Cerebral myiasis with a 10-day history of convulsions due to an intracerebral hematoma caused by a Hypoderma bovis larva is reported in an 8-year-old child. Computerized tomography (CT) showed the hematoma in a right parieto-occipital location. The H. bovis larva and the extensive intracerebral hematoma were discovered during surgery. Among human parasitoses, cerebral myiasis is rare: a review of the literature revealed only two reports, one published in 1969 and one in 1980. This is the first case that has been diagnosed as cerebral myiasis with exact identification of the Hypoderma bovis larva both from the CT scans and at surgery in a patient during life.
The effects of nimodipine and thyrotropin-releasing hormone (TRH) were compared in a clip-compression model of experimental spinal cord injuries (SCI) in rats. Thirty rats received a 50-g clip-compression injury on the cord at T9. Ten rats were given 0.02 mg/kg nimodipine and dextran 40 (3 ml) i.v. 1 h after injury. Ten rats were given 2 mg/kg TRH and dextran 40 (3 ml) i.v. 1 h after injury followed by 1 mg/kg per hour for 4 h. The remaining ten rats were given only saline. TRH treatment significantly improved somatosensory-evoked potentials (SEPs) and mean arterial blood pressures (MABPs), whereas nimodipine treatment had no effect on these variables (Fisher's exact test (P less than 0.01).
Background: The characteristics of Chiari malformation type III and its treatment are evaluated in this study. Radiological and surgical findings were correlated and the benefits of the therapy are discussed. Methods: Eight patients (6 males, 2 females) with Chiari malformation type III were studied. All patients underwent surgery to remove encephalocele along with neural tissue and to repair the dura and the skin. Associated pathologies such as hydrocephalus, tethered cord syndrome and syringomyelia were also surgically treated. Follow-up was based on the evaluation of postoperative motor and mental development, as well as on magnetic resonance imaging findings. Results: Ventriculoperitoneal shunt malfunction in 2 patients was the only surgical complication. One patient died 10 days after the operation, 7 patients survived, and the outcome of 2 patients was quite poor because of severe mental retardation and neurological deficits at the beginning. In the remaining patients, motor and mental development was normal, and the neurological outcome was satisfactory. Conclusion: Surgery in the newborn period, initial severity of neurological deficits, the presence of intermittent apnoea, delayed treatment of hydrocephalus and the amount of neuronal tissue within the excised encephalocele were determined as unfavourable prognostic factors for the outcome. If the appropriate surgical procedure is done at the right time, the outcome of the Chiari malformation type III patient can be satisfactory with a low mortality rate.
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