Spinal cord compression(SCC) caused by cervical spinal canal invasion of a pulmonary sarcomatoid carcinoma metastasis has never been reported previously. A 59-year-old man, with a history of pulmonary carcinosarcoma, ...Spinal cord compression(SCC) caused by cervical spinal canal invasion of a pulmonary sarcomatoid carcinoma metastasis has never been reported previously. A 59-year-old man, with a history of pulmonary carcinosarcoma, developed over several weeks important neck swelling. Admitted to our division with severe tetraparesis he underwent a cervical spine computed tomography scan that showed a large cervical mass measuring 11 cm × 27 cm × 17 cm with SCC, extending from the occiput to C7. Emergency spinal cord decompression was performed leading to minor neurological improvement. Poor outcome was due to the unusual clinical sign that led to late diagnosis and treatment.展开更多
Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable met...Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable methods preventing possible retraction complications.The objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain tissue.The chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be opened.This should guarantee an appreciable workspace similar to that of current neurosurgical procedures.The experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction phase.Following pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different inclinations.Note that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.展开更多
文摘Spinal cord compression(SCC) caused by cervical spinal canal invasion of a pulmonary sarcomatoid carcinoma metastasis has never been reported previously. A 59-year-old man, with a history of pulmonary carcinosarcoma, developed over several weeks important neck swelling. Admitted to our division with severe tetraparesis he underwent a cervical spine computed tomography scan that showed a large cervical mass measuring 11 cm × 27 cm × 17 cm with SCC, extending from the occiput to C7. Emergency spinal cord decompression was performed leading to minor neurological improvement. Poor outcome was due to the unusual clinical sign that led to late diagnosis and treatment.
文摘Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain lesions.There are still no reliable methods preventing possible retraction complications.The objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain tissue.The chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be opened.This should guarantee an appreciable workspace similar to that of current neurosurgical procedures.The experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction phase.Following pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different inclinations.Note that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.
