Penetrating Superior Sagittal Sinus Post Part Injuries by Carpenter’s Nail
Zabsonré Denléwendé Sylvain,
Kinda Boureima,
Diallo Ismael,
Sondo Kongnimissom Apoline,
Savadogo Mamadou,
Korsaga Alexandre,
Tinto Sayouba,
Haro Yacouba,
Kabré Abel
Issue:
Volume 3, Issue 1, June 2019
Pages:
1-4
Received:
18 March 2019
Accepted:
23 April 2019
Published:
5 June 2019
Abstract: Introduction. Superior sagittal sinus posterior part injuries can rapidly lead to death by uncontrollable bleeding. The type of weapon used, the size of the sinus wound and the portion of the sinus concerned can make their gravities. We report diagnostic circumstances, treatment and evolution of 3 cases of penetrating superior sagittal sinus injuries by carpenter's nail. Methods. We describe 3 cases of a penetrating superior sagittal sinus posterior part injuries by carpenter's nail admitted in Neurosurgery department of Yalgado Ouédraogo University Teaching Hospital of Ouagadougou in 2007, 2013 and 2017. Results. Three patients aged 25, 28 and 24 years respectively admitted 19 hours on average after a traumatic brain injury by a penetrating object. Circumstance was the popular verdict 1 case. In the other cases, the circumstance could not be elucidated. The neurological examination was normal for the 3 patients. Local examination noted in 2 patients, a nail implanted in the skull in the posterior part of the median line. In 1 patient, there were 2 punctiforms wounds of the scalp in the posterior part of the median line. CT scan showed a large nail about 10 cm long in 2 patients and 2 nails of the same size in 1 patient. These nails were in contact or crossing the superior sagittal sinus in its posterior part. The removal of these nails was done under general anesthesia. The postoperative course was simple under antibiotic prophylaxis. Conclusion. Posterior sagittal sinus injuries by carpenter's nails were criminal origin in a context of popular justice. During their ablation under general anesthesia, bleeding from the superior sagittal sinus caused by nails removal was controlled by finger compression and stopped by placement of hemostatic compresses. Apposition of epicranium reinforced the dura closure.
Abstract: Introduction. Superior sagittal sinus posterior part injuries can rapidly lead to death by uncontrollable bleeding. The type of weapon used, the size of the sinus wound and the portion of the sinus concerned can make their gravities. We report diagnostic circumstances, treatment and evolution of 3 cases of penetrating superior sagittal sinus injuri...
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Traumatic Posterior Atlantoaxial Dislocation without Related Fractures of C1 - C2 in a Patient with Traumatic Brain Injury: Case Report and Literature Review
Lenin Moyo,
Aaron Musara,
Kazadi Kalangu
Issue:
Volume 3, Issue 1, June 2019
Pages:
5-8
Received:
6 February 2019
Accepted:
25 June 2019
Published:
9 July 2019
Abstract: It is exceptionally rare to have posterior atlanto axial dislocation without an associated atlas or odontoid fracture and very few cases have been reported in literature. We present a case of a 50 year old female pedestrian who was hit by car while crossing a road. She presented with a depressed level of consciousness and the Glasgow coma score of 12/15, pupils were equal and reactive to light and all limbs were moving equally. She had an extensive abrasion on the forehead which extended into scalp. CT scan showed a posterior dislocation of the atlas with respect of axis with no associated fractures of C 1 and C2. She had traumatic subarachnoid hemorrhage in the basal cisterns and multiple brainstem contusions. Closed reduction of the dislocation was done successfully under fluoroscopy guidance. MRI was done post reduction because funds were not available initially and it showed increased signal in the tectorial membrane and transverse and alar ligaments with mild cord oedema at the cervicomedullary junction. However, the patient post reduction began to deteriorate and eventually passed away before definitive treatment of her cervical-spine injury. The case is reported in view of its rarity and to review literature on this uncommon condition.
Abstract: It is exceptionally rare to have posterior atlanto axial dislocation without an associated atlas or odontoid fracture and very few cases have been reported in literature. We present a case of a 50 year old female pedestrian who was hit by car while crossing a road. She presented with a depressed level of consciousness and the Glasgow coma score of ...
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Perianeurysmal Edema After Embolization with Flow Diversion
Mehrnoush Gorjian,
Scott Raymond,
Matthew Koch,
Aman Patel
Issue:
Volume 3, Issue 1, June 2019
Pages:
9-12
Received:
23 June 2019
Accepted:
4 August 2019
Published:
19 August 2019
Abstract: Flow diversion is an endovascular technique for embolization of intracranial aneurysms using a semi-porous stent to that redirects blood flow away from the aneurysm and is a scaffold for vessel remodeling. With flow diversion, aneurysms close slowly over 6-12 months as endothelial growth into the stent covers the neck of the aneurysm. Flow diversion is the preferred treatment for unruptured, large, paraclinoid aneurysms, which are otherwise challenging to treat with conventional open surgical or endovascular techniques. Post-embolization perianeurysmal edema (PAE) is an uncommon complication that occurs weeks to months after embolization and manifests as brain parenchymal edema surrounding the treated aneurysm. The clinical presentation is varied and includes headache, seizure or focal neurologic deficit. Frequently, PAE is misdiagnosed as an embolic stroke, which is a more common post-embolization complication and has some clinical and imaging overlap. PAE can be differentiated from ischemia by the absence of restricted diffusion and aneurysm wall enhancement on post-contrast Magnetic Resonance Imaging (MRI). PAE was initially described following coil embolization, but has subsequently been observed after flow diversion alone or with adjunctive coiling. Post-embolization PAE presumably results from rapid aneurysm thrombosis, endothelial cell necrosis, and the ensuing inflammatory reaction, which spreads to the adjacent brain parenchyma. Early recognition of PAE is critical to initiate appropriate therapy.
Abstract: Flow diversion is an endovascular technique for embolization of intracranial aneurysms using a semi-porous stent to that redirects blood flow away from the aneurysm and is a scaffold for vessel remodeling. With flow diversion, aneurysms close slowly over 6-12 months as endothelial growth into the stent covers the neck of the aneurysm. Flow diversio...
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