Patient: Male, 56Final Diagnosis: Spindle cell oncocytoma of the adenohypophysisSymptoms: Disturbed conscious level • visual disturbancesMedication: —Clinical Procedure: Urgent craniotomySpecialty: NeurosurgeryObjective:Rare diseaseBackground:Spindle cell oncocytoma (SCO) is a rare nonfunctioning neoplasm of the adenohypophysis, and was first described in 2002. SCO has been categorized as a separate entity by the 2007 World Health Organization (WHO) and is classified as a Grade 1 tumor of the central nervous system (CNS). Review of the literature has shown that 33 cases of SCO have been reported to date, and most of them presented with a mass effect or with panhypopituitarism. However, all reported cases have described the tendency of SCO to be hypervascular on imaging and histology. We detail the first reported case of SCO to present with acute symptoms (pituitary apoplexy) and intraventricular hemorrhage, and review the literature on SCO.Case Report:We report the case of 56-year-old man who presented suddenly with a severe headache and an altered level of consciousness. Brain magnetic resonance imaging (MRI) showed a suprasellar mass with hemorrhagic areas within the tumor and bleeding into the lateral ventricle with chiasmal and hypothalamic compression. The patient underwent urgent craniotomy, tumor resection and placement of an external ventricular drain (EVD). Histology and immunohistochemistry supported a diagnosis of SCO.Conclusions:SCO of the adenohypophysis should be considered in patients who present suddenly with symptoms of pituitary apoplexy and intraventricular hemorrhage which may worsen the prognosis.
Background: Thoracolumbar spine fractures (traumatic & pathological) is a common vertebral pathology we face in our clinical practice. Neurological affection may occur with spinal cord compression. Both anterolateral and posterior approaches have been used to treat the condition. The ideal approach however is still not agreed on particularly when there is neurological affection due to spinal cord compression.
Aim of Study:To compare the result of anterolateral versus posterior approach in decompression and stabilization of spine.
Arachnoid cyst can be defined as cerebral-spinal fluid entrapment within the central nervous system. It may occur primarily as a congenital malformation or secondary as a complication following trauma, infection, bleeding, or surgical manipulation. Congenital arachnoid cyst usually asymptomatic and cause no pressure symptoms. No treatment is needed unless size increase and cause pressure symptoms and increased intracranial pressure. We report a case presented to the hospital with neurological signs of increased intracranial pressure, 3 years Post aborted craniotomy for meningioma resection. Radiological imaging showed postoperative newly developed arachnoid cyst with mass effect. He underwent the urgent cerebral spinal fluid diversionary procedure with cystoperitoneal shunt.
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