Osteoma is the most common benign tumor of the cranium, and the frontal sinus is its most frequent location in the cranium. A 39-year-old woman presented with left exophthalmos was found to have orbital and intracranial extension of a giant osteoma involving anterior cranial fossa. The etiology, presenting features, diagnosis and treatment of this tumor are reviewed.
Adult ; Cranial Fossa, Anterior* ; Diagnosis ; Exophthalmos ; Female ; Frontal Sinus ; Humans ; Orbit ; Osteoma* ; Skull

The authors present a rare case of tuberculous spondylitis and a large abscess in the left psoas muscle that occurred after spinal surgery for an acute traumatic burst fracture of the L2 vertebral body. We retrospectively reviewed the patient's first magnetic resonance imaging (MRI) we found that some unusual findings, indicative of psoas abscess had been overlooked. As a result, diagnosis and treatment of tuberculous psoas abscess and spondylitis were considerably delayed. Despite the critical condition of patients in a similar emergency, surgeons should always pay close attention to the radiological findings and clinical symptoms of the patient before considering a surgical intervention or biopsy.
Abscess ; Biopsy ; Emergencies ; Humans ; Magnetic Resonance Imaging ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Spondylitis ; Tuberculosis

STUDY DESIGN: Case report. OBJECTIVES: To report a case of mononeuritis multiplex as the initial manifestation of Candida infective endocarditis (IE). SUMMARY OF LITERATURE REVIEW: Mononeuritis multiplex is actually a group of diseases, not a distinct disease entity. It often results from blood vessel diseases, diabetes, or inflammation due to autoimmune connective tissue disorders, although many cases are idiopathic. IE is an infection of the endocardial surface of the heart. Multiple nerves were affected simultaneously in several cases of IE, making consideration of IE important in the differential diagnosis of mononeuritis multiplex. MATERIALS AND METHODS: We present a rare case of a 71-year-old man with IE in whom mononeuritis multiplex was revealed on electromyography; further, he presented with lower back pain and sciatica. RESULTS: The presence of the characteristic symptoms of lumbar radiculopathy in this case delayed the diagnosis and proper treatment of the patient. CONCLUSIONS: Physicians should carefully consider all patient-related data, and also provide accurate information to consultants when they refer patients. This can help to prevent serious complications.
Aged ; Blood Vessels ; Candida* ; Connective Tissue ; Consultants ; Diagnosis ; Diagnosis, Differential ; Electromyography ; Endocarditis* ; Heart ; Humans ; Inflammation ; Low Back Pain ; Mononeuropathies* ; Radiculopathy ; Sciatica

Myeloid sarcoma is a solid, extramedullary tumor composed of leukemic myeloblasts or immature myeloid cells. Intraparenchymal myeloid sarcoma without the involvement of the skull or meninges is extremely rare. Here, we present the case of a 49-year-old man who developed intraparenchymal myeloid sarcoma on the left cerebellum after allogeneic bone marrow transplantation (BMT). He received radiotherapy after complete removal of intraparenchymal myeloid sarcoma, but he was diagnosed spinal myeloid sarcoma three month later. Nine months after the operation, new intracranial and spinal myeloid sarcoma were diagnosed and the patient's condition had been worsened rapidly. Although the spinal myeloid sarcoma was not histologically diagnosed, this report provides valuable insights into the clinical course of progression of intraparenchymal myeloid sarcoma.
Bone Marrow Transplantation ; Cerebellum ; Granulocyte Precursor Cells ; Humans ; Leukemia, Myeloid, Acute ; Meninges ; Middle Aged ; Myeloid Cells ; Sarcoma, Myeloid ; Skull

No abstract available.
Humans ; Kyphoplasty

Seven cases of A2 anomaly including azygous A2 and accessory A2 were observed during aneurysm surgery. We present case histories, angiograms and operative descriptions, and discuss with the clinical significance of the anomaly. The recognition of the anatomic variations prior to clip placement for anterior cerebral artery aneurysm is emphasized.
Aneurysm ; Anterior Cerebral Artery* ; Intracranial Aneurysm*

The recurrence of lumbar disc herniation after single-level discectomy is a well-known complication. Pain and neurological symptoms during the first week after surgery can be caused by missed pathology or early recurrent disc herniation. However, recurrent disc herniation that causes segmental instability after repeat operation is rare. Here, we report a case of a 42-year-old woman having a rare complication of rapid recurrent lumbar disc herniation after 2 microscopic discectomies within a short period. We suggest that rapid disc fragmentation and rapid growth of annular defect caused rapid repeated recurrence of lumbar disc herniation and segmental instability. Further investigation will be needed to identify the cause of this rapid disc degeneration.
Adult ; Diskectomy ; Female ; Humans ; Intervertebral Disc Degeneration ; Recurrence

OBJECTIVE: Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS).METHODS: The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS.RESULTS: The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80–84 years and in women aged 75–79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant.CONCLUSION: To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.
Accidents, Traffic ; Age Distribution ; Aged ; Aging ; Brain Injuries ; Diagnosis ; Epidemiology ; Female ; First Aid ; Glasgow Coma Scale ; Hematoma, Subdural, Acute ; Humans ; Incidence ; Korea ; Male ; Mortality ; Retrospective Studies ; Sex Characteristics

Conservative therapy with appropriate antibiotics is essential for most patients with infectious spondylitis. Although most antibiotics do not cause problems if it used properly and serious side effects are rare, side effects can occur with any class of drugs and adverse reactions of antibiotics can range from mild allergic reactions to serious and fulminant adverse events. These side effects are also extremely variable from patient to patient and from antibiotic to antibiotic. A side effect of antibiotics may paradoxically increase inflammatory marker levels. Here, the author presents two cases of antibiotic-induced increase in inflammatory markers in cured infectious spondylitis. The patients were successfully treated after stopping the antibiotic therapy. The differential diagnosis between antibiotic side effects and infection should be considered very carefully because the treatment is completely different. Although the exact mechanisms underlying successful treatment without antibiotics are unclear, we should consider the side effects of antibiotics when following inflammatory markers during treatment of infectious spondylitis.
Anti-Bacterial Agents ; Diagnosis, Differential ; Humans ; Hypersensitivity ; Inflammation ; Spondylitis

Unexpected bleeding is a common complication that can occur during surgery. This unexpected bleeding can be managed by checking the patients’ preoperative hemodynamic state or by autologous transfusion of an appropriate volume during surgery depending on the amount of blood loss and hemodynamic condition. However, patients like Jehovah’s Witnesses, who refuse autologous transfusions for religious reasons even in life-threatening situations, present a predicament for treating physicians. The author reports on a large meningioma on the posterior fossa of a Jehovah’s Witness patient who underwent surgery without autologous blood transfusion. There were no major problems other than the fear of unexpected massive bleeding. The surgeon’s attention and efforts to minimize bleeding during surgery seemed to be the most important factors for success.