Cavernous haemangioma has various forms. The cases with spontaneous intracerebral haemorrhage are most common, but post-traumatic intracerebral haematoma was not reported. The aim of this report is to present cases of cavernous haemangioma with unusual clinical course. In seven patients with post-traumatic intracerebral haematoma, fragments of histologically confirmed cavernous haemangioma tissue situated in the place of haematoma were found. In one case, delayed intracerebral haematoma twenty four hours after trauma and initial CT-scan was observed. On the initial CT-scan in this patient only traumatic changes in the brain without haematoma or tumour were present. In our cases, cavernous haemangioma was situated most frequently in frontal and temporal region, shown as haematoma usually 24 hours after trauma, mainly in men in age range 30-44 years with disorders of consciousness (GCS 11). As the result of operation, the majority of patients (6 out of 7) were discharged as self-independent. The authors reviewed the literature for cavernous haemangioma. The tumour may be present in any region of the brain including infratentorial region. The lesion is disclosed most frequently in children as spontaneous brain haemorrhage and rarely as seizures or intracranial hypertension. Final diagnosis is based on cerebral angiography or MRI. CT-scans are not typical and before the appearance of haematoma do not suggest the presence of tumour. Surgical removal of haematoma with tumour fragments is the main method of therapy, but radiation is possible in order to diminish the mass. The authors conclude that in each patient with post-traumatic intracerebral haematoma, the presence of cavernous haemangioma is possible.

Adult↗

PubMedDate not supplied

Cerebrospinal meningitis with the presence of Acinetobacter spp.

The study was conducted on 16 strains of Acinetobacter sp. which were isolated from cerebrospinal fluid. The diagnostic material was analysed with the use of automatic BacT/Alert system (Organon Teknika). The analysis was performed in the Department of Microbiology, Medical University in Bydgoszcz. API 20NE system (bioMérieux) enabled the identification of 14 strains (87.5%) as A. baumannii, 1 strain as A. haemolyticus and 1 strain as A. lwoffii. The micro-organisms were isolated from patients whose age ranged between 4 and 66 years. These patients were treated in the departments of Neurosurgery (75.0%), Neurology (18.8%) and Intensive Therapy (6.2%). The infection of cerebrospinal fluid was caused by injury and subsequent exposure to the bacteria present in external environment. Antibiotic-sensitivity of these micro-organisms was evaluated with the help of disc-diffusion method, observing standardisation conditions outlined by NCCLS. All the strains proved sensitive to carbapenems, 15 strains were sensitive to netilmicin, 7 strains--to tobramycin and 7 strains--to amikacin. All the strains displayed multiple resistance. The only exception was A. haemolyticus. The use of two-discs allowed for the detection of ESBLs in 7 A. baumannii strains. Positive results were most frequently obtained after the combination of sublactam and aztreonam. Due to microscopic resemblance between Acinetobacter spp., and bacteria of Neisseria, Moraxella and Haemophilus genus, microbiological diagnostics should not be restricted to microscopic assessment of cerebrospinal fluid and quick serological tests evaluating the antigens of the most frequent aetiological factors. Considering multiple resistance of Acinetobacter spp. to antibiotics, the treatment should be based on sensitivity tests and the ability of a given antibiotic to penetrate into cerebrospinal fluid. In our opinion, both reasonable antibiotic policy as well as observing the principles of hygiene and monitoring infections play equally important roles in the prevention of infections with Acinetobacter spp. Such combined measures may help to prevent the spreading of multiple resistant strains in hospital environment.

Acinetobacter↗

PubMedDate not supplied

[Unilateral exophthalmos during the course of epidural hematoma].

Based on 10 cases in the literature and one of our own a review is made on the occurrence of an association of an intracranial epidural haematoma with unilateral exophthalmos. The possible pathogenesis of this infrequent phenomenon is discussed.

Adult↗

PubMedDate not supplied

[Injury of the deep branch of the ulnar nerve].

The authors report the clinical material from the Department of Neurosurgery, WAM in Lódź from the last 11 years including cases of damage to the deep branch of the ulnar nerve. In view of the importance of this branch for the function of the hand, damage to it requires very careful surgical management with autogenous graft. Sometimes this is technically difficult in view of the topographic conditions in this area. Damage to the deep branch of this nerve is usually associated with damage to the sensory part of the ulnar nerve, to the median nerve and tendons of finger flexors.

Adolescent↗

PubMedDate not supplied

[Nerve transplants in the reconstruction of damaged nerve trunks].

The authors present the first in the Polish literature group of 320 cases of autogenic nerve cable grafts. The overall results of this treatment are: very good and good in 43.3%, satisfactory in 29.1%, poor in 18.2%, bad in 9.4%. Nearly all bad results were obtained in grafting nerves in the lower extremity. A comparison of the results obtained with the classic nerve suture and short cable grafts shows a decidedly evident superiority of grafts over the classic suture. The advantages of grafts are discussed, particularly with respect to nerve blood supply. The importance of early surgical treatment and prolonged heat treatment is stressed.

Arm↗

PubMedDate not supplied

[Microsurgical method of transplantation of peripheral nerves].

The authors present the microsurgical technique of grafting thin cutaneous nerves at the site of peripheral nerve defect. The application of grafts in place of end-to-end suture makes possible elimination of nerve stretching at the time of suturing and at the time of rehabilitation. The use of cutaneous nerves makes possible good revascularization of grafts and their correct regeneration. The use of the microsurgical technique makes possible a good evaluation of the fascicular structure of nerve trunks, their adequate resection, and good adaptation of nerve stumps and grafts connecting the corresponding nerve fascicles. The use of the technique of nerve gluing with autologous plasma enables a stable connection of grafts and stumps to be obtained, with simultaneous elimination of foreign material (threads) from the area of connection.

Humans↗

PubMedDate not supplied

[Use of gelatin-resorcinol-formaldehyde glue in the surgical treatment of cerebrospinal rhinorrhea].

The introduction of tissue adhesives in neurosurgery for treating cerebrospinal fluid fistulas has been a major advance in the operative technique. The authors describe the use of gelatin-resorcin-formaldehyde adhesive (GRF) in the surgical treatment of cerebrospinal fluid fistulas. The method of preparation of GRF, the technique of adhesive application, its clinical use and advantages are described.

Adult↗