scholarly journals Atlanto-axial subluxation with cervical myelopathy operated with occipital C2 fusion: A case report

2017 ◽  
Vol 1 (1) ◽  
pp. 4-7
Author(s):  
Rahul Kadam ◽  
Vishal Bauva ◽  
Krutarth Shah ◽  
Sunil Yadav
Keyword(s):  
Case Report ◽  
Cervical Myelopathy ◽  
Muscle Tone ◽  
Rare Condition ◽  
Posterior Arch ◽  
Atlantoaxial Joint ◽  
Posterior Aspect ◽  
Posterior Displacement ◽  
Grisel Syndrome ◽  
Magnetic Resonance Imaging Mri

Background: Atlantoaxial subluxation with cervical myelopathy is a rare condition that can occur mainly by trauma followed by Rheumatoid arthritis, Grisel syndrome, Down’s syndrome and various other metabolic disorders. It is characterized by excessive movement of atlas (C1) over axis (C2) either by bony or ligamentous abnormality. Due to its laxity the spinal cord may get damaged and cause neurologic symptoms. Reduction and fixation is needed for such instability. Case Report: This 55-year-old gentleman was apparently all right 4 years back when he gradually developed difficulty in walking and imbalance. Bilateral Babinski sign was positive, All deep tendon reflexes were brisk; muscle tone was increased with clasp-knife spasticity present in all four limbs. Ankle and patellar clonus was present bilaterally. His X-ray cervical spine showed C1-C2 subluxation in flexion and extension views. Magnetic resonance imaging (MRI) of Cranio-vertebral junction.  Mild subluxation of atlantoaxial joint (3.1 mm) with posterior displacement of dens causing narrowing of bony cervical spinal canal with reduced distance between posterior aspect of dens of C2 and anterior aspect of posterior arch of C1 vertebrae was noticed. Atlas was also slightly displaced anteriorly in relation to baso-occiput. We managed this patient with occipital cervical fusion after reduction from a posterior approach using screws and rods construct and fusion with bone graft from iliac crest. Post operatively the patient was able to walk without any support and tone of the muscles in lower limb decreased, no tingling or numbness are present, no signs of local infection or inflammation. Conclusion: We suggest to operate atlanto-axial subluxation and cervical myelopathy with occipital C2 fusion.

scholarly journals Dyke-Davidoff-Masson Syndrome: A case Report in a patient presenting with drug-resistant epilepsy and pseudoseizures

2021 ◽  
Author(s):  
Pedro Schmidt dos Reis Matos Figueiredo ◽  
Thiago Oliveira Chaves
Keyword(s):  
Case Report ◽  
Cognitive Dysfunction ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Drug Resistant ◽  
Cerebral Hemiatrophy ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Drug Resistant Epilepsy

Context: Dyke-Davidoff-Masson (DDM) syndrome is a rare neurological condition, first described in 1933. Characteristics include cerebral hemiatrophy, contralateral hemiparesis, seizures, and cognitive dysfunction, combined into different degrees and patterns. Brain magnetic resonance imaging (MRI) is used to perform diagnosis throughout its specific findings. Case Report: A eighteen-year-old female presented to our service with a history of cognitive dysfunction and seizures since early childhood, which persistence even with adequate use of antiepileptic drugs. During Investigation were found signs and symptoms compatible with DDM syndrome, and evidence of pseudoseizures captured in a video electroencephalography monitoring. Conclusion: DDM syndrome is a rare condition that must be part of differential diagnosis in patients with seizures and cerebral hemiatrophy. Management is based on adequate control of seizures and other comorbidities.

scholarly journals Microsurgical Resection of Medulla Oblongata Hemangioblastoma: 2-Dimensional Operative Video

2018 ◽  
Vol 15 (5) ◽  
pp. E64-E65 ◽  
Author(s):  
Mirza Pojskić ◽  
Kenan I Arnautović
Keyword(s):  
Medulla Oblongata ◽  
Posterior Arch ◽  
Tumor Nodule ◽  
Posterior Aspect ◽  
Von Hippel Lindau ◽  
Postoperative Mri ◽  
Suboccipital Craniectomy ◽  
Microsurgical Resection ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract This video demonstrates the microsurgical resection of brainstem hemangioblastoma. The patient is a 32-yr-old woman with Von Hippel Lindau syndrome who presented with quadriparesis and inability to swallow. Magnetic resonance imaging (MRI) of the neuroaxis revealed a brainstem cystic lesion with contrast-enhancing tumor nodule right along the posterior aspect of the lower part of medulla oblongata. The surgery was performed in the prone position with suboccipital craniectomy and partial C1 posterior arch removal. The aim of the surgery was to remove the tumor nodule.1-12 The tumor was separated from the right dorsal nerve roots, and then progressively dissected with coagulation of arterial feeders and draining vein and division of the pia circumferentially. Postoperative MRI revealed complete resection. The patient completely recovered from her quadriparesis and difficulty swallowing.

scholarly journals Agenesis of Submandibular Glands: A Report of Two Cases with Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Medine Kara ◽  
Oğuz Güçlü ◽  
Fevzi Sefa Dereköy ◽  
Mustafa Resorlu ◽  
Gürhan Adam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Submandibular Gland ◽  
Conservative Therapy ◽  
Rare Condition ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
The Family ◽  
Magnetic Resonance Imaging Mri

Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG.Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI).Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family.

scholarly journals Motor tic disorder and traumatic cervical myelopathy: a case report

2011 ◽  
Vol 10 (2) ◽  
pp. 152-154
Author(s):  
Ericson Sfredo ◽  
Felipe Martins de Lima Cecchini ◽  
Sérgio Fernando Raupp ◽  
Julia Bertholdo Bossardi ◽  
Asdrubal Falavigna
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Functional Mri ◽  
Cervical Myelopathy ◽  
Cord Compression ◽  
Tic Disorder ◽  
Intramedullary Lesion ◽  
Abnormal Movements ◽  
Magnetic Resonance Imaging Mri ◽  
Motor Tics

The association between motor tics and cervical myelopathy is rare and not well understood. Only a few papers in the literature reported this disorder until the present date. This is a case report of a cervical myelopathy case secondary to a motor tic disorder. A 23-year-old male with a 10-year history of motor tic disorder, involving sudden forced extension of the head and cervical spine. Disturbed tactile sensation and kinetic posturing that progressed to the Lhermitte sign every time he made the movement were detected over the last six months. Magnetic resonance imaging (MRI) showed hyperintense intramedullary lesion at C2-C3, degeneration at C3-C4, and no signs of spinal cord compression. On sagittal view, functional MRI with head extension showed anterior compression with protrusion of the intervertebral disc and posterior compression of the yellow ligaments causing spinal cord stenosis. Anterior discectomy and fixation of C3-C4 were performed. There were no complications. The patient showed improvement and the motor tics were controlled by haloperidol. The patient remains symptom-free after 2 years of follow-up. Uncontrolled motor tics can compromise spinal cord function. Functional MRI can reproduce the abnormal movements and clarify the physiopathology.

scholarly journals POSTERIOR C1-C2 FUSION FOR ATLANTOAXIAL ROTATORY FIXATION AFTER POSTERIOR FOSSA CRANIOTOMY IN A 4-YEAR-OLD: A CASE REPORT

2019 ◽  
Author(s):  
Vinicius Meldau Benites ◽  
Sergio Cavalheiro
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Plain Radiograph ◽  
Posterior Arch ◽  
Neurosurgical Procedures ◽  
Atlantoaxial Joint ◽  
First Case ◽  
Atlantoaxial Rotatory Fixation ◽  
Harms Technique ◽  
Rotatory Fixation

Abstract Study Design: Case report Objective: This study aimed to highlight that Atlantoaxial rotatory fixation (AARF) can be related to neurosurgery procedures in children with an afterwards demonstration of good results after halo-gravity traction and C1-C2 stabilization using the Harms technique. Summary of Background Data: AARF is characterized by dislocation or subluxation of the atlantoaxial joint, leading to a rotational deformity which may cause pain. Such a condition is mostly found in pediatric patients. Trauma, upper respiratory infections, surgery of the head and the neck, and even rheumatoid arthritis and Down syndrome have been designated as predisposing factors. It is important to note that in some cases AARF evolves with no apparent cause and to date, the choice of optimal surgical procedure should be carefully selected, considering the anatomical and bone conditions, as well as the surgeon’s experience with each technique. Methods: We report the first case related, in our knowledge, of a 4-year-old boy who presented atlantoaxial rotatory fixation after a posterior fossa craniotomy to treat a cerebellar astrocytoma. Results: At our medical facility, we diagnosed AARF by plain radiograph and CT image, and he was treated with continuous cranial traction for 14 days. Initially, we detected that he had no C1 posterior arch or C2 spinous process, so our choice was to perform Harms technique. Postoperatively, the patient was placed in a cervical collar for four weeks. At him 4-years postoperative follow-up, he was doing well and did not develop any complication. Conclusion: We call the attention to the fact of AARF can be developed after neurosurgical procedures. A surgical technique to be used in Atlantoaxial subluxation should be carefully select. In our case, Harms technique after cranial traction was an excellent option to correct and stabilize the abnormal neck position presented. However, further studies are required to determine the best technique to be used in the pediatric population.

scholarly journals XI cranial nerve cervical schwannoma – Case report

2014 ◽  
Vol 33 (02) ◽  
pp. 160-163
Author(s):  
Roger Schmidt Brock ◽  
Marcelo Viana da Silva Barroso ◽  
Iuri Santana Neville ◽  
Marcos Queiroz Teles Gomes ◽  
Alberto Capel Cardoso ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Stimulation ◽  
Nerve Palsy ◽  
Rare Condition ◽  
Neurological Status ◽  
Posterior Arch ◽  
Cervical Pain ◽  
Spinal Accessory ◽  
Suboccipital Craniectomy ◽  
Complete Surgical Resection

Cisternal spinal accessory schwannoma are still a rare condition without neurofibromatosis with only 32 cases reported so far. We describe a cisternal accessory schwannoma presented in a 36-year-old woman with posterior cervical pain and cervical mieolopaty, defined by grade IV tetraparesia. A suboccipital craniectomy with C1 posterior arch resection was performed. During microsurgical dissection together with electrophysiological monitoring and nerve stimulation tumor was identified as having the spinal accessory root as its origins. Carefully intraneural dissection was then performed with complete lesion removal, histopatological examination confirmed the hypothesis of schwannoma. The patient was free from pain and improved her neurological status with no accessory nerve palsy. Complete surgical resection is indicated for such lesions and can be achieved with good outcome.

scholarly journals Cataplexy in a patient treated for prolactinoma: Case report

2017 ◽  
Vol 74 (8) ◽  
pp. 782-785 ◽  
Author(s):  
Marina Nikolic-Djurovic ◽  
Alberto Pereira ◽  
Zvezdana Jemuovic ◽  
Dragan Pavlovic ◽  
Dragana Jankovic ◽  
...  
Keyword(s):  
Case Report ◽  
Tricyclic Antidepressants ◽  
Muscle Tone ◽  
Rare Condition ◽  
Empty Sella ◽  
Psychiatric Evaluation ◽  
First Case ◽  
Obstructive Sleep ◽  
Cardiovascular Evaluation ◽  
Suicidal Ideas

Introduction. Isolated cataplexy, without the presence of narcolepsy, is a relatively rare condition, and can be regarded as attacks of motor inhibition with loss of muscle tone and areflexia. The diagnosis of cataplexy relies on the clinical presentation and medical history and it is rarely confirmed by video-polygraph. We here described a female patient treated for prolactinoma who developed isolated cataplexy. Case report. A 53-year-old female treated with bromocriptine for a macroprolactinoma presented with sudden episodes of weakness and toneless legs leading to falls and injuries on several occasions. Cardiovascular evaluation was completely normal. Psychiatric evaluation showed no psychotic phenomenology or suicidal ideas. Pituitary imaging showed empty sella with a remnant sellar mass with infra- and parasellar extension. Neurological examination revealed mild obstructive sleep hypopnea/apnea. Electroencephalographic monitoring during sleep and awakening did not show appearance of epi potentials. HLA haplotyping was positive for HLADR3,16; DR51;DQ1 allele, confirming a diagnosis of isolated cataplexy. Treatment included tricyclic antidepressants and reduction of bromocriptine dosage with resolution of cataplexy. Conclusion. We reported the first case of isolated cataplexy most probably associated with dopamine agonist treatment for prolactinoma.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

MARKED FIRST-DEGREE ATRIOVENTRICULAR BLOCK ASSOCIATED WITH PSEUDO-PACEMAKER SYNDROME: A CASE REPORT

2019 ◽  
pp. 199-206
Author(s):  
О. З. Скакун ◽  
С. В. Федоров ◽  
О. С. Вербовська ◽  
І. З. Твердохліб
Keyword(s):  
Case Report ◽  
Atrioventricular Block ◽  
Heart Block ◽  
Pacemaker Implantation ◽  
Rare Condition ◽  
Permanent Pacemaker ◽  
Type I ◽  
Atrial Contraction ◽  
General Weakness ◽  
Pacemaker Syndrome

Distinctive atrioventricular type I heart block is diagnosed when the PQ interval is 0.30 s. or more. Prolongation of the PQ interval more than 0.50 s. is a very rare condition. Usually it is associated with a pseudo-pacemaker syndrome. The last one manifests itself with dizziness, syncope, general weakness, shortness of breath upon physical exertion, cough, seizures, cold sweat, a feeling of pulsation in the head, neck and abdomen, a headache, paroxysmal nocturnal dyspnea, swelling of the lower extremities, tachypnea and jugular venous pulsation. The P wave appears immediately after the previous QRS complex. Atrial contraction occurs at the moment when the ventricles don’t relax after the previous contraction; due to the fact that pressure in the ventricles at this moment is higher than in the atria, the tricuspid and mitral valves remains closed. During the atrial contraction, most of the blood is ejected not into the ventricles, but backward into the pulmonary veins from the left atrium and into the venae cavae from the right atrium. Also, an atrial kick is absent which results in a less ventricular filling. There is increased pressure in the atria leading to their distension and excessive secretion of the atrial natriuretic peptide. A case report of the distinctive atrioventricular type I heart block associated with the pseudo-pacemaker syndrome is described. The patient suffered from a pre-syncope, short-term dizziness during the previous two days, tinnitus, general weakness, feeling of pulsation in the abdomen, neck, head, which interfered with his sleep. He developed these complaints after an infectious disease, which manifested as a runny nose and sore throat. In this patient, an extremely prolonged PQ interval up to 0.70 s. was observed. Also, episodes of Mobitz I and Mobitz type II atrioventricular block were detected. During the monitoring of patient state, the interval PQ was gradually shortening, and in 1 month it reached the normаl duration. It can be assumed that in the case of distinctive atrioventricular type I heart block, a significant prolongation of the refractory period in the rapid pathways of the AV-node plays a key role in the pathogenesis of this condition. According to the recommendations of the ACC/AHA (1998), for patients with distinctive atrioventricular type I heart block accompanied by the pseudo-pacemaker syndrome and documented alleviation of symptoms with temporary AV pacing, the pacemaker implantation should be considered (IIaB). The implantation of dual chamber pacemaker may reduce symptoms and lead to an improvement in the functional state of patients, in whom shortening of the interval between atrial and ventricular contractions improves hemodynamics. For asymptomatic patients with the PQ interval of ≥ 0.30 s, pacemaker is not recommended. The distinctive atrioventricular type I heart block in patients with pseudo-pacemaker syndrome is a rare condition and often remains undiagnosed. But it may have a benign course with a gradual normalization of the PQ interval. Indications for permanent pacemaker implantation should be reviewed as this block may be completely reversible. A permanent pacemaker may be used in the case of absence of positive dynamics in a shortening of the PQ interval.    

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