Traumatic carotid cavernous fistulas. Rare and life threatening.

Purpose: Carotid-cavernous fistulas (CCFs) are often underdiagnosed or misdiagnosed. In polytraumatized patients, the focus is primarily on treating potentially life-threatening conditions such as increased intracranial pressure and hemorrhages. This case report aims to identify common diagnostic mistakes in rare pathologies.

Misdiagnosis of acute subarachnoid hemorrhage in the era of multimodal diagnostic options.

Objective: Patients suffering from aneurysmatic Subarachnoid Hemorrhage (SAH) may present with a variety of symptoms. The aim of this study is to evaluate the spectrum of misdiagnoses and to analyze the significance of delay of correct diagnosis on the clinical outcome.

Methods: The data was collected prospectively from 2003 to 2013.

Clinical and radiological course of intracerebral haemorrhage associated with the new non-vitamin K anticoagulants.

Background: Clinical outcome and mortality in intracerebral haemorrhage (ICH) associated with anticoagulant treatment is poor. Novel direct oral anticoagulant drugs (NOACs) are increasingly prescribed. Management of NOAC-associated ICH might be more challenging.

A novel simple measure correlates to the outcome in 57 patients with intracerebellar hematomas. Results of a retrospective analysis.

Background: The incidence of intracerebellar hemorrhages approaches 5-10% of all intracerebral hematomas. The clinical presentation varies from headaches and dizziness to rapid deterioration of consciousness to the point of coma in severe cases. In order to find some concrete criteria that could influence the prognosis of these patients, we performed this retrospective study.

Extensive growth of an anaplastic meningioma.

We present the case of a 30-year-old male patient with an almost complete destruction of the calvarial bone through an anaplastic meningioma diagnosed in line with dizziness. Neuroimaging revealed an extensive growing, contrast enhancing lesion expanding at the supra- and infratentorial convexity, infiltrating and destroying large parts of the skull, and infiltrating the skin. Due to progressive ataxia and dysarthria with proven tumor growth in the posterior fossa in the continuing course, parts of the tumor were resected.

Predictors and incidence of posttraumatic seizures in children and adolescents after brain injury.

The present study evaluates the incidence of early and late seizures after head injury in patients under 18 years old. Factors correlating with a high risk of developing posttraumatic seizures were identified. Such risk factors were the severity of the head trauma and a Glasgow Coma Scale of 3-8.

Factors influencing surgical outcome after anterior stabilization of the cervical spine with heterogeneous material.

Intervertebral fusion through an anterior approach with polymethylacrylate is a well-established neurosurgical technique in the treatment of cervical spine degeneration. However, questions still remain concerning the post-surgical outcome. Factors influencing surgical outcome that could help to predict which patients need further post-surgical treatment and what to expect after surgery are the subject of numerous studies.

Treatment of 817 patients with spontaneous supratentorial intracerebral hemorrhage: characteristics, predictive factors and outcome.

The aim of this study was to present the data of a large cohort of patients with spontaneous supratentorial intracerebral hemorrhage (ICH), who were treated in our department and give a current overview considering special clinical characteristics, performed therapy and different predictive factors for morbidity and mortality. We reviewed the data of all patients with spontaneous ICH, who were treated in our department in a time span of 11 years through an analysis of our prospective database. Patients with spontaneous supratentorial ICH were included in the study.

Special features of subarachnoid hemorrhage of unknown origin: a review of a series of 179 cases.

Objectives: The aim of this study was to work out the special features of subarachnoid hemorrhage (SAH) of unknown origin in respect of diagnostic evaluation, clinical course, and outcome in a large cohort of patients.

Methods: We reviewed the data of 179 patients with SAH of unknown origin during 1991 and 2008. The differentiation between perimesencephalic (PM-SAH) and non-perimesencephalic SAH (NON-PM-SAH) was done under consideration of the bleeding pattern on CT scanning.

Does magnetic resonance imaging produce further benefit for detecting a bleeding source in subarachnoid hemorrhage of unknown origin?

Background: Spontaneous subarachnoid hemorrhage (SAH) without evidence of a bleeding source on the first digital subtraction angiogram (DSA) - also called SAH of unknown origin - is observed in up to 27% of all cases. Depending on the bleeding pattern on CT scanning, SAH can be differentiated into perimesencephalic (PM-SAH) and non-perimesencephalic SAH (NON-PM-SAH). The aim of our study was to investigate the effectiveness of magnetic resonance imaging (MRI) for detecting a bleeding source in SAH of unknown origin.

Symptomatic spinal cavernous malformations: indication for microsurgical treatment and outcome.

Purpose: We demonstrate clinical features, therapy and outcome of 14 patients with symptomatic spinal cavernous malformations (CM).

Methods: We retrospectively reviewed all patients who underwent microsurgical treatment of symptomatic spinal CM during the last decade in our department through an analysis of our database.

Results: We analyzed the data of 14 patients (11 females, 3 males) with symptomatic spinal CM in a range of 16-77 years (mean age 47.

Post-traumatic extensive knee ganglion cyst.

A rare case of a posttraumatic extensive ganglion cyst of the anterolateral thigh with connection to the knee joint is presented. A 54-year-old man presented a palpable mass in the anterolateral region of his right thigh with a 15 months existing sense of fullness and tightness. He had an accident with his bicycle 21 months ago.

A case of idiopathic encephalomeningocele.

In the present case we report about an encephalomeningocele in an adult female. Since the cause of this medical entity is a congenital fusion defect of the neural tube of the cranial base, most of the encephaloceles occurs in children leading to facial disfigurement. In the rare cases described in adults, rhinorrhea is usually present.

A rare case of extradural lumbar nerve root cavernoma.

We present a very rare case of an extradural nerve root cavernoma of the lumbar spine. The patient had signs of radiculopathy for the last 3 years. Conservative treatment was unsuccessful.

The effect of lung-protective permissive hypercapnia in intracerebral pressure in patients with subarachnoid haemorrhage and ARDS. A retrospective study.

Objective: Lung protective ventilation has a beneficial effect in treating patients with acute respiratory distress syndrome (ARDS). An effect of this ventilation modality is hypercapnia, which leads to increased cerebral blood flow. Since increased cerebral blood flow can induce brain oedema the question arises whether lung protective ventilation can be applied in patients with subarachnoid haemorrhage.

Continuous intra-arterial infusion of nimodipine at the onset of resistant vasospasm in aneurysmal subarachnoidal haemorrhage. Technical report.

Cerebral vasospasm complicating the aneurysmal subarachnoid haemorrhage is a well known medical entity. The delayed ischemic neurological deficits (DINDs) as a result of vasospasm, remain the main cause of morbidity among patients who manage to survive this severe disease pattern. When the traditional treatment options either medical or interventional, fail to reverse the vasospasm, continuous intra-arterial infusion of nimodipine through catheters direct in the spastic arteries, presents a promising treatment modality.