Slitlike arachnoid valve because of post-traumatic symptomatic arachnoid cyst: A case report

Arachnoid cysts are intra-arachnoid collections of cerebrospinal fluid. Arachnoid cysts of the posterior fossa are rare lesions that are considered to be mostly congenital in origin. Arachnoid cysts of the posterior cranial fossa may manifest themselves in several different ways. When they are symptomatic, headache, gait disturbance, nausea, vomiting, focal neurologic signs, dizziness, and seizures are most common in the patients with increased intracranial pressure. Increased intracranial pressure is caused by the ball-valve mechanism of the cyst's membrane that communicates with subarachnoid space or arachnoid cells and contains specialized membranes and enzymes, which have secretory activity. A postsurgical arachnoid cyst in the posterior cranial fossa has doubled and slitlike arachnoid membrane that supports our knowledge about the underlining mechanism is reported. Copyright © 2008 by Lippincott Williams & Wilkins

Noninvasive assessment of subcutaneous fibrous tunnel patency of fractured ventriculoperitoneal shunt by ultrasonography

Shunt malfunction caused by fracture of the distal tube is a common complication of ventriculoperitoneal shunts. Functionality of the fractured distal shunt tube must be evaluated before its removal, because a connective tissue sheath or subcutaneous fibrous channel around the peritoneal catheter may be patent. Although an accurate assessment of shunt function is made by invasive tests such as radio-isotope or radiopaque injection via tapping the reservoir, these methods have risks. In our case, patency of a subcutaneous fibrous tunnel that had developed around the distal catheter before the fracture was demonstrated noninvasively by real-time ultrasonography

Choroid plexus metastasis from carcinoma of the bladder: A case report

Metastatic tumours in the choroid plexus are generally considered to be very rare. We report a case of bladder carcinoma metastasizing to the choroid plexus of the trigone of the lateral ventricle. This tumour was shown by computed tomography and magnetic resonance imaging of the brain, followed by stereotactic biopsy and histological confirmation. Systemic investigation revealed bladder carcinoma. The differential diagnosis for intraventricular masses should include metastasis

Fatal complication of the percutaneous radiofrequency trigeminal rhizotomy

PubMedID: 9202781[No abstract available

Intracranial arterial aneurysm complicating Behçet's disease

PubMedID: 8738367Behçet's disease, a rare condition in central Europe but more common in Turkey where it was originally described, is characterized clinically by the presence of a diagnostic triad of oral and genital aphthous ulcers, meningitis, and relapsing iridocyclitis. Vascularlesions including arterial and venous occlusions, arterial aneurysms and varices are one of the common complications of Behçet's disease occur most commonly in the abdominal aorta, femoral arteries and pulmonary arteries. There have been only four reports of aneurysms of cerebral arteries in the literature. The authors describe a patient with Behçet's disease who suffered secondary subarachnoid hemorrhage due to a ruptured aneurysm of the anterior communicating artery 3 years after the initial diagnosis. This case report draws further attention to this rare entity in patients with Behçet's disease

Multiple anterolateral cervical meningoceles associated with neurofibromatosis

PubMedID: 10547012In neurosurgical practice, the term 'spinal t meningocele' is generally used to describe a congenital spinal malformation including protrusion of the spinal meninx from the congenitally dysraphic vertebrae. Although non- dysraphic meningocele is very rare, it is usually associated with neurofibromatosis or Marfan's syndrome in the literature. Thoracic and/or lumbar spinal levels are the most common localization. Anterolateral localization of meningocele is very rare in the cervical region. Operative treatment is indicated if the lesion is symptomatic. Detailed radiological assessment of the meningocele is necessary since it may be associated with neuroma in the sac. If the neuroma is found in the meningocele, an anterior surgical approach should be considered for the treatment of both of the lesions

Malignant meningioma of the lateral ventricle. Case report.

PubMedID: 15344901This 65-year-old man presented with a very rare malignant meningioma in the trigonum of the right lateral ventricle. Neurological examination showed bilateral papilledema. Magnetic resonance imaging revealed a solid, enhancing tumor in the right trigonum with a hypointense cystic component located in the center of the tumor. The lesion was totally resected via a superior parietooccipital transcortical approach. Histological examination showed an anaplastic (malignant) meningioma with architectural disarray, high mitotic activity (20/10 hpf), necrosis, and cytological atypism. As in our case, heterogeneous signal, due to necrotic tissue and frequently demonstrated on both T1- and T2-weighted sequences, is suggestive of an aggressive type of meningioma

Effects of antithrombin III on myeloperoxidase activity, superoxide dismutase activity, and malondialdehyde levels and histopathological findings after spinal cord injury in the rat

PubMedID: 15792522OBJECTIVE: Among the many possible mechanisms of the secondary spinal cord injury (SCI), microcirculatory disturbances as a result of activated leukocyte-induced endothelial cell injury is important because it is potentially treatable and reversible. Currently, clinically available pharmacological agents for treatment of acute SCI do not inhibit neutrophil activation. The effect of antithrombin III (AT-III) on neutrophil activation was studied in rats with SCI produced with an aneurysm clip on the T2-T7 segments. METHODS: Forty rats were randomly allocated to four groups. Group I (10 rats) was killed to provide normal spinal cord tissue for testing. Group II (10 rats) underwent a six-segment laminectomy for the effects of total laminectomy to be determined. In Group III, 10 rats underwent a six-segment laminectomy and SCI was produced by extradural compression of the exposed cord. The same procedures were performed in 10 rats in Group IV, but they also received one (250 IU/kg) intraperitoneal injection of AT-III immediately after the injury and a second dose 24 hours later. The animals from Groups II through IV were killed 48 hours after the trauma. The effect of AT-III on the myeloperoxidase activity, superoxide dismutase activity, and malondialdehyde levels and histopathological findings were studied. RESULTS: Myeloperoxidase activity, superoxide dismutase activity, and malondialdehyde levels were significantly lower and there was less histopathological damage in the AT-III treatment group than in the trauma group. CONCLUSION: The results demonstrate that AT-III treatment may reduce secondary structural changes in damaged rat spinal cord tissue by inhibiting leukocyte activation

Postoperative radicular neuroma. Case report.

PubMedID: 16466240Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the "failed back surgery syndrome." The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented

Intraventricular meningiomas: A review of the literature and report of 8 cases

Intraventricular meningiomas are rare tumors, comprising only 0.5% to 5% of all intracranial meningiomas. In this article, 8 cases of histopathologically proven intraventricular meningioma that were treated at the Çukurova University Neurosurgery Department are discussed. The radiologic, histologic, and clinical findings of intraventricular meningiomas and the surgical approach to lateral intraventricular meningiomas were reviewed retrospectively. Our 8 patients ranged in age from 18 to 65 years (mean = 44.6 years). Two patients were male and 6 were female, for a 1:3 male-to-female ratio. Computed tomography and magnetic resonance imaging demonstrated the 7 tumors within the lateral ventricle and only 1 tumor within the third ventricle. All lateral ventricular tumors were located in the region of the trigone. Headache and hemiparesis were the most common presenting symptoms. Histologic studies revealed meningotheliomatous meningiomas in 5 patients, transitional meningioma in 2 patients, and anaplastic (malignant) meningioma in 1 patient. The superior parieto-occipital approach in 5 patients, posterior middle temporal gyrus approach in 2 patients, and posterior transcallosal approach in 1 patient were used for surgical therapy, and total resection was achieved in all patients. The overall neurologic outcome at follow-up (mean follow-up = 12 months, range: 1 month to 5 years) was excellent (no deficit) in 4 patients, good (some deficit but independent) in 2 patients, and poor (dependent) in 1 patient. One patient died after surgery. We conclude that intraventricular meningiomas are curable by complete surgical resection. This is possible with little neurologic morbidity when the neurosurgeon understands the surgical approaches available and the indications for those approaches