As conclusions; in NM, Gram-negative pathogens were seen more frequently; A.baumanni was the predominant pathogen; and NM caused by Gram negatives had worse clinical and laboratory characteristic and prognostic outcome than Gram positives.
Although vertebroplasty is assumed to be contraindicated in osteoporotic thoracolumbar fractures with posterior body involved, we successfully used this procedure to safely treat such fractures without introducing neurological deficits. Percutaneous vertebroplasty may be an alternative method of treating thoracolumbar burst fractures that avoids the complications of major surgical procedures and achieves early mobilization and pain relief.
A 47-year-old woman was admitted with complaints of progressive weakness in the lower extremities and pain in the back and left leg. Thoracic magnetic resonance imaging (MRI) revealed a spinal intramedullary tumor between the T9 and L1 levels, which were iso- to hypointense on T2 and slightly hyperintense on T1-weighted images. The tumor was resected as total, and the diagnosis was malignant melanoma confirmed with histopathology. Neurological findings improved at the postoperative period and no residual or recurrence was noted on postoperative MRI at the 9-month follow-up. Primary melanoma of the spinal cord, particularly intramedullar localization, is seldomly reported in the literature. We report a primary malignant melanoma of the spinal cord and emphasize the diagnostic and prognostic challenges.
Giant cell tumors (GCTs) are extremely rare lesions, representing less than 5% of all bone tumors. They primarily occur in the long bones. However, a small percentage of these tumors occur in the pelvis, spine, or skull bones. These lesions are usually benign as well as locally aggressive and require complete removal. Nowadays, GCT and other skull base lesions can be treated using the extended endoscopic endonasal approach. We present a case report of a GCT located in the skull base, originating from the clivus and sphenoid bone, invading through the cavernous sinus, and treated using the fully endoscopic endonasal approach.
Anterior communicating artery (AcoA) aneurysm is the most common form of intracranial aneurysm. It occurs rarely together with other intracranial lesion. Today, microsurgical techniques and endovascular methods are used in the treatment of these aneurysms. Endoscopic endonasal approach is a useful technique for midline lesions of the skull base and is underpinned with extensive experience. In this article, we present a 72-year-old female patient who underwent endoscopic endonasal transplanum-transtubercular surgery for tuberculum sellae meningioma followed by clipping of the incidental AcoA aneurysm. After complete removal of a tuberculum sellae meningioma via an endoscopic endonasal approach, an anterior and superior projected saccular AcoA aneurysm in the gyrus rectus area was totally clipped successfully via pure endoscopic endonasal transplanum-transtubercular approach, without any damage to parent arteries. The patient was discharged from the hospital within a short period of time without any postoperative complication. Endoscopic endonasal approach is a new paradigm in the treatment of aneurysm. Although this technique cannot be routinely used due to lack of experience, it is an effective and safe method in selected and anatomically appropriate cases. We believe that increased knowledge and experience will create successful results in this approach, and it can offer an alternative method for selected aneurysm cases.
Cavernous malformations (CMs) of the central nervous system are benign, angiographically occult vascular lesions and are diagnosed by magnetic resonance imaging techniques. Giant CMs do not differ from smaller-sized CMs in their clinical, surgical or histopathological presentation but may be radiologically different. In this paper, we report a 10-year-old male with a giant CM of 8 × 7.5 × 7 cm in diameter that was completely removed by microsurgical treatment. This case addresses important points for practicing neurosurgeons to consider when making a differential diagnosis of large intracranial mass lesions in pediatric patients. In this report, the radiological features of this vascular malformation are described based on a pertinent literature review.
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