RESUMEN
STUDY DESIGN: A case report of acute post-traumatic spinal subdural haematoma (ASSH). OBJECTIVE: To report a rare post-traumatic problem. SETTING: Dicle University Hospital, Diyarbakir, Turkey. METHOD: A 3-year-old boy was admitted to our clinic with paraplegia 24 h after falling from a height of about 5 meters. Investigation revealed an acute spinal subdural haematoma. RESULTS: Following surgery there was marked improvement. The rehabilitation of the patient continues. CONCLUSION: MRI is the most valuable diagnostic method. In each case diagnosed as ASSH, prompt evacuation should be performed before irreversible neurological damage occurs.
Asunto(s)
Hematoma Subdural/diagnóstico , Hematoma Subdural/etiología , Imagen por Resonancia Magnética , Paraplejía/terapia , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/diagnóstico , Enfermedad Aguda , Preescolar , Hematoma Subdural/terapia , Humanos , Laminectomía , Imagen por Resonancia Magnética/métodos , Masculino , Metilprednisolona/uso terapéutico , Traumatismos de la Médula Espinal/terapia , Vértebras TorácicasRESUMEN
A child (8 years old) with a gigantic mass of intracranial hydatid cysts (95x90x75 mm) is presented. The first manifestation was difficulty in walking, which was followed by symptoms of raised intracranial pressure. A craniotomy was performed, and more than 25 hydatid cysts were removed. The literature is reviewed and the incidence of gigantic mass of cerebral hydatid cyst is compared in the published reports.
Asunto(s)
Encéfalo/patología , Helmintiasis del Sistema Nervioso Central/diagnóstico , Equinococosis/diagnóstico , Equinococosis/cirugía , Encéfalo/diagnóstico por imagen , Encéfalo/parasitología , Helmintiasis del Sistema Nervioso Central/patología , Helmintiasis del Sistema Nervioso Central/cirugía , Niño , Craneotomía , Equinococosis/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Radiografía , Resultado del TratamientoRESUMEN
STUDY DESIGN: Review of cases. OBJECTIVE: To review cases of brucellosis in order to clarify diagnostic guidelines, treatment regimes and prognosis. SETTING: University Hospital, Turkey. METHODS: Study of 11 patients (9 male, 2 female) with either brucellar spondylitis or epidural brucellar abscess. Diagnosis made on clinical presentation, laboratory findings, radiographic evidence and a minimum brucellar anti body of 1 : 160, a positive bacteriological culture and/or histological finding of inflammation of granulomatous tissue. All patients were treated with a combination of oral antibiotics. Surgery was performed in 8 patients. RESULTS: At least 6 months antibiotic therapy using Rifampicin and Doxycycline is recommended. Surgery is indicated in the presence of spinal instability, cord compression or radiculopathy. In our series eight patients required surgery. CONCLUSION: The patients complaining of back pain, particularly in endemic areas should be investigated as possible cases of brucellosis.
Asunto(s)
Brucelosis , Enfermedades de la Columna Vertebral , Absceso/diagnóstico , Absceso/rehabilitación , Absceso/terapia , Adulto , Brucelosis/diagnóstico , Brucelosis/rehabilitación , Brucelosis/terapia , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades de la Columna Vertebral/diagnóstico , Enfermedades de la Columna Vertebral/rehabilitación , Enfermedades de la Columna Vertebral/terapia , Estadísticas no ParamétricasRESUMEN
It was investigated whether treatment with the calcium channels blocker Nimodipine, a 1,4-dihydropyridine derivative, influences vasculopathy and neuronal injury in experimental pneumococcal meningitis. Rats were randomly assigned to one of three experimental groups. The first group (Control group, n = 20) was given saline (0.4 ml/day) intraperitoneally (i.p.), whereas the second group (group C, n = 22) was treated only with ceftriaxone in a dosage of 30 mg/day/i.p.. The third group (group C-N, n = 22) was treated with the combination of ceftriaxone 30 mg/day/i.p., and nimodipine 0.6 mg/day/i.p.. Treatment was begun at the time of inoculation in all three groups. The control group was compared clinically and histopathologically with groups C and C-N at 24 h, three and six days after inoculation. Six rats in the control group and eight rats in group C and group C-N were sacrificed at 24 hours and seven rats in each group were sacrificed on the third and sixth day after inoculation. Clinically, there were no significant differences between group C and group C-N (p>0.05). There were significant differences between group C and group C-N for vasculopathy and neuronal injury (p < 0.0001 and p < 0.005, respectively).
Asunto(s)
Bloqueadores de los Canales de Calcio/uso terapéutico , Meningitis Neumocócica/tratamiento farmacológico , Nimodipina/uso terapéutico , Animales , Modelos Animales de Enfermedad , Humanos , Meningitis Neumocócica/patología , Neuronas , Ratas , Ratas Sprague-DawleyRESUMEN
Subdural empyema, a collection of pus in the space between the dura and arachnoid, is a rare type of intracranial infection. We report on 23 patients, aged 8 months to 70 years, with subdural empyema who were treated in our clinic between 1989 and 1994. The sources of subdural empyemas were meningitis in five patients, middle ear in five, trauma in four, paranasal sinus in three, complications of surgery and subdural tap in four, and unknown in two patients. The common presentations were headache, focal neurologic deficit, fever, vomiting, seizures, and neck stiffness. Diagnosis was achieved by computerized tomography and neurologic examinations in all cases. Treatment was effected by burr hole or small craniotomy with catheter drainage, and antibiotics were administered to all patients. The mortality rate was 8.7%; the remaining patients made a good recovery without sequelae. We therefore recommend burr hole with catheter drainage plus antibiotics as a method of treating subdural empyema.
Asunto(s)
Craneotomía/métodos , Empiema Subdural/cirugía , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Niño , Preescolar , Terapia Combinada , Drenaje/métodos , Empiema Subdural/diagnóstico , Empiema Subdural/etiología , Empiema Subdural/mortalidad , Humanos , Lactante , Persona de Mediana Edad , Examen Neurológico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Intracranial infections can locate at anywhere in the brain. Subdural empyemas are the less common type of intracranial infections, and parafalxial localization is seen rare. Findings of intracranial pressure increase developed in a cases who were treated for purulent meningitis. Parafalxial empyemas were diagnosed in succeeding cranial computed tomography. Middle line was drained by means of craniotomy or burrhole. We reported two cases who recovered without any postoperative sequel considered the rare localization site of infection.