Tumori mozga i epilepsija

Brain tumors are a common cause of epilepsy. Tumor type and location are determining factors that significantly influence seizure frequency. The aim of this study was to analyze clinical data of patients diagnosed with brain tumors and epilepsy. Data for this study were obtained from patient medical records over a 6-year period (2000-2005). Patient history and findings obtained by diagnostic methods such as electroencephalography, computerized tomography and magnetic resonance were analyzed. Data were analyzed by appropriate statistical methods and the structure, prevalence, mean and standard deviation were calculated. The significance of results was tested by use of t-test and χ2-test. A total of 15 933 patient charts were analyzed. Out of 15 933 patients, 10.8% were diagnosed with epilepsy and 175 (1.09%) patients had brain tumor, 75 (42.86%) of which were significantly associated with epilepsy (P>0.05). Almost forty-three percent (42.86%) of tumors were epileptogenic, with no significant sex difference (confidence level of 95%). Fifty-seven (32.5%) brain tumor patients were aged 51-60. The mean age of all patients with brain tumors was 41.6 years. Focal sensorimotor seizures were dominant in 40 (53.3%) cases. Among epilepsy cases with known etiology, 75 (6.8%) patients had epileptogenic tumors. Types of seizures in patients with epilepsy were different from seizures provoked by brain tumors. The most common tumor site was temporal region (43.4%). There was no significant difference according to epileptogenesis. Focal sensorimotor seizures were common in patients with frontal and parietal region tumors.Tumori mozga su čest uzrok epilepsije. Vrst tumora i lokalizacija su odlučujući čimbenici koji značajno utječu na učestalost konvulzija. Cilj ove studije bio je analizirati kliničke podatke bolesnika s dijagnosticiranim tumorom mozga i epilepsijom. Podaci za studiju prikupljeni su iz medicinske dokumentacije bolesnika kroz 6-godišnje razdoblje, od 2000.do 2005. godine. Analizirani su anamnestički podaci i nalazi dobiveni dijagnostičkim metodama poput elektroencefalografije, kompjutorizirane tomografije i magnetske rezonancije. U analizi su se primijenile odgovarajuće statističke metode, te je izračunata struktura, učestalost te srednja vrijednost i standardna devijacija. Značajnost rezultata ispitana je pomoću t-testa i χ2-testa. Analiza je obuhvatila 15933 bolesničkih kartona. Od 15933 bolesnika epilepsija je bila dijagnosticirana u 10,8%; 175 (1,09%) bolesnika je imalo tumor mozga, od kojih je 75 (42,86%) bilo značajno udruženo s epilepsijom (P>0,05). Gotovo je 43% (točnije, 42,86%) tumora bilo epileptogeno, bez značajne razlike prema spolu, na razini pouzdanosti od 95%. Utvrđeno je 57 (32,5%) slučajeva tumora mozga među bolesnicima u dobi od 51 do 60 godina. Srednja dob svih bolesnika s tumorom mozga bila je 41,6 godina. Žarišni senzomotorni napadaji prevladavali su u 40 (53,3%) bolesnika. Među bolesnicima s epilepsijom poznate etiologije 75 (6,8%) ih je imalo epileptogene tumore. Vrste napadaja u bolesnika s epilepsijom razlikovale su se od napadaja izazvanih tumorom mozga. Najčešće mjesto tumora bilo je temporalno područje (43,4%) i nije bilo značajne razlike u odnosu na epileptogenezu. Žarišni senzomotorni napadaji bili su česti u bolesnika s tumorima frontalnog i parietalnog područja

Acute Mastoiditis Complicated with Concomitant Bezold’s Abscess and Lateral Sinus Thrombosis

Bezold’s abscess is a very rare extracranial complication of acute mastoiditis. Lateral sinus thrombosis is another intracranial complication of acute mastoiditis that can occur, but there are only few reports of concomitant ispilateral Bezold’s abscess and lateral sinus thrombosis with favorable outcome. We diagnosed and treated successfully a 14-year-old girl suffering from Streptococcus pneumoniae acute mastoiditis complicated with Bezold’s abscess and lateral sinus thrombosis. Surgical treatment included myringotomy, cortical mastoidectomy, and Bezold’s abscess incision and drainage. During the course of treatment, we concluded that lateral sinus thrombosis was not caused from mastoiditis by direct spread but from pressure on internal jugular vein caused from Bezold’s abscess

Superior Sagittal Sinus Thrombosis Presenting with Hallucinations in the Puerperium: A Case Report

Cerebral venous sinus thrombosis is an uncommon cause of stroke presenting with varied presentation patterns. We report a case of a 21-year-old woman with superior sagittal sinus (SSS) thrombosis (SSST) developing after childbirth, presenting with visual hallucinations, severe headache, and tonic-clonic seizures. Time-of-flight magnetic resonance angiography (TOF-MRA) demonstrated the presence of thrombus in SSS. She was treated with low molecular weight heparin (LMWH) followed by warfarin. She had excellent recovery a few weeks after admission and was regularly followed up. Although this condition can be presented with different neurological symptoms, it does not typically present with hallucinations. We suggest that CSVT should be suspected even when a patient presents with an atypical picture in a category of patients at higher risk

A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report

Laparoscopic sleeve gastrectomy (LSG) has become a frequent procedure to reduce weight and morbid obesity. The procedure involves laparoscopic resection of more than 75% of the greater curvature of the stomach, resulting in early satiety and neuro-hormonal changes that collectively promote effective weight loss. We present a rare case of complication of superior mesenteric vein thrombosis (SMVT) and splenic vein after LSG, with consequent bowel ischemia that was treated with open laparotomy and appropriate anticoagulation therapy. A 56-year-old obese woman (BMI of 42.5 kg/m2), smoker for 30 years, presented to the emergency department with symptoms such as abdominal pain, fever, nausea and vomiting, 2 weeks after LSG intervention. Her white blood cell count was 15.5 (normal values: 3.8-10.4 × 103 /µL), while C- reactive protein level was 193 (normal values: 0.0-6.0 mg/L) and her D-Dimer level 4.69 (normal values: 0-0.50 mg/L). Abdominal CT with contrast showed a filling defect in the superior mesenteric and splenic vein, free perihepatic and Douglas pouch fluid, as well as small bowel thickening. An open laparotomy was performed and the necrotic segment of bowel of 80 cm was removed. The postoperative period went relatively well, despite the diarrhea that continued for the next 4 months after the intervention. The most common causes leading the development of this complication include: hypercoagulable state, dehydration, increased intra-abdominal pressure during the procedure and other secondary factors. The main symptom is abdominal pain, followed by nausea, vomiting, diarrhea and bleeding from the gastrointestinal tract. SMVT and SVT should be considered as a possible complication in patients with abdominal pain and increased inflammatory parameters after LSG. Early diagnosis through CT imaging and rapid anticoagulation therapy is considered to reduce further complications such as intestinal infarction and portal hypertension