Recurrent spontaneous intracerebral hemorrhage associated with polyglobulia

Spontaneous intracerebral hemorrhage (ICH) accounts for 15% of stroke cases in the US and Europe and up to 30% in Asian populations.  Intracerebral hemorrhage is a relatively uncommon form of stroke-it causes only 10 to 15 percent of all strokes. It is more disabling and has a higher mortality rate than ischemic stroke, and it can occur at any age. It is slightly more common in men than in women. Its etiologies are dominated by hypertension, arteriovenous malformation, aneurysmal rupture, cerebral amyloid angiopathy, intracranial neoplasm and coagulopathy. We report the first case to date of spontaneous intracerebral hemorrhage associated with polyglobulia. A 56-years-old man, with history of polyglobulia and spontaneous intracerebral hemorrhage treated surgically in 2011, was admitted to the emergency service with the complaint of headache, disturbance of consciousness. Clinical examination is estimated GCS 13/15 and 2/5 left hemiparesis. An emergency CT-scan revealed a recurrent parieto-temporal hematoma, sequelar frontal hypodensity of the old stroke with its cranial flap.Pan African Medical Journal 2015; 2

Management and outcome of intracranial chondroma of the dural origin: case report and review of the literature

Abstract Background The intracranial chondroma is a sporadic type of benign tumor with an incidence of less than 0.5% of all intracranial tumors. Furthermore, this type of tumor has been reported more frequently at the skull base, less at the falx cerebri, and exceptionally of the dura, when it happened to be intracranial. Case presentation We report a challenging diagnosis and the successful management of a rare case of intracranial dural chondroma in a 19-year-old student without past medical history, revealed by secondary epilepsy with behavioral and mood disorder without neurological deficit. Conclusion The dural origin of intracranial chondroma is a rare type of tumor with nonspecific clinical manifestations, and diagnosis confirmation requires a histopathological finding. Surgical gross total resection of the lesion is the golden standard of its management

Cervical intramedullary spinal cord metastasis from esophageal adenocarcinoma: a case report

Abstract Background Intramedullary spinal cord metastasis (ISCM) is a rare pathologic entity. To the best of our knowledge, this is the second case of ISCM due to esophageal adenocarcinoma reported in the literature. Case description We report a 63-year-old man with a history of surgical removal of an esophageal adenocarcinoma who presented with the Brown–Sequard syndrome. Pan-spinal MRI showed intramedullary cervical lesions with intense homogeneous enhancement on gadolinium injection at C3 level. There were other sites of spinal metastases and one in the brain. We proceeded with the surgical removal of the lumbar metastatic lesion. The patient died 10 days later from respiratory failure. Conclusion ISCM from esophageal adenocarcinoma appeared as homogeneous high intensity of the intramedullary lesion in T1 gadolinium. Their prognosis is very poor

Cross-sectional study of recurrent disc herniation risk factors and predictors of outcomes after primary lumbar discectomy: A STROBE compliance

Objectives: The purpose of this study is to determine if lifting weight, smoking status, occupational work, and diabetes were predictors for recurrent lumbar disk herniation (rLDH) leading to reoperation and if the outcome can be influenced by the reoperated level and side. Methods: From June 2010 to July 2019, the 2196 consecutive patients who underwent first-time single-level lumbar discectomy at our institution were revised. Data on first lumbar spine surgery, reoperation as well as preoperative data were brought into the analysis. Multivariate Logistic Regression Analysis was performed to determine whether lifting weight, smoking status, occupational work, and diabetes were predictors for recurrent lumbar disk herniation. The outcome level was assessed by the Multivariable Cox-regression Kaplan–Meier analysis for repeated lumbar disc herniation excision at the L4L5 and L5S1 levels independently. Results: From the 101(4.59%) patients that presented with recurrent lumbar disc herniation (rLDH), 75 cases (3.41%) met the inclusion criteria. There were 54 cases of ipsilateral recurrent herniation and 21 contralateral with a male predominance of 64% (n = 48). The average age at the time of recurrence was 48 ± 9.34 years (age range 29–67 years). The group of diabetes patients who smoke is at high risk (Odds 2.77) of rapid recurrence for lumbar disc prolapse; about 3 months after the first surgery followed by the group of diabetes who lift weight (Odds 0.83), about 4 months after the first surgery. At the L4L5 level, only the group of patients operated for opposite side recurrence (Odd ratio 1.01) did well and were pain-free immediately after surgery compared to the group of patients operated for recurrence on the same side (Odd ratio 6.73). Conclusion: Coexisting diabetes and smoking status in the same patient increase the risk of rLDH and the patient’s outcome is favorable with pain-free after reoperation without the need for physiotherapy when the recurrence is on the same level and opposite side