Onol B

Vertebral Hemangioma Symptomatic during Pregnancy–Report of a Case and Review of the Literature

A spinal tumor complicating pregnancy is a rare condition. A 25-year-old woman who became paraplegic during the 35th week of her second pregnancy presented during the postpartum period. She underwent two surgical interventions, and the cord compression caused by a T5 vertebral body hemangioma with laminar involvement and extradural extension was relieved. The occurrence of vertebral hemangiomas during pregnancy is discussed; the radiological features with special reference to magnetic resonance imaging are outlined; and cases from the literature are reviewed.

Intramedullary Epidermoid Cyst of the Cervical Spinal Cord Associated with an Extraspinal Neuroenteric Cyst

A 4-year-old girl presented with an intramedullary epidermoid cyst of the cervical spinal cord. The clinical, radiological, and surgical features and a brief critical review of the literature are included in this report. The cyst contents were removed totally in two operations. The child had a coexisting neuroenteric cyst in the posterior mediastinum. To our knowledge, this coexistence has not been previously reported. Contemporary imaging modes and prospects of the surgical treatment are discussed.

Balo's concentric sclerosis. Report of two patients with magnetic resonance imaging follow-up.

Balos concentric sclerosis was diagnosed antemortem in 2 patients, by magnetic resonance (MR) imaging showing striking concentric alternating rings in 1 patient and by characteristic histopathological features in the other. The course of the lesions and the concentric pattern were followed by MR imaging for 3 years and 18 months, respectively. One patient demonstrated spontaneous remission that has not been reported in Balos disease . Balos disease may not have a fulminant course as described in the past and the MR appearance of the chronic lesion may resemble that of a chronic multiple sclerosis plaque.

Extensive damage to the end-plates as a complication of laser discectomy an experimental study using an animal model

SummaryTo date, there have been no reports of experiments demonstrating the effects of neodymium:YAG laser (Nd∶YAG laser) on the vertebral end-plates. In this study the effect of Nd∶YAG laser on end-plates was examined in 32 guinea pigs which were randomly divided into two groups. The first group was the control group, the second one the Nd∶YAG laser group. All animals had experimental disc degeneration at three levels. Re-exploration was performed two months after the surgical ventral disc herniation. In the second group the same procedure was performed but at the end of the reexploration, Nd∶YAG laser irradiation of the degenerated discs was done. The wounds in both groups were closed again. Two months later all animals were sacrificed for histological and biochemical analysis. The cervical spine was excised en bloc and the overlying muscles were removed. Determination of hydroxyproline was done colorimetrically in the specimens harvested from each of these groups. Light microscopy was undertaken to evaluate the extent of morphological changes. The differences observed between the two groups were statistically significant (p<0.05). From the results of this study, there is the question whether the Nd∶YAG laser is a useful instrument in neurosurgery. Therefore, it remains to be proven whether or not this is of real benefit in the treatment of patients with degenerated disc disease.

Familial short rib syndrome, type Beemer, with pyloric stenosis and short intestine, one case diagnosed prenatally

Two sibs with Beemer type short rib syndrome, one of them diagnosed in utero, are reported. Both patients had previously unreported additional abnormalities such as pyloric stenosis and short bowels. Dysplasia of pancreatic Langerhans cells was present in one sib.

Meningiomas of the lateral ventricle. Report on six cases.

In this study 6 patients who had meningioma of the lateral ventricle are reviewed. The incidence is 1.8% of cases of meningiomas in our series. Microsurgical techniques were employed in all patients. There was no death and the follow-up period was between 5 months and 10 years. No recurrence was seen. Although the origin of these tumors is still not known, Dunn and Kernohan note that the choroid plexus has the potential for the production of menigothelial, fibrous, or mixed patterns. Our pathological results confirmed this suggestion.

Ossified adamantinous type craniopharyngiomas. A series of 13 patients.

SummaryThirteen patients admitted to hospital mainly with visual disturbances (100%), retarded growth (39%) and diabetes insipidus (23%) were all diagnosed as ossified adamantinous craniopharyngioma. Tumour size was found to be large in all patients. Localization displayed a heterogenous dissemination; 8% intra-suprasellar, 69% suprasellar-extraventricular, 15% extra-intraventricular, and 8% in the suprasellar region extending bilaterally to the frontal and temporal lobes.During the early postoperative period, four patients died with hypothalamic deterioration. Three patients underwent a second operation in view of recurrence, and one died from an infection. Thus, the postoperative survival rate was 62%. All the patients who survived continued to have visual disturbances, but only one deteriorated. Five patients exhibited diabetes insipidus during the post-operative period, among them 4 after surgical intervention and 5 patients displayed panhypothyroidism, three of them after surgery.Consequently, it is confirmed by the present review that craniopharyngiomas still offer a potential dilemma in their management. Difficulties caused by adhesion or invasion of ossified craniopharyngiomas and thus the increase in morbidity and mortality during surgical intervention and in the postoperative period are discussed.

Epidural metastasis of testicular yolk sac tumor : an unusual cause of spinal cord compression

Testicular tumors in the pediatric age group are rare. Yolk sac tumor (YST) is the most common malignant tumor of germinal origin in this group, and it may spread to the retroperitoneal lymph nodes. We have been unable to find any previously published report of metastasis of testicular YST to the epidural space of the spinal cord presenting as a cause of spinal cord compression.

Changes in End-Plate Vascularity after Nd: YAG Laser Application to the Guinea Pig Intervertebral Disc

Summaryu2003The authors previously have reported the effects of neodymium-yttrium-aluminum-garnet (Nd: YAG) laser on the cartilage end-plates (CEPs) in an animal model. However, there is no experimental study in the literature which specifically addresses the effects of the laser on CEP vascularity. The aim of our study is to investigate the vascular response of the CEP to Nd: YAG laser.u2003In this study, sixteen guinea pigs were used. Experimental intervertebral disc (IVD) degeneration was induced in 12 animals by a ventral disc incision to study the effects of Nd: YAG laser on the CEP of the degenerated IVD from the aspects of pathology and radiology. At 2 months after the experimental annular lesion, the CEP vascular channel counts had increased significantly (p=0.00) in the cranial CEP to 104%, and to 99% in the caudal CEP. In the early period after laser irradiation the vessel counts from both CEPs decreased due to the extensive damage of Nd: YAG laser on disc tissue (p=0.00). Accordingly, the value of CEP index and MR signal intensity of the CEPs (cranial and caudal) had decreased one month after laser application. Thereafter, both the CEP vascular channel counts and the MR signal intensity remained relatively constant throughout the course of the experiment, but the value of CEP index had increased to 68% of the normal IVD.u2003From the results of present study, it is evident that laser application had a significant negative influence on the CEP vascularization of the degenerated IVD.

Low cervical chordoma : case report

We report a case of a 32-year old woman with radicular symptoms associated with a low cervical chordoma. According to our knowledge this is the 10th case of low cervical chordoma reported in the literature.