scholarly journals Delayed Tension Pneumocephalus following Gunshot Wound to the Head: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Arthur Wang ◽  
Elena Solli ◽  
Nathan Carberry ◽  
Virany Hillard ◽  
Adesh Tandon
Keyword(s):  
Gunshot Wound ◽  
Rare Complication ◽  
Mass Effect ◽  
Neurological Deficits ◽  
Neurosurgical Procedures ◽  
Review Of The Literature ◽  
Increased Intracranial Pressure ◽  
Tension Pneumocephalus ◽  
Postnasal Drip ◽  
The Right

Tension pneumocephalus is a rare complication of head trauma and neurosurgical procedures, amongst other causes. It is defined by the combination of intracranial air, increased intracranial pressure, and mass effect. Although it often presents soon after surgery, it can also rarely present in a delayed fashion. We present a case of delayed tension pneumocephalus, occurring approximately 16 weeks after bifrontal craniectomy for a self-inflicted gunshot wound. Following a month of rhinorrhea, postnasal drip, and cough, the patient presented with a sensation of expansion in the area of the right forehead. As tension pneumocephalus is an emergency that can be fatal, this patient was treated expediently and avoided severe neurological deficits. The case recounted here is important as a demonstrative example that tension pneumocephalus does not always follow a defined course immediately after trauma or neurosurgery but rather can develop insidiously without obvious signs.

Endovascular Treatment of an Aneurysm of a Persistent Primitive Hypoglossal Artery With Complete Resolution of Brainstem Compressive Symptoms: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 68 (3) ◽  
pp. E854-E857 ◽  
Author(s):  
Ferdinand K. Hui ◽  
Albert J. Schuette ◽  
Charles M. Cawley
Keyword(s):  
Lower Extremity ◽  
Complete Resolution ◽  
Mass Effect ◽  
Neurological Deficits ◽  
Lower Extremity Weakness ◽  
Computed Tomographic ◽  
Hypoglossal Artery ◽  
Patient Reported ◽  
Persistent Primitive Hypoglossal Artery ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE: Aneurysms of the posterior circulation may manifest with neurological deficits related to mass effect on the brainstem. We present an unusual case of an aneurysm resulting in selective lower-extremity weakness and gait instability. CLINICAL PRESENTATION: A 61-year-old man presents with progressively worsening gait instability over the course of several months. A magnetic resonance image and computed tomographic angiogram demonstrate a persistent hypoglossal artery associated with an aneurysm invaginating into the pontomedullary junction. The patient manifested only lower-extremity symptoms. An endovascular approach through the right internal carotid artery and persistent primitive hypoglossal artery was assayed, coiling off the aneurysm with complete angiographic occlusion. One month after the procedure, the patient reported marked improvement in symptoms with residual difficulty walking. At the 1-year postprocedure interval, he reported nearly complete resolution of symptoms. CONCLUSION: Endovascular therapy of an aneurysm invaginating into the brainstem is safe and efficacious.

scholarly journals Retrograde venous bullet embolism after thoracic gunshot

2013 ◽  
Vol 12 (4) ◽  
pp. 324-328 ◽  
Author(s):  
Leonardo Pessoa Cavalcante ◽  
Marcos Velludo Bernardes ◽  
Ricardo Dias da Rocha ◽  
Marcos Henrique Parisati ◽  
Jose Emerson dos Santos Souza ◽  
...  
Keyword(s):  
Ct Scan ◽  
Gunshot Wound ◽  
Rare Complication ◽  
Iliac Vein ◽  
X Rays ◽  
Abdominal Injuries ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
The Right

Bullet embolism is a rare complication of penetrating gunshots. We present a case of a 24-year-old man with a gunshot wound in the left scapular area, with no exit wound. Abdominal X-rays and a computed tomography (CT) scan suggested that the bullet was located within the intra-abdominal topography (intrahepatic), but laparotomy revealed no intra-abdominal injuries. After surgery, a sequential CT scan showed that the bullet had migrated to the right internal iliac vein (IIV). Venography confirmed the diagnosis of right IIV embolism and the decision was taken to attempt snare retrieval of the bullet, which was unsuccessful. It was therefore decided to leave the missile impacted inside the right IIV and the patient was put on oral anticoagulation. The patient recovered and was event free at 6 months' follow up.

scholarly journals Conquering Mount Fuji: Resolution of Tension Pneumocephalus with a Foley Urinary Catheter

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Shahid M. Nimjee ◽  
Ali R. Zomorodi ◽  
D. Cory Adamson
Keyword(s):  
Ct Scan ◽  
Clinical Improvement ◽  
Computerized Tomography ◽  
Urinary Catheter ◽  
Symptomatic Relief ◽  
Neurological Deficits ◽  
Neurosurgical Procedures ◽  
Characteristic Finding ◽  
Tension Pneumocephalus ◽  
The Brain

Tension pneumocephalus is the presence of air or gas in the cranium that is under pressure. It occurs due to disruption of the skull, including trauma to the head or face, after neurosurgical procedures and occasionally, spontaneously (Schirmer et al., 2010). Patients typically present with headache but can also have neurological deficits such as decreased mental status, numbness, and weakness (Schirmer et al., 2010). It is diagnosed by computerized tomography (CT) scan (Michel, 2010). The characteristic finding is that the two frontal poles of the brain are separated by air. After diagnosis, treatment is imperative for both symptomatic relief and preventing further compression. We present a case of a patient who presented with tension pneumocephalus and unconventional treatment that resulted in clinical improvement of his symptoms and radiographic resolution of his condition.

scholarly journals Case Report: A 62-Year-Old Woman With Contrast-Induced Encephalopathy Caused by Embolization of Intracranial Aneurysm

2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Zhang ◽  
Ming Zhou ◽  
Dong Wang ◽  
Tao Liu ◽  
Pengfei Chang ◽  
...  
Keyword(s):  
Internal Carotid ◽  
Rare Complication ◽  
Symptomatic Treatment ◽  
Neurological Deficits ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Occipital Lobes ◽  
Supportive Management ◽  
The Brain ◽  
Benign Course

Contrast-induced encephalopathy (CIE) is a rare complication of endovascular treatment and is extensively reported as a transient and reversible phenomenon. This report describes a 62-year-old woman for embolization of an internal carotid artery (ICA) aneurysm. The operation was successful, but postoperation the patient suffered unconsciousness, blindness, hemiplegia, ophthalmoplegia, fever, and seizures. CT of the brain without the contrast showed widespread edema in the right cerebral hemisphere, which is involved in the frontal, parietal, temporal, and occipital lobes. She was diagnosed with CIE in time and treated with supportive management as soon as possible, and fortunately, the patient improved a benign course and was discharged without any neurological deficits. This study emphasizes the prevention of the CIE and the importance of early diagnosis and symptomatic treatment.

scholarly journals A Case Report of Lhermitte-Duclos Disease in a 10-Month-Old Child Presenting with Hydrocephalus

2019 ◽  
Vol 16 (3) ◽  
pp. 68-71
Author(s):  
Abhishek Tamrakar ◽  
Pritam Gurung ◽  
Samir Acharya ◽  
Pravesh Rajbhandhari ◽  
Basant Pant
Keyword(s):  
Obstructive Hydrocephalus ◽  
Clinical Manifestations ◽  
Mass Effect ◽  
Cerebellar Hemisphere ◽  
Third Ventriculostomy ◽  
Magnetic Resonance Imaging Scan ◽  
Increased Intracranial Pressure ◽  
Post Contrast ◽  
The Right ◽  
Cerebellar Symptoms

Lhermitte–Duclos Disease is a rare entity characterized by diffuse or focal enlargement of cerebellar folia. Clinical manifestations are usually related to a mass effect and secondary obstructive hydrocephalus. Increased intracranial pressure symptoms and cerebellar symptoms are the most frequent patient complaints. We present a 10-month-old male child with his mother who presented to the outpatient department with complaints of enlargement of size of head since the last one week. Magnetic Resonance Imaging scan revealed the features of Lhermitte–Duclos Disease involving the right cerebellar hemisphere with marked post contrast gyral enhancement. He underwent endoscopic third ventriculostomy. Lhermitte–Duclos Disease is very rare in early childhood and should be considered in the differential diagnosis of posterior fossa lesions.

scholarly journals Bullet embolism in a case of homicide: Case report

2013 ◽  
Vol 141 (3-4) ◽  
pp. 242-246
Author(s):  
Vladimir Zivkovic ◽  
Fehim Jukovic ◽  
Slobodan Nikolic
Keyword(s):  
Femoral Artery ◽  
Gunshot Wound ◽  
Imaging Techniques ◽  
Rare Complication ◽  
Gunshot Wounds ◽  
The Body ◽  
Gunshot Injury ◽  
Thoracic Vertebrae ◽  
Injured Part ◽  
The Right

Introduction. Bullet embolism is a special form of embolism, where embolus is either a bullet or its fragment. Bullet penetrates through the injured part of the body into circulation and then travels to a distant part of the body, until it gets blocked in a vessel of the same diameter as the bullet. Case Outline. We are presenting a case of gunshot injury in a 26?year?old male, found unconscious on the passenger seat, with the gunshot injury of the right hand and hemithorax, who died two hours after admission to hospital. Post?mortem X?ray revealed the presence of a metallic foreign body - a bullet, in the level of the left femoral neck. The autopsy revealed entrance and exit gunshot wounds of the upper third of the right upper arm. There was a second entrance gunshot wound, and the bullet passed through the right hemithorax and the right lung, and then through the intervertebral disc between the eighth and ninth thoracic vertebrae, and also making a complete laceration of the wall of the thoracic aorta, in the right posterior semicircumference. The slightly deformed bul? let, caliber 7.65 mm, was found embedded in the lumen of the vessel at the bifurcation of the deep femoral artery from the left femoral artery. Conclusion. Bullet embolism is a rare complication of gunshot wounds. It should be suspected in any gunshot wound victim without an exit wound, or the lack of a missile in the bullet pathway, or if there are premortem signs or symptoms unexpected for the presumed pathway of the bullet, such as distant ischemia or infection. In these cases, some of postmortem imaging techniques should be used to save time in diagnosis, treatment and at autopsy.

scholarly journals P.024 An atypical presentation of neurocysticercosis: a Manitoban case

2017 ◽  
Vol 44 (S2) ◽  
pp. S19-S19
Author(s):  
PA Szelemej ◽  
E Wiens ◽  
J Silvaggio ◽  
M Bigder
Keyword(s):  
Mass Effect ◽  
Atypical Presentation ◽  
Review Of The Literature ◽  
Large Lesion ◽  
Pathological Analysis ◽  
The Past ◽  
History Of ◽  
The Right ◽  
Developed Nations ◽  
Human Nervous System

Background: Neurocysticercosis is the world’s leading cause of epilepsy and the most common helminthic disease affecting the human nervous system. It is relatively rarely seen in developed nations, and usually presents clinically with seizures. Methods: This case report was prepared using the patient’s hospital chart, and a review of the literature was undertaken using PubMed. This case was subsequently compared and contrasted to the known neurocysticercosis literature. Results: This is the case of an otherwise healthy 38 year old Nepalese female who presented with a history of headaches. Nonspecific in nature, they had worsened in the past couple of weeks, thus prompting appropriate imaging of the head. A large 4 cm ring enhancing lesion with edema and mass effect was discovered in the right anterior temporal lobe. No other neurological findings were found on exam. Pathological analysis confirmed a larval scolex of T. solium. Conclusions: Aside from being an unusual pathology to be seen in Manitoba, this case is unique in both its clinical and radiographic presentations. There were no seizures noted on presentation, and a significant amount of mass effect was seen around a large lesion, all unusual features for neurocysticercosis.

Direct Vertebral Artery Access for Coil Embolization of a Partially Thrombosed Mid-Basilar Trunk Aneurysm: Technical Limitations

2021 ◽  
Author(s):  
Charles A Miller ◽  
Daniel R Felbaum ◽  
Ai-Hsi Liu ◽  
Jeffrey Mai ◽  
Abdullah Alfawaz ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Mass Effect ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Treatment Modalities ◽  
High Morbidity ◽  
Direct Exposure ◽  
Ct Head ◽  
The Right ◽  
V1 Segment

Abstract BACKGROUND AND IMPORTANCE Partially thrombosed basilar aneurysms have a high morbidity from the rupture risk and mass effect prompting early treatment. Depending on the size and location, they pose a surgical challenge often requiring multiple endovascular treatment modalities. Here we present a partially thrombosed mid-basilar aneurysm successfully coil embolized with direct vertebral artery access and discuss the technical limitations of direct V1 access. CLINICAL PRESENTATION A 70-yr-old woman presented with acute onset headache, nausea, and vomiting. A computed tomography (CT) head demonstrated a hyperdense prepontine mass which was further characterized as a partially thrombosed basilar aneurysm on CT angiography. After multiple failed attempts to access the vertebral artery via femoral and radial access the patient was taken to the operating room (OR) for surgical exposure of the right V1 segment and direct cannulation of the vertebral artery. The aneurysm was successfully coiled and the vertebral artery closed primarily. The patient was discharged home without any neurological deficits. CONCLUSION Partially thrombosed mid-basilar aneurysms are difficult to treat both surgically and endovascularly. We present a case where endovascular access to the aneurysm was very challenging requiring direct exposure and cannulation of the V1 segment to successfully embolize with coils and discuss the technical limitations of this approach.

Acute Paradoxical Herniation: A Case Report

2021 ◽  
Author(s):  
Vanessa Denny ◽  
Davina Shalev ◽  
Jahannaz Dastgir ◽  
Erin Johnson ◽  
Maria Escobar ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Medical Therapy ◽  
Decompressive Craniectomy ◽  
Atmospheric Pressure ◽  
Rare Complication ◽  
Neurological Deficits ◽  
Increased Intracranial Pressure

AbstractDecompressive craniectomy is used to relieve acute increased intracranial pressure (ICP) when medical therapy has failed. Paradoxical herniation is a rare complication that occurs when the pressure of the intracranial contents falls abnormally below the atmospheric pressure. Symptoms often include neurological deficits, the etiology of which is often mistaken for elevated ICP. This diagnosis requires quick recognition, and treatment requires a change from ICP reduction therapies to those that increase the ICP, and ultimately cranioplasty.

scholarly journals Spinal Cord Compression Secondary to Extramedullary Hematopoiesis: Case Report and Review of the Literature

2016 ◽  
Vol 9 (2) ◽  
pp. 290-297 ◽  
Author(s):  
Arthur Wang ◽  
Nathan Carberry ◽  
Elena Solli ◽  
John Gillick ◽  
Humayun Islam ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Blood Cells ◽  
Mass Effect ◽  
Myeloproliferative Disorders ◽  
Extramedullary Hematopoiesis ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Review Of The Literature ◽  
Spleen And Lymph Nodes

Extramedullary hematopoiesis (EMH) is a rare cause of spinal cord compression (SCC). EMH represents the growth of blood cells outside of the bone marrow and occurs in a variety of hematologic illnesses, including various types of anemia and myeloproliferative disorders. Although EMH usually occurs in the liver, spleen, and lymph nodes, it may also occur within the spinal canal. When this occurs, the mass effect can compress the spinal cord, potentially leading to the development of neurological deficits. We present a case of SCC secondary to EMH. This report illustrates the importance of considering EMH in the differential diagnosis of SCC, even in the absence of signs of its most common etiologies.

Sign in / Sign up

Export Citation Format

Share Document