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Acta neurologica Belgica 08/2012; · 0.54 Impact Factor
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Acta neurologica Belgica 07/2012; · 0.54 Impact Factor
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ABSTRACT: The risks associated with percutaneous vertebroplasty (PV) are low. Patients show marked improvement and are able to rapidly resume normal activities after PV. The sudden development of postoperative vertebral compression fracture (VCF) is a common complication, and additional PV is frequently performed in these cases. However, there have been no studies reporting acute compression fractures of an adjacent vertebra immediately after PV.
This case report presents a rare case in which the patient had to undergo a second PV because of PV-induced adjacent VCF. Further, we review previous studies and discuss the possible pathogenesis of this rare complication.
Case report.
Pain management clinic.
A 62-year-old woman presented with a severe pain in the lower back, which started after she slipped. A radiograph showed severe vertebral collapse with a vertebral vacuum cleft in the T12 vertebral body. T1-weighted magnetic resonance imaging showed low signal intensity in T12, suggesting acute VCF, but the signals from the other vertebrae were normal.
The patient underwent PV at T12. When the cannula was inserted into the fracture line of the vertebral body, reduction of the collapsed T12 was developed. Although the postoperative course was uneventful, the patient's pain did not resolve. Postoperative radiographic image obtained 4 hours after the PV showed reduction of T12 and adjacent acute VCF in T11. We performed a second PV at T11. However, 2 weeks later, adjacent acute VCF in L1 was developed and PV was performed.
This report describes a single case.
To the best of our knowledge, this is the first case report of adjacent VCF that developed almost immediately after PV. Although the exact mechanism underlying this rare complication remains unclear, we assume that the VCF was induced by PV, although this was not proven. However, we suggest that the insertion of the cannula into the fracture line induced the iatrogenic dynamic mobility of the fractured vertebra. Reduction was caused by the cannula and positional gravity. The upward reduction may have had an effect on the upper and adjacent vertebrae.
Pain physician 07/2012; 15(4):E527-32. · 10.72 Impact Factor
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ABSTRACT: Mucosa-associated lymphoid tissue (MALT) lymphoma is one of the most common lymphomas and accounts for about 7% of all newly diagnosed non-Hodgkin's lymphoma (NHL). The clinical course of MALT lymphoma is relatively indolent and, in the majority of cases (50%), the lymphoma arises within the stomach. Primary central nervous system lymphoma (PCNSL), an uncommon variant of extranodal NHL, can affect any part of the neuraxis, including the eyes, brain, leptomeninges, or spinal cord. Herein, we present a rare case of PCNSL, which occurred one year after radiochemotherapy of gastric MALT lymphoma. A 62-year-old man presented with a 3-day history of left facial palsy. One year ago, he underwent antibiotic eradication therapy of Helicobacter pylori, local stomach fractional radiotherapy, and chemotherapy for gastric MALT lymphoma. Magnetic resonance imaging revealed a strong enhancing solid mass in the right frontal lobe. The tumor was completely removed, and the histological diagnosis of PCNSL developing from diffuse large B-cell lymphoma was made. Although elucidating the correlation between the first gastric MALT lymphoma and the second PCNSL seemed difficult, we have postulated and discussed some possible pathogeneses, together with a review of literature.
Journal of Korean Neurosurgical Society 06/2012; 51(6):377-9. · 0.60 Impact Factor
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ABSTRACT: The authors present an unusual case of isolated hemorrhagic contusion of an incidental meningioma showing radiological findings similar to those of a hemorrhagic cerebral contusion on computed tomography (CT) in a female patient who presented to our hospital for head trauma. This case has two characteristics. First, although the meningioma had a hemorrhagic contusion due to head trauma, most of the brain tissue was intact. Second, there was a possibility that the hemorrhagic contusion of the incidental meningioma on CT was misdiagnosed as a cerebral hemorrhagic contusion. In this case, we propose a possible mechanism to explain this rare phenomenon.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 05/2012; 18(3):277-9. · 0.33 Impact Factor
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ABSTRACT: IntroductionAneurysm formation at the anastomosis site after extracranial–intracranial (EC–IC) bypass surgery for major arterial occlusion
or stenosis due to atherosclerosis has only been reported a few times previously. However, no case describing the formation
of a giant aneurysm after EC–IC bypass surgery has been reported to date. Additionally, this complication associated with
moyamoya disease is extremely rare, and only one case has been reported so far.
Clinical reportWe report a case of a 51-year-old woman having a rare complication of intracerebral hemorrhage due to rupture of a giant aneurysm
that developed after superficial temporal artery–middle cerebral artery anastomosis for the treatment of moyamoya disease.
ConclusionTo the best of our knowledge, this is the first reported case of a giant aneurysm, also the largest so far occurring after
EC–IC bypass surgery and the second reported case of a rupture of an aneurysm formed after bypass surgery for moyamoya disease.
KeywordsGiant aneurysm-STA–MCA anastomosis-Moyamoya disease-Intracerebral hemorrhage
Acta Neurochirurgica 04/2012; 152(6):1069-1073. · 1.52 Impact Factor
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ABSTRACT: We report the case of a 52-year-old man in whom multiple conglomerated ring-enhanced lesions in the left frontal lobe were
revealed on magnetic resonance imaging (MRI); further, he presented with headache. Subtotal resection of the mass was performed
and the histopathological diagnosis of gemistocytic astrocytoma was made. He received postoperative radiotherapy of remnant
mass. Six months post-surgery, new multiple lesions were developed on the left cerebellum and the lesion yielded radiological
findings that were quite similar to those of the lesion previously observed in the left frontal lobe. Total resection was
performed with the aid of neuronavigation and a live yellow 10-cm-long worm with an active scolex was found. A pathologist
identified the worm as a sparganum of Spirometra mansoni. This suggests that the live worm may have moved to the ipsilateral cerebellum due to the stimulus from the surgery and radiation
on the frontal lobe. Although this case presented characteristic MRI findings of sparganosis, we did not conduct a serological
test; therefore, we misdiagnosed sparganosis as gemistocytic astrocytoma. To the best of our knowledge, this is the first
report of the ipsilateral transtentorial migration of cerebral sparganosis.
Acta Parasitologica 04/2012; 54(3):276-280. · 0.79 Impact Factor
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The Korean journal of pain 04/2012; 25(2):131-2.
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ABSTRACT: Myeloid sarcoma is a solid, extramedullary tumor composed of leukemic myeloblasts or immature myeloid cells. Intraparenchymal myeloid sarcoma without the involvement of the skull or meninges is extremely rare. Here, we present the case of a 49-year-old man who developed intraparenchymal myeloid sarcoma on the left cerebellum after allogeneic bone marrow transplantation (BMT). He received radiotherapy after complete removal of intraparenchymal myeloid sarcoma, but he was diagnosed spinal myeloid sarcoma three month later. Nine months after the operation, new intracranial and spinal myeloid sarcoma were diagnosed and the patient's condition had been worsened rapidly. Although the spinal myeloid sarcoma was not histologically diagnosed, this report provides valuable insights into the clinical course of progression of intraparenchymal myeloid sarcoma.
Journal of Korean Neurosurgical Society 03/2011; 49(3):171-4. · 0.60 Impact Factor
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ABSTRACT: Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient's headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief.
The Korean journal of pain 03/2011; 24(1):48-52.
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ABSTRACT: Haemangioblastoma is a slow-growing, highly vascular tumour and typically occurs in the cerebellum but can also occur in the brainstem and spinal cord. Because of their hypervascularity and location, cerebellar haemangioblastomas can be difficult to remove. The purpose of preoperative embolization of haemangioblastomas is to decrease the intraoperative blood loss and to facilitate excision. However, the safety and efficacy of this procedure remain controversial. Here, we report the case of a man with cerebellar haemangioblastoma who underwent preoperative embolization with Onyx. The tumour was completely removed with minimal tumour bleeding. There was no complication related to embolization.
Neurologia i neurochirurgia polska 01/2011; 45(3):292-6. · 0.43 Impact Factor
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ABSTRACT: The fifth lumbar vertebra has massive transverse processes that are continuous with the pedicle and encroach the body of the vertebra. These processes are mainly meant for the attachment of the iliolumbar ligament. With increasing age, the iliolumbar ligament can undergo secondary degenerative changes such as calcification, hyalinization, and myxoid degeneration. The authors present the incidental discovery of extremely elongated transverse processes of the fifth lumbar vertebra in a 45-year-old woman who underwent surgery for an intervertebral disc herniation. We also propose a possible pathogenesis to explain this rare condition and conclude that this unusual variant may be caused by calcification of the iliolumbar ligament rather than a congenital anomaly.
Turkish neurosurgery 01/2011; 21(4):648-50. · 0.62 Impact Factor
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ABSTRACT: Berberine has a wide range of biochemical and pharmacologic effects, including antitumor activity, but the mechanisms involved in berberine-induced apoptosis remain unclear. The purpose of the present study was to investigate the changes in oxidative stress and endoplasmic reticulum (ER)-related molecules, which are closely associated with cell death-signaling transduction pathways, in human glioblastoma T98G cells treated with berberine. Berberine significantly decreased the cell viability of T98G cells in a dose-dependent manner. Berberine increased the production of reactive oxygen species (ROS) and level of intracellular Ca(2+). Berberine induced ER stress as evidenced by the detection of ER stress-associated molecules such as phosphorylated protein kinase-like ER kinase, eukaryotic translation initiation factor-2α, glucose-regulated protein 78/immunoglobulin heavy chain-binding protein, and CCAAT/enhancer-binding protein (C/EBP)-homologous protein/growth arrest and DNA damage-inducible gene 153, which was associated with the activation of caspase-3. Furthermore, the administration of the antioxidants, N-acetylcysteine and glutathione, reversed berberine-induced apoptosis. Berberine also markedly enhanced apoptosis in T98G cells through the induction of a higher ratio of Bax/Bcl-2 proteins, disruption of the mitochondrial membrane potential, activation of caspase-9 and -3, and cleavage of the poly(ADP-ribose) polymerase (PARP). The inhibition of ER stress using salubrinal led to an increased the level of Bcl-2, whereas the level of Bax, cleavage of procaspase-9 and -3, and PARP were decreased when compared with cells treated with berberine alone, indicating that berberine-induced apoptosis is associated with mitochondrial dysfunction. These results demonstrate that berberine induces apoptosis via ER stress through the elevation of ROS and mitochondrial-dependent pathway in human glioblastoma T98G cells.
Biological & Pharmaceutical Bulletin 01/2010; 33(10):1644-9. · 1.66 Impact Factor
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ABSTRACT: We present the first case of a bilateral diffuse intracerebral hemorrhagic infarction following cranioplasty using an autologous bone graft. The case is that of a 63-year-old man who had undergone previous decompressive craniectomy due to right middle cerebral artery and posterior cerebral artery territory infarction. In order to avoid this extremely rare complication, the possible pathogenic mechanism underlying the deleterious cascade following cranioplasty is discussed.
Clinical neurology and neurosurgery 11/2009; 112(4):336-40. · 1.30 Impact Factor
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ABSTRACT: Rhabdoid papillary meningioma is a recently described clinically aggressive variant of meningiomas with a high recurrence rate. Additionally, only one case of intraventricular rhabdoid meningioma has been reported so far. We present a case of a 50-year-old man who developed an intracranial tumor of the left lateral ventricle at the trigone, for which he underwent total tumor resection followed by gamma knife radiosurgery for recurrence of the tumor. The histological diagnosis was rhabdoid papillary meningioma. Five years after surgery, diffuse craniospinal leptomeningeal metastases developed and subtotal removal of the spinal tumor was performed. The spinal tumor was considered to have metastasized via cerebrospinal fluid (CSF) in view of its histological features that were identical to those of the primary tumor. Immunohistochemistry revealed the unusual cytoplasmic expression of glial fibrillary acidic protein (GFAP) of tumor cells. To our knowledge, this is the first reported case of diffuse craniospinal metastases of intraventricular rhabdoid papillary meningioma with GFAP expression and the second reported case of the rhabdoid subtype amongst intraventricular meningiomas.
Clinical neurology and neurosurgery 06/2009; 111(7):619-23. · 1.30 Impact Factor
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ABSTRACT: The Mayer-Rokitansky-Küstner-Hauser (MRKH) syndrome is characterized by congenital aplasia of the uterus and upper part (2/3) of the vagina in women showing normal development of secondary sexual characteristics with a normal 46, XX karyotype. We report a case of a 30-year-old woman who presented with complaints of headache. Pituitary macroadenoma and MRKH syndrome were diagnosed. To the best of our knowledge, pituitary macroadenoma has not been reported in association with MRKH syndrome. However, no genetic links between MRKH syndrome and pituitary macroadenoma have been observed. Thus, the association may be incidental rather than causal.
Journal of Clinical Neuroscience 06/2009; 16(5):719-20. · 1.25 Impact Factor
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ABSTRACT: We report the case of a 78-year-old man with chronic subdural haematoma (CSDH) who presented with impairment in recent memory and gait disturbance. He underwent burr-hole craniostomy with a closed-drainage system. A computed tomography scan conducted on postoperative day 3 demonstrated an acute epidural haematoma over the contralateral frontoparietal convexity. Craniotomy and haematoma evacuation were immediately performed. The haematoma was located between the outer and inner dura mater that each comprise a single layer. To our knowledge, this is the first reported case of an acute haematoma located between the separated dura mater that occurred following drainage of a contralateral CSDH, and it is the second reported case of interdural haematoma over the cerebral convexity.
British Journal of Neurosurgery 05/2009; 23(2):213-5. · 0.88 Impact Factor
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ABSTRACT: The authors report a case of 42-year-old woman with an intraventricular tumor in the trigone of the left lateral ventricle. The first operation achieved a microscopically complete resection. The tumor was histologically atypical meningioma. After 26 months, there were recurrences of intraventricular meningioma. Complete resection of the tumor and adjuvant radiation therapy were performed, and the histological diagnosis was malignant meningioma. Sixteen months after the second operation, spinal metastasis in cervicolumbar lesion was diagnosed and a subtotal removal of cervical intradural extramedullary mass was performed. We describe an unusual case of intraventricular malignant meningioma with cerebrospinal fluid-disseminated spinal metastases with review of the clinical courses of previous reports.
Journal of Korean Neurosurgical Society 05/2009; 45(4):256-9. · 0.60 Impact Factor
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ABSTRACT: Acute epidural hematoma (AEDH) occurring as a result of traumatic head injury constitutes one of the most critical emergencies in neurosurgery. However, there are only several reports that show the rapid disappearance of AEDH without surgical intervention. We suggest redistribution of hematoma through the overlying skull fractures as the mechanism of rapid disappearance of AEDH. A 13-year-old female fell from a height of about 2 m and presented with mild headache. A computed tomography (CT) scan performed 4 hours after the injury revealed an AEDH with an overlying fracture in the right temporal region and acute small hemorrhagic contusion in the left frontal region. A repeat CT scan 16 hours after injury revealed that the AEDH had almost completely disappeared and showed an increase in the epicranial hematoma. The patient was discharged 10 days after injury with no neurological deficits. This case is characterized by the rapid disappearance of an AEDH associated with an overlying skull fracture. We believe that the rapid disappearance of the AEDH is due to the redistribution of the hematoma, rather than its resolution or absorption, and fracture plays a key role in this process.
Journal of Korean Neurosurgical Society 03/2009; 45(2):96-8. · 0.60 Impact Factor
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ABSTRACT: The authors present a case of 68-year-old woman who underwent resection of a metastatic adenocarcinoma in the left parietooccipital area. The intraoperative course was uneventful; however, after closure of the scalp incision, increased bleeding from the suture line was noted. A computerized tomography scan that was performed immediately after operation revealed acute epidural hemorrhage with mass effect under the bone flap. The patient developed disseminated intravascular coagulation and immediate re-exploration was performed. This patient was successfully treated owing to early recognition of the condition and immediate treatment with transfusion. Neurosurgeons should be alert that hypercoagulabe state is common in cancer patients and consumptive coagulopathy can occur after resection of metastatic brain tumor.
Journal of Korean Neurosurgical Society 12/2008; 44(5):341-4. · 0.60 Impact Factor
