A retrospective and anatomopathological study of 40 orbital tumors

In casuistry of the neurosurgery clinic in Iasi I recorded 40 observations of orbital tumors over a period of 20 years. The anatomopathological analysis of our observations has shown us a great variety of intraorbital processes occurring especially in small children with optic nerve glioma which lead to malignant tumors with age.&nbsp

Giant frontal and cerebellopontine angle epidermoid cyst: Case report

We present the case of a 38-years old woman presenting in a state of unconsciousness, (Glasgow Coma Scale score 7), with right hemiparesis, the onset of symptoms being acute, after 3 consecutive convulsive crisis, in a patient with no previous neurological sign, except progressive aggravating headaches. Cranial computed tomography reveal an enormous hypodense lesion in the left frontal and temporal lobe, frontal horns of the ventricular system and prepontine and cerebellopontine angle regions. The patient underwent emergent surgical intervention, the evacuation of the content and partial removal of the capsule of the giant epidermoid cyst was achieved by frontal craniotomy. The diagnosis was presumed by the classical aspect of the content of the cyst and it was confirmed by histological examination. The immediate postoperative evolution was good with regression of hemiparesis and comatose state, with one complication in the third day after surgery; she developed the symptoms of Mollaret meningitis, with nearly normal CSF parameters, who responded well at the treatment with dexamethasone

Contusion injuries of the optic nerve -First results in thirty observations

Abstract The paper presents the first results of thirty cases of contusion injuries of optic nerve : an analysis of symptoms and the aspect of visual impairment. Indirect injury may damage the optic nerve and this leads to optic nerve contusions. In such cases, the fractures of the base of the skull, involving or not the optic canal, immediately leads to uni or bilateral blindness, stationary or slightly regressive

Contusion injuries of the optic nerve: First results in thirty observations

The paper presents the first results of thirty cases of contusion injuries of optic nerve : an analysis of symptoms and the aspect of visual impairment. Indirect injury may damage the optic nerve and this leads to optic nerve contusions. In such cases, the fractures of the base of the skull, involving or not the optic canal, immediately leads to uni or bilateral blindness, stationary or slightly regressive

Severe head injury: The place for regional centers

We are discussing the administrative aspect of solving the severe head trauma and the new modern aspects for pre and post operatory survey, using as a point of departure the case of a patient explored and sent to our department. The aim is not always to improve patient prognosis but to be more precise in depicting patient future evolution especially with patient with isolated, severe head injury who are most prone to be subjects for organ transplantation

Gait temporospatial parameters: Assessment tools for post-surgical recovery in patient with different anatomo-topographic types of lumbar disc herniation

The development in technology and informatics in the last decades enables integrated analysis of biomechanical and clinical data and facilitates the understanding of relations between human gait characteristic and different medical conditions of a patient. The aim of the study was to demonstrate the importance of gait temporospatial parameters analysis [opposite foot off, opposite foot contact, foot off, cadence, step length, walking speed, step time, step width, stride length, stride time] to quantify the response to surgical treatment for patients with lumbar disc herniation related to the anatomotopographic type of disc herniation. The study was prospective, with consecutive selection of subjects according to eligibility criteria, using a control group. The number of subjects was 64: 41 patients [61% with extensive lumbar disc hernia, 22% with paracentral lumbar disc hernia and 17% with intraforaminal lumbar disc herniation] and 23 healthy subjects. The flowchart had 2 visits: presurgical evaluation and postsurgical evaluation. The patients were evaluated clinically, imagistically and biomechanically. The biomechanical evaluation was performed with VICON MX optical motion capture system. Data of interest were temporospatial parameters of gait: opposite foot off, opposite foot contact, foot off, cadence, step length, walking speed, step time, step width, stride length, stride time. Specific statistic techniques were used in order to confirm the results. The most consistent response in terms of normalization of gait temprospatial parameters are to be observed in patients with intraforaminal herniation, followed by patients with paracentral disc herniation. The gait temprospatial parameters of patients with extensive lumbar disc herniation responded the least in terms of normalization.&nbsp

Two cases of bone marrow tissue implant into chronic cervical spinal cord injury

Two patients with chronic cervical spinal cord injury and quadriplegia underwent partial resection of the medular scar and implant of bone marrow tissue with a combination of drugs at the site of spinal cord injury. Post-operatively they received a similar treatment in the neuromotor rehabilitation centre and were treated additionally with cerebrolysin . Sensory improvements were noticed, but no significant motor improvements were observed twenty months afterwards

Neuronavigation in the Percutaneous Treatment of Trigeminal Neuralgia: Technical note

Objective: To describe neuronavigation-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia.Methods: Neuronavigation guided percutaneous radiofrequency thermocoagulation of the Gasser ganglion was used in nine patients with trigeminal neuralgia who developed resistance to drugs used in the treatment of TN or have had adverse effects due to drug toxicity. The age of the patients was between 62 and 78 years. Results: All patients had immediate pain relief after thermocoagulation guided by neuronavigation. Neuronavigation allowed visualization of instrument position in relation to target and the related anatomical structures. The technique helped preoperative planning of the optimal trajectory for needle insertion. There were no complications of the procedure.Conclusion: Image guided percutaneous thermocoagulation in the treatment of trigeminal neuralgia is a safe and promising procedure. The technique has reduced the risk of postoperative complications caused by “hunting” of the foramen ovale.&nbsp

Posterior fossa meningiomas: Correlation between site of origin and pathology

Aim: to identify the possible correlation between demographic data of the patients, site of tumor origin, and pathological characteristics of each subgroup of the posterior fossa meningiomas as the anatomical location of these tumors is a critical determinant of the operative approach that will be chosen.Materials and Methods: We analyzed medical records of 35 patients with posterior fossa meningiomas who underwent surgery between January 2005 and December 2009 at Neurosurgery Department, Ia?i. The analysis included: age and gender of the patients, tumor location, and pathologic findings. According to the anatomical relationship with posterior fossa structures, these 35 meningiomas were classified into 5 types: cerebellar convexity, cerebellopontine angle, petroclival, foramen magnum, and unclassified tumors. According to the classification scheme of WHO 2007 (19), all cases were classified into three histopathological groups: benign, atypical, and malignant meningiomas, and every histopathological subtype was noted.Results: Posterior fossa meningiomas have a 3.33:1 female-to-male ratio with a mean age of 51.6 years. 29 patients had anatomically distinct attachment to the dura of the 4 chosen compartments of the posterior fossa (cerebellar convexity – 14.28%, cerebellopontine angle – 48.57%, petroclival – 11.42%, and foramen magnum – 8.57%) and 6 patients (17.14%) had giant tumors with broad attachment in multiple areas of the posterior fossa. Grade I meningiomas encountered in majority of cases (82.85%), whereas grade II meningiomas were diagnosed in 11.42% of the operated case, and anaplastic meningiomas (grade III) accounted only 5.71%. The most common benign histological subtypes among posterior fossa meningiomas were fibrous (37.79%) and psamomatous (24.13%). Petroclival meningiomas accounted a higher incidence then that presented in other studies (11.42% of all posterior fossa meningiomas). The mean age for female patients was older (55 years) then in other studies. There were various benign histological subtypes (psammomatous, meningothelial, and secretory) and even an atypical one that was diagnosed in a male patient. Foramen magnum meningiomas affected only females with a mean age of 52.66 years. All tumors were benign (grade I) with psammomatous subtype being the most common histological subtype (66.66%). Cerebellar convexity meningiomas presented a female to male ratios of 4:1. Female patients were older (64.25 years) then the mean age of patients with posterior fossa meningiomas. In cerebellar convexity location, all meningiomas presented only benign histology (fibrous subtype, 100%) that made us thinking to a different tumorigenesis for this tumors comparative with other locations. Cerebellopontine angle meningiomas presented a strong preponderance of female patients (5:1). Though majority of cerebellopontine angle meningiomas had grade I of malignancy, they exhibited a large variety of histological subtypes.Conclusion: In our series, posterior fossa meningiomas are clearly various tumors in their histology and demographic data. We identified a significant association between age and gender of the patients, histology of posterior fossa meningiomas, and their site of origin