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Supratentorial Hemangioblastomas Without Von - Hippel Lindau Disease – Case Report and Review
Jose Carlos Rodrigues Junior,
Vithor Ely Bortholin da Silva,
Roberto Bezerra Vital,
Renan Luiz Lapate,
Marcelo Ferraz Campos
Issue:
Volume 5, Issue 1, June 2021
Pages:
1-3
Received:
27 April 2020
Accepted:
19 August 2020
Published:
4 January 2021
DOI:
10.11648/j.ijn.20210501.11
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Abstract: Background and Importance: Hemangioblastomas (HBL) are tumors constantly present in the neurosurgeon's daily life, affecting mainly the posterior fossa region. In patients with von Hippel-Lindau, their presence is even more striking. However, the authors, through a report of a case with the literature review, show that hemangioblastomas should also be part of the range of differential diagnoses of supratentorial lesions even in patients not carrying the genetic mutation. Clinical Presentation: A 45-year-old male patient has a 2 weeks history of headache associated with nauseas and vertigo. In the last two weeks the pain was being progressively more frequently with increase in intensity and duration. At examination he was oriented, with face of pain, muscle examination was normal as all the neurological examination. The patient was submitted to a Magnetic Resonance (MR) of the brain that showed an expansive lesion in the brain located in the left frontal lobe, adjacent to the medial line with moderated adjacent edema and with gadolinium injection the tumor was heterogeneous almost solid with cystic parts and including adjacent impregnation of the dura of the midline. Surgical treatment was done. The lesion was completed resected including the dura of the convexity that was invaded by the tumor. Postoperative period was uneventful, with resolution of the headache and no deficits. Patient was discharged 3 days after surgery. Pathology reveals the lesion was a hemangioblastoma. Patient made genetic exams and confirms that didn’t have Von Hippel Lindau disease. MR of the brain, almost 3 years of the surgery, reveals no tumor. Conclusion: Hemangioblastoma is a rare tumor, especially in its supratentorial location. However, this case reflects the importance of including HBL as a differential diagnostic allowing a better therapeutic planning, ensuring better prognosis and facilitating their treatment.
Abstract: Background and Importance: Hemangioblastomas (HBL) are tumors constantly present in the neurosurgeon's daily life, affecting mainly the posterior fossa region. In patients with von Hippel-Lindau, their presence is even more striking. However, the authors, through a report of a case with the literature review, show that hemangioblastomas should also...
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Spontaneous Resorption of Chronic Subdural Hematoma with Curative Thrombolysis and Atorvastatin
Ouiminga Habib Abdoul Karim,
Kabore Raphael Marie,
Li Mengyou,
Sankara Desire Harouna,
Wang Hongbo,
Rabo Rasmane,
Sakine Habiba Amira,
Gaye Magatte
Issue:
Volume 5, Issue 1, June 2021
Pages:
4-7
Received:
7 January 2021
Accepted:
14 January 2021
Published:
22 January 2021
DOI:
10.11648/j.ijn.20210501.12
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Abstract: The aim of this study is to report a case of chronic subdural hematoma with antivitamin K curative dose, treated by Atorvastatin. Clinical case: A 48-year-old man was admitted for motor deficit of the left complete hemiparesis, associated with dysarthria. He was followed in Neurology and cardiology for ischemic stroke due to atrial fibrillation, and was treated with antivitamin K treatment for 2 years. The clinical examination showed a Glasgow score at 15, a left hemiparesis with left facial paralysis. Sensitivity was preserved. Brain CT-scan showed a right fronto-parietal subacute hematoma with mass effect and a recent ischemic stroke of a central branch of the left middle cerebral artery. Angio-MRI shows an occlusion of the right vertebral artery and right communicating artery. A curative anticoagulation was initiated. Atorvastatin was administered at 20 mg per night for 8 weeks associated with functional rehabilitation. The evolution had been favorable, with the regression of headaches and hemiparesis, however the persistence of facial paralysis. After 8 months, the patient was asymptomatic. Cerebral CT control showed complete regression of subdural hematoma. Conclusion: Atorvastatin may constitute a non-surgical and effective treatment of chronic subdural hematoma among the patients whose curative anticoagulation cannot be interrupted. It is very important to really value the report risks / profits of every therapeutic option before making a decision.
Abstract: The aim of this study is to report a case of chronic subdural hematoma with antivitamin K curative dose, treated by Atorvastatin. Clinical case: A 48-year-old man was admitted for motor deficit of the left complete hemiparesis, associated with dysarthria. He was followed in Neurology and cardiology for ischemic stroke due to atrial fibrillation, an...
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Decompresive Craniectomy in Infants at Fann University Hospital in Dakar
El Hadji Cheikh Ndiaye Sy,
Abdoulaye Diop,
Yakhya Cisse,
Mohameth Faye,
Attoumane Fahad,
Maguette Mbaye,
Mbaye Thioub,
Jean Michel Nzisabira,
Lounceny Fatoumata Barry,
Rel Gerald Boubaka Kala,
Ansoumane Donzo,
Abdou Soilihi Ansaou,
Nantenin Doumbia,
Alioune Badara Thiam,
Momar Code Ba,
Seydou Boubakar Badiane
Issue:
Volume 5, Issue 1, June 2021
Pages:
8-12
Received:
11 February 2021
Accepted:
3 March 2021
Published:
12 March 2021
DOI:
10.11648/j.ijn.20210501.13
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Abstract: Introduction: Decompressive craniectomy is a neurosurgical technique indicated as a last resort in the management of intracranial hypertension refractory to medical treatment. Carried out in infants, it represents an additional challenge due to the morbidity and mortality with which it is associated. The objective of our study was to report the experience of the neurosurgery department of Fann University Hospital in Dakar. Patients and Methods: It's a retrospective study on 4 infants who have undergone a decompressive craniectomy at Fann University Hospital in Dakar over a period of 10 years, from January 1, 2010 to December 31, 2020. Results: Four patients under 2 years of age underwent decompressive craniectomy out of a total of 26 patients over the study period. The mean age at diagnosis was 10 months with extreme (60 days to 24 month). The average consultation time was 3 days with extremes (1 to 8 days). Two infants had had severe head trauma. Only one infant showed significant clinical improvement postoperatively; the other three died within 1 to 6 days of surgery. These deaths were linked to acute bleeding in 75% of cases. The mean survival time was 2 days with extremes ranging from 1 to 4 days. Conclusion: Decompresive craniectomy remains the challenge in infants due to the risk of bleeding and hemodynamic instability. Given the low number of publications, we encourage other authors to share their. In our study, three patients died at the end of the operation from bleeding complications. Among these deaths a patient had a coagulopathy which also poses another challenge to the management of these patients.
Abstract: Introduction: Decompressive craniectomy is a neurosurgical technique indicated as a last resort in the management of intracranial hypertension refractory to medical treatment. Carried out in infants, it represents an additional challenge due to the morbidity and mortality with which it is associated. The objective of our study was to report the exp...
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Diagnostic, Therapeutic and Evolutionary Peculiarities of Spinal Trauma in Children in Sub-Saharan Africa: Experience of Senegal
Faye Mohameth,
Adolphe Bimangou,
Mualaba Celebre,
El Hadji Cheikh Ndiaye Sy,
Diop Abdoulaye,
Barry Lounceny Fatoumata,
Mhaks Malangu,
Ba Momar Code
Issue:
Volume 5, Issue 1, June 2021
Pages:
13-18
Received:
14 February 2021
Accepted:
24 February 2021
Published:
7 April 2021
DOI:
10.11648/j.ijn.20210501.14
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Abstract: Introduction: Spinal trauma in children is rare, accounting for 1 and 10% of all spinal traumas. They constitute an entity in their own right due to the injuries they cause. Difficulties (diagnostic) and modalities (therapeutic), different from those of adults the growth of children. The lack of studies in Sub-Saharan Africa leads us to carry out this study focused on the traumatic spine of the child. Patients and Methods: Over a period of 8 and a half years from January 2012 to June 2020, we retrospectively studied 44 cases involving 4 Senegalese hospitals, 3 of which were in the capital and 1 in the province, including children up to the age of 16 who had suffered spinal trauma. Results: Forty-four children were retained, a frequency of 7.11%, with an average age of 10.5 years; sex ratio: 1.6. The most frequent aetiologies were: falls (from trees, from buildings): 41%; play accidents and accidents on public roads: 20.4% each. The average consultation time was 31.3 days. 34% of the patients were ASIA E patients. The majority of patients had performed a spine CT scan as an imaging examination, i.e. 95.4%. The most common site of injury was cervical with 61.3%. The most frequent lesions were: fractures, fracture-luxations and dislocations with 27.3%, 25% and 25% respectively. Five patients had associated lesions, i.e. 11.3% (4 head traumas, 9.1% and 1 pelvic trauma, 1.9). Most of the treatment was surgical (43% orthopaedic, 38.6%) and functional (16%). The post-therapy neurological evaluation (ASIA - backward step) was: A: 25%; B: 2.3%; C: 7%; D: 13.7%; E: 52.3%. We noted 3 deaths and 4 patients were re-operated. There were no consolidation complications such as pseudoarthrosis. Conclusion: Trauma to the spine in children, like any bone trauma, responds well to orthopaedic treatment. Deaths are often related to upper cervical spine injuries or occur in the context of polytrauma. Follow-up should be carried out over several years to detect possible complications at an early stage. Delays in treatment due to the difficulties of punctual medicalised transport remain the challenge to be met in our environment.
Abstract: Introduction: Spinal trauma in children is rare, accounting for 1 and 10% of all spinal traumas. They constitute an entity in their own right due to the injuries they cause. Difficulties (diagnostic) and modalities (therapeutic), different from those of adults the growth of children. The lack of studies in Sub-Saharan Africa leads us to carry out t...
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A Clinical Study in Cases of Trigeminal Neuralgia and Microvascular Decompression
Tushar Soni,
Mayuresh Rampurkar
Issue:
Volume 5, Issue 1, June 2021
Pages:
19-23
Received:
7 April 2021
Accepted:
21 April 2021
Published:
29 April 2021
DOI:
10.11648/j.ijn.20210501.15
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Abstract: Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome after micro vascular decompression. This study includes 150 cases of trigeminal neuralgia treated with micro vascular decompression in VSGH and SVP hospital, Ahmedabad over the period of 10 years. In this study, the peak incidence of Trigeminal neuralgia was in 50-69 age groups with male preponderance (male-female ratio- 1.17:1). Most common complaint was typical trigeminal neuralgic pain along one side of face over a period of 2-5 years. The right side of face and V2+V3 segment of trigeminal nerve was involved more commonly. Intraoperatively, an arterial loop compressing trigeminal nerve was found in 90% of the patients. Duration of post-operative hospitalization in maximum patients was less than 5 days (60%) and there were no postoperative complications in 96% patients. The complications noted were pseudo-meningocele (2%), persistent facial pain (1.3%), transient facial weakness (2%), meningitis (0.66%) and death (1.3%). We can conclude from this study that, trigeminal neuralgia is a very painful disease of old age with slight male preponderance. Right sided v2v3 and v3 divisions are commonly involved with arterial loop compressing trigeminal nerve being the most common pathology. Micro vascular decompression is proved to be an effective modality of surgery with high success rate and very few complications.
Abstract: Trigeminal neuralgia is one of the most painful conditions affecting area of face supplied by trigeminal nerve, which has a major impact on quality of life. There are few reports of trigeminal neuralgia in oriental population. The objective of this study is to evaluate of important clinical factors about trigeminal neuralgia and analysis of outcome...
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Bubbles and Troubles: A Case of Azygous ACA with Bilateral ICA Aneurysm, Besides the Usual Distal ACA Aneurysm
Issue:
Volume 5, Issue 1, June 2021
Pages:
24-27
Received:
31 March 2021
Accepted:
15 April 2021
Published:
30 April 2021
DOI:
10.11648/j.ijn.20210501.16
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Abstract: Azygous ACA is one of the rare anatomic variants of anterior cerebral artery. Predisposition to aneurysm development is attributed to the alteration in flow dynamics. Such hemodynamic alteration is most commonly seen in the anterior circulation, causing distal ACA aneurysm to be the most commonly associated vascular pathology. Although neurosurgical literature is replete with anatomical reports of such cases, there has been no case reports where bilateral ICA aneurysms are also present with the distal ACA aneurysm. In this case, the presence of hypoplastic left A1 segment might predispose the other segments of Circle of Willis to hemodynamic alterations. Thus, whenever one comes across an azygous ACA in association with an additional anomaly he should be vigilant enough to look for other pathologies beyond the commonly encountered distal ACA aneurysm. The presence of azygous ACA also poses a technical challenge due to the risk of ischemic insult to anterior regions of bilateral hemispheres during temporary clipping of the single A2 trunk. In addition to it, the presence of a hypoplastic A1 segment also makes the approach to the giant aneurysm in ICA segment more technically demanding as cross flow is not adequate. So, the presence of multiple anatomic anomalies not just increases the number of vascular pathologies but also enhances the challenges that the surgeon has to face in planning the strategic approach to tackle all the lesions.
Abstract: Azygous ACA is one of the rare anatomic variants of anterior cerebral artery. Predisposition to aneurysm development is attributed to the alteration in flow dynamics. Such hemodynamic alteration is most commonly seen in the anterior circulation, causing distal ACA aneurysm to be the most commonly associated vascular pathology. Although neurosurgica...
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Application of Sedation and Analgesia Nursing in Endovascular Treatment of Patients with Acute Ischemic Stroke
Wencai Yang,
Feifeng Qiu,
Jiancong Chen,
Lifang Chen,
Min Guan
Issue:
Volume 5, Issue 1, June 2021
Pages:
28-32
Received:
20 February 2021
Accepted:
12 March 2021
Published:
30 April 2021
DOI:
10.11648/j.ijn.20210501.17
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Abstract: Background: For acute ischemic stroke (AIS) patients with anterior circulation occlusion, local anesthesia can significantly shorten the time from endovascular treatment to recanalization. Objective: To investigate the application of individualized sedation and analgesia nursing in endovascular treatment (EVT) of patients with anterior-circulation AIS. Methods: From October 2019 to October 2020, all of 78 patients who underwent EVT with anterior-circulation AIS were retrospectively collected. Before interventional preoperative, doctors and nurses cooperated to comprehensively evaluate the patient's condition. Based on fully considering patients' respiratory function, hemodynamic status and pathological and physiological status, individualized sedation and analgesia targets were formulated. The nurses dynamically assessed the patients' sedation score with Sedation-Agitation Scale (SAS) and analgesia score with Critical-Care Pain Observation Tool (CPOT), monitored the depth of sedation and analgesia in real time, adjusted the drug dose, and maintained the ideal sedation and analgesia state of the patients. During the operation, we actively prevented and dealt with the occurrence of adverse reactions such as hypersedation and respiratory depression, and placed oropharyngeal airway to improve ventilation for patients with retroglossal drop and respiratory depression. Results: The SAS score of 78 patients was 5.8±3.7 while entering the operating room. Among them, 71 patients were treated with the midazolam with an average dose of 5.3±2.7 mg, as well as the SAS score of 3.3±1.8 during the operation, and the other 7 patients were cooperated with consciously. Sixty patients were sedated with fentanyl solution at an average dose of 0.38±0.22mg, and the CPOT score was 4.8±3.2 during the operation. The other 18 patients did not use analgesics. The time of Door to Recanalization (D2R) in 78 patients was 50.8±28.6 min. During the operation, there was good cooperation between doctors and nurses, no case of intracranial hemorrhage and no case died. Conclusion: In the EVT of the anterior-circulation AIS patients, medical cooperation developed individualized sedation and analgesia, and the nurses dynamically evaluated the sedation and analgesia score of the patients. By monitoring the depth of sedation and analgesia in real time to adjust the dosage of drugs, patients can maintain in a moderate sedation and analgesia state to ensure the safety of EVT performed.
Abstract: Background: For acute ischemic stroke (AIS) patients with anterior circulation occlusion, local anesthesia can significantly shorten the time from endovascular treatment to recanalization. Objective: To investigate the application of individualized sedation and analgesia nursing in endovascular treatment (EVT) of patients with anterior-circulation ...
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Penetrating Brain Injury by an Iron Bar in a Child
Yameogo Wendlasida Serge Pacome Arnauld,
Zabsonre Denlewende Sylvain,
Taoko Lassane 1er Jumeau,
Jemel Hafedh,
Kabre Abel
Issue:
Volume 5, Issue 1, June 2021
Pages:
33-37
Received:
12 April 2021
Accepted:
5 May 2021
Published:
14 May 2021
DOI:
10.11648/j.ijn.20210501.18
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Abstract: Introduction: Penetrating brain injury is not common among the civilian population and it is rare in children. The use of computed tomography is essential for decision-making in the management of patient’s with penetrating brain injury. Here, we report a case about the management of a penetrating brain injury by an iron bar in a child after an assault. Case report: We describe a case of a 5-year old male, who was admitted to the trauma emergency unit of the Hospital Center University Yalgado OUEDRAOGO on April 1, 2019 with an iron bar stuck into the head, one hour after the injury. The patient was aware. He was complained about headaches and was agitated. His vitals were stable. At the initial examination, there was no neurological disorder. Cranial computerized tomography showed iron bar planted deep into the left frontal lobe and directed obliquely into the right frontal lobe. Patient’s agitation has led to a displacement of the iron bar. New examination has revealed right hemiparesia. An emergency surgery was performed. The patient was discharged without any complications. Conclusion: Penetrating brain injuries by an iron bar are rare in children. Children must be kept calm in order to avoid the displacement of the iron because it can increase the risk of cerebral damage. An earlier management provides better prognosis.
Abstract: Introduction: Penetrating brain injury is not common among the civilian population and it is rare in children. The use of computed tomography is essential for decision-making in the management of patient’s with penetrating brain injury. Here, we report a case about the management of a penetrating brain injury by an iron bar in a child after an assa...
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Traumatic Retroclival Subdural Hematoma on Top of Stable Bilateral Occipital Condyle Fracture: Impact of Hematoma on Craniocervical Stability and Management Decision
Mohamed Awad Mohamed Hassan,
Alfadil Osman Alawaad,
Ghalib Almesedin,
Saggaf Alawi Assaggaf
Issue:
Volume 5, Issue 1, June 2021
Pages:
38-41
Received:
24 April 2021
Accepted:
8 May 2021
Published:
27 May 2021
DOI:
10.11648/j.ijn.20210501.19
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Abstract: Background and Importance: Bilateral occipital condyle fracture (OCF) is a rare type of injury that occurs at the occipitocervical junction, mostly due to high energy trauma to cranium with axial loading. These fractures are difficult to diagnose based on conventional cervical or cranial radiography and they have non-specific clinical manifestations. However, unstable fractures carry the most risk for morbidity and mortality due to their close relation to important neural and vascular structures. Acute retro-clival subdural hematoma (rcSDH) is a collection of blood dorsal to the tectorial membrane, which is a critical structure for maintaining occipitocervical stability, presence of posttraumatic acute retroclival subdural hematoma in the setting of non-displaced bilateral occipital condyle fractures in traumatic patients is a marker of high energy trauma with fatal course in acute setting due to compression on subarachnoid space by acute hematoma and subsequent increase intracranial pressure and a merely marker of occipitocervical instability due to injury/damage to tectorial membrane. We describe the imaging features and clinical symptoms and signs that led to the diagnosis and classification of stable bilateral OCFs with a quickly resolving rcSDH in a previously healthy man aged 25 years involved in a motor vehicle accident, allowing conservative management. The co-existing of both injuries has not been described in the literature to the best of our knowledge.
Abstract: Background and Importance: Bilateral occipital condyle fracture (OCF) is a rare type of injury that occurs at the occipitocervical junction, mostly due to high energy trauma to cranium with axial loading. These fractures are difficult to diagnose based on conventional cervical or cranial radiography and they have non-specific clinical manifestation...
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Obstructive Hydrocephalus in Children: Predictive Factors of Ventriculocisternostomy Dysfunction at the University Hospital Center of Conakry
Ibrahima Sory Souare,
Mohamed Lamine Sylla,
Hugues Ghislain Atakla,
Ibrahima Sory Junior Souaré,
Mohamed Cherif,
Seylan Diawara,
Beavogui Luc Kezely
Issue:
Volume 5, Issue 1, June 2021
Pages:
42-46
Received:
12 February 2021
Accepted:
26 February 2021
Published:
21 June 2021
DOI:
10.11648/j.ijn.20210501.20
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Abstract: The treatment of hydrocephalus is surgical and uses two (2) main methods to date: ventriculoperitoneal shunt (DVP) and endoscopic ventriculocisternostomy (VCS). The latter offers the advantage of avoiding the implantation of a foreign body (valve) in the body. However, there are sometimes dysfunctions that can lead to the evolutionary continuation of hydrocephalus. The objective of this study is to identify factors predictive of VCS dysfunction in cases of obstructive hydrocephalus in children at the University Hospital Center (CHU) in Conakry. This is a mixed analytical study of 32 cases of children aged 0-15 years who received VCS during the study period. Outcomes were evaluated according to Drake and Canadian Pediatric Neurosurgery Group clinical criteria. The hospital frequency was 17% and a sex ratio (M/F) of 1.13. Clinical signs were dominated by progressive macrocraniality (93.8%), bulging fontanel (84.4%), ectasia of scalp veins (68.8%). CSF leakage (9.4%) was the most frequent post-operative complication. We recorded one case of death. The success rate of CSF according to Drake's criteria was 56%. The factors often associated with the dysfunction of the VCS found in this study are essentially: age, bulging fontanelle, ectasia of the scalp veins, arachnoid adhesions, closure of the Sylvius aqueduct and pulsation of the bottom of the 3rd V. In the absence of a statistically significant relationship, it would be useful to analyse these parameters closely on a much larger sample.
Abstract: The treatment of hydrocephalus is surgical and uses two (2) main methods to date: ventriculoperitoneal shunt (DVP) and endoscopic ventriculocisternostomy (VCS). The latter offers the advantage of avoiding the implantation of a foreign body (valve) in the body. However, there are sometimes dysfunctions that can lead to the evolutionary continuation ...
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Posterior Lumbar Fixation Surgeries, Indications and Approaches (Posterolateral Fixation, PLIF and TLIF) Clinical Perspective
Adel Nabih Mohamed,
Ahmed Faisal Toubar,
Muhamed Abdelmoez,
Omar Elfarouk
Issue:
Volume 5, Issue 1, June 2021
Pages:
47-51
Received:
17 May 2021
Accepted:
19 June 2021
Published:
25 June 2021
DOI:
10.11648/j.ijn.20210501.21
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Abstract: Background: Posterior lumbar fixation surgery is common procedure associated with lumbar fusion with different technique. The most frequent type of spine fusion is lumbar spine fusion, which can be done for a variety of reasons. There are two main techniques for lumbar spine fusion, posterolateral fusion and lumbar interbody fusion. This review aims to summarise, evaluate systematic reviews and analyze the therapeutic efficacy and outcome of posterior lumbar fixation surgeries and lumbar fusion including posterolateral fusion, PLIF and TLIF for most common diagnoses. In cases of recurrent lumbar disc herniation, there is no evidence that spine fusion has therapeutic advantage over repeated discectomy. There was no difference in the rates of re-operation between the two surgical procedures. According to lumbar fracture, we found no superiority in clinical benefit, system failure rate and other radiological parameters of arthrodesis over fixation only, in thoracolumbar burst fracture. The no-fusion group had much less surgical time and blood loss. Results of review for patients receiving fusion surgery for spondylolisthesis show that, In terms of attaining radiographic fusion, TLIF is superior to PLF without any observable increased risk for infection. However, There is very little evidence, that TLIF is better than PLF for attaining clinical improvement. If surgical intervention for spondylodiscitis is needed, less invasive surgical approaches (single-stage anterior or posterior fusion techniques) are strongly recommended, since they can have a better therapeutic outcome than more complex mixed anterior–posterior procedures. For more accurate evaluation of the efficacy of spinal fusion surgery on all indications, more evidence is required.
Abstract: Background: Posterior lumbar fixation surgery is common procedure associated with lumbar fusion with different technique. The most frequent type of spine fusion is lumbar spine fusion, which can be done for a variety of reasons. There are two main techniques for lumbar spine fusion, posterolateral fusion and lumbar interbody fusion. This review aim...
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Acute Spinal Subarachnoid Hemorrhage: Case Report Cured by Continuous Cerebrospinal Fluid Drainage by Lumbar Puncture
Junfu Li,
Dianshuang Xu,
Zhiyong Chen,
Wei Li,
Maoying Zhang,
Zhaoming Li
Issue:
Volume 5, Issue 1, June 2021
Pages:
52-56
Received:
31 May 2021
Accepted:
17 June 2021
Published:
26 June 2021
DOI:
10.11648/j.ijn.20210501.22
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Abstract: Background: Spinal subarachnoid hemorrhage (SSH) is a rare condition that can lead to severe neurological deficits. Clinicians should consider SSH when neurological deficits such as low back pain, pain hyperalgesia, paraplegia, and urinary and fecal incontinence are present. There is much debate as to whether SSH should be treated surgically or conservatively. There are few reports in the literature about this disease. In this paper, we report a case of SSH in terms of etiology, clinical manifestations, diagnosis and treatment. Methods: A case of SSH in our hospital was retrospectively analyzed in terms of etiology, pathogenesis, clinical manifestations, diagnosis and treatment. Results: The possible etiology of SSH in this case was due to rapid changes in intra-thoracic and intra-abdominal pressure due to prolonged bending, which caused tearing of the blood vessels in the subarachnoid space. The patient has returned to normal life with continuous lumbar puncture for cerebrospinal fluid drainage. Conclusion: We report a case of SSH with typical symptoms of back pain, sensory, motor and autonomic dysfunction. MRI is used as the method of choice to diagnose SSH, which is typically characterized by the lumbar sedimentation sign. Lumbar puncture for continuous drainage of cerebrospinal fluid is simple and less invasive, and may be considered by neurosurgeons as the treatment of choice for SSH, with further surgical treatment considered if results are poor.
Abstract: Background: Spinal subarachnoid hemorrhage (SSH) is a rare condition that can lead to severe neurological deficits. Clinicians should consider SSH when neurological deficits such as low back pain, pain hyperalgesia, paraplegia, and urinary and fecal incontinence are present. There is much debate as to whether SSH should be treated surgically or con...
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