Intracranial dermoids are rare congenital tumors. Supratentorial dermoid cysts were more frequently reported in the last decade, and they are known to have a predilection for the cavernous sinus. Interdurally localized dermoids presenting with ophthalmoplegia is uncommon. Previously, the association of dermoid lesions with the cavernous sinus and the complexity of the operative procedure were emphasized only by a few authors. We report a case of a dermoid cyst that was embedded fully in the cavernous sinus and review the related cavernous dermoid lesions in the literature. Fronto-orbitozygomatic craniotomy was performed, and despite adherence of the tough capsule to the cranial nerves, the lesion was grossly removed in total. The patient was doing well 1 year after the operation, and there was no recurrence of signs and symptoms. Interdural growth of cavernous dermoid tumors must be considered, and careful evaluation of preoperative computed tomography and magnetic resonance images aids in making the decision concerning the operative approach. Upon review of the literature, we detected only eight similar cases concerning cavernous dermoid cysts. Although total excision of these cavernous lesions has been reported previously, we believe that total excision can sometimes be hazardous and not feasible.
Although intervertebral disc degeneration usually occurs in the natural course of alkaptonuria, detection of the disease by black disc material in a patient without any other sign of alkaptonuria is an extremely rare condition. The authors report a 45-year-old previously healthy female patient who was operated on for prolapsed lumbar disc herniation, and in whom the nucleus pulposus was discovered to be black intraoperatively. The alkaptonuria was diagnosed after histopathological examination of the black disc material. Elevated urinary concentration of homogentisic acid confirmed the diagnosis.
The results suggested the neuroprotective properties of both agents, emphasizing more potent protection against ischemia by CsA. It was proposed that CsA could have exerted this effect with the blockage of mitochondrial permeability transition (MPT) pores, which are also critical if the necrotic and apoptotic cascades of the cell are considered. MP is judged to be neuroprotective, particularly in terms of its effects on lipid peroxidation. In conclusion, CsA and MP are ascertained to be neuroprotective agents as long as they cross the blood-brain barrier.
A rare neurovascular complication of a antebrachial arteriovenous fistula in a chronic hemodialysis patient is reported. A large brachial venous pseudoaneurysm caused median neuralgia by direct compression of the nerve. Surgical resection of the pseudoaneurysm resulted in complete relief of neuralgia.
Although spinal osteochondromas can cause various clinical signs, the spinal cord or nerve root compression by solitary lumbar osteochondromas are rare clinical entities. We present a 62-year-old female patient with lower-back pain, progressive left leg paresis, numbness on the both lower extremities and urinary incontinence. The patient's clinical picture made us suspect the possibility of cauda equina syndrome. Radiological examination revealed a lesion originating from the left inferior articular facet of the second lumbar vertebrae. Urgent surgical decompression was performed and the lesion was removed totally. Histopathological examination confirmed the diagnosis of benign osteochondroma.
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