Microvascular decompression (MVD) is a standard surgical procedure for treating vascular compression syndromes. There are two basic ways to perform MVD: interposition using a prosthesis and transposition. With the transposition technique, adhesions and granuloma around the decompression site are avoided, but the required operation is more complex than that for the interposition method. We describe a simple, quick MVD transposition procedure that uses a small "belt" cut from a sheet of 0.3-mm-thick expanded polytetrafluoroethylene membrane. The belt has a hole at the wide end and the other end tapered to a point. The belt is encircled around offending vessels by inserting the pointed end into the hole. The pointed end is then passed through a dural tunnel over the posterior wall of the petrous bone and is tied two or three times. This method avoids the risks involved in handling a surgical needle close to the cranial nerves and vessels.
A 22-year-old woman developed an unruptured fusiform aneurysm of the internal carotid artery 7 months after being diagnosed with Wagener's granulomatosis. Intracranial aneurysmal formation is an extremely rare complication of Wegener's granulomatosis. This rare case of intracranial aneurysm was treated by endovascular balloon occlusion.
IntroductionPituicytoma is a rare neoplasm of the neurohypophysis. To the best of our knowledge there have been no reports of pituicytoma in which long-term magnetic resonance imaging observation was performed. We calculated the doubling time of the tumor volume and described the growth pattern of a pituicytoma.Case presentationA 52-year-old Japanese man with a history of decreased libido was found to have a sellar and suprasellar mass. He underwent transsphenoidal surgery, but only a small specimen was obtained because of intraoperative bleeding. The tentative histological diagnosis was schwannoma. He noticed bitemporal hemianopsia 7 years later. A follow-up magnetic resonance imaging disclosed a tumor volume doubling time of 3830 days. Transcranial gross-total tumor resection was performed. The lesion consisted of elongated and plump tumor cells that were arranged in a fascicular or storiform pattern and were positive for S-100 protein and focally positive for glial fibrillary acidic protein. The final histological diagnosis was pituicytoma.ConclusionPituicytoma is a slow-growing tumor, but the growth rate may change during follow-up.
Idiopathic thrombocytopenic purpura(ITP) is the most common autoimmune disease in women of childbearing age group . Although maternal antiplatelet antibodies might cross the placenta, they usually do not cause severe bleeding disturbances in the fetus . Occurrence of fetal intracranial hemorrhage is extremely uncommon . We report acase of a fetus developed intracranial hemorrhage at 34 weeks of gestational age , possibly secondary to maternal ITP The hemorrhage was intra and periventricular , with the development of posthemorrhagic hydrocephalus . Cesarean section was performed at 35 weeks of gestation because of progression of hydrocephalus . In order to con − trol hydrocephalus , Ommaya ' s reservoir was placed in the right anterior horn three days after birth , considering the poor general condition of the infant girL Her level of consciousness suddenly decreased the f{) 110wing day. CT scan showed recurrence of intraventricular hemorrhage . She underwent platelet transfusion and repeated aspira − tion of bloody cerebrospinal fluid from the reservoir . F(〕 110wing this , her platelet count normalized gradually . Ven − triculoperitoneal shunt was carried out successfully 2 months after birth . Thereafter she did not experience any hemorrhagic episodes . The problem of ITP of the mother in relation to pregnancy and its effects on the fetus and the newborn infant are discussed in the present report , (
We report a case of infected subdural hematoma ISH. We followed up an 81 year old man with asymptomatic chronic subdural hematoma CSDH. After half a year, he came to our hospital because of reduced activities of daily living and a high fever. Although his inflammatory markers were high, various cultures and imaging studies yielded negative results. Right hemiparesis developed 5 days later. Burr hole surgery was performed to treat the CSDH. The hematoma proved to be mixed with pus, suggesting ISH. The ISH recurred twice despite antibiotic therapy and repeated irrigation. Finally, inflammatory parameters normalized and computed tomography disclosed an organized CSDH. ISH should be suspected in patients with CSDH presenting with high fever.
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