1,720,967 research outputs found
Pleomorphic rhabdomyosarcoma of the cerebellopontine angle in an adult: a review of literature.
No full textRhabdomyosarcoma (RMS) is a rare and aggressive neoplasm characterised by rapid growth and metastatic invasion. The most frequent localisation is the skeletal musculature of the limbs. The head and the neck are rarely involved. A 50-year-old woman presented to our attention because of a progressively increasing headache, ataxia and vomiting. MRI showed a lesion at the right cerebellopontine angle. Thereafter, the patient was submitted to a piece-meal removal of the neoplasm. Despite the postoperative MRI showed no signs of remnant, 7 months after the surgery, the disease recurred with multiple localisations, and the patient died a few days later. This report is the first description in the literature of a pleomorphic RMS of the cerebellopontine angle. This particular tumour carries a bad prognosis because of the vicinity of nervous structures and of the impossibility of achieving a one-piece resection. More than ever, the adjunctive treatments had to be effective against a potential remnant and in controlling recurrences.©2014 BMJ Publishing Group. All rights reserved
Epidural hematoma with detachment of the dural sinuses
No full textEpidural hematoma (EH) is a neurosurgical emergency that requires early surgical treatment. It is rarely extended bilaterally causing a detachment of the dural sinus or sinuses. The authors present two rare cases of EH with dural sinus detachment and describe how they suspend them. In these cases it is crucial to firmly suspend the dura mater and the dural sinus to the inner skull surface to prevent postoperative rebleeding
Historical Landmarks in the Management of Aneurysms and Arteriovenous Malformations of the Central Nervous System
No full textDelayed intraparenchymal hematoma following diagnostic lumbar puncture
No full textLumbar puncture is a safe and commonly performed procedure, with an overall complication rate of 0.1% to 0.5%. Well-known contraindications to lumbar puncture are an intracranial tumor, noncommunicating hydrocephalus, coagulopathy, and ruptured aneurysm with subarachnoid hemorrhage. We report a case of a young man with epilepsy who, after a lumbar puncture performed for research purposes, presented with an intracerebral hematoma and neurological deficits. To the best of our knowledge, post-tap intraparenchymal hematoma is extremely rare and only 1 case has been reported previously. In consideration, all patients undergoing a lumbar puncture should be informed about this possible rare complication, even in the absence of documented hemorrhagic risk factors
Posterior Cervical Transfacet Fusion with Facetal Spacer for the Treatment of Single-Level Cervical Radiculopathy: A Randomized, Controlled Prospective Study
No full textEndoscopic interlaminar approach for intracanal L5-S1 disc herniation: Classification of disc prolapse in relation to learning curve and surgical outcome
No full textChordoid meningioma: a retrospective series of seven consecutive cases
No full textChordoid meningioma is a rare variant of meningioma characterized by a more aggressive behavior. The present study documents the histological, radiological and clinical features of seven cases treated at the Policlinico Umberto I of Rome from 1999 to 2010. There were five males and two females. Most of the cases were located in the supratentorial space, especially the convexity. Surgical gross total resection was achieved in four cases. Of the remaining three cases, two relapsed and underwent further surgeries and adjuvant treatment. The MIB-1 index had a mean value of 7.5 (range 0.3-25.8). Tumors were composed of epithelioid cells or plump to spindle cells, forming cords, cribriforms or nests, in a mucoid matrix. All tumors showed diffuse positive immunoreactivity to vimentin and epithelial membrane antigen. Surgery is the first line of treatment for this kind of lesion. Gross total resection guaranteed a survival free from recurrences in our series. On the other hand, radiation therapy must be considered in patients submitted to a subtotal resection
Valutazione del Ki-67LI nel follow-up di adenomi ipofisari: quale cut-off? l'esperienza del nostro centro
No full textFull endoscopic transforaminal endoscopic approach for symptomatic lumbar disc herniation, our experience
No full textLumbar Endoscopic Microdiscectomy: Where Are We Now? An Updated Literature Review Focused on Clinical Outcome, Complications, and Rate of Recurrence
Full text linkEndoscopic disc surgery (EDS) for lumbar spine disc herniation is a well-known but developing field, which is increasingly spreading in the last few years. Rate of recurrence/residual, complications, and outcomes, in comparison with standard microdiscectomy (MD), is still debated and need further data. We performed an extensive review based on the last 6 years of surgical series, systematic reviews, and meta-analyses reported in international, English-written literature. Articles regarding patients treated through endoscopic transforaminal or interlaminar approaches for microdiscectomy (MD) were included in the present review. Papers focused on endoscopic surgery for other spinal diseases were not included. From July 2009 to July 2015, we identified 51 surgical series, 5 systematic reviews, and one meta-analysis reported. In lumbar EDS, rate of complications, length of hospital staying, return to daily activities, and overall patients' satisfaction seem comparable to standard MD. Rate of recurrence/residual seems higher in EDS, although data are nonhomogeneous among different series. Surgical indication and experience of the performing surgeon are crucial factors affecting the outcome. There is growing but still weak evidence that lumbar EDS is a valid and safe alternative to standard open microdiscectomy. Statistically reliable data obtained from randomized controlled trials (better if multicentric) are desirable to further confirm these results.</p
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