Is postoperative haematoma an avoidable complication of intracranial surgery?

Postoperative intracranial haematoma is a serious complication of intracranial surgery with a mortality rate of around 30%. There have been reports implicating abrupt rises of blood pressure during the last stages or immediately after the procedure, in the production of the clot. This prospective study examined this hypothesis.

Magnetic resonance angiography demonstration of an angiographically occult anterior communicating artery aneurysm.

In almost one in six patients with spontaneous subarachnoid haemorrhage (SAH) no lesion responsible for the bleed will be found by cerebral angiography. Current management strategies include repeat cerebral angiography after a period of 1-8 weeks during which a number of these patients will rebleed with considerable morbidity and even mortality. We report the case of a young female patient with spontaneous subarachnoid haemorrhage.

Case report: sclerotic skeletal haemangiomatosis presenting with spinal cord compression--CT and MRI findings.

We report the case of a 59-year-old man with skeletal haemangiomatosis who presented with progressive bilateral lower extremity weakness. Computed tomography (CT) and magnetic resonance imaging (MRI) located the causative lesion in the neural arch of the T4 vertebra. CT demonstrated osseous expansion with a mixed lytic and sclerotic pattern.

Acute subarachnoid haemorrhage: detection with magnetic resonance imaging.

The purpose of this study was the evaluation of fluid attenuated turbo inversion recovery (FLAT TIRE) MR pulse sequence for detecting acute subarachnoid hemorrhage (SAH). Seven patients with SAH were studied within 6 days of ictus. Six of them underwent both CT and MRI and one MRI only.

Thecoperitoneal shunt for post-traumatic syringomyelia.

A case of post-traumatic syringomyelia developing two years after spinal cord injury is presented. The patient was treated with the placement of a thecoperitoneal shunt incorporating a low pressure valve. Response was excellent with restoration of neurological function and almost complete collapse of the cavity at one year follow up.

Thecoperitoneal shunt for syringomyelia: report of three cases.

During 8 months, three consecutive cases of syringomyelia were treated by the placement of thecoperitoneal shunts. In the first two patients, the cord cavitation was idiopathic in one and thought to be related to spinal trauma in the other. In the third case, there was associated anomaly of the craniocervical junction of the Chiari I type.

The symptomatic incompetent cervical intervertebral disc.

A series of 16 patients with symptoms such as pain in the neck, occiput, shoulder and arm; numbness in the hands; and/or difficulty in walking, is described. Neurological examination of the upper extremities disclosed signs of nerve roots dysfunction in 5 patients and long tract signs in 12, whereas examination of the lower extremities disclosed long tract signs in every patient. Positive contrast cervical myelograms suggested mild posterior bulging of one or two intervertebral discs in every patient, but computed tomographic myelograms invariably demonstrated a coincident narrow cervical spinal canal, thus revealing the true compressive potential of the aforementioned mild disc protrusion on the spinal cord.

The syndrome of normal-pressure hydrocephalus.

A series of 40 patients with the syndrome of normal-pressure hydrocephalus is presented. Diagnosis was based on clinical and computerized tomography (CT) scan criteria and was followed by the insertion of a ventriculoperitoneal shunt in every instance. All patients responded favorably to treatment (four of them had a fair outcome), and this response was maintained.

Benign extramedullary foramen magnum tumors: diagnosis by computed tomography.

This paper reports two cases of benign extramedullary tumors of the foramen magnum studied by computed tomography (CT). The first case was a neurinoma; the second was a meningioma. Several different CT findings allowed a correct preoperative diagnosis of the location and nature of the tumors.

Subfrontal schwannoma. Report of a case.

A case of subfrontal Schwannoma in a 17-year-old patient is reported. The tumour presented with symptoms and signs of increased intracranial pressure. The pre-operative diagnosis, based on the CT scan appearances, was that of a meningioma.