Aqueductal stenosis following mumps virus infection. Case report

A case of aqueductal stenosis following mumps infection is reported, to the authors' knowledge the 12^th case in the literature. The pathogenetic events are discussed and the literature reviewed.

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Sommario È riportato un caso di stenosi dell'acquedotto a seguito di una infezione parotitica. Questo rappresenta il 12° caso della letteratura a conoscenza degli autori. Gli eventi patogenetici vengono discussi alla luce della letteratura.

     

Transplantation of fetal rat cortex into regenerating nerve to the biceps femoris of adult rat

Morphological aspects of the implantation of 11-day-old fetal (E11) rat cortex into regenerating peripheral nerves of adult rats were analyzed during the first 3 weeks after transplantation. On day 11 of gestation, donor fetuses were removed from one uterine horn of pregnant Sprague-Dawley rats and pieces of cortex (1.0 X 0.5 mm) were dissected from them for transplantation. Fetuses and normally delivered pups from the other uterine horn were used as age-matched controls. In 45 adult male Sprague-Dawley rat hosts (200 to 300 g), the epineurium of the nerve to the biceps femoris muscle was crushed and incised, the perineurium minced, and E11 donor cortex was injected into the nerve. At 1 to 7 days postimplantation (DPI), undifferentiated neuroepithelial cells were dispersed or in oval neuroepithelial-like structures throughout the regenerating nerve. At 7 to 14 DPI, neurons and neuroglia were differentiating and interspersed among fascicles of regenerating host axons. At 14 to 21 DPI, aggregates of differentiated neurons surrounded by neuropil containing a rich synaptic bed were interspersed with regenerated host peripheral axons. Fetal cortical implants survived, increased in size, and differentiated throughout the postoperative period, matching their timed controls.     

Absence of postnatal death among motoneurones supplying the inferior gluteal nerve of the rat

Motoneurones innervating the caudal part of the gluteus maximus muscle of 0-2 day, 10-12 day and 2-3-month-old rats were labelled by a half-hour application of a solution of 30% horseradish peroxidase (HRP) and 2% lysophatidylcholine delivered by suction electrode to the cut inferior gluteal nerves. The numbers of motoneurones labelled 24-48 h later were not significantly different in the 3 age groups (mean = 58.75, 54.0, 57.5, respectively). When a simple 30% HRP solution was used in adult rats, the number of motoneurones labelled was significantly less (mean = 48.75). In contrast, application of 0.5 microliter of HRP in a pledget of gelfoam to either the cut or uncut inferior gluteal nerve of neonates labelled large numbers of motoneurones, presumably by diffusion into nearby muscles. It is concluded that no death of motoneurones innervating the gluteus maximus muscle occurs postnatally, and that spread of HRP to neighbouring muscles can give rise to spuriously high motoneurone counts in neonates, and that incomplete uptake or transport of HRP in adults can lead to incorrectly low counts.     

The action of the rectus femoris muscle following distal tendon transfer: does it generate knee flexion moment?

Rectus femoris transfer surgery involves detaching the rectus femoris from the patella and reattaching it posterior to the knee. While this procedure is thought to convert the rectus femoris from a knee extensor to a knee flexor, the moments generated by this muscle after transfer have never been measured. We used intramuscular electrodes to stimulate the rectus femoris in four subjects, two after transfer to the semitendinosus and two after transfer to the iliotibial band, while measuring the resultant knee moment.
Electromyographic activity was monitored in the quadriceps, hamstrings, and gastrocnemius muscles to verify that the rectus femoris was the only muscle activated by the stimulus. We found that the rectus femoris generated a knee extension moment in all of the subjects tested. This finding suggests that transfer surgery does not convert the rectus femoris to a knee flexor, and that a mechanism exists which may transmit the force generated by the rectus femoris anterior to the knee joint center after distal tendon transfer.     

Delayed cerebral pseudo-tumoral radionecrosis following scalp-tumour irradiation. Case report and review of literature

Summary A case of delayed radionecrosis of the brain is reported, following irradiation of a scalp dermatofibrosarcoma. Signs and symptoms were those of an intracranial neoplasm and appeared 5 years after an irradiation dosage of 1890 rets. Twenty-seven similar cases were gathered from a survey of the literature. Surgical excision was the treatment of choice and led to cure or improvement in 20 cases. Analysis of doses and fractionation revealed excessive irradiation in all but one of the cases.     

Esophageal perforation: a delayed complication following traumatic spinal cord injury. Case report.

Esophageal perforation is an uncommon but serious complication of penetrating injuries to the neck and chest. A case of delayed esophageal perforation in a patient with traumatic spinal cord injury is presented. The pathophysiology, diagnosis, and treatment of this potentially fatal complication are discussed.     

Meningioma following high-dose radiation therapy Case report and review of the literature

A case of meningioma induced by high-dose radiation therapy (40 Gy) is reported. The radiation had been given 11 years previously following operation for cerebral astrocytoma. Pertinent cases of benign meningioma occurring after radiation therapy are reviewed and analyzed.     

Adenocarcinoma of the sphenoid sinus. Case report

We report a rare case of adenocarcinoma of the sphenoid sinus in which the very rarity of the site made for considerable uncertainty in the early diagnosis despite major neurological deficits at onset. Only the subsequent course of the tumor enabled us to identify the site in the sphenoid sinus, an atypical area surrounded by numerous neurovascular structures which, if involved, may give rise to a protean and nonspecific symptom-complex.

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Sommario Gli AA riportano l'osservazione di un raro caso di adenocarcinoma primitivo del seno sfenoidale che proprio per la sua rarità di localizzazione ha comportato notevoli incertezze nella diagnosi precoce, pur avendo esordito con importanti deficit neurologici. Solo successivamente l'evoluzione della neoplasia ha permesso di identificare la sede nel seno sfenoidale, distretto atipico e circondato da numerose strutture vasculo-nervose, capaci di realizzare, se interessate, una polimorfa e non specifica sintomatologia.

     

“Snapping bottom”: Subluxation of the tendon of the long head of the biceps femoris muscle

Subluxation of the tendon of origin of the long head of the biceps femoris muscle (or snapping bottom) is a rare, previously unreported degeneration of the tendinous attachment of the muscle at the ischial tuberosity. It occurs in a patient who wears out this attachment through a lifetime of hyperflexion hip movements, such as are required in bending to reach the floor. The snapping of the tendon across its point of origin causes pain and swelling in the buttock. In the older nonathlete, if conservative measures fail, the treatment of choice is simple tenotomy. The condition should not be confused with weaver's bottom (ischiogluteal bursitis), even though it may be a cause for that bursitis.     

Cluster headache: remission following ascending aorta/innominate artery bypass surgery. Case report

A 51-year-old man with cluster headache has been free from cluster attacks for over two years following ascending aorta/innominate artery bypass surgery for correction of an atherosclerotic narrowing at the origin of the innominate artery. Surgery may have been a causal factor in the remission of these attacks.

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Sommario A distanza di oltre due anni da un intervento di bypass tra aorta ascendente ed arteria anonima un uomo di 51 anni con cefalea a grappolo non ha più riferito ulteriori episodi algici. Viene avanzata l'ipotesi che l'intervento abbia svolto un ruolo causale nella remissione di tali episodi.

     

Aneurysm within the optic nerve. Case report

In a group of 65 aneurysms of the anterior communicating artery treated in the years 1977 to 1984 in the Department of Neurosurgery, Medical Academy in Katowice in one case the aneurysm had an atypical situation penetrating into the optic nerve. A similar case of an aneurysm of the internal carotid artery was reported in the Polish literature only by Tokarz et al. in 1977.     

Fatal hemorrhagic complication following endovascular treatment of a cerebral arteriovenous malformation. Case report and review of the literature

Evaluation of the natural history of brain Arteriovenous Malformations (AVMs) including its morbidity and mortality is a crucial point in the management of patients having a cerebral AVM. The risks associated with the AVM natural history, especially regarding the occurrence of an hemorrhage, have to be compared to the risks due to the therapeutic approach. In the literature, the risk of annual bleeding of an AVM is estimated from 2 to 4%. Morbidity from AVM rupture is estimated from 13% to 50% with a risk of mortality reported from 3 to 30%. Endovascular treatment is an efficient tool in the therapy of these lesions. However, AVM embolization remains a difficult procedure. Complications of the endovascular treatment must be evaluated in relation to the potential risk associated to the AVM natural history. After AVM endovascular treatment, morbidity with permanent neurological deficit is reported in 0.4% to 12.5% of patients and mortality in 0.4% to 7.5%. In more recent reports, after brain AVM embolization, a permanent neurological deficit is estimated to occur in 9% of patients and death in 2%. Hemorrhage appears the most frequent and serious complication in the endovascular treatment of a brain AVM. We report a case of fatal hemorrhagic complication following endovascular treatment of a cerebral AVM in a 20 year old patient. This case contributes to remind that embolization, even in specialized centers with experience in the management of this pathology, can be followed by a poor and even fatal outcome. In most cases, the treatment is performed in order to protect the patient of a potential risk. Consequently, the complication of the embolization must always be carefully considered and discussed between the medical team, the patient and its family for planning the AVM endovascular treatment.     

Hemangiopericytic meningioma of the pineal region. Case report

A case of hemangiopericytic meningioma of the pineal region is reported. We discuss the origin of meningiomas in this region and their histological nature. The rapid recurrence in situ of the tumor in this particular case seems to confirm the need to complement surgery with radiation therapy.     

Multifocal cavernous hemangioma of the skull. Case report

A 39 year old female presented with a multifocal lesions in the skull, at the frontal right and parietal left. We performed bilateral craniectomies guided with navigation, and the bone defects were repaired with titanium mesh. The pathological examination reported intraosseous cavernous hemangioma in both lesions. Follow up of six months without any complication or recurrence and good cosmetic outcome.