Anterior Herniation of Partially Calcified and Degenerated Cervical Disc Causing Dysphagia

We report a rare case of anterior cervical disc herniation associated with dysphagia. A 32-year-old man presented with complaints of dysphagia and concomitant pain in the right arm resistant to conservative therapy. On physical examination with respect to the muscle strength, the right shoulder abduction and flexion of the forearm were 3/5. Lateral X-ray revealed calcified osteophytes at the anterior C4-5 level. Magnetic resonance imaging showed soft disc herniation involving the right C6 root at the C5-6 level and anterior herniation of the C4-5 cervical disc. Anterior discectomies for C4-5 and C5-6 levels stabilized and ameliorated the dysphagia and pain. Cervical disc herniation usually presents with radicular findings. However, dysphagia may be an uncommon presentation. Anterior cervical disc herniation should be considered in a patient presenting with dysphagia

Cervical Spine Dysmorphism: Report Of Two Unusual Cases Of Craniovertebral Junction

Craniocervical junction anomalies are rare and their classification is considerably complex. Here we report two unusual cases of cervical spine dysmorphism presenting with the absence of posterior vertebral elements which are also accompanied with Wildervanck syndrome and hydrocephalus. The first case was a 17-year-old female who presented with short stature, broad neck, coarse voice, deafness as well as bilateral lateral gaze paresis. Cervical computerized tomography (CT) and magnetic resonance imaging (MRI) revealed the absence of posterior vertebral elements of cervical spine including partial agenesis of suboccipital bone, rotational deformity of cervical column, Chiari abnormality and cystic cavitation of cervical spinal cord. Additionally dextrocardia, which has not been defined as a feature of Wildervanck syndrome yet, was a marked feature of chest X-ray. The second case was a 32-year-old male presenting with complaints of gait disturbance, dysphonia, severe neck pain, short stature and scoliosis. Cervical X-ray, CT and MRI revealed severe basilar invagination, absence of dorsal elements of first two cervical vertebrae and hydrocephalus. Despite the absence of whole posterior cervical vertebral elements and even occipital bone, basilar invagination was not a predominant feature in the first case. We conclude that presence of a stable ligamentous structure only in anterior cervical column may have contributed to the strength of craniocervical junction and explains the absence of basilar invagination for Case 1.WoSScopu

Examination of annulus fibrosus and nucleus pulposus in cervical and lumbar intervertebral disc herniation patients by scanning acoustic microscopy, scanning electron microscopy and energy dispersive spectroscopy

Intervertebral disc herniation (IVDH) is observed in humans as a result of the alteration of annulus fibrous (AF) and nucleus pulposus (NP) tissue compositions in intervertebral discs. In this study, we studied the feasibility of scanning acoustic microscopy (SAM), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) in characterizing the herniated segments of AF and NP tissues from male and female patients. SAM determined the acoustic property variations in AF and NP tissues by calculating the acoustic impedance values of samples of 15 patients. SEM obtained higher resolution images and EDS made elemental analysis of the specimen. Consequently, we suggest that these techniques have the potential to be combined for the investigation and removal of the disrupted AF and NP tissues with micrometer resolution in clinics

Olbrzymia torbiel naskórkowa śródkościa

A 60-year-old man presented with an occipital mass under the scalp and complained of headache, nausea, and dizziness. Magnetic resonance imaging showed a well-defined mass in the occipital scalp extending from the scalp through the cranium and several centimetres into the posterior fossa. There were well-defined margins in the deep portion and the mass was totally removed. Histological examination showed that the cystic structure was lined by squamous epithelium containing laminated keratin material. The pathological findings were consistent with the diagnosis of an epidermoid cyst. The patient was discharged free of symptoms.Mężczyzna, lat 60, zgłosił się z powodu guza podskórnego okolicy potylicznej, skarżąc się na bóle głowy, nudności i nieukładowe zawroty głowy. W badaniu za pomocą rezonansu magnetycznego uwidoczniono wyraźnie zarysowany guz podskórny okolicy potylicznej, szerzący się z tkanki podskórnej poprzez czaszkę na głębokość kilku centymetrów do tylnej jamy czaszki. Położona głęboko część guza miała wyraźne granice i guz został usunięty w całości. W badaniu histopatologicznym stwierdzono obecność torbieli wyścielonej naskórkiem wielowarstwowym płaskim zawierającym blaszki keratyny. Wyniki badania histopatologicznego pozwoliły na rozpoznanie torbieli naskórkowej. Chory został wypisany ze szpitala bez objawów

Deneysel Tavşan Modelinde Kraniyotomi Sonrası Kraniyal Subdural Adezyonların Önlenmesinde Spongostan™ Kullanımı

AIM: Spongostan (TM) is a sterile, water-insoluble, porcine gelatin absorbable sponge, which is widely used as a hemostatic material. The aim of this study is to test the anti-fibrotic capacity of Spongostan (TM), using a craniotomy model in an experimental rabbit model. MATERIAL and METHODS: Eighteen rabbits were divided into two groups: Each group consisted of 9 rabbits, duratomy plus Spongostan (TM) (group 1), and duratomy without Spongostan (TM) (group 2). Right parietal bone was removed via trephine and low speed drill and dura was opened. On the group 1 rabbits, an appropriate piece of Spongostan (TM) was meticulously placed under dural layer. On group 2 rabbits, same procedures were repeated without Spongostan (TM). Histological sections were taken from each group and evaluated for degree of fibrosis and collagen fibers. RESULTS: There was marked increase in number of fibroblasts and collagen fibers in group 2 rabbits, however most of the rabbits in Spongostan (TM) group demonstrate scarce histopathological findings for fibrosis. CONCLUSION: We conclude that an appropriately placed subdural Spongostan (TM) over cerebral tissue may prevent postoperative surgical adhesions after neurosurgical operations.WoSScopu

Deneysel Tavşan Modelinde Etilen Vinil Alkol Kopolimer Preparatları,Dimetil Sülfoksid ve N-Bütil 2-Siyanoakrilat’ın Serebral Parankim Üzerindeki Toksik Etkilerinin Karşılaştırılması

AIM: Ethylene vinyl alcohol copolymer (EVOH), its organic solvent dimethyl sulfoxide (DMSO), and N-Butyl 2-Cyanoacrylate (NBCA) are widely used in neurovascular embolization procedures and yet with potential risk of cytotoxicity.The aim of this study was to evaluate the toxic effect of EVOH-DMSO, its solvent DMSO and NBCA on cerebral parenchyma in a rabbit model. MATERIAL and METHODS: Forty-eight albino male rabbits were divided into 6 groups based on the substance injected into the parenchyma; normal saline, DMSO, NBCA, 6% EVOH-DMSO and 20% EVOH-DMSO and control group. At 72 hours the subjects were sacrificed and brain samples were harvested for histopathological examination and lipid peroxidase measurements. RESULTS: Neuronal degeneration and inflammatory reaction in the brain parenchyma was prominent especially in DMSO group and EVOH-DMSO groups. Furthermore, the extent of degeneration and inflammatory reaction was related to the concentration of the embolic agent in the EVOH group. Lipid peroxidase activity was significantly increased in the NBCA group as compared to all but to 20 % EVOH-DMSO group. CONCLUSION: EVOH and its solvent DMSO cause degeneration and inflammatory reaction in brain parenchyma and for EVOH this reaction was appeared to be dose dependent.WoSScopu