Introduction: Skull base chordomas present with headache, commonly VI cranial nerve palsy or sometimes with lower cranial nerve involvement.Sometimes in neglected case it presents with complete blindness and facial nerve palsy.
Case presentation: A 60-year old man presented with headache,visual disturbance progressing to blindness and facial nerve palsy. At first, radiological imaging showed large tumor which eroded his clivus, sella floor and involved both cavernous carotid more on left side,both ethmoid sinus,middle cranial fossa entension with transdural extension posteriorly.
Conclusion: Patients who present with complete blindness and facial nerve palsy, endoscopic excision in a single skull base approach of a skull base chordoma type III is challenging and who developed visual improvement following surgery, has been highlighted in this report.
Bang. J Neurosurgery 2019; 9(1): 57-63
Cauda equina syndrome is reported as a complication in 0.2% - 1% following lumbar disc herniation . The pathophysiologic mechanism of this complication and its management is yet poorly understood. Though some factors has postulated in different studies. In this case, patient’s back pain and leg pain is satisfactorily improved with newly onset retention of urine followed by overflow incontinence and constipation after a single level lumbar discectomy. No abnormalities were seen on the postoperative imaging studies. This is a retrospective analysis of records and radiographs in a patient who developed acute bowel and bladder dysfunction after surgery for lumbar disc herniation.
Bang. J Neurosurgery 2019; 9(1): 54-56
Introduction: To review the surgical approaches, techniques, outcomes and recurrence rates in a series of 11 olfactory groove meningioma (OGM) patients operated from January 2010 to April 2019.
Methods: Eleven patients underwent craniotomy and micro-neurosurgical removal of olfactory groove meningioma. Tumor diameter varied from 5 to 8.5 cm among 11 cases, 2 cases underwent Transglabellar/ Subcranial approach, 3 cases by bifrontal approach, 1 case unifrontal approach, 2 extended endonasal and 3 cases fronto-lateral approach.
Result: Total removal was possible in all cases except 2 cases. Histopathology revealed typical meningioma (WHO grade 1). There was 1 operative mortality and no permanent focal neurological deficit except anosmia. 3 patients developed CSF leak and two cases meningitis which were resolved by lumber drain and antibiotic therapy.
Conclusion: Extended endonasal approach or transglabellar/ subcranial approach were sufficient for gross total removal of OGM which is associated with bony hyperostosis, paranasal extension and optic canal.
Bang. J Neurosurgery 2020; 10(1): 9-19
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