Pub Date : 2016-11-01DOI: 10.1097/WNQ.0000000000000181
Atef Benn Nsir, M. Boughamoura, M. Kilani, M. Darmoul, N. Hattab
Capillary hemangiomas are benign vascular tumors that are most often encountered superficially in the soft tissues of the head and neck region and frequently follow trauma; epidural location is exceptional. We report an uncommon case of epidural capillary hemangioma in the thoracic spine masquerading as an osteolytic lesion. In addition, we discuss the pathogenesis and management of this unusual condition.
{"title":"Osteolytic Capillary Hemangioma—An Unusual Presentation of a Rare Spinal Tumor: A Case Report","authors":"Atef Benn Nsir, M. Boughamoura, M. Kilani, M. Darmoul, N. Hattab","doi":"10.1097/WNQ.0000000000000181","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000181","url":null,"abstract":"Capillary hemangiomas are benign vascular tumors that are most often encountered superficially in the soft tissues of the head and neck region and frequently follow trauma; epidural location is exceptional. We report an uncommon case of epidural capillary hemangioma in the thoracic spine masquerading as an osteolytic lesion. In addition, we discuss the pathogenesis and management of this unusual condition.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"63 1","pages":"343–346"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886307","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000183
Jhe-Syun Wu, Chi Wu, Jia-Hui Chen
One rare complication of a ventriculoperitoneal shunt is colonic perforation by the catheter. Laparotomy to repair the perforation site is usually required for patient with peritonitis. We present a 54-year-old male who was admitted for 1-week history of abdominal pain. He had previously undergone a ventriculoperitoneal shunt for hydrocephalus secondary to intracerebral hemorrhage. Computed tomography demonstrated the shunt within the colonic lumen and through the transverse and descending colon. Laparoscopy was performed with intracorporeal purse-string closure of the colonic perforation. The proximal catheter was released by neurosurgeon and we removed the whole catheter using the trocar. Postoperative course was uneventful. Laproscopic management of the colonic perforation may be considered as an alternative choice for diagnosing and treating this kind of complication.
{"title":"Laparoscopic Management of Colonic Perforation Due to Ventriculoperitoneal Shunt: A Case Report","authors":"Jhe-Syun Wu, Chi Wu, Jia-Hui Chen","doi":"10.1097/WNQ.0000000000000183","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000183","url":null,"abstract":"One rare complication of a ventriculoperitoneal shunt is colonic perforation by the catheter. Laparotomy to repair the perforation site is usually required for patient with peritonitis. We present a 54-year-old male who was admitted for 1-week history of abdominal pain. He had previously undergone a ventriculoperitoneal shunt for hydrocephalus secondary to intracerebral hemorrhage. Computed tomography demonstrated the shunt within the colonic lumen and through the transverse and descending colon. Laparoscopy was performed with intracorporeal purse-string closure of the colonic perforation. The proximal catheter was released by neurosurgeon and we removed the whole catheter using the trocar. Postoperative course was uneventful. Laproscopic management of the colonic perforation may be considered as an alternative choice for diagnosing and treating this kind of complication.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"347-350"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886326","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000188
S. Noell, Susanne Barking, A. Gerber, M. Liebsch, G. Feigl, M. Tatagiba, R. Ritz
Tumor resection in the rolandic region, also known as sensorimotor cortex, is a challenge. This study aims at reviewing a series of patients undergoing resection of metastases in the sensorimotor cortex using a multimodal concept including neuronavigation, sonography, and intraoperative electrophysiological monitoring. Eleven patients suffering from metastases located in precentral (8) and postcentral gyrus (3) were analyzed concerning their functional motor outcome. Improvement of motor function could be seen in 5 patients 1 week after surgery, 5 patients remained unchanged, and only 1 deteriorated. Median survival time averaged 15 months. A multimodal approach, including preoperative and intraoperative neuronavigation, intraoperative sonography, and intraoperative electrophysiological monitoring can lead on to excellent functional outcome in surgery of metastases in the sensorimotor cortex.
{"title":"Surgery of Metastases in the Sensorimotor Cortex Performance and Clinical Results","authors":"S. Noell, Susanne Barking, A. Gerber, M. Liebsch, G. Feigl, M. Tatagiba, R. Ritz","doi":"10.1097/WNQ.0000000000000188","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000188","url":null,"abstract":"Tumor resection in the rolandic region, also known as sensorimotor cortex, is a challenge. This study aims at reviewing a series of patients undergoing resection of metastases in the sensorimotor cortex using a multimodal concept including neuronavigation, sonography, and intraoperative electrophysiological monitoring. Eleven patients suffering from metastases located in precentral (8) and postcentral gyrus (3) were analyzed concerning their functional motor outcome. Improvement of motor function could be seen in 5 patients 1 week after surgery, 5 patients remained unchanged, and only 1 deteriorated. Median survival time averaged 15 months. A multimodal approach, including preoperative and intraoperative neuronavigation, intraoperative sonography, and intraoperative electrophysiological monitoring can lead on to excellent functional outcome in surgery of metastases in the sensorimotor cortex.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"33 1","pages":"302–305"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886446","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000192
R. Kemerdere, T. Kaçıra, H. Ak, E. Ozyurt, T. Tanrıverdi
Aim:Postoperative seizure disorder can affect the outcome of patients with unruptured intracranial aneurysms. The objective of this study is to evaluate the frequency of postoperative seizures and the need for antiepileptic prophylaxis after the surgery of unruptured intracranial aneurysms. Methods:The medical data of 30 patients who were operated for unruptured intracranial aneurysms were reviewed for age and sex of the patients, location of the aneurysms, length of hospital stay, postoperative complications, and history of preoperative seizures. Postoperative early and late seizures were investigated through their relation with antiepileptic drug usage. Results:Postoperative seizures were observed in 2 patients (7.14%): 1 early seizure in the first week and 1 late seizure occurred 2 years after the surgery. All seizures were generalized tonic clonic in type. The patient with early seizure had left internal capsule ischemia. The patient with late seizure had encephalomalacia in the operative field on magnetic resonance imaging. Conclusions:Antiepileptic prophylaxis in unruptured intracranial aneurysms should be ceased if the patient has no history of preoperative epilepsy and if no seizure is observed at the end of 3 months.
{"title":"Antiepileptic Drug Prophylaxis in Unruptured Intracranial Aneurysms","authors":"R. Kemerdere, T. Kaçıra, H. Ak, E. Ozyurt, T. Tanrıverdi","doi":"10.1097/WNQ.0000000000000192","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000192","url":null,"abstract":"Aim:Postoperative seizure disorder can affect the outcome of patients with unruptured intracranial aneurysms. The objective of this study is to evaluate the frequency of postoperative seizures and the need for antiepileptic prophylaxis after the surgery of unruptured intracranial aneurysms. Methods:The medical data of 30 patients who were operated for unruptured intracranial aneurysms were reviewed for age and sex of the patients, location of the aneurysms, length of hospital stay, postoperative complications, and history of preoperative seizures. Postoperative early and late seizures were investigated through their relation with antiepileptic drug usage. Results:Postoperative seizures were observed in 2 patients (7.14%): 1 early seizure in the first week and 1 late seizure occurred 2 years after the surgery. All seizures were generalized tonic clonic in type. The patient with early seizure had left internal capsule ischemia. The patient with late seizure had encephalomalacia in the operative field on magnetic resonance imaging. Conclusions:Antiepileptic prophylaxis in unruptured intracranial aneurysms should be ceased if the patient has no history of preoperative epilepsy and if no seizure is observed at the end of 3 months.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"325–328"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886969","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000173
Mehmet Tiryaki, H. Süslü, Dilber Ayçiçek Çeçen, N. Tatarlı
Although rare, hydatid cyst disease remains a serious parasitic infection in some developing and underdeveloped countries. Radiologically, the appearance of a dumbbell-shaped mass in the spine is highly suggestive of neurofibroma. Extradural spinal hydatid cyst, although very rare, may also have the same appearance. In this report, a case of hydatid cyst disease involving the T11 to L2 vertebrae with extensions through the neural foramina to the adjacent perirenal fascia and compressing the left kidney is presented. The clinical presentation of the patient was a loss of strength in the legs; this patient initially underwent surgery to decompress the spinal cord by laminectomy and posterior stabilization with bilateral T11 and L1 posterior pedicular screw fixation. Then a retroperitoneal approach to excisea paravertebral mass compressing the left kidney was carried out. The serology was positive for hydatid cyst. Hydatid cyst disease should be considered in the differential diagnosis of spinal mass lesions.
{"title":"Extradural Dumbbell-shaped Hydatid Cyst of the Thoracolumbar Junction and Paravertebral Region Compressing the Left Kidney","authors":"Mehmet Tiryaki, H. Süslü, Dilber Ayçiçek Çeçen, N. Tatarlı","doi":"10.1097/WNQ.0000000000000173","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000173","url":null,"abstract":"Although rare, hydatid cyst disease remains a serious parasitic infection in some developing and underdeveloped countries. Radiologically, the appearance of a dumbbell-shaped mass in the spine is highly suggestive of neurofibroma. Extradural spinal hydatid cyst, although very rare, may also have the same appearance. In this report, a case of hydatid cyst disease involving the T11 to L2 vertebrae with extensions through the neural foramina to the adjacent perirenal fascia and compressing the left kidney is presented. The clinical presentation of the patient was a loss of strength in the legs; this patient initially underwent surgery to decompress the spinal cord by laminectomy and posterior stabilization with bilateral T11 and L1 posterior pedicular screw fixation. Then a retroperitoneal approach to excisea paravertebral mass compressing the left kidney was carried out. The serology was positive for hydatid cyst. Hydatid cyst disease should be considered in the differential diagnosis of spinal mass lesions.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"365–368"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61885251","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000189
H. Yi, H. Hwang, I. Shin, I. Choi, Jong-Young Lee, In Bok Jang
Objective:To review major complications in procedures for blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA). Methods:We reviewed retrospectively 1176 patients with aneurysmal subarachnoid hemorrhage at the Hallym Medical Center between January 2001 and January 2012. There were 31 ICA trunk aneurysms: of them, 22 were BBAs and 9 were saccular aneurysms including one giant aneurysm. The saccular aneurysms were excluded from this study. The 22 BBA patients underwent clipping (n=13), trapping (n=2), endovascular procedures (n=6), and wrapping (n=1) treatments. Results:The average Hunt Hess grade was 3.0 (from 2 to 4) and the Fisher grade was 3.2 in the BBA cases (from 2 to 4). Half of the BBA cases had a history of hypertension. Twelve (54.5%) of the BBAs had intraoperative rupturing. The mean GOS was 3.14 and the mortality rate was high, at 31.8%. Conclusions:We had very high mortality with direct clippings and endovascular procedure during early learning curve, which had higher regrowth of BBA. We agree that the cerebral blood flow and volume should be protected by endovascular procedures with stents or high-flow bypass because the collateral circulation is quite vulnerable to vasospasm, although ICA sacrifice may be tolerable with balloon test occlusion for the trapping of BBAs.
{"title":"The Necessity of New Designed Device for Ruptured Internal Carotid Artery Trunk Blood Blister-like Aneurysms","authors":"H. Yi, H. Hwang, I. Shin, I. Choi, Jong-Young Lee, In Bok Jang","doi":"10.1097/WNQ.0000000000000189","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000189","url":null,"abstract":"Objective:To review major complications in procedures for blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA). Methods:We reviewed retrospectively 1176 patients with aneurysmal subarachnoid hemorrhage at the Hallym Medical Center between January 2001 and January 2012. There were 31 ICA trunk aneurysms: of them, 22 were BBAs and 9 were saccular aneurysms including one giant aneurysm. The saccular aneurysms were excluded from this study. The 22 BBA patients underwent clipping (n=13), trapping (n=2), endovascular procedures (n=6), and wrapping (n=1) treatments. Results:The average Hunt Hess grade was 3.0 (from 2 to 4) and the Fisher grade was 3.2 in the BBA cases (from 2 to 4). Half of the BBA cases had a history of hypertension. Twelve (54.5%) of the BBAs had intraoperative rupturing. The mean GOS was 3.14 and the mortality rate was high, at 31.8%. Conclusions:We had very high mortality with direct clippings and endovascular procedure during early learning curve, which had higher regrowth of BBA. We agree that the cerebral blood flow and volume should be protected by endovascular procedures with stents or high-flow bypass because the collateral circulation is quite vulnerable to vasospasm, although ICA sacrifice may be tolerable with balloon test occlusion for the trapping of BBAs.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"306–314"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886493","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000202
C. Yaldiz, T. Kaçıra, D. Ceylan, K. Asil
Arachnoid cysts and chronic subdural hemorrhages are very common in brain surgeries. Our case, a 15-year-old male amateur footballer, was admitted to our emergency unit following a minor blow. Clinical examinations found chronic subdural hemorrhage associated with an arachnoid cyst. Chronic subdural hemorrhage was drained using 2 burr holes and full recovery was achieved clinically. We present this case because there are rare reports of similar cases in the literature.
{"title":"Chronic Subdural Hemorrhage Associated With an Arachnoid Cyst After Sports Injury in Childhood: A Case Report and the Literature Review","authors":"C. Yaldiz, T. Kaçıra, D. Ceylan, K. Asil","doi":"10.1097/WNQ.0000000000000202","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000202","url":null,"abstract":"Arachnoid cysts and chronic subdural hemorrhages are very common in brain surgeries. Our case, a 15-year-old male amateur footballer, was admitted to our emergency unit following a minor blow. Clinical examinations found chronic subdural hemorrhage associated with an arachnoid cyst. Chronic subdural hemorrhage was drained using 2 burr holes and full recovery was achieved clinically. We present this case because there are rare reports of similar cases in the literature.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"361–364"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886959","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 : 2016-11-01DOI: 10.1097/WNQ.0000000000000191
Jian-jun Sun, Zhen-yu Wang, Q. Chang, Hai-bo Wu
Aim:Aim of this prospective study was to determine the occurrence of histologic differentiation tendency of recurrent multisegment intramedullary spinal cord tumors (MSICTs). Methods:The improved JOA scoring system and the grading for urine and stool conditions were used to evaluate preoperative and postoperative neurological functions of patients. The extent of resection was classified into grades of I to IV. The histologic classification and grading of tumors were determined by a blinded neuropathologist with hematoxylin and eosin staining and immunohistochemical staining. Results:Five patients suffering from recurrent MSICTs were all male. The neurological function of the patients with recurrent MSICTs was worse than during their primary presentation. The extent of resection of the first operation affected the recurrence-free survival time for patients. Extensive surgical resection correlates with longer duration before recurrence. The extent of resection was determined by histologic type and infiltrative characteristics of tumor during the first operation. The recurrence-free survival time correlates with histologic grading of the recurrent tumor. Moreover, the shorter the time before relapse, the worse the neurological function was observed preoperatively for patients with recurrent tumor. Conclusions:The histologic differentiation of the recurrent MSICT depends on the nature of the residual seeds of the primary tumor, which in turn affects the recurrence-free survival time.
{"title":"Histologic Differentiation of Recurrent Multisegment Intramedullary Spinal Cord Tumors","authors":"Jian-jun Sun, Zhen-yu Wang, Q. Chang, Hai-bo Wu","doi":"10.1097/WNQ.0000000000000191","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000191","url":null,"abstract":"Aim:Aim of this prospective study was to determine the occurrence of histologic differentiation tendency of recurrent multisegment intramedullary spinal cord tumors (MSICTs). Methods:The improved JOA scoring system and the grading for urine and stool conditions were used to evaluate preoperative and postoperative neurological functions of patients. The extent of resection was classified into grades of I to IV. The histologic classification and grading of tumors were determined by a blinded neuropathologist with hematoxylin and eosin staining and immunohistochemical staining. Results:Five patients suffering from recurrent MSICTs were all male. The neurological function of the patients with recurrent MSICTs was worse than during their primary presentation. The extent of resection of the first operation affected the recurrence-free survival time for patients. Extensive surgical resection correlates with longer duration before recurrence. The extent of resection was determined by histologic type and infiltrative characteristics of tumor during the first operation. The recurrence-free survival time correlates with histologic grading of the recurrent tumor. Moreover, the shorter the time before relapse, the worse the neurological function was observed preoperatively for patients with recurrent tumor. Conclusions:The histologic differentiation of the recurrent MSICT depends on the nature of the residual seeds of the primary tumor, which in turn affects the recurrence-free survival time.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"319–324"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61886561","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 : 2016-08-01DOI: 10.1097/WNQ.0000000000000167
Ayçiçek Ceçen, Erhan Çelikoğlu, M. İş, A. Ramazanoğlu
Silver-Russell syndrome (SRS) is a disorder characterized by severe intrauterine and postnatal growth retardation, a typical triangular face, asymmetry, clinodactyly, and feeding difficulties. Hypomethylation in the imprinting control region 1 gene at 11p15 is the major epigenetic disturbance in SRS, and approximately one tenth of patients also carry a maternal uniparental disomy of chromosome 7. We report the first case of a 5-year-old girl with SRS presenting with epileptic seizures following a left-sided middle cerebral artery occlusion. Early diagnosis and effective therapy of thromboembolic events in SRS can prevent complications and sequelae.
{"title":"Silver-Russell Syndrome and Middle Cerebral Artery Infarct: A Case Report","authors":"Ayçiçek Ceçen, Erhan Çelikoğlu, M. İş, A. Ramazanoğlu","doi":"10.1097/WNQ.0000000000000167","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000167","url":null,"abstract":"Silver-Russell syndrome (SRS) is a disorder characterized by severe intrauterine and postnatal growth retardation, a typical triangular face, asymmetry, clinodactyly, and feeding difficulties. Hypomethylation in the imprinting control region 1 gene at 11p15 is the major epigenetic disturbance in SRS, and approximately one tenth of patients also carry a maternal uniparental disomy of chromosome 7. We report the first case of a 5-year-old girl with SRS presenting with epileptic seizures following a left-sided middle cerebral artery occlusion. Early diagnosis and effective therapy of thromboembolic events in SRS can prevent complications and sequelae.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"273–277"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61884994","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 : 2016-08-01DOI: 10.1097/WNQ.0000000000000159
V. Vrsajkov, Jasna Jevđić, D. Mihajlovic, Vesna Pajtić, A. Lazukić, Jelena Pantić-Vrsajkov
Objective:The aim of our study was to evaluate the frequency of angiographic vasospasm and computed tomography (CT) detectable cerebral ischemia after subarachnoid hemorrhage, the relationship between these events, and the impact on outcome. Patients and Methods:We prospective enrolled 54 patients with subarachnoid hemorrhage treated from March 2011 to January 2013. CT and CT angiography of brain were obtained on the ninth day of rupture regardless of neurological status. The control brain CT and CT angiography were obtained earlier if clinical symptoms implied delayed cerebral ischemia. The outcome was assessed after 6 months using the extended Glasgow Outcome scale scale. Results:Fifty-four percent of the patients recruited had CT angiography vasospasm and 46% had cerebral ischemia on CT scans. Our study shows a strong correlation between angiographic vasospasm and cerebral ischemia visible on CT (P=0.001) and severity of vasospasm and frequency of ischemia (P=0.03). Twenty percent of the patients showed ischemia with no demonstrable vasospasm confirming multiple cause of delayed cerebral ischemia. Logistic regression model has shown the strong impact of angiographic vasospasm (P=0.004, odds ratio=6.85; 95% confidence interval, 1.83-26.65) and arterial hypertension (P=0.02, odds ratio=4.32; 95% confidence interval, 1.16-16.01) on the development of cerebral ischemia. Angiographic vasospasm (P=0.01) and cerebral ischemia (P=0.005) were associated with worse 6-month outcome. Conclusion:A strong association exists between angiographic vasospasm and cerebral ischemia on CT although some ischemia occurs in area without vasospasm.
{"title":"Ischemic Lesion on Computed Tomography after Subarachnoid Hemorrhage: Good Correlation With Angiographic Vasospasm and Worse Outcome","authors":"V. Vrsajkov, Jasna Jevđić, D. Mihajlovic, Vesna Pajtić, A. Lazukić, Jelena Pantić-Vrsajkov","doi":"10.1097/WNQ.0000000000000159","DOIUrl":"https://doi.org/10.1097/WNQ.0000000000000159","url":null,"abstract":"Objective:The aim of our study was to evaluate the frequency of angiographic vasospasm and computed tomography (CT) detectable cerebral ischemia after subarachnoid hemorrhage, the relationship between these events, and the impact on outcome. Patients and Methods:We prospective enrolled 54 patients with subarachnoid hemorrhage treated from March 2011 to January 2013. CT and CT angiography of brain were obtained on the ninth day of rupture regardless of neurological status. The control brain CT and CT angiography were obtained earlier if clinical symptoms implied delayed cerebral ischemia. The outcome was assessed after 6 months using the extended Glasgow Outcome scale scale. Results:Fifty-four percent of the patients recruited had CT angiography vasospasm and 46% had cerebral ischemia on CT scans. Our study shows a strong correlation between angiographic vasospasm and cerebral ischemia visible on CT (P=0.001) and severity of vasospasm and frequency of ischemia (P=0.03). Twenty percent of the patients showed ischemia with no demonstrable vasospasm confirming multiple cause of delayed cerebral ischemia. Logistic regression model has shown the strong impact of angiographic vasospasm (P=0.004, odds ratio=6.85; 95% confidence interval, 1.83-26.65) and arterial hypertension (P=0.02, odds ratio=4.32; 95% confidence interval, 1.16-16.01) on the development of cerebral ischemia. Angiographic vasospasm (P=0.01) and cerebral ischemia (P=0.005) were associated with worse 6-month outcome. Conclusion:A strong association exists between angiographic vasospasm and cerebral ischemia on CT although some ischemia occurs in area without vasospasm.","PeriodicalId":56275,"journal":{"name":"Neurosurgery Quarterly","volume":"26 1","pages":"225–229"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/WNQ.0000000000000159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61884442","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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