Publications by authors named "Ihsen Zammel"

Giant cell tumors (GCTs) are rare neoplasms, primarily found in long bones, typically affecting the epiphysis of the distal femur, proximal tibia, and distal radius. However, their occurrence in the cervical spine is exceedingly rare. Here, we present a case report of a 21-year-old female patient who presented with progressive neck pain, radiating numbness, and right hemiparesis.

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Arachnoid cysts are rare subtypes of spinal cord tumors, usually found in extradural or intradural extramedullary locations. Intramedullary arachnoid cysts are exceedingly rare, with only a few cases reported in the literature. Although these cysts are histologically benign, they can cause significant functional impairment and lead to severe neurological deficits if left untreated.

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Background: Spinal cavernomas (SCs) account for about 5% of all spinal vascular malformations. Intradural SCs occur in just 3% of cases and are typically intramedullary.

Case Description: A 58-year-old female presented with progressive left occipital neuralgia, left cervicobrachial neuralgia, and paresthesia of all four extremities.

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Article Synopsis
  • Thymomas are usually benign tumors from the thymus gland, but they can become malignant if they invade surrounding tissues, and they rarely spread to distant sites.
  • A case study of a 63-year-old man showed that his brain lesions were metastases from a primary thymoma, classified as B3, which was confirmed after surgery and further examination.
  • Although he was recommended for chemotherapy and radiotherapy, the patient sadly passed away shortly after starting treatment, highlighting the poor prognosis for those with brain metastases from thymomas and the need for prompt surgical intervention.
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Introduction: Osteochondromas, also known as osteocartilaginous exostosis, are among the most common benign cartilaginous bone tumors, primarily occurring as solitary lesions. While typically found in long bones, spinal involvement is rare, accounting for only a small percentage of benign lesions in this location. Solitary osteochondromas responsible for spinal cord compression are seldom.

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Background: Intracranial inflammatory pseudotumours (IPT) are rare entities that frequently lead to misdiagnosis with malignant lesions. The identification of these lesions is difficult, but important to avoid inadvertent iatrogenicity and to adjust therapeutic protocols.

Case Presentation: We report the case of a 30-year-old man who presented a single tonic-clonic seizure.

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Vertex epidural hematomas are very uncommon complications of traumatic head injury. Besides the volume of the epidural bleeding, compression of the superior sagittal sinus may be source for added elevated intracranial pressure. Clinical presentation of such lesions is heterogenous and symptoms can develop in an acute to a chronic frame.

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Supratentorial-infratentorial epidural hematomas (SIEH) are a rare occurrence following traumatic head injuries, representing only 2% of traumatic epidural hematomas. Given the unique anatomical characteristics of the infratentorial region, mainly its small size, surgical intervention is commonly undertaken to alleviate the pressure on the posterior fossa components. Consequently, there is ongoing debate surrounding the optimal surgical approaches.

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Purpose: To the best of our knowledge, this is the first study conducted in Tunisia on the neurosurgical management of child cranial trauma. The objectives of the present work were to identify the causes of pediatric head injuries, explore epidemiological and clinical specificities, and analyze the short- and long-term postoperative evolution.

Methods: A retrospective review was conducted on one hundred children with head injuries over a five-year period at one of the largest neurosurgery departments in Tunisia.

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Introduction: Paediatric rhabdoid meningioma (RM) is the rarest but most aggressive subtype of meningioma, related to a severe prognosis. They account for 1-3% of all intracranial meningiomas.

Case Presentations: We report an institutional experience of 3 cases through which we discuss clinical, histological, and therapeutic features of this tumour.

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Introduction And Importance: Spinal meningiomas are typically intradural lesions. Some may infiltrate the dura mater, thus exhibit direct extradural extension. Pure spinal epidural meningiomas are very rare.

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Background: Inflammatory pseudotumors are rare, and those attributed to immunoglobulin G4 (IgG4) diseases are even less frequently encountered. Here, we reviewed 41 cases from the literature of spinal inflammatory pseudotumors due to IgG4 and have added our single new case.

Case Presentation: A 25-year-old male presented with progressive back pain, bilateral paraparesis, and sphincter dysfunction.

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Penetrating intracranial foreign bodies are rare and have a high potential for death or serious morbidity. Their surgical management is complicated and challenging. Herein, we present the case of a 30-years-old man who was a victim of aggression from a rake blow to the head.

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We report the case of a 4-year-old boy who had a ventriculoperitoneal shunt due to hydrocephalus related to a cystic craniopharyngioma. Postoperative, he presented abdominal distension and meningismus. Imaging showed regression of the tumor.

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Bilateral epidural hematoma is a rare presentation in head trauma injuries, accounting for only 1%-2% of all epidural hematomas, but with a higher mortality rate than the unilateral form. Herein, we report the case of a 27-year-old man admitted to our department following a road traffic accident. On admission,his Glasgow Coma Scale (GCS) score was 13/15.

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Background: Intracranial inflammatory pseudotumors (IIPT) are one of the differential diagnosis for the central nervous system (CNS) tumors. They represent a rare condition that may mimic clinically and radiologically intracranial tumors and induce their complications. Among their etiologies, neurosarcoidosis is one of the less known and less frequent.

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Sellar region is a rare localization for intracranial metastases. The diagnosis is frequently delayed as symptoms are generally non specific. Radiologic diagnosis may be difficult as these tumours present similiraities to other more frequent sellar tumours.

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Introduction: Herniation of the thoracic spinal cord is a rare pathology related to the genesis of a breach in the anterior dura. Adding to the previously published cases, we report our department's experience with 2 cases of young adults who presented with transdural spinal cord herniation following spinal trauma.

Presentation Of The Cases: We report the cases of 2 men aged 27 and 57, with history of spinal trauma, who presented diverse clinical complaints (motor impairment, genito-sphincteric disorders, etc.

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Introduction: Medulloblastoma is a malignant tumor of the posterior fossa which is mainly found in children aged less than 15 years of age. This tumor is uncommon in adults, especially those above 40 years old. We report the very rare case of a 61 years-old woman who was diagnosed with a cerebellar medulloblastoma.

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Introduction: The term pneumocephalus refers to the existence of air in any intracranial compartment. Its presence in the follows of a supratentorial craniotomy is very common, and it usually represents a benign complication as it is very rarely responsible for clinical manifestations.

Case Presentation: We report the case of a 24 years-old man, who underwent posterior fossa surgery in prone position for resection of a vermian tumor.

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Introduction And Importance: Hereditary multiple exostoses (HME) is a benign disease, usually encountered in the metaphysis of long bones. On the opposite, spinal localizations are very rare. We herein describe a case of HME with a spinal cord compression.

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Gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) is the main contrast agent used in MRI, known for its good tolerance and rare toxicity. Even intrathecal injection of limited doses of Gadolinium can be performed in some indications. To our knowledge, only 3cases of accidental intraventricular injection of Gadolinium have been yet reported in the literature.

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Intracranial meningiomas are uncommon in the pediatric group. Myxoid meningioma is a subtype of metaplastic meningioma. It is the rarest WHO grade I meningioma.

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Introduction: Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children. TBI in children are responsible for a range of clinical symptoms and signs that are comparable to those in adults, but present several differences in both physiopathology and management. Many postoperative complications may occur, ischemic stroke among others, which is generally related to an injury of an intracranial artery.

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Lumbar pigmented villonodular synovitis is rarely localized on the lumbar spine. Awareness of pigmented villonodular synovitis is important despite its rarity because it may mimic several other lesions of this location.

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