Multisegmental tubercular spinal epidural abscess

Pan African Medical Journal 2013; 14:

Recurrent spontaneous intracerebral hemorrhage associated with polyglobulia

Spontaneous intracerebral hemorrhage (ICH) accounts for 15% of stroke cases in the US and Europe and up to 30% in Asian populations.  Intracerebral hemorrhage is a relatively uncommon form of stroke-it causes only 10 to 15 percent of all strokes. It is more disabling and has a higher mortality rate than ischemic stroke, and it can occur at any age. It is slightly more common in men than in women. Its etiologies are dominated by hypertension, arteriovenous malformation, aneurysmal rupture, cerebral amyloid angiopathy, intracranial neoplasm and coagulopathy. We report the first case to date of spontaneous intracerebral hemorrhage associated with polyglobulia. A 56-years-old man, with history of polyglobulia and spontaneous intracerebral hemorrhage treated surgically in 2011, was admitted to the emergency service with the complaint of headache, disturbance of consciousness. Clinical examination is estimated GCS 13/15 and 2/5 left hemiparesis. An emergency CT-scan revealed a recurrent parieto-temporal hematoma, sequelar frontal hypodensity of the old stroke with its cranial flap.Pan African Medical Journal 2015; 2

Cystic Trigeminal Schwannoma: Case presentation

Trigeminal schwannoma is the second commonest intracranial schwannoma; they remain rare. A minority exhibit cystic changes, with even fewer an intracystic fluid level. We report a case of a 45-year-old man, presented with a progressive hearing loss, worsening right-sided facial spasms and facial numbness in the region of the right trigeminal nerve. Neurological examination revealed hypoesthesia in the right facial region and intermittent rights sided hemi-facial spasms, without signs of raised intracranial pressure or achieve the mixed nerves or neurological deficit. A Magnetic resonance imaging of the brain revealed a cystic mass in the right cerebello-pontine angle with extension forward towards the cavum meckel. The patient was operated by retro sigmoid approach, with a total resection of the tumor. Intracranial cystic schwannomas constitute an uncommon subset of tumors with a distinct clinico-biological behavior. The presence of fluid–fluid levels within the tumors, although rare, confirms the cystic nature of the neoplasms. Cystic areas are usually secondary to the coalescence of mucinous or microcystic regions in Antoni B tissues. The treatment is surgical in the majority of cases and stereotactic radiosurgery has a clear role for adjuvant treatment of post-surgical recurrence of the tumor or residue

Spontaneous regression of a lumbar disc herniation: Case report

Lumbar disc herniation is a common disease that induces back pain and radicular pain. Some cases require conservative treatment or at times relived spontaneously. Spontaneous regression of disc herniation is an atypical clinical presentation, and it has been recognized with the advancement of recent advances in imaging techniques. We present a 35-year-old woman presented a spontaneous regression of a lumbar disc herniation with good outcome after intensive physical therapy program. Spontaneous regression of disc herniation is thought to occur via an inflammatory reaction with molecular mechanisms of phagocytic processes

Metastatic leiomyosarcoma of the thoracic spine: case report

Leiomyosarcoma is a rare malignant mesenchymal tumor arising from smooth muscle cells. Metastatic spreading is possible, which even rarely metastasize to the bone being the latter localization a delayed manifestation of its natural progression. Spinal metastases represent the most common bone localizations with prevalence in the thoracic and lumbar spine.We present a 55-year-old female, operated there’s 2 years for a hysterectomy of uterine leiomyosarcoma, admitted in our department with a flaccid paraplegia. Spine magnetic resonance imaging showed an extradural mass, iso-intense on T2, enhancing after gadolinium administration; placed at T5-T6 level with a severe cord compression. The patient underwent a decompressive laminectomy T5 and a total removal of the tumor. The histological examination revealed a metastatic leiomyosarcoma.The prognosis of patients with leiomyosarcoma is variable depending on the resectability and existence of metastasis. The essential treatment is surgery but an additional therapy, such as radiotherapy and/or chemotherapy, may be required to improve local control

Une cause rare de recidive de lombosciatalgie

Le terme de textile est un terme non médical qui désigne un objet synthétique oublié dans le foyer opératoire ainsi que la réaction inflammatoire qui l’entoure. Cette complication bien qu’elle soit connue est rarement publiée à cause implications médico-légale. Les manifestations cliniques peuvent êtres frustes et l’imagerie permet parfois d’avoir un diagnostic de certitude. Dans ce travail, nous présentons le cas d’un textilome retrouvé au niveau de l’espace épidural après cure d’une hernie discale réalisée deux ans auparavant et qui s’est révélé par des lombosciatalgies, ainsi que les facteurs humains et techniques impliqués dans cet événement indésirable

Rola dynamicznej tomografii komputerowej złącza szczytowo-potylicznego przy ustalaniu postępowania w przypadkach stwierdzenia os odontoideum

Abstract Os odontoideum is an uncommon abnormality of the craniovertebral junction (CVJ) that exists as a separate ossicle apart from a hypoplastic dens. Its genesis and natural history have been debated, and its proper treatment remains uncertain. A 48-year-old woman complained of persistent upper neck pain and paraesthesia of her left side. Magnetic resonance imaging of the CVJ demonstrated an os odontoideum. Dynamic computed tomography scan of the CVJ showed a reduction of the space available for the spinal cord to 50% from extended to flexed position. The patient underwent posterior spinal fusion of C1–C2 using a sublaminar titanium hook and rods fixed in moderate extension. We discuss the usefulness of the dynamic computed tomography (CT) scan in the evaluation of atlantoaxial motion and the management of this pathology.Streszczenie Os odontoideum jest rzadko spotykaną nieprawidłowością złącza szczytowo-potylicznego, w której słabo wykształcony ząb obrotnika tworzy dodatkową kość. Sposób jej powstawania i historia naturalna są przedmiotem dyskusji; istnieje również niepewność co do właściwego postępowania. Czterdziestoośmioletnia kobieta zgłosiła się z powodu utrzymującego się bólu górnej części szyi oraz lewostronnych parestezji. W badaniu złącza szczytowo-potylicznego za pomocą rezonansu magnetycznego uwidoczniono os odontoideum. Dynamiczna tomografia komputerowa tej okolicy wykazała zmniejszanie się przestrzeni dostępnej dla rdzenia kręgowego o 50% podczas zgięcia w porównaniu z prostowaniem szyi. U chorej wykonano tylne zespolenie kręgów C1–C2 za pomocą tytanowego haka i prętów, uzyskując stabilizację szyjnego odcinka kręgosłupa w umiarkowanym wyproście. Autorzy omawiają przydatność dynamicznej tomografii komputerowej (TK) w ocenie ruchomości stawu szczytowo-obrotowego i w leczeniu wspomnianej patologii

Benign chondroid syringoma of the orbit: a rare cause of exophtalmos

Chondroid syringoma (CS) of the orbit is an extremely rare benign neoplasm. To the best of our knowledege, this is the second case reported in the english litérature