Ghassen Gader

Cervicothoracic syringomyelia caused by cervical spinal stenosis: Case report and literature review

Background: Syringomyelia is commonly associated with Chiari malformations, spinal trauma, arachnoiditis, or tumors. However, rarely, cervical canal stenosis is implicated in intramedullary cavitations. Case Discription: Here, we report the case of a 60-year-old male patient who presented with loss of pain and temperature sensation in upper extremities associated with a spastic tetraparesis. On magnetic resonance imaging, the patient was found to have syringomyelia extending from C1 to Th3. Following posterior decompressive surgery, the syrinx resolved along with the patients neurological complaints. Conclusion: Here, the authors presented a case and reviewed the literature regarding how cervical spinal stenosis may contribute to cervical or thoracic syringomyelia.

Atypical imaging features of posterior fossa's dermoid cyst: Case report and review of literature

Background: Intracranial dermoid cysts are uncommon lesions with characteristic imaging appearances. Symptomatic clinical presentation usually occurs in one of two ways: mass effect or rupture. Radiologically, dermoid cysts typically present as low density masses on computed tomography (CT) scan and are generally hyperintense on T1-weighted magnetic resonance imaging (MRI) sequences with variable signal on T2-weighted sequences. Case Description: We present the case of a 35-year-old female presented with symptoms of increased intracranial pressure. Radiological investigations showed a cystic posterior fossa tumor that was not only hyperdense on CT scans but also hypointense on MRI T1-weighted images. The patient underwent a total-gross resection of an extra-parenchymal posterior fossa tumor. Pathologic examination of the specimen concluded to dermoid cyst. Conclusion: Dermoid cyst of the posterior fossa is a benign lesion surgically treatable. Only an appropriate radiological diagnosis of this lesion would permit a well-targeted therapeutic approach.

A Rare Complication of Chronic Subdural Hematoma Evacuation: Brain Stem Hemorrhage: A Case Report

Abstract Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.

Transoral migration of the inferior end of a ventriculoperitoneal shunt: A case report with literature review

Ventriculoperitoneal (VP) shunt surgery is the most widely used technique for the treatment of hydrocephalus. However, it can incur certain complications. Beside frequent complications (infection, obstruction), migration of the peritoneal catheter is a rare but dangerous complication. This report presents the case of a 4-year-old boy who had undergone VP shunt for hydrocephalus. One month later, the patient presented with protrusion of the peritoneal catheter through his mouth. He underwent another procedure to remove the peritoneal catheter, retaining the original ventricular catheter and valve chamber. Progression was favorable. To the best of our knowledge, only 7 cases of VP shunt transoral extrusion were reported, but many risk factors were identified. Bowel perforation is a serious complication of VP shunt surgery, sometimes leading to fatal outcome.

Neuroblastome révélé par une compression médullaire dorsale chez un nourrisson : à propos d’un cas et d’une revue de la littérature

Introduction Le neuroblastome est la tumeur solide la plus frequente chez l’enfant. Le diagnostic est rarement fait devant des signes neurologiques. L’objectif de ce travail est d’etudier les differents modes de revelation, l’importance du diagnostic precoce, les indications neurochirurgicales et le pronostic de cette tumeur. Observation Enfant âgee de 18xa0mois a ete pris en charge dans notre service. La patiente a ete hospitalisee en pediatrie pour des troubles de la marche apparus 3xa0jours avant son hospitalisation. Son examen clinique objective une paraparesie spastique et un syndrome rachidien dorsal. L’imagerie par resonance magnetique montre une masse mediastinale posterieure paravertebrale gauche etendue a travers les foramens de conjugaison dans le canal rachidien et comprimant la moelle epiniere de T4xa0a T7. L’enfant a ete operee en urgence. Une laminectomie avec exerese de la portion tumorale intracanalaire etait pratiquee. Le deficit neurologique a totalement regresse en postoperatoire. L’anatomopathologie conclue a un neuroblastome et l’enfant a ete alors adressee en onco-pediatrie pour demarrer la chimiotherapie. Discussion–conclusion Le neuroblastome est une tumeur frequente de l’enfant. La compression medullaire est un signe revelateur qui doit interpeller et faire indiquer les explorations radiologiques necessaires. Le traitement repose essentiellement sur la chimiotherapie. La chirurgie est indiquee en urgence pour decomprimer les structures nerveuses. Le pronostic depend essentiellement de la rapidite de la prise en charge.

Symptomatic pneumocephalus: A rare complication of discal herniation's surgery

Context: We report the case of a 40-year-old woman with no pathological history, operated from an L4-L5 disc herniation by a left unilateral approach. The dura mater enveloping the left L5 root was accidentally injured at its lateral face causing a breach with CSF leakage. This breach could not be sutured. A few hours after waking, the patient presented an agitation followed by three generalized tonico-clonic seizures. Cerebral imaging revealed pneumocephalus. The patient was hospitalized in an intensive care unit. The symptoms gradually faded and the patient was discharged 3 days after surgery. Findings: Pneumocephalus is defined by the presence of air inside the skull. The symptoms of pneumocephalus are generally non-specific and varied, and this complication should also be kept in mind to prevent potentially severe course. The prevention of postoperative pneumocephalus depends on a well-defined strategy in the case of iatrogenic dural tear. Conclusions: Symptomatic pneumocephalus is a very rare complication in the course of lumbar surgery. Conservative therapy may be appropriate even in severe symptomatic manifestations.

Skull metastasis revealing a renal tumor: A case report and review of the literature

Highlights • Skull metastases are rare forms of manifestations of renal tumors.• Any unusual lesion of the skull should be thoroughly evaluated whether the patient has a prior history of cancer or not.• Treatment of metastatic renal cell carcinoma is complex, and the optimal regimen for achieving a lasting response without severe toxicity has not yet been defined.

Cerebellar metastasis of gastrointestinal stromal tumor: A case report and review of the literature

Highlights • Brain metastases are rare forms of manifestations of gastro-intestinal stromal tumors.• Brain metastases of gastro-intestinal stromal tumors are usually supra-tentorial. Infra-tentorial localizations are very rare.• The treatment is based on surgery and radiotherapy. Chemotherapy has only limited interest.

Cervical ganglioneuroma: clinical and radiological features of a rare tumour

Ganglioneuromas are rare benign tumours of neurogenic origin that most frequently develop in the cervical sympathetic chain,1 2 with genetic associations demonstrated with Neurofibromatosis type 1 xa0(NF-1). We report the case of a 41-year-old woman with a history of cavum neoplasm at the age of 23. This tumour was classified after assessment of extension as T1N0M0xa0(tumour, node, metastases). Pathological examination of a biopsy concluded to a keratinising squamous cell carcinoma. The patient was then irradiated (2D Cobalt radiotherapy). The patient presented with gait trouble that appeared axa0few weeks ago. Clinical examination found a Brown-S e quard syndrome with paresis …