Granular cell tumors (GCTs) in the spine are uncommon. They are mostly located in the intradural extramedullary space and rarely, in an intramedullary (IM) location. Complete resection is the treatment of choice. Recurrences are rare in intradural-intramedullary (IDEM) GCTs. Recurrent and incompletely excised cases are subjected to adjuvant radiation therapy. We report such a recurrence in a 13-year-old girl who was re-operated and subjected to radiotherapy.
Herpes Simplex Encephalitis is the commonest form of sporadic encephalitis. Availability of effective antiviral therapy viz Acyclovir has significantly reduced the mortality of Herpes Simplex Encephalitis. Elevated intracranial pressure resulting in herniation syndromes continues to be an important cause of mortality. Antiviral therapy and medical measures for managing raised intracranial pressure including osmotic diuretics, careful usage of steroids and controlled hyperventilation continue to be the cornerstones in management of these patients. Authors present a 38-year-old male patient with Cerebrospinal fluid Meningo-encephalitic panel positivity for herpes simplex virus 1 and bilateral temporal lobe lesions with secondary decline due to impending herniation syndrome despite osmotic diuretics and steroids with patient survival and complete recovery following decompressive hemicraniectomy.
Solitary fibrous tumor (SFT) is a spindle cell lesion, classified under mesothelial tumors. Involvement of the nasal cavity, paranasal sinuses, and nasopharynx is rare. We present an extremely rare case of SFT of nasal origin eroding the anterior skull base. Complete local excision is the treatment of choice in the head and neck SFT, and we successfully excised the tumor by endoscopic approach only. The patient followed an uneventful course without any evidence of recurrence on 8-months follow-up.
Fronto-temporal lobectomy for refractory intracranial hypertension following an acute arterial ischemic stroke in a child is rarely performed following failed conventional measures including decompressive craniectomy. We present a case of a 10-year-old child who presented with acute ischemic stroke with intractable cerebral edema and failed conventional measures including decompressive craniectomy and had significant neurological recovery following frontotemporal lobectomy.
Pesudotumor cerebri is a syndrome which causes intracranial hypertension with no associated mass lesion. It is managed both medically as well as surgically. Cerebral spinal fluid diversion using theco-peritoneal shunt is commonly performed to decrease intracranial tension. We present a case of a middle age lady who had severe low pressure headaches following theco-peritoneal shunt for pesudotumor cerebri. She was managed by attaching pressure gradient chamber to the pre-existing theco-peritoneal shunt. Patient had marked improvement in headache, which gradually subsided. Attaching pressure gradient chamber to the pre-existing theco-peritoneal shunt helps to improve low pressures headaches in pseudotumor cerebri. It is an alternative procedure considering other extensive surgical options.
Background: Although rare, mobile schwannomas have been observed at various vertebral levels. Most of them have been reported within the lumbar spine or thoracic spine. We report a rare case of mobile schwannoma of high cervical spine and only two cases of such in cervical spine have been reported in literature. Case description: We report case of young lady with high cervical spine schwannoma (C3-C4) on preoperative MRI imaging. Intra-operatively to our surprise we could not find the tumor at C3-4 and had migrated cranially upto C2-3. Partial C2 laminectomy was done to excise the tumour completely. She recovered with no deficit. Conclusion: Mobile cervical tumors are a rare entity. There are many predisposing factors for tumours to migrate. In our case we presume that prone positing along with slight flexion may have caused the tumour to migrate cranially. One should always be prepared for negative exploration.
A prospective comparative cohort analysis of adverse events following
spine surgery in patients above 60 years of age in comparison with
those under 60 years old using Spinal Adverse Events Severity System,
version 2 , SAVES V2 in a tertiary care centre in Indian scenario
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