• Title/Summary/Keyword: Cranial infection

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A Case of Varicella-Zoster virus infection with multiple cranial nerve involvement (다발성 하부뇌신경을 침범한 대상포진 감염 치험 1례)

  • Shin, Jung-Eun;Yoo, Seung-Joo;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.222-230
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    • 1999
  • Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

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Dural Reconstruction in Refractory Cranial Infection using Omental Free Flap (반복적인 두개내 감염에서 유리 대망피판을 이용한 경질막 재건)

  • Yoo, Ji Han;Eun, Seok Chan;Han, Jung Ho;Baek, Rong Min
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.670-673
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    • 2009
  • Purpose: Epidural abscesses and subdural empyemas after craniotomy are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage and dural reconstruction in these patients are challenging. Methods: A 28 - year - old female patient showed recurrent intracranial infection after craniotomy for evacuation of a arachnoid cyst and subdural hematoma. Despite prolonged systemic antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated WBC count, CSF leakage, low CSF glucose level, and purulent wound discharge. The authors removed the previously applied lyophilized dura and transferred free omental flap to reconstruct the dura, obliterate the cyst and cover the cerebral hemisphere in the craniotomy defect. Microvascular anastomosis was between gastroepiploic and superficial temporal vessels. Results: The postoperative course was uneventful and flap survival was excellent. The infection - resistant omental tissue allowed sufficient blood circulation and dead space control. The patient was discharged 1 month after surgery and wound discharge or recurrence was absent during 13 months of follow up periods. Conclusion: The use of vascularized free omentum proved useful in cases of intractable cranial wound infection and cerebrospinal fluid leakages.

Salvage of an exposed cranial prosthetic implant using a transposition flap with an indwelling antibiotic irrigation system

  • Hwang, Sung Oh;Chang, Lan Sook
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.73-76
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    • 2020
  • Cranial implant removal is recommended if implants become exposed owing to scalp necrosis after cranioplasty. However, it carries the risk of extensive bleeding, and the resultant cranial defects can cause both aesthetic and functional problems. We present a case of a scalp defect exposing a cranial prosthetic implant that was reconstructed with a local flap and salvaged using an indwelling antibiotic irrigation system. A 73-year-old man presented with scalp necrosis after undergoing cranioplasty due to intracranial hemorrhage. The cranial implant was exposed through the scalp defect. Methicillin-resistant Staphylococcus aureus was detected in the culture from the open wound. After debridement of the necrotic tissue and burring of the superficial layer of the implant, a transposition flap was used to cover the defect and an indwelling antibiotic irrigation system was installed. Continuous irrigation with vancomycin was conducted for 5 days, and intravenous vancomycin was continued for 4 weeks. The flap was in good condition at 4 months postoperatively, with no infection. The convex contour of the scalp was well maintained. The patient's neurological status was stable. Exposed cranial implants can be salvaged with continuous antibiotic irrigation as an alternative to implant removal; thus, the risk of bleeding and possible disfigurement may be avoided.

MRI Features of Multiple Cranial Neuropathies in Guillain-Barré Syndrome Occurring after COVID-19 Vaccination: A Case Report (COVID-19 백신 접종 후 발생한 길랑-바레증후군에서 보이는 다발성 뇌신경병증의 MRI 소견: 증례 보고)

  • Youngsoo Soh;Eun Ae Yoo;Eun-Sil Kim;Soo Jung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.964-969
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    • 2023
  • Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating polyneuropathy characterized by progressive, ascending, and symmetrical paralysis. It is known to be triggered by an antecedent infection or vaccination. Recently, GBS development following coronavirus disease 2019 (COVID-19) vaccination has been reported. Cranial neuropathies in typical GBS patients usually involve the facial and the lower cranial nerves (from IX to XII). We report a rare case of multiple cranial neuropathies involving trigeminal, abducens, and facial nerves in a patient who developed GBS following COVID-19 vaccination on the basis of obvious MRI features.

Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

  • Kwon, Seung Gee;Kim, Yong Oock;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.345-351
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    • 2012
  • Background Cranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction. Methods Between April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability. Results The mean follow-up period was 11.8 months and the mean operation time for reconstruction was $8.4{\pm}3.36$ hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures. Conclusions The reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

A Case of Pseudoaneurysm of the Common Carotid Artery secondary to Deep Neck Infection (심경부 감염과 동반된 총경동맥 가성동맥류 1례)

  • 정필섭;조정석;정필상
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.159-163
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    • 1997
  • The complications of deep neck infection have become much less common in the antibiotic era. The vascular complications of deep neck infection can have devasting consequences. Most commonly, the internal carotid artery is involved, although the common carotid and external carotid artery can also be affected.0 the cases of patients with a protracted course, recurrent bleeding, cranial neuropathies, or trismus, the presence of vascular complications must be considered. Appropriate imaging should be carried out to allow the localization of the infection and ascertain the status of the vessels in the neck The vascular structures can be imaged with duplex doppler or color doppler flow ultrasound to see the flow between the mass and vessels. Also angiography plays a key role in the diagnosis and management of vascular complication of deep neck infection. Prompt diagnosis and treatment of these patients is necessary to prevent significant hemmorrhagic complications. We experienced a case of pseudoaneurysm of the common carotid artery secondary to deep neck infection treated successfully with surgical excision in 45-year-old-male.

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Microvascular Reconstruction of the Cranial Base Defects (두개저 결손의 미세수술적 재건술)

  • Minn, Kyung-Won;Kim, In-Chul;Lee, Min-Goo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.71-76
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    • 1999
  • Until recently, the cranial base tumors were deemed unresectable due to the inability to diagnose the extent of the involvement accurately and to approach and excise the tumor safely. With refinements in CT and NMR scanning and development of craniofacial techniques, reconstruction becomes absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, the free tissue transfer was a useful alternative because it can provide large amount of well-vascularized tissues and reliable separation of intracranial space from bacterial flora of the upper airway. The microvascular free tissue transfer was used in 9 patients at our center to reconstruct the cranial base defects. Of these, 8 were free rectus muscle flaps, and 1 was free latissimua dorsi muscle flap. There were 1 case of partial flap loss and 1 case of postoperative wound infection. The large, complex defects were successfully reconstructed by one stage operation and the functional and aesthetic results were satisfactory with acceptable complication rates.

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BRAIN ABSCESS FOLLOWING ODONTOGENIC INFECTION (치성 감염에 의한 뇌 농양)

  • Kim, Il-Kyu;Ryu, Mun-Kwang;Ku, Je-Hoon;Jang, Keum-Soo;Kim, Ju-Rok;Kawk, Hyun-Jong;Choi, Jin-Ung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.174-178
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    • 2006
  • Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.

Treatment of Ramsay Hunt Syndrome That is Mistaken for Trigeminal Herpes Zoster -A case report- (삼차신경절 침범으로 생각되어진 Ramsay Hunt Syndrome 환자의 치료 증례 -증례보고-)

  • Park, Jong Min;Yu, Sung Jun;Park, Ah Reum;Lee, Sang Mook
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.237-240
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    • 2008
  • Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed to varicella zoster virus infection in the geniculate ganglion. Ramsay Hunt syndrome accounts for about 10% cases of facial palsy. We report a 46-year-old healthy man developed left side skin vesicles on the face with severe pain. We thought of the trigeminal herpes zoster. He was treated with intravenous acyclovir, and stellate ganglion block daily. Four days later, brain magnetic resonance imaging revealed small areas of enhancement in the seventh cranial nerve and eighth cranial nerve, not in the fifth cranial nerve. Eight days later, the left facial palsy was come. We confirmed him as Ramsay Hunt syndrome. We started steroid therapy immediately. He recovered completely a month later. The patient was improved through the early antiviral therapy, steroid medication and stellate ganglion block.

Two Cases of Cerebral Aspergillosis Following Cranial Operation - Case Report - (개두술후 발생한 뇌 아스퍼질루스증 2예)

  • Kim, Jung Dug;Kim, Eui Jung;Park, Sang June;Cho, Chang Weon;Youn, Sung Moon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1094-1097
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    • 2000
  • Aspergillosis is an opportunistic infection associated with diabetes, alcoholism, use of corticosteroid and transplantation procedure. Aspergillosis of central nervous system is a rare disease and known to show an aggressive course with high mortality. We managed two cases of cerebral aspergillosis, following cranial operation, with combination therapy of surgery and antifungal agents. One patient recorvered but the other patient died. The clinical course of these two patients is presented with review of pertinent literature.

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