Acute epidural haematomas (AEDH) are quite rare entity in geriatric age group as the dura adheres firmly to the inner table of the cranial bone. Falls due to the accompanying diseases are the main cause of traumatic brain injuries (TBIs) in older adults. Traffic accidents and assaults are the other causes. Presentation may range widely from normal mental status to severe intracerebral injury in the elderly although acute deterioration may occur in previously conscious patients. There are only a few studies in the literature concerning acute epidural haematomas in geriatric age group. In our study we reviewed 106 adult patients who were operated in Ondokuz Mayıs University School of Medicine at Department of Neurosurgery due to the AEDH between the years of 2005-2009. As there is only one patient at the geriatric age in this group ,we considered to present it as a case report reviewing the literature.
Previously, some different techniques had been presented in terms of precise dissection and separation of tumors from surrounding brain. Purpose of this study was to describe the effect of vibration in the surgical dissection and separation of malignant brain tumors. We recently developed an instrument for micro-dissection and separation of brain lesions from brain tissue. This instrument was produced by a medical instrument producing factory in Samsun. This instrument has the capability of producing mechanical vibration. The holding and using of this instrument was described. In this study, we used this instrument in four high grade glial tumors for dissection and separation of these lesions from surrounding brain tissue. Dissection and separation were graded as poor, moderate and good. Vibrato-dissection technique was superior to those of conventional technique in the aspect of dissection and separation of brain tissue. The capability of dissection and separation with this instrument during surgical treatment of brain tumors may enhance dissection and separation of lesions.
Three-years-old-boy with a history of ventriculo-peritoneal shunt placement was admitted to our neurosurgery department with headache, vomiting and sunset eye phenomena. Direct X-ray examination of the shunt system was completely normal. The palpation of the shunt dome resulted the unfilling of pumping device. Computerised Tomography (CT) of the head revealed ventricular enlargement and periventricular oedema. The patient was hospitalised for shunt revision. The symptoms were spontaneously disappeared within 48 hours. The pumping device returned to normal refilling. Follow up CT showed small ventricular size and shape. This case indicates that the symptomatic intermittent occlusion of the proximal shunt catheter can be seen in the paediatric age group and the obstruction may continue for a certain period and spontaneously return to normal function with correlated clinical response.
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