Abstract:
OBJECT:Parafalcine subdural empyema and those along the superior and inferior surface of the tentorium are rare entities. We present a series of 10 patients where we have attempted to describe the pathophysiology, clinical features, and management of subdural empyema. METHODS:The study group included 10 cases of falcotentorial subdural empyemas managed between 2004 and 2010. The mean age group was 14.4 years. Seven patients had empyema along the falx or superior surface of tent, and the remaining three had empyema along the inferior surface of tent. Fever, raised intracranial pressure symptoms, falx syndrome, and seizures were the usual presenting features. These patients had an indolent presentation as compared to convexity subdural empyemas. The diagnosis was made based on radiology. Chronic suppurative otitis media was a causative factor in five patients; in the remaining patients, the source was ascribed to be hematogenous. All patients were treated with antibiotic therapy (6 weeks) ± surgery. Two patients were treated conservatively, and the remaining eight patients underwent definitive surgery in the form of craniotomy (supratentorial)/craniectomy (infratentorial) and evacuation of pus. The pus was limited within two leaves, one adherent to the falx/tent and the other one to the pia-arachnoid of adjacent parenchyma. The wall along the falx or tent could be peeled off easily and was excised in all cases to lay open the cavity widely. The wall along pia-arachnoid was left as it is. Pus culture was positive in four and blood culture positive in two cases. There was only a single mortality in our series. The outcome was assessed by the Glasgow Outcome Scale. The mean duration of follow-up was for 18.8 months, and all patients who survived had a good outcome. CONCLUSION:Falcotentorial empyema remains a rare entity. The presentation is indolent as compared to convexity subdural empyemas, possibly due to its limitation secondary to arachnoid adhesions at the junction of falx, tent, and convexity dura. The main stay of management remains craniotomy, evacuation, and partial excision of the wall, laying it completely open, unless it is extremely thin. With appropriate surgery and antibiotic therapy, a good outcome can be expected.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Salunke PS,Malik V,Kovai P,Mukherjee KKdoi
10.1007/s00701-010-0695-5subject
Has Abstractpub_date
2011-01-01 00:00:00pages
164-9; discussion 170issue
1eissn
0001-6268issn
0942-0940journal_volume
153pub_type
杂志文章abstract::Cell-mediated cytotoxicity (CTX) of meningioma patients towards meningioma cells and fibroblasts was studied in vitro before and after surgery, using the 3H-proline microcytotoxicity test. When incubated with allogeneic target cells before surgery, lymphocytes from three out of seven donors showed a specific destructi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01808518
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abstract::Superficial radial intraneural ganglion cysts are rare. Only nine previous cases have been described. We provide two examples with a wrist joint connection and review the literature to provide further support for the unifying articular (synovial) theory for the pathogenesis and treatment of intraneural ganglia. ...
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journal_title:Acta neurochirurgica
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doi:10.1007/s00701-018-3620-y
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abstract::Oculomotor nerve palsy due to a venous varix arising from flow anomalies caused by a dural arteriovenous fistula (AVF) is a rare phenomenon. We report a case of surgical third nerve palsy with a rare underlying AVF as the cause and discuss in detail the patho-anatomy and its significance. A tentorial dural AVF mimicki...
journal_title:Acta neurochirurgica
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abstract:BACKGROUND:The scientific activity of neurosurgeons and neurosurgery residents as measured by bibliometric parameters is of increased interest. While data about academic output for neurosurgeons in the USA, the UK, and Canada have been published, no similar results for German neurosurgical residents exist. Within this ...
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doi:10.1007/s00701-019-04011-2
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journal_title:Acta neurochirurgica
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abstract::Immunohistochemical staining for proliferating cell nuclear antigen (PCNA) and BrdU using anti-PCNA and anti-BrdU monoclonal antibodies, respectively, was performed in 16 human brain tumours, including 3 glioblastomas multiforme, 2 anaplastic astrocytomas, 1 cerebellar astrocytoma, 2 recurrent meningiomas, 4 non-recur...
journal_title:Acta neurochirurgica
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doi:10.1007/BF01400617
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abstract::We present 7 cases of false intracavernous carotid artery aneurysms. Four occurred after trauma and three were caused iatrogenically. Two of the latter occurred in patients with pituitary adenomas, one after transsphenoidal microsurgery and the other after yttrium [YI90] seed implantation into the sella. The third iat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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abstract:BACKGROUND:Post-operative CSF leak is the major source of morbidity following endoscopic transsphenoidal surgery. The purpose of this study was to identify factors associated with post-operative CSF leak in patients undergoing this surgery and facilitate the prospective identification of patients at higher risk of this...
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pub_type: 杂志文章,多中心研究
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更新日期:2018-05-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01417678
更新日期:1995-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00701-002-0970-1
更新日期:2002-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-05-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2205-7
更新日期:2014-10-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-006-1077-x
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The necessity of red blood cell (RBC) transfusions in neurosurgical procedures is under debate. Although detailed recommendations exist for many other surgical disciplines, there are very limited data on the probability of transfusions during neurosurgical procedures. METHODS:Three-thousand and twenty-six c...
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pub_type: 杂志文章
doi:10.1007/s00701-012-1373-6
更新日期:2012-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1987-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Establishment of a reliable and rapid diagnosis is of paramount importance in spinal tuberculosis. The available gadgetry of investigations, such as AFB smear, culture of Mycobacterium tuberculosis, and Uniplex PCR, suffers from a lack of adequate sensitivity and/or a lack of rapidity. Therefore, many times ...
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pub_type: 杂志文章
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更新日期:2017-03-01 00:00:00