1,721,036 research outputs found
Pericranial flap fixation using titanium miniplates and screws
No full textOpening the frontal sinuses is a common occurrence during neurosurgical procedures involving the anterior cranial base. Obliteration of the exposed sinuses is usually accomplished packing them with various materials and/or covering them with an anteriorly-based pericranial flap. In the absence of more extensive cranial base defects, the flap only needs to be wrapped around the sinus and secured against its posterior wall. We describe the technique for and the results of using titanium miniplates and screws to secure the pericranial flap to the inner surface of the frontal bone. In 10 patients treated with this alternative technique, the pericranial flap provided an excellent separation between the sinuses and the intradural compartment. No cases of cerebrospinal fluid leakage or infections were observed
The Decision-Making Process in Traumatic Lesions of the Craniovertebral Junction: An Evidence-Based Approach? Part II.
No full textThis paper is Part II of a two-part report. Part I of the report covered atlanto-occipital dislocation or dissociation, and isolated condylar fractures. This part of the report covers isolated and combination fractures of the atlas and axis
Posterolateral decompression and stabilization of thoracolumbar injuries using diapason instrumentation
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Nontraumatic acute spinal subdural hematoma. Report of five cases and review of the literature
No full textGas-containing otogenic brain abscess
No full textBACKROUND: Gas-containing brain abscesses are very rare. Two mechanisms may be responsible for the presence of intracavitary gas: bacterial fermentation or penetration through an abnormal communication between the exterior and the intracranium. The need to search for this potential communication is considered an indication for open surgery. We report the case of a surgically treated gas-containing brain abscess originating from an undiagnosed chronic otitis media. CASE DESCRIPTION: A 54-year-old man developed acute neurologic deterioration, becoming comatose within 24 hours. A contrast-enhanced computed tomography (CT) scan disclosed a gas-containing cystic mass in the right temporal lobe. Urgent surgical decompression revealed the presence of an abscess, which was excised. During the same surgery, we performed a radical mastoidectomy, removing a previously undiagnosed attic cholesteatoma. Neither procedure revealed a discontinuity of the floor of the middle cranial fossa. Cultures grew a mixed flora. Antibiotics were administered for 6 weeks. The patient made a complete neurologic recovery. CONCLUSION: This report demonstrates that otogenic brain abscesses may contain gas due to fermentation of nonclostridial bacteria. © 2002 by Elsevier Science Inc.
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Extracranial aneurysms of the posterior inferior cerebellar artery. Literature review and report of a new case
No full textAneurysms arising from the extracranial portion of the posterior-inferior cerebellar artery (PICA) are considered extremely rare. To date, only ten cases have been reported in the literature. The authors report a case of a 29 year-old male patient admitted comatose in Hunt-Hess grade IV because of an subarachnoid haemorrhage predominantly involving the left cranio-vertebral junction up to C2 rather than the posterior fossa and the fourth ventricle. Angiography showed an extracranial aneurysm at left vertebral artery-PICA junction a few millimetres superior to the dural entry point of the vertebral artery (VA). A left extreme-lateral approach was performed and the aneurysm was successfully clipped. On first year follow-up the patient had completely recovered with no neurological deficits. This paper analyzes the literature review about these rare aneurysms and the technical notes regarding the cranio-vertebral junction approach to these lesions. Factors affecting the neurological outcome of these aneurysms are also reported
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