Pradipta Tripathy

Cerebral venous sinus thrombosis with nontraumatic subdural hematoma

International Journal of Critical Illness and Injury Science | Vol. 5 | Issue 1 | Jan-Mar 2015 Dear Editor, A 60‐year‐old‐patient reported to our hospital with complaints of acute onset of weakness over right side limbs for 2 days and complex partial seizure for 1 day. He was a known diabetic and hypertensive under irregular medication with no history of recent trauma. He had grade‐III power in right side limbs, right side extensor plantar reflex, and bilateral papilledema. Noncontrast computed tomography (NCCT) scan of head shows thin isodense (subacute) subdural hematoma (SDH) over left frontal lobe convexity [Figure 1]. Contrast‐enhanced magnetic resonance imaging (MRI) of brain shows T1W iso to hyperintense, T2W hypointense thin collection over left frontal lobe convexity and occluding thrombus in right transverse, sigmoid sinus and part of superior sagittal sinus. The patient was treated with antidiabetic, antihypertensive drugs and low molecular weight heparin, followed by oral warfarin with maintenance of the prothrombin time, international normalized ratio (prothrombin time INR) at 2:1. The patient recovered well on treatment.

Gossypiboma complicated with paraspinal abscess and lumbar sinus: An uncommon complication of posterior lumbar spinal surgery

A 42-year-old female presented with the complaint of purulent discharging sinus over posterior lumbar area following one month of lumbar spinal surgery for prolapsed intervertebral disc. Gossypiboma complicated with paraspinal abscess and sinus track formation over posterior lumbar area was diagnosed in magnetic resonance imaging which was confirmed in re- exploration of lumbar spinal operative site.

Congenital dermal sinus in mid-dorsal spine with large intramedullary dermoid cyst in an 18-months-old child

Intramedullary dermoid cyst is a rare entity. It is usually associated with spinal dysraphism and dermal sinus. Our case is an 18-months-old female child who presented with history of fever and mild difficulty in moving left leg. She had a sinus in mid dorsal spine since birth with history of intermittent discharge from it. On magnetic resonance imaging of spine she was diagnosed to have large intramedullary epidermoid/dermoid cyst in the D2-7 vertebral level with a sinus tract. A dermoid cyst along with the sinus tract was excised. Post-operative follow up period was uneventful with full recovery.

Esthesioneuroblastoma with early drop metastasis to spinal cord

436 Neurology India | Jul-Aug 2012 | Vol 60 | Issue 4 normal capillary bed within the subcutaneous fatty layer of the scalp.[2] Most patients with scalp AVMs complain of headache, tinnitus and a subcutaneous (SC) mass with a palpable thrill. Enlargement of the mass over time can lead to worsening of these symptoms. Factors such as trauma, birth, and hormonal imbalance have been suggested as possible causes for the progression of these lesions.[3] They grow by having feeders from subcutaneous or intracranial vessels. The hemodynamic changes within the AVM can result in aneurysm formation. A few decades ago manual compression of the feeding artery used to be a method of treatment with an expectation of disappearance of scalp AVM over a period of time. However, the results were never encouraging. Various therapeutic modalities available to manage these lesions include: surgical excision, vessel ligation, transarterial and transvenous embolization, injection of sclerosant into the nidus, and electrothrombosis.[4] Scalp AVMs are generally treated by surgical excision. However, there is a risk of recurrence due to collateral supply. Surgical excision is associated with large skin incision, blood loss, and sometimes damage to the facial nerve. Endovascular treatment is used as an adjunct to the surgery or in isolation. Injection of the AVM has been done directly or by using ultrasound guidance. Embolization of AVM can be done using liquid embolizing material e.g. NBCA, ethanol or solid material like surgecele and gelfoam. Some authors have used a combination of trombin and transarterial coil placement. As there is no method which can avoid recurrence, the endovascular procedures have an edge due to their minimally invasive nature. There are three stages of scalp AVM.[1] Type 1 (a and b) and Type 2 are the most suitable AVMs for endovascular procedures.

Occipital intradiploic epidermoid presenting as benign intracranial hypertension: A rare manifestation

Presentation of IDEM tuberculoma is usually subacute, but it can be chronic or acute or paradoxical. Contrast MRI is the investigation of choice.[1,2,5,8] Whole craniospinal axis should be scanned with contrast to pick up other asymptomatic lesions in the CNS. Medical treatment alone will not improve the deteriorating neurological status of these patients and surgical resection of the IDEM tuberculoma followed by full course of antitubercular chemotherapy results in good outcome.[4] Despite surgery, full course of ATT is a must for complete cure of the disease, thus avoiding potential neurological morbidity.[9] Also, use of steroids along with ATT is strongly recommended.[8]

A calcified epidermoid cyst within right lateral ventricle: A report of a rare case

A young patient reported to neurosurgery outdoor department with symptoms of increased intracranial pressure. Noncontrast computed tomography examination showed a single calcified mass within right lateral ventricle with mild hydrocephalus. Contrast-enhanced magnetic resonance imaging revealed nonenhancing single mass within right lateral ventricle with mild hydrocephalus. Intraventricular calcified choroid papilloma/calcified epidermoid were radiological differentials. The mass was excised, removed from the lateral ventricles and found to be calcified epidermoid on gross and microscopic examination, which is rare.