No abstract available.
Animals ; Growth Hormone* ; Prolactin* ; Rats*

325 patients underwent emergency evacuation of traumatic intracranial hematomas over a 5-year period. Ten(3%) developed delayed contralateral epidural hematomas. These hematomas were not present on initial computed tomography(CT) scan, but repeat CT scan after craniectomy showed sizable hemorrhage. The authors analyzed 10 cases with delayed post-traumatic contralateral epidural hematoma according to their etiology, hematoma types on computerized tomography, initial Glasgow Coma Scale(GCS) & follow up Glasgow Outcome Scale(GOS). 1) Delayed development of post-traumatic contralateral epidural hematoma after evacuation of initial hematoma occurred in 10 of the 325 head injured patients, an incidence rate of 3%. 2) The important factors affecting patients outcome were the initial GCS & the time interval after surgery. 3) Eight patients were found to have a skull fracture at the site of delayed epidural hematoma formation(80%). 4) The results of delayed contralateral epidural hematoma was 50% good, 50% bad and had a mortality rate of 30%.
Coma ; Craniocerebral Trauma ; Emergencies ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Head ; Hematoma* ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Traumatic ; Mortality ; Skull Fractures ; Tomography, X-Ray Computed

No abstract available.

No abstract available.

Charcot spinal arthropathy is a rare, progressive type of vertebral joint degeneration that occurs in the setting of any preexisting condition characterized by decreased afferent innervation to the extent that normal protective joint sensation in the vertebral column is impaired. The authors report on a case of Charcot arthropathy of the lower lumbar spine mimicking a spinal tumor following cervical cord injury.
Joints ; Preexisting Condition Coverage ; Sacrum ; Sensation ; Spinal Cord Injuries* ; Spinal Cord* ; Spine*

BACKGROUNDS: Thymic carcinomas are very rare tumors that are often associated with extrathoracic metastasis to other organs. However, it is well known that thymic carcinomas rarely metastasize to the spine, and the prognosis, treatment, and natural course of this disease are not yet standardized. METHODS: We describe seven thymic carcinoma patients with spinal metastasis who were diagnosed and treated in our institute from January 2006 to December 2011. We performed surgical treatment and adjuvant chemotherapy and/or radiation therapy, in consideration of each individual disease's course, and we regularly followed up the patients. RESULTS: Of the seven patients, five were male and two were female. Six had metastases in the thoracic spine, and one had metastases in the lumbar spine. An extradural lesion was found in five patients, and two patients had both extradural and intradural lesions. The period from the primary diagnosis to spinal metastases varied widely (range, 1.23-14 years). After surgery, all patients showed an improvement of back pain and radicular pain. Two patients were lost to follow-up, but the other five maintained ambulatory function until their final follow-up. Four patients died because of pulmonary complications accompanied with the disease's progression. One patient died from uncontrolled brain metastases. After surgery, the median survival was 204+/-111.43 days. CONCLUSION: Because metastasis to the spine from thymic carcinoma is very rare, there are no treatment guidelines. Nevertheless, we suggest that appropriate surgical management of the metastatic lesion is necessary for the preservation of the patient's quality of life during survival.
Back Pain ; Brain ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Lost to Follow-Up ; Male ; Neoplasm Metastasis* ; Prognosis ; Quality of Life ; Spine ; Thymoma*

The authors hypothesized that the placement of the interspinous implant would show a similar clinical outcome to the posterior lumbar interbody fusion (PLIF) in patients having spinal stenosis with mild segmental instability and that this method would be superior to PLIF without significantly affecting degeneration at the adjacent segments. Forty two adult patients having degenerative spinal stenosis with mild segmental instabilit who underwent implantation of Coflex(TM) (Spine motion, Germany) or PLIF at L4-5 between January 2000 and December 2003 were consecutively selected and studied for one-year clinical outcome. At 12 months after surgery, both groups showed a significant improvement in the visual analogue scale score and Oswestry disability index score for both lower extremity pain and low back pain. However, the range of motion at the upper adjacent segments (L3-4) increased significantly after surgery in the PLIF group, which was not manifested in the Coflex(TM) group during the follow-up. The authors assumed that interspinous implantation can be an alternative treatment for the spinal stenosis with segmental instability in selected conditions posing less stress on the superior adjacent level than PLIF.
Treatment Outcome ; Spinal Stenosis/complications/*surgery ; Spinal Fusion/*instrumentation/methods ; Prosthesis Design ; Pain Measurement ; Outcome Assessment (Health Care) ; Middle Aged ; Male ; Lumbar Vertebrae/*surgery ; Longitudinal Studies ; Joint Instability/complications/*prevention & control ; Intermittent Claudication/diagnosis/etiology/*prevention & control ; Humans ; Female ; Equipment Failure Analysis ; Back Pain/diagnosis/etiology/*prevention & control ; Aged ; Adult

Candida is a relatively rare cause of spinal infections that commonly affects immunocompromised patients. A 70-year-old woman, who underwent a lumbar discectomy on L5-S1 two months earlier, was admitted to our department complaining of persistent back and leg pain. Magnetic resonance imaging showed irregular enhancing mass lesion in L5-S1 intervertebral space, suggest of pyogenic discitis with epidural abscess. The surgery was performed via retroperitoneal approach and the infected material at L5-S1 intervertebral space was removed. The histological examination of the specimen revealed chronic inflammation involving the bone and soft tissue, and a culture of the excised material was positive for Candida parapsilosis. The patient received intravenous fluconazole for 4 weeks after surgery and oral fluconazole 400 mg/day for 3 months after surgery. The patient made a full recovery with no symptoms 6 months after surgery. We present a rare case of spondylodiscitis after a lumbar discectomy due to Candida parapsilosis and discuss treatment option with a review of the literatures.
Aged ; Candida ; Discitis ; Diskectomy ; Epidural Abscess ; Female ; Fluconazole ; Humans ; Immunocompromised Host ; Inflammation ; Leg ; Magnetic Resonance Imaging ; Osteomyelitis ; Spine

A 67-Year-old male patient was adimitted due to aggravation of long-standing left moter weakness. Past history revealed weakness of left extremity for 20 years caused by CVD attack. On adimission, his mental state was drowsy and brain CT scan showed a round mass mimicking a brain tumor in the frontal horn of right lateral ventricle with asymmetric dilatation of lateral ventricles. After failed carotid angiography due to vascular tortuosity, his mental state was progressively deteriorated and left hemiparesis aggravated. A right external ventricular drainage was done, and 5 days later a craniotomy was performed under the impression of the intraventricular tumor causing obstruction of right foramen of Monro, but a large thrombosed aneurysmal sac was found intraoperatively. Retrial of carotid angiography revealed a large anterior communicating artery aneurysm. After second operation, maningoencephalitis with wound infection was complicated. Twenty days after second operation, clipping of the aneurysmal neck with removal of partially thrombosed aneurysmal sac was performed successfully.
Aged ; Aneurysm ; Angiography ; Animals ; Brain ; Brain Neoplasms ; Cerebral Ventricles ; Craniotomy ; Dilatation ; Drainage ; Extremities ; Horns ; Humans ; Hydrocephalus* ; Intracranial Aneurysm* ; Lateral Ventricles ; Male ; Neck ; Paresis ; Tomography, X-Ray Computed ; Wound Infection

We report a case of pseudoaneurysm of the parietal division of the superficial temporal artery (STA) secondary to iatrogenic head injury due to Gardner traction. A 54-year-old man presented with a pulsatile, cystic, and painless mass in the right anterior temporal region which developed three weeks after head fixation via Gardner traction. At the time of discovery, the mass was 10 mm in diameter, compressible and disappeared after manual compression of the proximal STA. A bruit was audible over the mass, which was thought to be a pseudoaneurysm. A computed tomography angiogram (CTA) showed a pseudoaneurysm of the parietal division of the right STA. The tip of the pseudoaneurysm was thrombosed and was both red and tender. The pseudoaneurysm was thought to be filled with infected thrombus, and the mass was resected with ligation of the proximal and distal ends of the STA. A pseudoaneurysm of the STA should be suspected when there is a history of possible vessel injury, such as a history of head-pin fixation, and when a patient presents with a pulsatile, cystic mass near the temple. Pseudoaneurysms can be successfully treated by excision.
Aneurysm, False ; Craniocerebral Trauma ; Glycosaminoglycans ; Head ; Humans ; Ligation ; Middle Aged ; Temporal Arteries ; Thrombosis ; Traction