STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH) as a complication of spinal surgery. SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage is rare but lethal as a complication of spinal surgery. Interestingly, dural tears and cerebrospinal fluid (CSF) leakage are reported in all published cases of RCH. MATERIALS AND METHODS: A 67-year-old man had posterior lumbar decompression and posterolateral fusion for spinal stenosis at L4/5/S1. Intraoperatively, the dura was torn and there was a loss of CSF. The dural tear was sutured immediately in a water-tight manner. After surgery, the patient complained of headache and dizziness. On postoperative day 44, brain magnetic resonance imaging (MRI) showed meningeal enhancement suggesting meningitis. On postoperative day 54, brain computed tomography (CT) showed cerebellar edema and hemorrhage, and external ventricular derivation was performed. RESULTS: The patient died. CONCLUSIONS: Special attention should be paid to prevent dural damage during spinal surgery or minimize CSF leakage in the case of dural damage and tears during spinal surgery, and CT and MRI should be promptly performed for symptomatic patients.
Aged ; Brain ; Cerebrospinal Fluid* ; Decompression ; Dizziness ; Edema ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Spinal Stenosis ; Tears

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of epidermoid cyst in the spinal canal. SUMMARY OF LITERATURE REVIEW: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer. MATERIAL AND METHODS: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6-T8 level. The cystic mass was excised after durotomy using a posterior approach. RESULTS: We confirmed the presence of an epidermoid cyst for histopathology. CONCLUSION: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
Diagnosis ; Diagnosis, Differential ; Epidermal Cyst* ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Paresthesia ; Spinal Canal ; Spine

This paper reports two cases of schwannomas arising from the oral cavity. One is an intraoral ancient schwannoma located at the left cheek, which evolved over a period of 13 years. The tumor was a well-demarcated buccal mass, which was located in the left lower first premolar area, with an obliterated the buccal vestibule, leaving the overlying mucosa intact. The second case was a central intraosseous schwannoma located from the left lower 1st molar periapical area to the left 3rd molar periapical area. Pathologically, the first mass was composed of the spindle shaped tumor cells with wavy nuclei beneath the fibroconnective tissue of the gingiva but second case mass was not. Occasional nuclear pleomorphism was observed but mitosis or necrosis was absent. There were Antoni A and B areas along with strong, diffuse staining with the S-100 protein. Ancient schwannomas were diagnosed. Schwannoma is a slow-growing benign tumor, and an ancient schwannoma that shows cellular atypism is a variant of a schwannoma caused by purely degenerative changes. To date, only limited cases of ancient schwannomas in the oral cavity have been reported.
Bicuspid ; Cheek ; Gingiva ; Mitosis ; Molar ; Mouth ; Mucous Membrane ; Necrosis ; Neurilemmoma ; S100 Proteins

Ameloblastoma ; Curettage ; Enamel Organ ; Facial Asymmetry ; Mandible ; Molar ; Molar, Third ; Odontogenic Cysts ; Phenobarbital ; Recurrence ; Tooth ; Tooth, Impacted

Cicatrix ; Endoscopes ; Facial Nerve ; Follow-Up Studies ; Humans ; Jaw Fixation Techniques ; Mandible ; Mouth ; Surgery, Oral

STUDY DESIGN: This is a case report. OBJECTIVE: We present here a patient who had a discal cyst of the lumbar spine along with neurological symptoms. SUMMARY OF THE LITERATURE REVIEW: Discal cysts are intraspinal cysts that communicate with an adjacent intervertebral disc, and these are rare lesions that can cause lumbar radiculopathy. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. MATERIAL AND METHODS: The patient complained of moderate lumbar pain and right lower extremity radiculopathy and he was administered conservative treatment for 5 months. But the radiculopathy became aggravated and he then underwent a hemilaminectomy, cyst decompression and discectomy. RESULTS: The radiculopathy disappeared and any signs of recurrence were not found on the follow up performed at 1 year. CONCLUSION: Discal cyst is rare, but it can be treated successfully.
Decompression ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Lower Extremity ; Natural History ; Radiculopathy ; Recurrence ; Spine

Endoanal ultrasonography has recently emerged as a popular diagnostic modality for mapping and imaging the anal sphincter. This procedure can be performed as an outpatient procedure; it is relatively quick and virtually painless. The imaging typically is performed in a proximal to distal manner with defining a variety of levels of the anal canal as it progresses. Anal ultrasond can provide a detailed image of the anal sphincter musculature. The internal anal sphincter appears endosonographically as a hypoechoic circular band that is most prominently seen at the level of the mid-anal canal. The external anal sphincter appears as a thicker circular mixed echogenic band outside of the hypoechoic internal sphincter. Anal ultrasond can be used to evaluate patients with anal fistulas with or without abscess. Imaging is performed and the fistulous tracts or abscesses are identified by hypoechogenicity within the external sphincter muscle or the ischiorectal fossa. Its ability to clearly image the anal sphincters has allowed its use for the evaluation of anal fistulas. Moreover, anal ultrasound has emerged as the technique of choice for imaging the anal sphincters and for evaluating incontinence. Each of the individual physiologic tests offers valuable information that is relevant to the continence mechanism, and the ultrasound yields results that are complementary to other tests. Ultrasound serves as a surveillance tool to monitor the results after sphincterplasty. We illustrate the endo-anal sonographic features of various anal diseases and the ultrasound-anatomic correlation for the anus.
Abscess ; Anal Canal ; Fistula ; Humans ; Muscles ; Organothiophosphorus Compounds ; Outpatients ; Rectal Fistula

PURPOSE: The US examination has been used to evaluate the infant and child having an inguino-scrotal bulge or mass for the non-invasive diagnostic work up to exclude neoplasm, cryptorchidism, lymphadenopathy, hydrocele of spermatic cord, etc. We performed this study to determine the characteristic ultrasound features of hydrocele of spermatic cord in children. MATERIALS AND METHODS: From February 2002 to March 2007, 213 pediatric patients with swelling or palpable mass of the inguino-scrotal area, or suspected cryptorchidism underwent ultrasonography for evaluation of accurate diagnosis. Ninetythree of 213 patients had a cystic lesion of the inguino-scrotal area. Among 93 patients, the sonographic images of 28 patients, who were confirmed as having hydrocele of the spermatic cord, were collected on a retrospective basis. The age of the patients ranged from 15 days to 11 years. The ultrasound images of the patients were subsequently reviewed to analyze the typical features in the diagnostic workup of hydrocele of spermatic cord. Eight patients were confirmed by surgery. Twenty patients who were less than one year old were clinically followed up. RESULTS: The most common finding was testicular hydrocele, which was found in 44 patients of the 93 patients that had a cystic lesion of the inguino-scrotal area. Of the 28 patients who had a hydrocele of spermatic cord, 10 patients had the lesions on the left side and 17 patients on the right side. One patient has bilateral hydrocele of spermatic cord. Well-defined elongated or elliptical-shaped cystic lesions were noted in the 24 of 29 cases (one patient had bilateral hydrocele of the spermatic cord). One patient had septations within elongated cystic lesion was seen and round shape in one case; tear drop shape was found in three cases. CONCLUSIONS: The most common ultrasound imaging of spermatic cord hydrocele is well-defined, elongated cystic mass separating the testes.
Child ; Cryptorchidism ; Humans ; Infant ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spermatic Cord ; Testicular Hydrocele ; Testis

Congenital undescended scapula is congenital structural abnormality which affects only one side usually. Scapula located higher than the usual and rotating deformity that inferior angle to medial side, superior angle to lateral side is common. This report presents one case of the surgical therapy of a sprengel deformity patient who passed an optimal operation period with age 3~7years old, and includes brief review of the literature. 7 years old boy whose chief complaint was the limitation of left scapular-thoracic movement and he had an omovertebral bone bridge and periscapular muscle atrophy. There was improvement of motion ranges and cosmetic problems after surgical treatment.
Child ; Congenital Abnormalities* ; Humans ; Male ; Muscular Atrophy ; Scapula

PURPOSE: To assess the histological degeneration of the cruciate ligaments and it's correlation with gross appearance of the cruciate ligaments and functional status of the knee. MATERIALS AND METHODS: Macroscopic and microscopic evaluations of cruciate ligaments were made in 80 osteoarthritic knees undergoing cruciate-substituting total knee arthroplasty (TKA). Gross appearance was classified into "normal", "abnormal" and "tear". A scoring system was made to represent the degree of histological degeneration, and correlation with the gross appearance and functional status by knee society score (KSS) was statistically analysed. RESULT: Gross appearance of the anterior cruciate ligament (ACL) was "normal" in 24 cases, "abnormal" in 50 and "tear" in 6 with average histological score 3.7, 4.5 and 8.0 respectively. Gross appearance of the posterior cruciate ligament (PCL) was "normal" in 70, "abnormal" in 10 with average histological score 3.8 and 6.4 respectively. There was no "tear" of the PCL. Gross appearance of the ACL was correlated with histological score of ACL and PCL (p<0.05) and KSS (p<0.05). CONCLUSION: Gross appearance of the ACL was related to the degree of histological degeneration of the PCL as well as the ACL and functional loss of the knee. Therefore intraoperative gross appearance of the ACL can be one of the factors to decide if the PCL would be sacrificed or not during TKA.
Anterior Cruciate Ligament ; Arthroplasty ; Knee* ; Ligaments* ; Posterior Cruciate Ligament