A posterior fossa lipoma extending into the cervical spine and subcutaneous space via a cranium bifidum

2008 ◽  
Vol 30 (9) ◽  
pp. 603-605 ◽  
Author(s):  
Tomozumi Takatani ◽  
Hidee Arai ◽  
Katsunori Fujii ◽  
Toshiyuki Yasuda ◽  
Yoichi Kohno
Keyword(s):  
Cervical Spine ◽  
Posterior Fossa ◽  
Cranium Bifidum ◽  
Subcutaneous Space

Occipital condyle to cervical spine fixation in the pediatric population

2014 ◽  
Vol 13 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Libby Kosnik-Infinger ◽  
Steven S. Glazier ◽  
Bruce M. Frankel
Keyword(s):  
Cervical Spine ◽  
Posterior Fossa ◽  
Pediatric Population ◽  
Occipital Bone ◽  
Occipital Condyle ◽  
Type I ◽  
Posterior Fossa Surgery ◽  
Clinical Scenarios ◽  
Spine Fixation ◽  
Cervical Spine Fixation

Fixation at the craniovertebral junction (CVJ) is necessary in a variety of pediatric clinical scenarios. Traditionally an occipital bone to cervical fusion is preformed, which requires a large amount of hardware to be placed on the occiput of a child. If a patient has previously undergone a posterior fossa decompression or requires a decompression at the time of the fusion procedure, it can be difficult to anchor a plate to the occipital bone. The authors propose a technique that can be used when faced with this difficult challenge by using the occipital condyle as a point of fixation for the construct. Adult cadaveric and a limited number of case studies have been published using occipital condyle (C-0) fixation. This work was adapted for the pediatric population. Between 2009 and 2012, 4 children underwent occipital condyle to axial or subaxial spine fixation. One patient had previously undergone posterior fossa surgery for tumor resection, and 1 required decompression at the time of operation. Two patients underwent preoperative deformity reduction using traction. One child had a Chiari malformation Type I. Each procedure was performed using polyaxial screw-rod constructs with intraoperative neuronavigation supplemented by a custom navigational drill guide. Smooth-shanked 3.5-mm polyaxial screws, ranging in length from 26 to 32 mm, were placed into the occipital condyles. All patients successfully underwent occipital condyle to cervical spine fixation. In 3 patients the construct extended from C-0 to C-2, and in 1 from C-0 to T-2. Patients with preoperative halo stabilization were placed in a cervical collar postoperatively. There were no new postoperative neurological deficits or vascular injuries. Each patient underwent postoperative CT, demonstrating excellent screw placement and evidence of solid fusion. Occipital condyle fixation is an effective option in pediatric patients requiring occipitocervical fusion for treatment of deformity and/or instability at the CVJ. The use of intraoperative neuronavigation allows for safe placement of screws into C-0, especially when faced with a challenging patient in whom fixation to the occipital bone is not possible or is less than ideal.

086 Clinical course and therapy of a lipoblastoma of the posterior fossa and cervical spine in a newborn child

1999 ◽  
Vol 3 (6) ◽  
pp. A156
Author(s):  
S. Schiegl ◽  
A. Fiedler ◽  
M. Helmig ◽  
P. Gruss ◽  
J. Aderbauer ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Posterior Fossa ◽  
Clinical Course ◽  
Newborn Child

scholarly journals POGOSTOST ZRAČNE EMBOLIJE IN POOPERATIVNI ZAPLETI PRI NEVROKIRURŠKIH POSEGIH V SEDEČEM POLOŽAJU Skrajšana verzija naslova: ZRAČNA EMBOLIJA PRI NEVROKIRURŠKIH POSEGIH V SEDEČEM POLOŽAJU

2015 ◽  
Vol 84 (9) ◽  
Author(s):  
Alenka Spindler Vesel ◽  
Nina Pirc ◽  
Božidar Visočnik ◽  
Jasmina Markovič - Božič
Keyword(s):  
Cervical Spine ◽  
Posterior Fossa ◽  
Spine Surgery ◽  
Air Embolism ◽  
Neck Surgery ◽  
Postoperative Treatment ◽  
Posterior Fossa Surgery ◽  
Cervical Spine Surgery ◽  
Venous Air Embolism ◽  
Doppler Probe

Background: Posterior fossa surgery and cervical spine surgery are at risk for venous air embolism (VAE) occurrence. Mostly air emboli are small and asymptomatic, but invasion of large quantity of air in the circulation is symptomatic and potentially lethal. Transesophageal echocardiography is the most sensitive method for detection of air emboli in the heart, followed by the precordial Doppler probe, end tidal carbon dioxide monitoring (etCO2) and others.Methods: In our 14- years retrospective review we evaluated the incidence of VAE and postoperative complications in patients with posterior fossa surgery or cervical spine surgery. VAE was recognized by using Doppler probe and/or drop of etCO2. If VAE occurred, aspiration of air through the CVC was used to prevent or to minimized VAE occurrence, the surgeon was warned about the incident. VAE treatment was supportive.Results: VAE was recognized in 74 patients. Two patients after head surgery and four patients after neck surgery needed postoperative treatment in intensive care unit and controled mechanical ventilation. In six patients after head surgery and in four patients after neck surgery new neurological symptoms occurred. Two patients after head surgery died due to complications of massive VAE.Conclusions: VAE is rare, but serious complication of neurosurgery in sitting position. Preventive treatment, early detection of VAE, supportive treatment and treatment of cardiovascular complications are necessary for survival of patients with VAE.

scholarly journals 1223 Central sleep apnea and Chiari 1 malformation in a pediatric patient with Klippel-Feil sequence

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A467-A467
Author(s):  
Zara Martirosyan ◽  
Sonal Malhotra
Keyword(s):  
Cervical Spine ◽  
Sleep Apnea ◽  
Posterior Fossa ◽  
Chiari Malformation ◽  
Sleep Disturbances ◽  
Heart Defects ◽  
Central Sleep Apnea ◽  
Apnea Hypopnea Index ◽  
Posterior Fossa Decompression ◽  
Congenital Condition

Abstract Introduction Klippel- Feil Sequence (KFS) is a rare congenital condition that classically presents with a triad of congenital cervical spine fusion, reduced cervical spine flexion and low posterior hairline. KFS has been associated with several comorbidities including congenital heart defects, hearing loss, renal dysfunction, Chiari malformation and sleep disordered breathing (SDB). The co-occurrence of SDB and chiari malformation type 1 (CM1) has been reported in multiple individuals. However, the pathological basis of the connection between CM1 and SDB in the setting of KFS is not clearly understood. Report of Case Here we present a pediatric case report of a patient with KFS, SDB, drooling and dysphagia. The drooling and dysphagia prompted an MRI that revealed CM1. Baseline polysomnogram (PSG) showed mild central sleep apnea with apnea-hypopnea index (AHI) 6.06 comprised of central apnea index 4.81 and obstructive apnea index 1.28. Posterior fossa decompression of this patient, following neurology recommendations, resolved majority of the symptoms, namely the drooling, nocturnal cough, dysphagia and sleep disturbances. However unexpectedly repeat polysomnogram eight weeks after posterior fossa decompression revealed worsening central sleep apnea despite the patient being clinically asymptomatic. Conclusion Taken together this case highlights the point that while it is critical to recognize the association of SDB in the setting of KFS, decompression alone may not be sufficient to completely alleviate SDB and/or certain neurological symptoms such as nocturnal coughing. Our observations are consistent with the hypothesis that SDB in a setting of KFS is multifactorial and pathophysiology is not clearly understood.

Paroxysmal Hemicrania-Tic and Chiari I Malformation: An Unusual Association

Cephalalgia ◽  
2007 ◽  
Vol 27 (12) ◽  
pp. 1408-1412 ◽  
Author(s):  
P Monzillo ◽  
P Nemoto ◽  
A Costa ◽  
AJ Rocha
Keyword(s):  
Cervical Spine ◽  
Trigeminal Neuralgia ◽  
Posterior Fossa ◽  
Chiari I Malformation ◽  
Paroxysmal Hemicrania ◽  
Unusual Association ◽  
Chronic Paroxysmal Hemicrania ◽  
Ihs Criteria ◽  
Chiari I ◽  
Clinical Description

A 54 year-old female has a clinical diagnosis of chronic paroxysmal hemicrania (CPH) according to IHS-criteria (2004) three years ago. Six months after that, she developed symptoms compatible with trigeminal neuralgia (TN) involving the second and third trigeminal territories also at the left side. Cranial and cervical spine resonance magnetic images showed extensive cervical syringomyelia that included nucleus caudalis (C2 level) region and a posterior fossa Chiari I malformation without hydrocephalus. The association between CPH and TN is called chronic paroxysmal hemicrania-tic syndrome (CPH-tic). This is the first clinical description of a secondary cause of CPH-tic syndrome in the literature.

Congenital neural abnormalities presenting with mirror movements in a patient with Klippel-Feil syndrome

1983 ◽  
Vol 59 (5) ◽  
pp. 891-894 ◽  
Author(s):  
Ian R. Whittle ◽  
Michael Besser
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Posterior Fossa ◽  
Pyramidal Tract ◽  
Cervical Spinal Cord ◽  
Content Type ◽  
Mirror Movements ◽  
Posterior Fossa Cyst ◽  
Vertebral Anomalies ◽  
Fine Print

✓ A young girl with Klippel-Feil syndrome presented with the onset of mirror movements in early childhood. Computerized tomography studies of her cervical spine and brain revealed fibrous diastematomyelia with duplication of the cervical spinal cord and an extra-axial midline posterior fossa cyst, together with the multiple cervical vertebral anomalies. Exploration of the posterior fossa lesion revealed it to be a dermoid cyst. The congenital spinal and cord abnormalities found in this case support the hypothesis that the Klippel-Feil syndrome may be associated with variable duplication of the spinal cord and that mirror movements may be related to impairment of pyramidal tract decussation.

An infant with an intradural lipoma of the cervical spine extending into the posterior fossa

2003 ◽  
Vol 10 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Yasutoshi Kai ◽  
Toshiyuki Amano ◽  
Takanori Inamura ◽  
Toshio Matsushima ◽  
Miki Takamatsu ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Posterior Fossa ◽  
Intradural Lipoma
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