Magnetic resonance imaging artifact following acoustic neurofibroma surgery--case report.
(33/730)
Metallic artifacts in magnetic resonance (MR) imaging occur mostly in patients who have received an implant at surgery. Similar artifacts are now increasingly recognized in patients in whom high-speed drills have been used. A 15-year-old male with neurofibromatosis 2 had undergone excision of acoustic neurofibroma on the left 1.5 years prior to the present admission. MR imaging to evaluate the acoustic neurofibroma on the right showed a metallic artifact at the site of the previous surgery. Computed tomography did not show any evidence of metal debris. The artifact was probably caused by metallic dust or debris from a high-speed drill during the first surgery. We suggest that care should be taken to prevent deposition of such debris in the operative field to prevent this complication. (+info)
Extensive intracranial xanthoma associated with type II hyperlipidemia.
(34/730)
Xanthomas are associated with a spectrum of medical conditions, most commonly disorders of lipid storage and lipid metabolism. They occur primarily in the subcutaneous tissues, especially along the Achilles tendon and the extensor tendons of the hands. Intracranial xanthomas are extremely rare. We present a case of an extensive xanthoma of the temporal bone in a patient with hyperlipidemia. (+info)
Migration of craniotomy flap: an unusual complication.
(35/730)
An unusual complication following a craniotomy is reported. The free bone flap migrated over the adjacent bone four weeks following surgery and needed operative readjustment. The probable causes for such a complication are analysed and discussed. (+info)
A regional survey of emergency surgery: the trainees' perspective.
(36/730)
The reduction of junior doctors' hours and the 'Calmanisation' of higher surgical trainees have led to an inevitable decrease in clinical experience. The development of subspecialisation within general surgery limits the diversity of elective operative experience, while the resident surgical registrar continues to be faced by the same range of emergencies. Procedures such as tracheostomy, thoracotomy and emergency burr hole, although rare in an emergency setting, are seldom seen by surgical trainees outside ENT, cardiothoracic and neurosurgical departments, respectively. However, these life saving procedures continue to be within the remit of the general surgeon, and were considered as essential knowledge in the operative viva of the FRCS examination. (+info)
The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have been excellent. (+info)
Treatment of bacterial brain abscess by repeated aspiration--follow up by serial computed tomography.
(38/730)
Bacterial brain abscess often requires repeated aspiration before the abscess finally resolves. However, there are no guidelines for treatment by aspiration; for example, when should the abscess be tapped again, or when can an abscess be treated by antibiotics alone without further aspiration. Eleven patients with bacterial brain abscess treated by aspiration were evaluated to establish treatment guidelines for brain abscess, in particular the abscess size on serial computed tomography (CT) after aspiration. CT was performed about 24 hours after aspiration to evaluate the size of the abscess, and almost weekly during follow up. The diameter of the brain abscess before and after the initial and last aspirations were reviewed. In eight of the 11 patients, abscesses were aspirated repeatedly: two to three times in most patients. The diameter of the abscesses was 2.5-4.5 cm (mean 3.5 cm) before the last aspiration, and 1.4-3.4 cm (mean 2.3 cm) after the last aspiration, or when continuous drainage was discontinued. Perifocal edema was moderately decreased within 3 weeks after the last aspiration by medical treatment alone, with a concomitant decrease in the volume of the abscess. There were no deaths, and most patients had a favorable outcome. These results suggest that after the diameter of the abscess becomes less than 2 to 3 cm and does not increase anymore on serial CT, medical treatment alone can be anticipated to give satisfactory results without further aspiration. (+info)
Complications associated with intraarterial administration of papaverine for vasospasm following subarachnoid hemorrhage--two case reports.
(39/730)
Complications associated with intraarterial papaverine infusion occurred in two patients treated for vasospasm due to subarachnoid hemorrhage (SAH). A 42-year-old male with an anterior communicating artery aneurysm underwent craniotomy and aneurysm clipping. Five days after the SAH occurred, angiography demonstrated moderate vasospasm in spite of hypervolemic-hypertensive therapy. During papaverine infusion into the carotid artery, he suffered loss of consciousness due to a seizure for a few minutes. A 61-year-old female with a right internal carotid-posterior communicating artery aneurysm underwent clipping. Six days after the SAH occurred, angiography demonstrated severe vasospasm in spite of hypervolemic-hypertensive therapy. Angiography performed immediately after papaverine infusion into the carotid artery revealed exacerbation of the vasospasm. Finally she suffered cerebral infarction and died. Complications of intraarterial papaverine infusion are potentially dangerous. We recommend trial administration of papaverine with angiography and neurological examination before full dose infusion to avoid complications. (+info)
Malignant schwannoma metastasizing to the parenchyma of the brain--case report.
(40/730)
A 48-year-old male presented with a very rare case of malignant schwannoma metastasizing to the parenchyma of the brain. He had undergone previous radical surgical resection of an abdominal wall tumor that was histologically confirmed as a malignant schwannoma. Five years later, the patient presented with metastases to the parenchyma of the brain and lung. A large mass at the left frontoparietal region was totally resected immediately after intratumoral hemorrhage. He recovered well and the lung metastasis was also removed, but he later developed further multiple metastases in the lung and brain. (+info)