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

No abstract available.
Humans ; Kyphoplasty

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

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

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.

Pneumocephalus is defined as an abnormal presence of intracranial air or gas. Traumatic pneumocephalus (TP) typically occurs on the injured side and is in communication with the external environment. This report presented an extremely rare case of TP that occurred on the opposite side of the injured site, even with the absence of any traumatic injury.The patient sustained injuries, including linear skull fracture, acute epidural hematoma, fractures in the clavicle and scapula, and subcutaneous emphysema, on the left side of the body. However, TP occurred on the right side. Although the exact underlying pathogenic mechanism remains unclear, the condition might be attributed to the migration of air bubbles or negative pressure on the opposite side caused by side-to-side closed head injury.

Objective: Traumatic pneumocephalus (TP) is a common complication of traumatic brain injury (TBI), which is characterized by the abnormal entrapment of air in the intracranial cavity after TBI to the meninges. The purpose of this study was to investigate the clinical and radiological characteristics related to TP associated with TBI. Methods: From January 2013 to March 2018, the data from 71 patients with TP after TBI were collected. Demographic and clinical characteristics were investigated and the distribution of TP was investigated as radiological characteristics. The author compared the demographic characteristics of TP to the data from the Korean Neurotrauma Data Bank System (KNTDBS). Results: There was a higher ratio of males in patients with TP compared with KNTDBS. The mean age was 48.4±20.5 years and the incidence was highest in those 41–60 years of age (42.3%). Surgical treatment was performed in 23.9% patients. The mortality associated with the TP was 4.2%. The most common cause of injury was a traffic accident (52.1%). TP was mainly located in the epidural space (53.5%) and showed a scatter pattern (60.6%). It was mostly located in the frontal and temporal area (81.7%). Skull fractures were observed in 40.8% in the temporal bone and 25.4% in the frontal bone. Conclusion The author identified epidemiology, clinical, and radiological characteristics of TP associated with TBI. Although this study has many limitations, the author believes it is worthwhile as it examines various characteristics of TP, which previously had relatively little clinical interest.

Objective: It is important to know the epidemiologic aspects of traumatic brain injury (TBI) for its rapid detection, appropriate treatment, and prevention. The purpose of this study is to classify the time of arrival of patients in the emergency room (ER) by time of day, day of the week, month, and season, and to analyze the relationship between the frequency of presentation at different times and TBI. Methods: The time of arrival of 327 patients with TBI between January 2016 to December 2017 at the ER was analyzed retrospectively. The trends regarding the frequency of presentation of patients with TBI were analyzed in relation to arrival time at the ER. Results: Patients with TBI were found to have the greatest number of hospitalizations at 13:00–18:00, on Saturdays, in December, and during the summer. Surgical treatment was not related to the temporal pattern of TBI patient admission. Patients with TBI in the severe group (GCS score <8) arrived at the ER mainly at 07:00–12:00 (p=0.015). Patients with TBI in the mild group (GCS score 13–15) mainly presented in the ER during the summer (p=0.003), while patients TBI in the moderate group (GCS score 9–12) presented mainly in the winter (p=0.244). The combination of the mild and moderate group presented more often in the winter (p=0.014). Conclusion It is worthwhile understanding the temporal trends of TBI patients. These data may provide useful information in predicting the ER visits of TBI patients in advance and preparing for prompt and appropriate treatment.