Pub Date : 2023-07-24DOI: 10.58624/svoane.2023.04.0100
S. Saket, M. Arzaghi
Background and Aims: Cerebral sinus venous thrombosis (CSVT) is a rare stroke subtype in children, with limited data on its clinical presentation, etiology, and outcomes. This case report aims to describe a case of CSVT in a child, including their clinical presentation, imaging findings, and management, to increase awareness of this rare but serious condition. Case presentation: A 13-month-old boy presented with swelling and deviation of the left eye after being hospitalized for left periorbital cellulitis. The patient was diagnosed with thrombosis of the left transverse and superior sagittal sinuses and underwent treatment with levetiracetam, folinic acid, rosuvastatin and enoxaparin followed by warfarin. Genetic testing was also performed to identify the underlying genetic basis of thrombophilia. Results: Laboratory tests showed that there was one heterozygous mutation in the β-Fibrinogen gene and three homozygous mutations in MTHFR A1298C, PAI-I-675 4G/5G, and PAI-I-844 G/A genes. Additionally, Lipoprotein (a) was measured at 89.3 nmol/L and the patient's mother had two homozygous mutations in PAI-I-675 4G/5G and PAI-I-844 G/A genes. Conclusions: It appears that the mutation in MTHFR gene is more prevalent in our region, which may be a contributing factor to the increased incidence of stroke in children and adolescents in the country. Further research is needed to determine the prevalence of this mutation and its impact on thrombophilia in the population. This case highlights the importance of prompt diagnosis and treatment of CSVT in children, as well as the need for genetic counselling and testing to identify underlying risk factors.
{"title":"A 13-Month-Old Iranian Boy with Thrombosis of the Left Transverse and Superior Sagittal Sinuses Due to Homozygous Mutations in MTHFR A1298C: A Case Report & Review of Literature","authors":"S. Saket, M. Arzaghi","doi":"10.58624/svoane.2023.04.0100","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.0100","url":null,"abstract":"Background and Aims: Cerebral sinus venous thrombosis (CSVT) is a rare stroke subtype in children, with limited data on its clinical presentation, etiology, and outcomes. This case report aims to describe a case of CSVT in a child, including their clinical presentation, imaging findings, and management, to increase awareness of this rare but serious condition. Case presentation: A 13-month-old boy presented with swelling and deviation of the left eye after being hospitalized for left periorbital cellulitis. The patient was diagnosed with thrombosis of the left transverse and superior sagittal sinuses and underwent treatment with levetiracetam, folinic acid, rosuvastatin and enoxaparin followed by warfarin. Genetic testing was also performed to identify the underlying genetic basis of thrombophilia. Results: Laboratory tests showed that there was one heterozygous mutation in the β-Fibrinogen gene and three homozygous mutations in MTHFR A1298C, PAI-I-675 4G/5G, and PAI-I-844 G/A genes. Additionally, Lipoprotein (a) was measured at 89.3 nmol/L and the patient's mother had two homozygous mutations in PAI-I-675 4G/5G and PAI-I-844 G/A genes. Conclusions: It appears that the mutation in MTHFR gene is more prevalent in our region, which may be a contributing factor to the increased incidence of stroke in children and adolescents in the country. Further research is needed to determine the prevalence of this mutation and its impact on thrombophilia in the population. This case highlights the importance of prompt diagnosis and treatment of CSVT in children, as well as the need for genetic counselling and testing to identify underlying risk factors.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41749637","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 : 2023-07-10DOI: 10.58624/svoane.2023.04.099
Mohamed Elsayed Abd-ElHady, Imane A. Yassine, Ehab Ahmed Hashish, Maha Mohamed Anani, Mohamed Ibraheem Negm
Neurofilament light chain (NfL) is a main element of neurons’ structure which is exclusively confined to the neuroaxonal compartment, NfL therefore provides an advantage over other potential biomarkers since it’s highly selective for neuronal cell injury and eventual neuronal cell death. Independent of etiology, NfL levels in CSF and blood increase above normal in response to neuronal damage and neurodegeneration, making it a suitable candidate as a biomarker in these circumstances. Biomarkers of neuronal injury and neurodegeneration have the potential to enhance diagnostic accuracy, disease monitoring, and prognosis.
{"title":"Role of Neurofilament Light Chain as A Biomarker in Neurological Disorders: A Literature Review","authors":"Mohamed Elsayed Abd-ElHady, Imane A. Yassine, Ehab Ahmed Hashish, Maha Mohamed Anani, Mohamed Ibraheem Negm","doi":"10.58624/svoane.2023.04.099","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.099","url":null,"abstract":"Neurofilament light chain (NfL) is a main element of neurons’ structure which is exclusively confined to the neuroaxonal compartment, NfL therefore provides an advantage over other potential biomarkers since it’s highly selective for neuronal cell injury and eventual neuronal cell death. Independent of etiology, NfL levels in CSF and blood increase above normal in response to neuronal damage and neurodegeneration, making it a suitable candidate as a biomarker in these circumstances. Biomarkers of neuronal injury and neurodegeneration have the potential to enhance diagnostic accuracy, disease monitoring, and prognosis.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49039202","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 : 2023-07-05DOI: 10.58624/svoane.2023.04.098
Luigi Francesco Saccaro, Beatrice A. Milano, S. Galletta
We report the first case of isolated unilateral carotid arteritis, following an upper respiratory tract infection in a patient without other medical conditions. We collected clinical information during the patient’s hospitalization and follow-up. Through a Pubmed search, we identified articles discussing TIPIC syndrome, carotid pain, or inflammation. After reviewing the articles and the corresponding images, none of these reported clinical and radiological findings similar to ours. A 55-year-old man consulted for unilateral neck pain, without relevant clinical history apart from an upper respiratory tract infection, nor other signs or symptoms. An MRI before admission showed signs of focal adventitial inflammation of the left internal carotid artery. Ultrasound identified a mixed plaque with hypoechoic and isoechoic components at the beginning of the left internal carotid. In particular, there was no halo sign suggestive of giant cell arteritis. Extensive laboratory exams only found increased plasma IL-1 receptor antagonist. After three days of corticosteroid and acetylsalicylic acid treatment., cervicalgia completely regressed, and prednisone was stopped. The patient was discharged on day 7 on daily acetylsalicylic acid. At three months, he remained asymptomatic, carotid ultrasound was comparable to the first one, and treatment was stopped. We suggest that a purely vascular inflammation of the carotid could appropriately be defined “carotiditis”, considering the focal, isolated involvement of the carotid wall, and that such a unilateral presentation has never been reported before. Speculatively, we propose an association between carotidis and the upper respiratory tract infection in this patient.
{"title":"Unilateral Primary Carotiditis: A Case Report","authors":"Luigi Francesco Saccaro, Beatrice A. Milano, S. Galletta","doi":"10.58624/svoane.2023.04.098","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.098","url":null,"abstract":"We report the first case of isolated unilateral carotid arteritis, following an upper respiratory tract infection in a patient without other medical conditions. We collected clinical information during the patient’s hospitalization and follow-up. Through a Pubmed search, we identified articles discussing TIPIC syndrome, carotid pain, or inflammation. After reviewing the articles and the corresponding images, none of these reported clinical and radiological findings similar to ours. A 55-year-old man consulted for unilateral neck pain, without relevant clinical history apart from an upper respiratory tract infection, nor other signs or symptoms. An MRI before admission showed signs of focal adventitial inflammation of the left internal carotid artery. Ultrasound identified a mixed plaque with hypoechoic and isoechoic components at the beginning of the left internal carotid. In particular, there was no halo sign suggestive of giant cell arteritis. Extensive laboratory exams only found increased plasma IL-1 receptor antagonist. After three days of corticosteroid and acetylsalicylic acid treatment., cervicalgia completely regressed, and prednisone was stopped. The patient was discharged on day 7 on daily acetylsalicylic acid. At three months, he remained asymptomatic, carotid ultrasound was comparable to the first one, and treatment was stopped. We suggest that a purely vascular inflammation of the carotid could appropriately be defined “carotiditis”, considering the focal, isolated involvement of the carotid wall, and that such a unilateral presentation has never been reported before. Speculatively, we propose an association between carotidis and the upper respiratory tract infection in this patient.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42227901","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 : 2023-07-04DOI: 10.58624/svoane.2023.04.097
J. Cazzaniga, Cesar E Jara Silva, S. Nittala, D. Filippi
Introduction: Among the wide variety of clinical manifestations in Systemic Lupus Erythematosus (SLE), cognitive dysfunction (CD) is a subtle finding, where the reported prevalence ranges from 3-88% due to CD assessment inconsistencies and challenges with SLE correlations. Cognitive dysfunction may also be a cornerstone element for a diagnosis of Neuropsychiatric Systemic Lupus Erythematosus (NP-SLE). We present a case of Lupus Cerebritis displaying seizures and oculomotor dysfunctions referred to as Balint Syndrome. To our knowledge, no publications to date have shown a correlation between Lupus Cerebritis and Balint Syndrome. Case Report: A 35-year-old female with a history of lupus, seizures, and migraines presented complaining of a severe headache associated with vomiting. The patient stated the onset of her symptoms was three days prior and had been worsening. While in the emergency room, the patient had a generalized tonic-clonic seizure lasting around 2 minutes at which point neurology was consulted for seizure management. The patient had been seen about a year prior for similar complaints and was started on Keppra to control her epilepsy. The patient was seizure free for about 6 months so Keppra was discontinued. Discussion: A wide array of symptoms are associated with Lupus Cerebritis, which is a rare manifestation following a diagnosis of SLE. Our patient was having seizures and complaints of migraine with severe Balint Syndrome consisting of oculomotor apraxia, optic ataxia, and simultagnosia. Due to some patients’ rapid decline following a diagnosis of SLE and the complex diversity of symptoms, it is crucial to prevent organ failure by treating them immediately, and furthermore, to equip and educate clinicians in identifying atypical presentations. Conclusion: Due to the complexity of autoimmune diseases, patients may present with a plethora of symptomatology, ranging from mild to severe, making a thorough medical history and physical examination imperative elements of a complete workup. Since NP-SLE is a nuanced diagnosis requiring specific management, it is essential to have close follow-ups with neurology.
{"title":"Diagnosis of Lupus Cerebritis with Balint Syndrome: A Unique Case Report","authors":"J. Cazzaniga, Cesar E Jara Silva, S. Nittala, D. Filippi","doi":"10.58624/svoane.2023.04.097","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.097","url":null,"abstract":"Introduction: Among the wide variety of clinical manifestations in Systemic Lupus Erythematosus (SLE), cognitive dysfunction (CD) is a subtle finding, where the reported prevalence ranges from 3-88% due to CD assessment inconsistencies and challenges with SLE correlations. Cognitive dysfunction may also be a cornerstone element for a diagnosis of Neuropsychiatric Systemic Lupus Erythematosus (NP-SLE). We present a case of Lupus Cerebritis displaying seizures and oculomotor dysfunctions referred to as Balint Syndrome. To our knowledge, no publications to date have shown a correlation between Lupus Cerebritis and Balint Syndrome. Case Report: A 35-year-old female with a history of lupus, seizures, and migraines presented complaining of a severe headache associated with vomiting. The patient stated the onset of her symptoms was three days prior and had been worsening. While in the emergency room, the patient had a generalized tonic-clonic seizure lasting around 2 minutes at which point neurology was consulted for seizure management. The patient had been seen about a year prior for similar complaints and was started on Keppra to control her epilepsy. The patient was seizure free for about 6 months so Keppra was discontinued. Discussion: A wide array of symptoms are associated with Lupus Cerebritis, which is a rare manifestation following a diagnosis of SLE. Our patient was having seizures and complaints of migraine with severe Balint Syndrome consisting of oculomotor apraxia, optic ataxia, and simultagnosia. Due to some patients’ rapid decline following a diagnosis of SLE and the complex diversity of symptoms, it is crucial to prevent organ failure by treating them immediately, and furthermore, to equip and educate clinicians in identifying atypical presentations. Conclusion: Due to the complexity of autoimmune diseases, patients may present with a plethora of symptomatology, ranging from mild to severe, making a thorough medical history and physical examination imperative elements of a complete workup. Since NP-SLE is a nuanced diagnosis requiring specific management, it is essential to have close follow-ups with neurology.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46536088","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}
Introduction: Brain abscess is a focal infection of the brain parenchyma, in which different treatment methods are used, most authors agree that conservative methods with antibiotic therapy are effective in the cerebritis phase, while in the encapsulated phases the Minimally invasive surgery is the best option. Objective: To describe the clinical, imaging and surgical characteristics in patients with multiple brain abscesses. Case Report: Male, white, 20-year-old, right-handed patient, with a history of molar infection 3 months prior, comes to the emergency department of our hospital due to intense headache and tonic-clonic seizures. widespread. Tomography and cranial resonance studies were performed, which demonstrated the presence of multiple brain abscesses that were successfully treated using an occipital approach with endoscopic support and trans-surgical ultrasonographic guidance. Discussion: In the international literature consulted, the largest number of patients with brain abscesses are treated by conservative measures, in cases in late encapsulation phases where drugs do not penetrate the capsule, surgical alternatives are the most recommended, which depend on size, location, proximity to the ventricular system and number of lesions. Conclusion: Brain abscess is a neurosurgical entity, in which surgery by minimally invasive methods associated with exact localization techniques and antibiotic therapy is the most effective treatment alternative.
{"title":"Guided Surgery with Intraoperative Ultrasonography and Endoscopy in Multiple Occipital Brain Abscess","authors":"Enrique Marcos Sierra Benitez, Leniel Laud Rodríguez, Mairianny Quianella León Pérez","doi":"10.58624/svoane.2023.04.095","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.095","url":null,"abstract":"Introduction: Brain abscess is a focal infection of the brain parenchyma, in which different treatment methods are used, most authors agree that conservative methods with antibiotic therapy are effective in the cerebritis phase, while in the encapsulated phases the Minimally invasive surgery is the best option. Objective: To describe the clinical, imaging and surgical characteristics in patients with multiple brain abscesses. Case Report: Male, white, 20-year-old, right-handed patient, with a history of molar infection 3 months prior, comes to the emergency department of our hospital due to intense headache and tonic-clonic seizures. widespread. Tomography and cranial resonance studies were performed, which demonstrated the presence of multiple brain abscesses that were successfully treated using an occipital approach with endoscopic support and trans-surgical ultrasonographic guidance. Discussion: In the international literature consulted, the largest number of patients with brain abscesses are treated by conservative measures, in cases in late encapsulation phases where drugs do not penetrate the capsule, surgical alternatives are the most recommended, which depend on size, location, proximity to the ventricular system and number of lesions. Conclusion: Brain abscess is a neurosurgical entity, in which surgery by minimally invasive methods associated with exact localization techniques and antibiotic therapy is the most effective treatment alternative.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47135112","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 : 2023-06-07DOI: 10.58624/svoane.2023.04.094
V. Giannouli, Panagiota Tragantzopoulou
In the light of the public health crisis due to the coronavirus disease 2019 pandemic, it is important to acknowledge its impact on healthcare professionals and students during the Omicron wave. In this study, the aim was to compare the levels of depressive symptomatology, burnout, and creativity in Greek healthcare professionals and students while exploring associations with cognitive functioning. The sample consisted of 243 Greek individuals (104 healthcare professionals and 139 healthcare university students). Pearson correlation coefficient and independent t-test were used for data analysis. Both groups scored high in depression, however, no significant difference was found in the levels of creativity and cognitive functioning. Although health professionals scored higher in burnout, burnout levels were found to be low in both groups. No correlation was found among cognitive functioning, burnout, depression and creativity. Support should be provided to healthcare professionals and students. Further research should investigate cognitive functioning and possible associations with depression, burnout, and creativity.
{"title":"Creativity is Not Related to Higher Cognitive Functioning: An Exploration Among Healthcare Professionals and Students During the Covid-19 Omicron Wave","authors":"V. Giannouli, Panagiota Tragantzopoulou","doi":"10.58624/svoane.2023.04.094","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.094","url":null,"abstract":"In the light of the public health crisis due to the coronavirus disease 2019 pandemic, it is important to acknowledge its impact on healthcare professionals and students during the Omicron wave. In this study, the aim was to compare the levels of depressive symptomatology, burnout, and creativity in Greek healthcare professionals and students while exploring associations with cognitive functioning. The sample consisted of 243 Greek individuals (104 healthcare professionals and 139 healthcare university students). Pearson correlation coefficient and independent t-test were used for data analysis. Both groups scored high in depression, however, no significant difference was found in the levels of creativity and cognitive functioning. Although health professionals scored higher in burnout, burnout levels were found to be low in both groups. No correlation was found among cognitive functioning, burnout, depression and creativity. Support should be provided to healthcare professionals and students. Further research should investigate cognitive functioning and possible associations with depression, burnout, and creativity.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47516505","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 : 2023-05-05DOI: 10.58624/svoane.2023.04.093
Kaleab Tesfaye Moges
Study background and significance: Posterior fossa tumors are a common pathology worldwide and often present with obstructive hydrocephalus. In the year 2021 CSF diversion for acute hydrocephalus from brain tumors was the most common performed emergency procedure in Tikur Anbessa hospital. It is a clinical dilemma choosing the mode of management for the hydrocephalus as it could be a lifesaving procedure but with a risk of unfortunate and devastating outcome. Objective: The aim of the study will be to evaluate the acute complications that occur with CSF diversion procedures that are done for obstructive hydrocephalus in the presence of posterior fossa mass before tumor resection. Method: It will be prospective observational study conducted at Tikur anbessa specialized hospital, which will be held from March 2021 up to October 2022. The research will involve all patients who have undergone CSF diversion procedure for obstructive hydrocephalus from posterior fossa tumors prior to tumor resection and patients will be followed for the first 48 hours post operatively. Patient’s presentation, nature of the posterior fossa tumor on imaging, post-operative clinical status and post op imaging will be taken to account. Result: In the study time frame of 18 months there were 89 patients who came with acute obstructive hydrocephalus from posterior fossa of which all underwent CSF diversion procedure before tumor resection. 52.8% were pediatrics and 47.2% where adults. The most common tumor location was vermian (31.5%) followed by cerebellar hemisphere (29.2%), 4th ventricular (25.8%) and the rest 9% account for cranial nerve and extra axial location. The largest tumor was 9.8cm but the median was 5.1cm. Based on the size they were categorized in to 3 groups, 71.9% were tumor size 4-6cm, 22.5% had a tumor size of >6cm and there were 5.6% with tumor size <4cm. Of the CSF diversion procedures performed 93.3% were VPS, EVD and ETV account for 3.4% each. All were followed for 48 hours post op and 8 patients had clinical deterioration after CSF diversion was done, and all patients with clinical deterioration underwent urgent non -contrast CT scan. They were found to have upward herniation, intra-tumoral bleeding, intraventricular hemorrhage or a combination of these findings. Of the 8 patients that deteriorated 5 died without successful resuscitation. The rest 3 improved and underwent definitive surgery. The risk for postoperative deterioration was 8.9% and 48-hour mortality was 5.6%. Variables were chosen to check association with the outcome (post-operative deterioration). Variables tested include age of the patient, tumor size and tumor location, all did not have statistically significant relationship with outcome (post-operative deterioration and 48-hour mortality). The association between the type of intervention and outcome could not be checked as there were not enough samples representing ETV/EVD performed, and majority (93.3%) were VPS. Conclusion: Through
{"title":"Acute Complications of Pre-Resection CSF Diversion in Posterior Fossa Tumors with Hydrocephalus","authors":"Kaleab Tesfaye Moges","doi":"10.58624/svoane.2023.04.093","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.093","url":null,"abstract":"Study background and significance: Posterior fossa tumors are a common pathology worldwide and often present with obstructive hydrocephalus. In the year 2021 CSF diversion for acute hydrocephalus from brain tumors was the most common performed emergency procedure in Tikur Anbessa hospital. It is a clinical dilemma choosing the mode of management for the hydrocephalus as it could be a lifesaving procedure but with a risk of unfortunate and devastating outcome. Objective: The aim of the study will be to evaluate the acute complications that occur with CSF diversion procedures that are done for obstructive hydrocephalus in the presence of posterior fossa mass before tumor resection. Method: It will be prospective observational study conducted at Tikur anbessa specialized hospital, which will be held from March 2021 up to October 2022. The research will involve all patients who have undergone CSF diversion procedure for obstructive hydrocephalus from posterior fossa tumors prior to tumor resection and patients will be followed for the first 48 hours post operatively. Patient’s presentation, nature of the posterior fossa tumor on imaging, post-operative clinical status and post op imaging will be taken to account. Result: In the study time frame of 18 months there were 89 patients who came with acute obstructive hydrocephalus from posterior fossa of which all underwent CSF diversion procedure before tumor resection. 52.8% were pediatrics and 47.2% where adults. The most common tumor location was vermian (31.5%) followed by cerebellar hemisphere (29.2%), 4th ventricular (25.8%) and the rest 9% account for cranial nerve and extra axial location. The largest tumor was 9.8cm but the median was 5.1cm. Based on the size they were categorized in to 3 groups, 71.9% were tumor size 4-6cm, 22.5% had a tumor size of >6cm and there were 5.6% with tumor size <4cm. Of the CSF diversion procedures performed 93.3% were VPS, EVD and ETV account for 3.4% each. All were followed for 48 hours post op and 8 patients had clinical deterioration after CSF diversion was done, and all patients with clinical deterioration underwent urgent non -contrast CT scan. They were found to have upward herniation, intra-tumoral bleeding, intraventricular hemorrhage or a combination of these findings. Of the 8 patients that deteriorated 5 died without successful resuscitation. The rest 3 improved and underwent definitive surgery. The risk for postoperative deterioration was 8.9% and 48-hour mortality was 5.6%. Variables were chosen to check association with the outcome (post-operative deterioration). Variables tested include age of the patient, tumor size and tumor location, all did not have statistically significant relationship with outcome (post-operative deterioration and 48-hour mortality). The association between the type of intervention and outcome could not be checked as there were not enough samples representing ETV/EVD performed, and majority (93.3%) were VPS. Conclusion: Through","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44788170","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 : 2023-05-05DOI: 10.58624/svoane.2023.04.092
Damian Lastra Copello
Objective: Oligodendrogliomas are intracranial tumors that represent between 5 to 25 % of gliomas in adults. This study reviews the results of treatment in patients with oligodendrogliomas treated at “Hermanos Ameijeiras” Hospital between January 2015 and December 2020. Methods: We made an observational, descriptive and retrospective study type cohort in a series of 31 patients with oligodendroglioma treated at “Hermanos Ameijeiras” Hospital. Results: Predominate male patients with ages between 41 to 60 years (55%), with clinical presentation of seizures in 71% and frontal location in 52%. Total surgical resection was performed in 84% of patient, which supported by adjunctive treatment, achieved total regression of disease in 71 % of patients and postoperative improvement in 100% of the patients according to the Karnofsky functional scale. Conclusions: Oligodendroglia tumors are gliomas with their own imaging, histological and genetic characteristics. Combination of the different therapeutic modalities has an important role in the control of the disease and its survival, associated with a better neurofunctional state of the patient in the pre-surgical and post-surgical period
{"title":"Tumors of Oligodendroglial Origin, Results of a Five-Year Study","authors":"Damian Lastra Copello","doi":"10.58624/svoane.2023.04.092","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.092","url":null,"abstract":"Objective: Oligodendrogliomas are intracranial tumors that represent between 5 to 25 % of gliomas in adults. This study reviews the results of treatment in patients with oligodendrogliomas treated at “Hermanos Ameijeiras” Hospital between January 2015 and December 2020. Methods: We made an observational, descriptive and retrospective study type cohort in a series of 31 patients with oligodendroglioma treated at “Hermanos Ameijeiras” Hospital. Results: Predominate male patients with ages between 41 to 60 years (55%), with clinical presentation of seizures in 71% and frontal location in 52%. Total surgical resection was performed in 84% of patient, which supported by adjunctive treatment, achieved total regression of disease in 71 % of patients and postoperative improvement in 100% of the patients according to the Karnofsky functional scale. Conclusions: Oligodendroglia tumors are gliomas with their own imaging, histological and genetic characteristics. Combination of the different therapeutic modalities has an important role in the control of the disease and its survival, associated with a better neurofunctional state of the patient in the pre-surgical and post-surgical period","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48468800","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 : 2023-05-05DOI: 10.58624/svoane.2023.04.091
Kaleab Tesfaye Moges
Ventriculoperitoneal shunts are one of the commonest surgical procedures performed in neurosurgery and the most commonly used method to treat hydrocephalus worldwide. The mechanical complication of shunt migration is a rare event roughly noted in 1 in 1000 patients who have undergone a shunt procedure. Ventriculo-peritoneal shunt migration to mouth, thorax, transdiaphragmatic, heart, pulmonary artery, breast, stomach, gallbladder, liver, small bowel, umbilicus, colon, inguinal hernia sac, bladder, vagina, anus, and scrotum have been reported in the literature.
{"title":"Distal Shunt Migration; A Case Series","authors":"Kaleab Tesfaye Moges","doi":"10.58624/svoane.2023.04.091","DOIUrl":"https://doi.org/10.58624/svoane.2023.04.091","url":null,"abstract":"Ventriculoperitoneal shunts are one of the commonest surgical procedures performed in neurosurgery and the most commonly used method to treat hydrocephalus worldwide. The mechanical complication of shunt migration is a rare event roughly noted in 1 in 1000 patients who have undergone a shunt procedure. Ventriculo-peritoneal shunt migration to mouth, thorax, transdiaphragmatic, heart, pulmonary artery, breast, stomach, gallbladder, liver, small bowel, umbilicus, colon, inguinal hernia sac, bladder, vagina, anus, and scrotum have been reported in the literature.","PeriodicalId":93502,"journal":{"name":"SVOA neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46584549","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 : 2023-05-02DOI: 10.58624/svoane.2023.04.089
Damian Lastra Copello
The case of a 13-month-old infant who was assisted at the Neurosurgery Service of the Antonio Maria Beguez Cesar South Children's Hospital in Santiago de Cuba, referred from the oncology service of the aforementioned institution for presenting proptosis, exophthalmos of the right eye, is described. and increased head circumference. After carrying out the clinical examination and the pertinent complementary studies, including magnetic resonance imaging of the simple and contrasted skull; Histopathological study, aspiration and bilateral bone marrow biopsy concluded that we are in the presence of parameningeal neuroblastoma with medullary infiltration (stage IV) without evidence of a primary tumor. Satisfactory post-treatment chemotherapy evolution.
本文描述了一名13个月大的婴儿的病例，他在古巴圣地亚哥Antonio Maria Beguez Cesar南儿童医院的神经外科服务部门得到协助，从上述机构的肿瘤服务部门转介，表现为右眼突出。头围增加。在进行了临床检查和相关的补充研究后，包括单纯颅骨和对比颅骨的磁共振成像;组织病理学研究、穿刺和双侧骨髓活检结果表明，我们发现了伴有髓质浸润的神经母细胞瘤(IV期)，没有原发肿瘤的证据。治疗后化疗进展满意。
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