摘要:

THE TYPE II odontoid fracture, initially described by Anderson and D'Alonzo, is the most common axis fracture. Several factors that predict the need for operative intervention have been discussed in the literature; however, the initial treatment remains somewhat controversial. We present the case of a 20-year-old woman who suffered a Type II odontoid fracture during a skiing accident. She was managed initially with halo-vest immobilization, and after 12 weeks, bony fusion was documented by plain spine radiographs and tomography. Routine follow-up cervical spine films at 8 months after her injury revealed no union at the previous fracture site and resultant atlantoaxial instability. A posterior C1-C2 fusion was therefore performed, leading to a long-term solid bony fusion. There are no previous reports in the literature describing a nonunion after radiographically documented healing of a Type II odontoid fracture. We present this case in order to emphasize the importance of scheduled follow-up examinations, including cervical spine films, for at least 12 months after a documented fusion. Further reports of similar cases may generate a more thorough understanding of the pathogenesis of delayed nonunion and may elicit factors that will predict its development.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A CASE OF an abnormal loop of the extracranial vertebral artery enlarging the intervertebral foramen at C5-C6 and the transverse foramen at C5 is reported. This occurrence is rare and was associated with cervicobrachial neuralgia caused by neurovascular compression of the C6 root. The patient was cured by microvascular decompression.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 25-YEAR-OLD man presented with a suspected right-sided subdural hematoma after a skiing accident. A large hemorrhagic mass was found and was evacuated. Histological studies demonstrated a highly cellular neoplasm with extensive hemorrhage. Further histological, immunohistochemical (including staining for Ewing's sarcoma cell surface antigen), and ultrastructural analyses of the tumor were consistent with Ewing's sarcoma. Search for other foci of this neoplasm by bone scan, full body computed tomographic scans, magnetic resonance imaging scans of the spine, and a bone marrow aspiration with biopsy failed to detect any soft tissue or bony involvement outside the cranium. This case appears to represent the first report of a primary extraosseous Ewing's sarcoma occupying the cranial subdural area.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

EPITHELIOID HEMANGIOENDOTHELIOMA IS an unusual vascular neoplasm with prominent cytoplasmic vacuolization representing primitive lumen formation. A case is presented of this unique vascular neoplasm in a woman with a seizure disorder who had cardiac, hepatic, and recurrent nervous system lesions. To our knowledge, this is the third known case of intracranial epithelioid hemangioendothelioma. Emphasis is placed on the indolent course of this rare neoplasm, with a recommendation for aggressive surgical treatment and diligent follow-up.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

WE REPORT A patient with a systemic cytomegalovirus (CMV) infection, which occurred during postoperative chemoradiotherapy for a malignant astrocytoma. To our knowledge, there is no report that is especially focused on the association with a CMV infection. Interstitial pneumonia and gastrointestinal bleeding, which developed suddenly during postoperative chemoradiotherapy, resulted in the patient's death. A histopathological examination of the postmortem specimens revealed numerous “owl's eye” cells containing intranuclear inclusion bodies, which were identified as CMV by immunohistochemical examination and in situ hybridization. The premortem diagnosis of CMV infection is usually difficult, because an anti-CMV titer can be nonspecifically elevated. With immunohistochemical examination and in situ hybridization, CMV in excretory or biopsy specimens can be identified and the diagnosis of CMV infection can be established. When serious pneumonia or massive gastrointestinal bleeding occurs during postoperative chemoradiotherapy, the differential diagnosis should include the possibility of CMV infection and we recommend an immunohistochemical examination and in situ hybridization for the detection of CMV.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

THE AUTHORS HAVE reported a clinical trial of an autologous cervical sympathetic ganglion transplanted into the brain of a parkinsonian patient. A 45-year-old woman presented with bradykinesia and a gait disturbance for 8 years under L-dopa treatment. The patient underwent stereotactic transplantation of the right stellate ganglion into the right putamen. She showed marked amelioration of bradykinesia and gait disturbance 1 month after the operation, and she was able to conduct her activities of daily living without requiring L-dopa administration. The patient continued to improve gradually until 3 months after the operation. Two years after surgery, the patient functions independently as a housewife. The right hand tremor, however, became slightly worse after the operation, but it was transient. The patient developed a permanent right-sided Horner's syndrome after resection of the cervical sympathetic ganglion. Taken together with our previous data obtained from animal experiments, this case suggests that the autologous cervical sympathetic ganglion can be donor tissue for neural transplantation in Parkinson's disease.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

IT IS NECESSARY to pack the sella turcica to prevent the leakage of cerebrospinal fluid after transsphenoidal surgery if the arachnoid has been torn. The packing is usually supported by nasal cartilage. If this is not available, we recommend the Synthes minifragment plate to support the intradural pack.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

THIS TECHNICAL NOTE presents a retractor based on interchangeable blades–a totally different concept in retractors. With this retractor, there is less traction on the structures, more stability, and excellent visibility of the surgical field because only a minimal incision is needed.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

THE ELECTROMAGNETIC FIELD focusing (EFF) surgical instrument creates an oscillating electromagnetic field that induces eddy currents in the tissue, which converge at the point of contact. This energy creates a focal spark capable of vaporizing tissue. The EFF instrument was used to resect 17 meningiomas in 14 patients. The effectiveness of the EFF probe in resecting tumor tissue was compared with that of the Cavetron ultrasonic surgical aspirator (Model 100) in 11 patients. The EFF system was superior to the Cavetron ultrasonic surgical aspirator in tumor excision in all but two cases, in which the EFF grounding tip was poorly tuned. Surgical time and blood loss were reduced by subjective analysis in all but these two cases, especially in the rubbery or calcified meningiomas resistant to aspiration. No complications were directly attributable to use of the EFF. Drawbacks encountered with the EFF system include buildup of “char” on the tip, requiring scraping, and intense heat at the tip, which occasionally melted the insulating sheath, requiring replacement.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID