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Diabetes insipidus and syndrome of inappropriate antidiuretic hormone complicating pituitary surgery

Aboud SK, Yunus MR, Gendeh BS

Otolaryngol Head Neck Surg, 2011 Jun;144(6):1005-6.
PMID: 21493376 DOI: 10.1177/0194599810390899
Matched MeSH terms: Neurosurgical Procedures/adverse effects*
Fulltext Neurological deficit after surgery for spinal deformity--the value of normal intra operative wake-up tests in large sagitta curves. A report of two cases from an institution

Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:80-5.
PMID: 11814258

Neurological deficit after surgery for spinal deformity is a rare but devastating complication. Factors that have been associated with a post surgical deficit are congenital curves, large curves, kyphotic deformities, anterior and posterior surgery, ligation of multiple anterior vessels and hypotension; controlled or otherwise. Intra operative wake up tests have been used alone or in combination with spinal cord monitoring: to detect evolving neurological deficit in spinal deformity surgery. Despite these checks, major neurological deficits still occur post surgery. This is a report of two cases with normal intra operative wake up tests, but developed neurological deficit twelve hours after the end of surgery.

Matched MeSH terms: Neurosurgical Procedures/adverse effects*
Fulltext Postoperative intraspinal subdural collections after pediatric posterior fossa tumor resection: incidence, imaging, and clinical features

Harreld JH, Mohammed N, Goldsberry G, Li X, Li Y, Boop F, et al.

AJNR Am J Neuroradiol, 2015 May;36(5):993-9.
PMID: 25614472 DOI: 10.3174/ajnr.A4221

Postoperative intraspinal subdural collections in children after posterior fossa tumor resection may temporarily hinder metastasis detection by MR imaging or CSF analysis, potentially impacting therapy. We investigated the incidence, imaging and clinical features, predisposing factors, and time course of these collections after posterior fossa tumor resection.

Matched MeSH terms: Neurosurgical Procedures/adverse effects*
Fulltext Rare case of neglected large sacral Chordoma in a young female treated by wide En bloc resection and Sacrectomy

Phang ZH, Saw XY, Nor NFBM, Ahmad ZB, Ibrahim SB

BMC Cancer, 2018 Nov 14;18(1):1112.
PMID: 30428857 DOI: 10.1186/s12885-018-5012-3

BACKGROUND: Sacral chordoma is a locally aggressive malignant tumour originating from ectopic notochordal cells. The natural history of sacral chordoma is a slow growing tumour arising at the midline of the lower sacrum that can invade the sacrum and progressively increase in size expanding cranially and anteriorly. Metastasis is very rare even when the tumour is large. Sacral chordoma affects males more than females and is more commonly found in middle age and elderly patients.
CASE PRESENTATION: A 25 years old female had neglected an extremely large midline sacral mass for 2 years. On presentation to hospital, she had been bed bound for the past 2 years. The sacral mass was so large that it prevented her from lying down supine and sitting on the wheelchair comfortably. Clinical examination showed a 40 cm × 30 cm × 20 cm hard mass over the sacrum that involved both buttocks and the gluteal fold. Neurological exam of bilateral lower limb was normal. Computed Tomography Scan of the Pelvis showed a large destructive sacrococcygeal mass measuring 43 cm × 38 cm × 27 cm with extension into the presacral space resulting in anterior displacement of the rectum, urinary bladder and uterus; and posterior extension into the dorsal soft tissue with involvement of the gluteus, piriformis, and left erector spinae muscles. Biopsy taken confirmed Chordoma. This patient was managed by a multidisciplinary team in an Oncology referral centre. The patient had undergone Wide En Bloc Resection and Sacrectomy, a complex surgery that was associated with complications namely bleeding, surgical site infection and neurogenic bowel and bladder. Six months post operatively the patient was able to lie supine and sit on wheelchair comfortably. She required extensive rehabilitation to help her ambulate in future.
CONCLUSION: This is a rare case of neglected sacral chordoma in a young female treated with Wide En Bloc Resection and Sacrectomy associated with complications of this complex surgery. Nevertheless, surgery is still worthwhile to improve the quality of life and to prevent complications secondary to prolonged immobilization. A multidisciplinary approach is ideal and team members need to be prepared to address the complications once they arise.

Matched MeSH terms: Neurosurgical Procedures/adverse effects