JHN Journal最新文献_第10页

Functional Recovery and Risk of Readmission in Low-Grade aSAH Patients 低级别aSAH患者的功能恢复和再入院风险

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.013.2.006

J. Turpin, N. Mouchtouris, Michael J. Lang, Kaitlyn Barkley, G. Barros, N. Chalouhi, R. Starke, P. Jabbour, Md Mba Facs Faha Robert H. Rosenwasswer, S. Tjoumakaris

引用次数: 0

Resection of Fibrous Dysplasia of the Sphenoid Bone and a Concomitant Calcified Pituitary Adenoma via an Endoscopic Endonasal Transsphenoidal Approach 经鼻内窥镜经蝶窦入路切除蝶骨纤维性发育不良伴发的钙化垂体腺瘤

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.005.1.008

Benedict Tan, Sanjay Yadla, Peter G. Campbell, M. Rosen, James J. Evans

{"title":"Resection of Fibrous Dysplasia of the Sphenoid Bone and a Concomitant Calcified Pituitary Adenoma via an Endoscopic Endonasal Transsphenoidal Approach","authors":"Benedict Tan, Sanjay Yadla, Peter G. Campbell, M. Rosen, James J. Evans","doi":"10.29046/JHNJ.005.1.008","DOIUrl":"https://doi.org/10.29046/JHNJ.005.1.008","url":null,"abstract":"Background: Although pituitary adenomas have been described in association with polyostotic fibrous dysplasia in McCune-Albright Syndrome, no such relationship has been described with monostotic fibrous dysplasia. The authors describe a case of monostotic fibrous dysplasia of the sphenoid bone and concomitant pituitary adenoma in a 25-year-old male. To the authors’ knowledge this is the first such case reported in the literature. Clinical presentation, pathology, and surgical approach are described in detail. Case Description: A 25-year-old male initially presented with headaches, gynecomastia, and galactorrhea. Magnetic Resonance Imaging (MRI) revealed a sellar/suprasellar mass possibly consistent with a calcified pituitary adenoma or craniopharyngioma and a cranial base lesion obstructing the sphenoid sinus consistent with fibrous dysplasia. Both lesions were accessible via an endoscopic transnasal approach. The patient underwent resection of the affected sphenoid bone which allowed appropriate exposure for subsequent resection of the pituitary lesion without major complication. Pathology and immunohistochemical studies confirmed the diagnoses and postoperative imaging revealed gross total resection of the adenoma. Conclusions: The authors describe a case of monostotic fibrous dysplasia of the sphenoid bone and pituitary adenoma. Resection of such dual lesions can be both safe and efficacious via an endoscopic endonasal transsphenoidal approach.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129717871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transient Paraplegia in a Patient with Bilateral Posterior Frontal Contusions and Traumatic Thoracic Aortic Dissection 双侧额后挫伤并发外伤性胸主动脉夹层的短暂性截瘫1例

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.007.2.002

Sonia Teufack, P. Nguyen, Atul S. Rao, J. Jenoff, J. Harrop

{"title":"Transient Paraplegia in a Patient with Bilateral Posterior Frontal Contusions and Traumatic Thoracic Aortic Dissection","authors":"Sonia Teufack, P. Nguyen, Atul S. Rao, J. Jenoff, J. Harrop","doi":"10.29046/JHNJ.007.2.002","DOIUrl":"https://doi.org/10.29046/JHNJ.007.2.002","url":null,"abstract":"Background: In the setting of multi-system traumas, the etiology and pathophysiology of neurologic injuries can be difficult to identify. Methods: A unique case of a pedestrian struck by a motor vehicle that presented with acute paraplegia after an endovascular stent placement for a traumatic thoracic aorta dissection. The patient had no significant motor function in the lower extremities, but full preservation of all sensory modalities. Initial admission computed tomography (CT) imaging was negative for intracranial trauma, but noted an acute cranial fracture; no spinal trauma was identified. Results: The patient had a lumbar drain placed to maximize spinal perfusion pressures and was immediately evaluated with magnetic resonance imaging (MRI) of the neural axis. Acute bilateral posterior frontal contusions were identified on brain imaging, which were not present on preprocedural CT head. No spinal cord injury or ischemia was seen on spinal imaging. The patient recovered and regained use of his lower extremities following a short rehab stay. Conclusion: In the setting of multi-system trauma, a high level of suspicion should exist for alternative etiologies of neurologic injuries. Thorough neurologic examinations and imaging assessments of the nervous system should be conducted to avoid misdiagnosis and improper management of occult injuries. This is the first reported case of acute paraplegia due to vertex trauma which may be a rare mechanism of injury and/or under-recognized. INTRODUCTION Trauma is the leading cause of mortality for patients less than forty years of agecheck. Further multi-system trauma has been associated with increased mortality, especially when it involves vascular injuries.4 Therefore, prompt diagnosis and management is crucial and increases the probability of survival and a favorable outcome. Acute paraplegia is an associated complication of traumatic thoracic spinal cord and aortic injuries. Further, it can also result from open and endovascular repair of this injury due to decreased perfusion to the cord and ensuing ischemia and infarction.4,5,14 Few cases of acute lower extremity monoparesis have been reported from traumatic injury to the frontal lobe.2,10 We present the first case of acute paraplegia resulting from bilateral para-sagittal frontal contusions in a patient with concomitant thoracic aorta injury. CASE REPORT A 31 year-old male pedestrian was struck by a high velocity vehicle and thrown approximately seventy feet from the initial site of impact. The patient was intubated at the scene and transported to an outside hospital. At the time he was following commands and moving all extremities. CT of the brain revealed a bicoronal scalp laceration and underlying skull fracture with no intracranial hemorrhage or contusion; CT of the chest, abdomen and pelvis revealed an aortic isthmus tear, bilateral pneumo-hemothoraxes and pulmonary contusions, multiple ribs and right clavicle fractures, liver laceration with intr","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125577735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of Hypothalamic/Chiasmatic Astrocytomas in Children 儿童下丘脑/交叉星形细胞瘤的治疗

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.004.3.003

P. Amenta

引用次数: 0

Cerebrospinal Fluid Leakage and Cerebral Venous Sinus Thrombosis: A Case Report 脑脊液漏及脑静脉窦血栓1例报告

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.008.1.004

Bs year Medical student Thana Theofanis, Nohra el-Chalouhi, S. Tjoumakaris

引用次数: 2

Is Reconstruction of the Sella Necessary to Prevent Optic Chiasm Prolapse and Cerebrospinal Fluid Leakage Following Endoscopic Resection of Pituitary Macroadenomas 内镜下垂体大腺瘤切除术后需要重建鞍区以防止视交叉脱垂和脑脊液漏吗

JHN Journal Pub Date : 1900-01-01 DOI: 10.29046/JHNJ.010.2.002

M. Otten, B. Petrone, G. Nyquist, M. Rosen, James J. Evans, C. Farrell