone .The tumour usually has delayed presentation due to late onset of symptoms .The excision is relatively difficult due to narrow corridors available for surgery. We have described here our experience with use of Le Fort 2 osteotomy in removal of the tumour .Despite having adequate corridor, we could not achieve total excision and had to administer adjuvant therapy for control of disease.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121215165","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}
BACKGROUND: The diagnosis of neurosurgical pathology in a pregnant lady is a stressful event to the patient, her family and attending physician and the managment of these problems challenges the skills of obstetricians and neurosurgeons to secure both the baby and his mother. In this study, the author presents 10 pregnant women presented acutely to neurosurgery with different neurosurgical problems, the management of each patient was individualized according to the pathology and gestational age.
{"title":"Effect of pathology and gestational age on the management of neurosurgical emergencies in pregnant women","authors":"S. Elwatidy","doi":"10.5580/294f","DOIUrl":"https://doi.org/10.5580/294f","url":null,"abstract":"BACKGROUND: The diagnosis of neurosurgical pathology in a pregnant lady is a stressful event to the patient, her family and attending physician and the managment of these problems challenges the skills of obstetricians and neurosurgeons to secure both the baby and his mother. In this study, the author presents 10 pregnant women presented acutely to neurosurgery with different neurosurgical problems, the management of each patient was individualized according to the pathology and gestational age.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128322761","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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