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Atypical presentation of a posterior fossa tumour:A case report

World Journal of Clinical Cases 2024年第13期12卷 2281-2285页

作者： alisha narotam Mikara Archary Poobalan Naidoo Yeshkhir Naidoo Vanesha Naidu Department of Internal Medicine King Edward VIII Hospital-University of Kwazulu-NatalDurban 4001Kwa-Zulu NatalSouth Africa Department of Internal Medicine Nelson R MandelaSchool of MedicineUniversity of Kwa-Zulu NatalDurban 4001Kwa-Zulu NatalSouth Africa Department of Radiology King Edward VIII Hospital-University of Kwazulu-NatalDurban 4001Kwazulu-NatalSouth Africa

BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory *** is of interest as the patient had no other symptomatology,especially given the size of the mass,which would typically cause a pressure effect leading to neurological and auditory *** SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car *** had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose *** initially presented to our facility with severe respiratory *** reported a 1-wk history of shortness of breath and wheezing that was not relieved by his *** had no constitutional symptoms or impairment of *** clinical examination,the patient’s chest was“silent.”Our initial assessment was status asthmaticus with type 2 respiratory failure,based on the history of asthma,a“silent chest,”and the arterial blood gas *** A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord *** patient’s chief presenting feature was severe respiratory distress,which combined with his background medical history of asthma,was *** should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement.

关键词： Respiratory distress Meningioma Unilateral vocal cord palsy Posterior fossa tumour Neurosurgery Neurology Radiology Case report

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儿童外伤后大脑氧合作用与损伤严重程度及预后的相关性

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世界核心医学期刊文摘（儿科学分册） 2006年第8期2卷 50-51页

作者： narotam P. K. Burjonrappa S. C. Raynor S. C. 贺莉(译) - J. PEDIATR. SURG. 2006 41/3 (505-513) 不详

Introduction:Trauma is the commonest cause of death in the pediatric populati on,which is prone to diffuse primary brain injury aggravated by secondary insul ts(eg,hypoxia,hypotension).Standard monitoring involves intracranial pressur e(ICP)and cerebral perfusion pressure,which do not reflect true cerebral oxyg enation(oxygen delivery [DO2]).We explore the merits of a brain tissue oxygen-directed critical care ***:Sixteen patients with major trauma(Inj ury Severity Score,> 16/Pediatric Trauma Score [PTS],< 7)had partial pressure of brain tissue oxygen(PbtO2)monitor(Licox;Integra Neurosciences,Plainsbor o,NJ)placed under local anesthesia using twist-drill craniostomy and definiti ve management of associated ***2 levels directed therapy intensity level(ventilator management,inotrops,blood transfusion,and others).Patien t demographics,short-term physiological parameters,PbtO2,ICP,Glasgow Coma S core,trauma scores,and outcomes were analyzed to identify the patients at risk for low ***:There were 10 males and 6 females(mean age,14 years)su staining motor vehicle accident(14),falls(1),and assault(1),with a mean In jury Severity Score of 36(16-59);PTS,3(0-7);and Revised Trauma Score,5.5(4-11).Eleven patients(70%)had low DO2(PbtO2,< 20 mmHg)on admission des pite undergoing standard resuscitation affected by fraction of inspired oxygen,PaO2,and cerebral perfusion pressure(P =0.001).Eubaric hyperoxia improved ce rebral oxygenation in the low-DO2 group(P =0.044).The Revised Trauma Score(r = 0.65)showed moderate correlation with PbtO2 and was a significant predictor for low DO2(P =0.001).In patients with PbtO2 of less than 20 mm Hg,PTS corre lated with cerebral oxygenation(r = 0.671,P =0.033).The mean 2-hour PbtO2 a nd the final PbtO2 in survivors were significantly higher than deaths(21.6 vs 7.2 mmHg [P =0.009] and 25 vs 11mmHg [P =0.01]).Although 4 of 6 deaths were from uncontrolled high ICP,PTS and 2-hour low DO2 were significant for roots formo r

关键词：损伤严重程度评分原发性脑损伤氧合作用儿童 Glasgow昏迷评分预后大脑外伤后脑组织氧分压创伤患者

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