Giant facial schwannoma with intracranial extension: A case report

Introduction: Facial nerve schwannoma is a rare benign tumor which may originate from any segment of the facial nerve. We present a case of a giant cystic facial nerve schwannoma that showed extension to the middle cerebral fossa, together with its clinical and radiological characteristics, and a short review of the related literature. Case Report: A 52-year old female patient attended with complaints of numbness in the right half of her face, and mild hearing loss. Examinations revealed House-Brackmann Grade 3 peripheral facial paralysis, sensorineural hearing loss of 30% in her right ear. She described three episodes of facial paralysis in the last six years. Cranial MRI and CT scan revealed a round cystic lesion of about 40x44x38 mm, located centrally and medially in the right temporal area. The surgical operation was performed and the lesion was totally extracted. The histopathological investigation reported the lesion as a schwannoma. Conclusion: Facial nerve schwannoma is a rare, benign tumor that occurs in different localizations. It may commonly be mistaken in prediagnosis and may be confused with other clinical states due to its clinical characteristics. It has to be kept in mind in the prediagnosis of patients with facial paresis and hearing loss

Effects of Iodixanol on Respiratory Functions during Coronary Angiography and the Role of Body Composition

Purpose. The purposes of this study are to assess the acute effects of iodixanol, an iso-osmolar contrast media, on pulmonary functions and to evaluate the body composition in order to find out its role in causing this deterioration. Methods. 35 male and 25 female patients undergoing diagnostic coronary angiography (CA) were enrolled in the study. Before CA, all patients’ body compositions were evaluated by measuring their body mass indexes (BMIs) and waist-to-hip ratios (WHRs). Total body waters (TBWs), fat masses (FMs), fat-free masses (FFMs), and basal metabolism rates (BMRs) were measured via bioimpedance analysis. The CA was performed via radial artery route using iodixanol in every patient. The pulmonary function tests of these patients were performed before, during, and 2 hours after the CA. FEV1∆, FEF25–75%∆, and FVC∆ parameters were calculated by subtracting the measured baseline value from the measurement after the CA. Results. Angiography caused significant reduction in forced expiratory volume in 1 sec (FEV1, from 94.17 ± 18.83 to 84.45 ± 18.31, p<0.0001), forced vital capacity (FVC, from 96.57 ± 15.82 to 88.31 ± 17.96, p<0.0001), and forced expiratory flow at 25–75% (FEF25–75% from 82.54 ± 24.26 to 72.11 ± 25.41, p=0.001) and remained lower after 2 h after CA in male patients, respectively. FEV1 values were 103.40 ± 17.79 to 94.96 ± 17.063 (p=0.004); FVC values were 107.20 ± 19.03 to 99.08 ± 20.56 (p=0.009); and FEF25–75% values were 83.92 ± 24.30 to 73.24 ± 20.45 (p=0.005) before and after CA and remained lower after 2 h after CA in female patients, respectively. FEV1/FVC ratio remained unchanged. FEF25–75%∆ was statistically correlated with FFM, TBW, and WHR (p<0.05; r=−0.344, r=−0.347, and r=0.357, resp.), and FVC∆ was correlated with WHR in male patients (p=0.018, r=397). Conclusions. Our data suggested that diagnostic CA using iodixanol, an iso-osmolar contrast media, leads significant impairment in respiratory functions. Due to the persistence of these reductions even 2 hours after CA, ventilatory functions should be considered especially in patients whose body compositions or hydration levels are not within the desired physiological range

Obstructive hydrocephalus caused by giant basilar artery aneurysm

Giant basilar artery aneurysms are rarely associated with hydrocephalus. When it occurs the treatment usually addresses the hydrocephalus rather than the aneurysm itself, especially if it is already thrombosed. The treatment options include ventriculoperitoneal shunting and endoscopic third ventriculostomy, which may be related to high complication rates. However, reducing the intracranial hypertension may produce aneurysmal growth. We report a patient with obstructive hydrocephalus due to thrombosed giant basilar artery aneurysm. The patient initially presented with symptoms of increased intracranial pressure, and was managed by ventriculoperitoneal shunting with significant symptomatic improvement. Fifteen days after operation, the patient died due to a cerebrovascular event. We report a case that deteriorated because of cerebral infarction due to aneurysmal growth after ventriculoperitoneal shunting. We also discuss the treatment options in such cases

The Cervical Epidural Space Metastasis of Ewing's Sarcoma

Ewing's sarcoma is a primary bone malignancy with the highest incidence in the first to third decades of life. That in both locations follow a rapid course with metastasis to lung and bone. Ewing's sarcoma of the spine is a rare condition that appears with a clinical triad of local pain, neurological deficit and a palpable mass. The definitive management of Ewing's sarcoma of the spine, as in other locations, could include three main modalities: surgery, radiotherapy, and chemotherapy. In the presence of acute neurological decompensation, decompressive surgery via an appropriate approach should be performed. In this study; a 32-year-old male with a sudden progressive severe upper extremity spastic paresis and paraplegy has been presented. We wanted to discuss the preoperative process and treatment modalities

Application of fluorescent dextrans to the brain surface under constant pressure reveals AQP4-independent solute uptake.

Extracellular solutes in the central nervous system are exchanged between the interstitial fluid, the perivascular compartment, and the cerebrospinal fluid (CSF). The "glymphatic" mechanism proposes that the astrocyte water channel aquaporin-4 (AQP4) is a major determinant of solute transport between the CSF and the interstitial space; however, this is controversial in part because of wide variance in experimental data on interstitial uptake of cisternally injected solutes. Here, we investigated the determinants of solute uptake in brain parenchyma following cisternal injection and reexamined the role of AQP4 using a novel constant-pressure method. In mice, increased cisternal injection rate, which modestly increased intracranial pressure, remarkably increased solute dispersion in the subarachnoid space and uptake in the cortical perivascular compartment. To investigate the role of AQP4 in the absence of confounding variations in pressure and CSF solute concentration over time and space, solutes were applied directly onto the brain surface after durotomy under constant external pressure. Pressure elevation increased solute penetration into the perivascular compartment but had little effect on parenchymal solute uptake. Solute penetration and uptake did not differ significantly between wild-type and AQP4 knockout mice. Our results offer an explanation for the variability in cisternal injection studies and indicate AQP4-independent solute transfer from the CSF to the interstitial space in mouse brain

Evaluation of Heart Rate Turbulence Parameters According to Localization of Infarction in Patients with ST-elevation MI who Underwent Primary Percutaneous Coronary Intervention

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400338Turkish Soc Cardio

Right Atrial Hydatid Cyst Prolapsing into the Tricuspid Valve

WOS: 000225746300026PubMed: 15745306

Preventive effect of trimetazidine against ischemia-reperfusion injury in rat epigastric island flaps: an experimental study

uyanikgil, yigit/0000-0002-4016-0522WOS: 000588865000001Background For plastic surgery, ischemia-reperfusion (I-R) injury is a critical problem that results in partial or total flap necrosis. Trimetazidine (TMZ) is a drug used in the treatment of angina pectoris. This study investigated the effect of TMZ on I-R injury in epigastric island flaps using a rat model. Methods Sixteen Sprague-Dawley rats were assigned to two groups, each with eight rats. the sham group comprised of saline-treated rats, while the TMZ group had TMZ-treated rats. An epigastric flap measuring 6 x 4 cm in size was created 30 min after the intraperitoneal administration of either physiological saline or TMZ in both groups. Ischemia was induced on the flaps for 10 h, followed by reperfusion. the flaps were then inset to the original position. Samples were obtained 24 h after reperfusion for biochemical analysis and on day 7 for histopathological analysis. Also, flap survival was evaluated on day 7 using Image-Pro Express. Results the TMZ group had a significantly greater flap survival area compared to the sham group. on histopathological examination, the two groups showed significant differences. the TMZ group had a higher epidermal thickness. on biochemical examination, there were significantly higher levels of malondialdehyde and myeloperoxidase activity in the sham group, while the TMZ group showed significantly greater glutathione and nitric oxide levels. Conclusions in the present study, TMZ administration was found to reduce I-R injury macroscopically, histopathologically, and biochemically in a rat epigastric island flap model. Level of evidence: Not ratable