Search

Congenital hydrocephalus is an etiologically diverse disorder, including infectious, teratogenic, and genetic factors as the underlying mechanism. Information regarding the occurrence of hydrocephalus in twins is especially important in establishing the significance of environmental factors as well as the genetic basis. This paper reports a pair of monozygotic twins, both presenting with hydrocephalus, but one with triventricular and the other with tetraventricular hydrocephalus.

Objective: Arachnoid cysts (ACs) of the craniocervical junction are extremely rare entities. This report describes a craniocervical Junction AC with unusual clinical course at an unusual anatomical location. Methods: A 21-year-old man was admitted to our clinic after a craniospinal trauma. Examination was unremarkable. Computed tomography scans demonstrated mild to moderately enlarged third and the lateral ventricles, but the fourth ventricle was typically normal. Neuroimaging studies obtained after the onset of clinical symptoms revealed marked enlargement of the ventricular system and a new cyst formation at the CI-2 level which was absent before. He underwent suboccipital craniectomy and C1-2 laminectomies. The cyst was fenestrated into subarachnoid space. Results: He made a good recovery. The histopathological diagnosis was confirmed as AC. Conclusion: Due to rarity of this clinical entity, we urge readers to keep in mind the possibility of the development of this kind of AC with unusual clinical course. [ABSTRACT FROM AUTHOR]

Objective: We present a unique case of a saccular aneurysm originating from the distal end of the right frontopolar artery (FPA). Methods: This previously healthy, 54-year-old man had sustained a mild head trauma. On admission, he was lethargic, but his neurological examination results were otherwise normal. Neuroradiological studies (including brain computed tomography, magnetic resonance imaging, and cerebral angiography) demonstrated a distal-end aneurysm of the right FPA. The aneurysm was clipped and resected via a right frontal craniotomy. Results; The postoperative course was uneventful. Pathological examination of the resected specimen confirmed rupture of the wall of a true aneurysm. The patient's medical history was also negative for trauma in the past, previous neurological disease, and vascular collagen disorders. Routine angiography performed 30 days postoperatively demonstrated complete occlusion of the right FPA. The patient was free of focal neurological deficits. Conclusion: This case demonstrates that not all distally located aneurysms are necessarily mycotic or traumatic. [ABSTRACT FROM AUTHOR]

Objective: Arachnoid cysts (ACs) of the craniocervical junction are extremely rare entities. This report describes a craniocervical junction AC with unusual clinical course at an unusual anatomical location.Methods: A 21-year-old man was admitted to our clinic after a craniospinal trauma. Examination was unremarkable. Computed tomography scans demonstrated mild to moderately enlarged third and the lateral ventricles, but the fourth ventricle was typically normal. Neuroimaging studies obtained after the onset of clinical symptoms revealed marked enlargement of the ventricular system and a new cyst formation at the C1-2 level which was absent before. He underwent suboccipital craniectomy and C1-2 laminectomies. The cyst was fenestrated into subarachnoid space.Results: He made a good recovery. The histopathological diagnosis was confirmed as AC.Conclusion: Due to rarity of this clinical entity, we urge readers to keep in mind the possibility of the development of this kind of AC with unusual clinical course. [ABSTRACT FROM AUTHOR]

Objective: We present a unique case of a saccular aneurysm originating from the distal end of the right frontopolar artery (FPA).Methods: This previously healthy, 54-year-old man had sustained a mild head trauma. On admission, he was lethargic, but his neurological examination results were otherwise normal. Neuroradiological studies (including brain computed tomography, magnetic resonance imaging, and cerebral angiography) demonstrated a distal-end aneurysm of the right FPA. The aneurysm was clipped and resected via a right frontal craniotomy.Results: The postoperative course was uneventful. Pathological examination of the resected specimen confirmed rupture of the wall of a true aneurysm. The patient's medical history was also negative for trauma in the past, previous neurological disease, and vascular collagen disorders. Routine angiography performed 30 days postoperatively demonstrated complete occlusion of the right FPA. The patient was free of focal neurological deficits.Conclusion: This case demonstrates that not all distally located aneurysms are necessarily mycotic or traumatic. [ABSTRACT FROM AUTHOR]

Aim: Anterior cervical fusion procedures are among the most commonly performed spinal operations. Investigators have reported pseudoarthrosis rates ranging from 3 to 36% following anterior cervical fusion operations. The diagnosis of pseudoarthrosis has been based on the triad of pain, radiographic evidence of instability, and loss of correction or fixation. Scintigraphic imaging may be involved in pseudoarthrosis investigation by increase of nuclear agent uptake at the operated level but today it is not used in clinical practice as a routine imaging modality., Material and Methods: Nine cases operated for degenerative disc disease on single level but suffering postoperative prolonged neck pain were involved in the study. All cases underwent 99mTc-hydroxymethylene diphosphonate (HMDP) bone SPECT later than postoperative twelfth month., Results: Results showed a correlation between severity of neck pain and fusion status., Conclusion: Increased and prolonged uptake of nuclear agent should cause a suspicion on so-called fusion, proven by radiology.

Aim: Intracranial hypodense lesions include a wide group of pathologies with different structures and characters. Although the radiological imaging properties of these neoplastic and non-neoplastic lesions are similar, treatment modalities for each lesion differs due to histopathological structure., Material and Methods: In this study we have compared the results of radiological and scintigraphic evaluations with the results of stereotaxic biopsies to figure out the diagnostic impact of these non-inasive modalities. 16 patients who admitted to outpatient clinics with headache and/or seizure complaints were included in the study., Results: MR spectroscopic images diagnosed the lesions as accurately as stereotaxic biopsies., Conclusion: Although stereotaxic biopsy keeps the label of "gold standard" when establishing a diagnosis for these lesions, modern radiological modalities are quite reliable.

Objective: Despite advances in surgical techniques in the management of the brain abscess, long-term antibiotics are as crucial to cure as the initial surgical procedure itself. This study was designed to evaluate the effect of adjuvant hyperbaric oxygen (HBO) therapy on the duration of antibiotic treatment., Methods: Between 1999 and 2004, 13 patients with bacterial brain abscesses treated with stereotactic aspiration combined with HBO and systemic antibiotic therapy. Patients younger than 18 years of age were excluded from this study. Postoperatively, all patients were given a 4-week course of intravenous antibiotics. Additionally, patients received hyperbaric oxygen (HBO, 100% O2 at 2.5 ATA for 60 min) twice daily for five consecutive days, and an additional treatment (100% O2 at 2.5 ATA for 60 min daily) was given for 25 days., Results: There were eight male and five female patients. Their ages ranged between 18 and 71 years, with a mean of 43.9 years. The average duration of follow-up was 9.5 months (range, 8-13 mo). This treatment modality allowed infection control and healing for all 13 patients with 0% recurrence rate. HBO treatment was tolerated well, and there were no adverse effects of pressurization. At the end of the follow-up period, 12 patients had a good outcome: nine are without sequelae, and three have a mild hemiparesis but are capable of self-care. One patient has a moderate hemiparesis., Conclusion: Although the number of patients is small, this series represents the largest reported group of brain abscess patients treated with stereotactic aspiration combined with antibiotic and HBO therapy. Our preliminary results indicate that the length of time on antibiotics can be shortened with the use of HBO as an adjunctive treatment.

The diagnosis of carpal tunnel syndrome (CTS) is mainly based on the characteristic symptoms and confirmed with nerve conduction studies. Sonography can provide measurements of the increased cross-sectional area of median nerve. The use of sonography was evaluated for the diagnosis and postoperative follow up of 48 wrists in 26 consecutive patients with CTS. Clinical evaluation and sonography were effective for the diagnosis in 40 wrists. Nerve conduction studies were needed in eight wrists, because of the decrease in cross-sectional area of the nerve as a result of degenerative changes. After 3 months, sonography detected statistically significant decreases in the cross-sectional areas of the median nerves. The sonographic studies were well tolerated by all patients. Sonography was both time-saving and cost-effective.