Kraruplindgreen4960

In the presented case, surgical resection of the tumor was performed achieving a gross total resection, and the patient was discharged without neurological deficit. CONCLUSIONS The interpeduncular sulcus safe entry zone provides an alternative direct route for treating intrinsic pathological entities situated in the posterolateral tegmen of the pons between the superior and middle cerebellar peduncles. The surgical corridor provided by this entry point avoids most eloquent neural structures, thereby preventing surgical complications. BACKGROUND Fetal trauma during pregnancy can have significant impact on the developing brain. Fetal trauma can lead to several intracranial pathologies including hypoxic-ischemic injury, skull fractures, and intracranial hemorrhages. Blunt trauma to a fetus resulting in the need for neurosurgical intervention is a rare occurrence and seldom described in the literature. CASE DESCRIPTION Here we present the case of a 28-year old, 36-week pregnant woman who was brought to the hospital by ambulance following a high-speed motor vehicle collision as the restrained driver. On computed tomography (CT) of the abdomen, the fetus was found to have a left sided skull fracture with intracranial hemorrhage. The fetus was emergently delivered by way of caesarean section for lack of fetal movement and indeterminate heart tracings. Postnatally, the neonate had a Glasgow Coma Scale (GCS) of 7. A postnatal head CT better defined the skull fractures and multiple areas of intracranial hemorrhage. The baby was taken to the operating room for evacuation of the hematomas. At 16 months of age, the baby was well with only mild developmental delay, although a ventriculoperitoneal shunt was needed in a delayed fashion at 3 months of age. CONCLUSION We present a rare situation where emergent caesarean section delivery followed by neonatal craniotomy was necessary. Our case illustrates that good outcomes can be achieved with rapid identification of fetal intracranial injury and intervention. BACKGROUND Autologous bone resorption is a frequent complication of cranioplasty, often necessitating reoperation. The etiology of this phenomenon is not known although it has recently been associated with indolent Propionibacterium acnes (P. acnes) infection. https://www.selleckchem.com/products/EX-527.html CASE DESCRIPTION Here we present the case of a patient who initially presented with a traumatic acute subdural hematoma treated with emergent decompressive hemicraniectomy and hematoma evacuation. His bone flap was cryopreserved. Three months later he underwent cranioplasty with his autologous bone. Over the subsequent 14 months, serial imaging demonstrated progressive bone flap resorption, ultimately requiring repeat cranioplasty with a custom allograft. Although there was no evidence of infection at the time of repeat cranioplasty, routine culture swabs were taken and grew P. acnes after the patient had been discharged home. Pathological analysis of the fragments of the original bone flap that were removed demonstrated osteonecrosis with marrow fibrosis but no evidence of inflammation or infection. He was treated with six weeks of intravenous antibiotics and had no evidence of infection at eight-month follow-up. CONCLUSION Indolent P. acnes infection can precipitate autologous bone flap resorption. While the mechanism of this is unknown, our pathological analysis of a partially resorbed bone flap in the setting of an indolent P. acnes infection found no evidence of an infectious process or inflammation within the bone. Further studies are needed to elucidate the mechanism of action of P. acnes in bone flap resorption. BACKGROUND Rathke cleft cyst (RCC) can cause acute symptoms mimicking pituitary adenoma (PA) apoplexy. We evaluated the clinicoradiological features for distinguishing RCC from PA apoplexy. METHODS We retrospectively evaluated 22 RCC patients and 24 PA patients with apoplexy-like symptoms who underwent surgery via a trans-sphenoidal approach between November 1999 and December 2016. We compared the clinical data and MR images between the two groups. RESULTS The RCC group was younger and had smaller tumors compared to the PA group (p = 0.02 and 0.001, respectively). The incidences of visual deficits and cranial nerve palsy were lower in the RCCs than in the PAs (p ≤ 0.02 for all). MR images showed more frequent intracystic nodules in the RCCs (p less then 0.001), whereas nodular enhancement and lateral deviation of the pituitary stalk were more commonly seen in the PAs (p ≤ 0.003 for both). However, the presence of endocrine dysfunction or decreased consciousness, and the recurrence ratio were not significantly different between the groups (p ≥ 0.48 for all). In the multivariable logistic regression analysis, patients without nodular enhancement had a 15.84-fold greater risk of RCC than those with nodular enhancement (p = 0.031). The probability of RCC decreased 0.59-fold with each 1-cm3 increase in tumor volume. CONCLUSIONS RCC with apoplexy-like symptoms has different clinicoradiological features compared to PA apoplexy. Patients with RCC present with milder ocular symptoms and smaller tumor volumes compared to those with PA apoplexy. The absence of nodular enhancement on MR images could suggest RCC. OBJECTIVE To use computed tomography angiography to evaluate the regional anatomy of the lumbar segmental arteries (LAs) associated with the surgical field in oblique lateral interbody fusion (OLIF). METHODS Computed tomography angiography images from 50 patients were reviewed. In the sagittal plane, distances from the LA to the upper and inferior edges of the vertebral body were measured in the anterior quarter of the anterior and median lines of the intervertebral disc (IVD). LAs were classified as types I-IV based on the zone in which they passed through the vertebral body. RESULTS The LA branch angles were acute (La5. In zone I, the most frequent LA type was type IV at L1 (n=41; 85.4%) and L2 (n=42; 84.0%), type III at L3 (n=20; 40.0%), and type II at L4 (n=36; 80.0%) and L5 (n=5; 83.3%). In zone II, the most frequent LA type was type III at L1 (n=38; 79.2%), L2 (n=39; 78.0%), L3 (n=43; 86.0%), and L4 (n=28; 62.2%), while type II was the most frequent LA type at L5 (n=5; 83.3%). In zone III, type III was the most frequent LA type at L1-L4.