TAILIEUCHUNG - Cases with expert commentary in neurosurgery: Part 2

(BQ) Contniued part 1, part 2 of the document Cases with expert commentary in neurosurgery has contents: Trigeminal neuralgia, cerebral metastasis, the surgical management of the rheumatoid spine, cervical spondylotic myelopathy, peripheral nerve injury,. and other contents. Invite you to refer. | G Intracranial abscess Ciaran Scott Hill Expert commentary George Samandouras Case history A 20-year-old right-handed man presented to the Emergency department with a 4-week history of right-sided earache associated with a foul smelling purulent discharge. He had suffered from intermittent ear discharge since childhood but he had been well for the previous year. The current episode had been treated with a 1-week course of antibiotics by the general practitioner without any effect. The patient then developed general malaise positional headaches and was now describing intermittent horizontal vertigo the sensation of movement as if the environment were spinning. There were no meningitis symptoms. He had no headache neck stiffness or photophobia. His past medical history was otherwise unremarkable. On examination there was an erythematous boggy swelling over the right mastoid process. The right external auditory meatus was completely occluded by pus and the pinna was pushed anteriorly. The patient was admitted under the ear nose and throat surgeons who requested routine laboratory investigations and a microbiology swab that was sent for microscopy culture and sensitivity. A CT scan was performed and the CT images are shown in Figure . A diagnosis of mastoiditis was made and the patient was placed on the emergency theatre list for an exploratory mastoidectomy. However the next day the patient was noted to have developed a mild right-sided hemiparesis and was referred to neurosurgery. Review of the CT scans Figure with brain windows demonstrated a hypodensity of the right cerebellum in association with subtle triventricular hydrocephalus and displacement of the IVth ventricle. It was felt these images were consistent with cerebritis and a T1 T2 and T2 FLAIR MR scan was requested Figure . Additionally a T1 scan with contrast Figure diffusion-weighted imaging Figure and magnetic resonance venography MRV was performed Figure . Expert comment The

• Y khoa - Dược
• Oxford challenging concepts
• Cerebral metastasis
• The surgical management
• Peripheral nerve injury
• Trigeminal neuralgia
• The rheumatoid spine
• Chronic subdural haematoma
• Intramedullary spinal cord tumour
• Glioblastoma multiforme
• Cases with expert commentary
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• Pericardial diseases
• Gastrointestinal bleeding
• Electrolyte disorders