Willem Guillermo Calderon-Miranda

Postraumatic pneumorrhachis: report of three cases and classification proposal

Abstract The Pneumorrhachis is the presence of air at the level of the spinal canal. It can have several causes among which are: traumatic, iatrogenic among others. Clinical Cases: We present three cases of male patients handled by our neurosurgery service with traumatic pneumorrhachis patients, which were managed in a conservative manner, with control images. Conclusions: pneumorrhachis has traditionally been classified as internal if air is present in the subdural or subarachnoid space and external if the air is located at the epidural level. We propose a classification in degrees (Moscote-Agrawal-Padilla) which is more practical from the clinical and radiological point of view.

Association of abnormal metopic suture causing hypertelorism, interfrontal encephalocele with craniofacial cosmetic deformity associated with myelomeningocele: management literature review

Abstract Myelomeningocele may be associated with other neural and extraneural anomalies. Authors present association of metopic suture abnormality, an interfrontal encephalocele with widening of metopic suture and abnormal shape frontal bones in the forehead in those associated with hydrocephalus. Authors describes two neonates with interfrontal encephalocele, representing first series reporting in neonate. Management and pertinent literature is briefly discussed.

Intracranial foreign body in a child

Abstract Intracranial foreign bodies are rare events that occur accidentally and depending on the extent and involvement of the brain parenchymal, generate focal neurological deficit, bleeding and even long-term complications. In present article we describe a case of 4 year child and discuss the approach, management and prognosis.

Brain hydatidosis: review of the literature

Abstract Hydatidosis is a common disease worldwide. The causal agent may compromise any Organ of the body, the cerebral location is infrequent. The infection is caused by the larval form of Cestodo Echinococcus granulosus. The man is an accidental intermediary host for food consumption or water contaminated with eggs present in animal feces. We present a review of the literature. At the imaging level, the disease has a classic characteristic consisting of single, usually unilocular and less frequent multilocular, intra-axial and more frequently hemispheric cerebral lesions, compromising the vascular territory of the middle cerebral artery by the hematogenous dissemination of the parasite.

Extracranial internal carotid artery aneurysm: case illustration

Abstract Extracranial internal carotid artery aneurysms (EICAA) are uncommon lesion. These aneurysms can be classified as true or false aneurysms, atherosclerotic, dysplastic, infectious, posttraumatic and iatrogenic aneurysms. The most common presentation is central neurologic dysfunction, either a stroke or a transient ischemic attack. The rupture of these aneurysms can lead to severely impairment and can affect the quality of life of the patients or even may lead to death. Management of these lesions is required in most cases to prevent complications, however there is no treatment guideline or expert consensus for the management. We present a case of an unusual EICAA, associated with kinking of the affected vessel and review the literature.

Unilateral traumatic hemorrhage of the basal ganglion and bihemisferic cerebral infarction

Abstract Among the various injuries caused by the cerebral tramatic lesion are traumatic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction.

Intracranial actinomycosis: case report and review of literature

Abstract Actinomycosis infection is a slow progressing disease, in which involvment of the central nervous system by Actinomyces israelii is uncommon (less than 5%). Clinical picture is non-specific and is often misdiagnosed with neoplasia; some clinical clues my arise suspicion. The case of a 59 year-old female is reported who presented headache and focal neurologic signs and in whom a out-of the hospital diagnosis of a neuroepitelial dysembryoplastic tumor was made; nonetheless after careful interview and physical exploration, a spectroscopy magnetic resonance of the brain and hystopathological description of the lesion was made and yielded the definitive diagnosis of intracranial actinomyces infection. Treatment and progression were uneventful.

Solitary plasmocytoma of the skull: case report and review of the literature

Abstract Solitary plasmacytoma and extramedullary plasmocytoma are tumors of malignant character composed of plasma cells, with a mean age of onset at 60 years. They can appear anywhere where the reticuloendothelial system is present. Usually these tumors lead to the development of multiple myeloma in a period of time ranging from 3 to 5 years. We present a rare case handled in our neurosurgery service associated with an unusually long period of evolution.

Post-traumatic cerebellar infarction due to vertebral artery foramina fracture: case report

Abstract Posttraumatic cerebral infarction is an uncommon cause of morbidity and mortality and many studies have highlighted that trauma needs to considered as causative factor for cerebellar infarction. We present a case of cerebellar infarction in a 35 year old young patient secondary to vertebral fracture involving the vertebral foramen and vertebral artery injury. CT scan cervical spine showed C2-3 fracture on left side with fracture extending into the left vertebral foramen. A CT scan angiogram could not be performed because of poor neurological status. Possibly the infarction was due to left vertebral artery injury. Without surgical intervention prognosis of these patients remain poor. Prognosis of patients with traumatic cerebellar infarction depends on the neurological status of the patient, intrinsic parenchymal damage and more importantly extrinsic compression of the brainstem by the edematous cerebellar hemispheres.

Acute subdural hematoma as a complication of diagnostic lumbar puncture: case report

Abstract Background: Intracranial hemorrhagic complications are unusual after diagnostic lumbar puncture. Case report: A diagnostic lumbar puncture was performed in a 55 year-old male for acute bacterial meningitis workup. Immediately after the procedure he developed intense headache and a head Computed Tomography (CT) was done which identified an acute subdural fluid collection. No surgical management was offered and conservative medical follow-up was indicated. Conclusion: The occurrence of a headache with red flags after a lumbar puncture may suggest the possibility of an acute subdural hematoma.