Infratentorial empyema is a life threatening condition and constitutes a neurosurgical emergency. Purulent mastoiditis and medial otitis is the most common origin and a thorough eradication of the purulent foci is man...Infratentorial empyema is a life threatening condition and constitutes a neurosurgical emergency. Purulent mastoiditis and medial otitis is the most common origin and a thorough eradication of the purulent foci is mandatory. Decompression craniectomy has been primarily advised in the literature as the gold standard of the surgical treatment but burr hole evacuation when there the lack of cerebellar edema is less invasive and deemed equally efficient in the few reported cases. This is the report of a seventeen year old female who presented in a comatose state due to infratentorial empyema with acute hydrocephalus and who improved immediately after burr hole evacuation. Details of the surgical procedures are given. Mastoidectomy was completed, with the patient under combined antibiotherapy. She leads a normal life now, more than six years after surgery.展开更多
Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to ...Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to be given in stroke units worldwide to the prompt diagnosis and treatment of SDB in order to improve morbidity and mortality rates related with stroke.The preventive diagnosis and treatment of SDB reduce stroke rate and improves penumbra area in case of ischemic stroke.Stroke itself predispose to SDB,making the interrelationship more complicated.The review by Parra O and Arboix A reflects the results from carefully selected reviews reported in the literature so far.This review of the literature and presentation of the original study of the Authors based on their patients’data,enhances the conviction that there exists a direct relation between SDB and stroke.Diagnosis of SDB in new stroke cases should be sought and treated carefully whenever present.展开更多
Multiple saccular or giant aneurysms of azygos anteriorcerebral artery(AACA) at the distal segments A2-A5 are very rarely reported. Distal anterior cerebral artery(DACA) aneurysms represent approximately 2%-7% of all ...Multiple saccular or giant aneurysms of azygos anteriorcerebral artery(AACA) at the distal segments A2-A5 are very rarely reported. Distal anterior cerebral artery(DACA) aneurysms represent approximately 2%-7% of all cerebral aneurysms. We present the case of an Albanian 62-year-old male, admitted at our service after sudden onset of severe headache and vomiting. Computerized tomography(CT) of the head showed hemorrhage in the front of corpus callosum. CT angiography followed by digitally subtracted angiography(DSA) documented a large necked aneurysm with three lobes at the origin of calloso-marginal artery and a single DACA, also known as AACA. A frontal parasagittal craniotomy was performed. Obliteration of the aneurysm was done only by separate clipping of each three lobes at the respective neck. Postoperative DSA demonstrated complete exclusion of the aneurysm and a regular flow of AACA. The patient recovered uneventfully. Despite it is a rare occurrence, an aneurysm of distal segments of anterior cerebral artery A2-A5, concomitant to AACA should be studied with DSA. In the era of embolization, conserving good microsurgical skills is fundamental for dealing with multilobar cerebral aneurysms, associated with rare anatomical variations.展开更多
文摘Infratentorial empyema is a life threatening condition and constitutes a neurosurgical emergency. Purulent mastoiditis and medial otitis is the most common origin and a thorough eradication of the purulent foci is mandatory. Decompression craniectomy has been primarily advised in the literature as the gold standard of the surgical treatment but burr hole evacuation when there the lack of cerebellar edema is less invasive and deemed equally efficient in the few reported cases. This is the report of a seventeen year old female who presented in a comatose state due to infratentorial empyema with acute hydrocephalus and who improved immediately after burr hole evacuation. Details of the surgical procedures are given. Mastoidectomy was completed, with the patient under combined antibiotherapy. She leads a normal life now, more than six years after surgery.
文摘Stroke is a leading cause of death and disability.Despite expensive and elaborative research in finding out mechanisms of interrelation between sleep-disordered breathing(SDB)and stroke,there is yet much attention to be given in stroke units worldwide to the prompt diagnosis and treatment of SDB in order to improve morbidity and mortality rates related with stroke.The preventive diagnosis and treatment of SDB reduce stroke rate and improves penumbra area in case of ischemic stroke.Stroke itself predispose to SDB,making the interrelationship more complicated.The review by Parra O and Arboix A reflects the results from carefully selected reviews reported in the literature so far.This review of the literature and presentation of the original study of the Authors based on their patients’data,enhances the conviction that there exists a direct relation between SDB and stroke.Diagnosis of SDB in new stroke cases should be sought and treated carefully whenever present.
文摘Multiple saccular or giant aneurysms of azygos anteriorcerebral artery(AACA) at the distal segments A2-A5 are very rarely reported. Distal anterior cerebral artery(DACA) aneurysms represent approximately 2%-7% of all cerebral aneurysms. We present the case of an Albanian 62-year-old male, admitted at our service after sudden onset of severe headache and vomiting. Computerized tomography(CT) of the head showed hemorrhage in the front of corpus callosum. CT angiography followed by digitally subtracted angiography(DSA) documented a large necked aneurysm with three lobes at the origin of calloso-marginal artery and a single DACA, also known as AACA. A frontal parasagittal craniotomy was performed. Obliteration of the aneurysm was done only by separate clipping of each three lobes at the respective neck. Postoperative DSA demonstrated complete exclusion of the aneurysm and a regular flow of AACA. The patient recovered uneventfully. Despite it is a rare occurrence, an aneurysm of distal segments of anterior cerebral artery A2-A5, concomitant to AACA should be studied with DSA. In the era of embolization, conserving good microsurgical skills is fundamental for dealing with multilobar cerebral aneurysms, associated with rare anatomical variations.
