Browsing by Author "Jovanović, Nemanja (57225700904)"

Introduction Significant cranial defects result from a decompressive craniectomy following head trauma, malignant brain edema, intracranial hemorrhage, or resection of tumor affected bone. Unrepaired cranial defects are not just a tremendous esthetic problem. The underlying brain is unprotected, prone to injury, and this state can lead to the so-called “syndrome of the trephined” with mood instability, headaches, and even a neurological deficit. Currently, there is no widely accepted uniform technique of cranial vault shape restoration. Combining 3D technology with the use of polymethylmethacrylate is a challenging field that can bring good functional and aesthetic results and, in the case of smart design, become efficient, low-cost technology. We offer a possible solution to a problem that would be acceptable in neurosurgical practice. Case outline We present a 37-year-old male patient with a massive hemicranial defect as a consequence of previous decompressive craniectomy following severe craniocerebral injury the previous year. Together with engineers from the appropriate 3D modeling studio, we have designed a two-part mold by laser printing technology using biocompatible advanced polyamide. We made a customized polymethylmethacrylate graft intraoperatively using this mold and achieved good aesthetic results. Conclusion Reports of 3D printing assisted cranioplasties are growing, describing different techniques and cost-estimation. We hope to introduce a low-cost and simple method for repairing a skull defect. © 2022, Serbia Medical Society. All rights reserved.

We are reporting the case of a 53-year old woman presenting to our hospital with a hemorrhagic low-grade glioma (LGG). She was admitted to a nearby general hospital where she had presented with aphasia, right hemiplegia and change of mental status. Computer tomography (CT) images showed a left temporo-parietal hemorrhage with mass effect. She was transferred to our hospital neuro-intensive care unit where emergency craniotomy was performed. A tumor with hematoma was removed and further histopathology analysis revealed tumor progression. We reviewed the literature reporting cases of central nervous system tumors hemorrhage and found that these types of events are exquisitely rare in adults with LGG. However these events are possible, suggesting that it should be included in the differential diagnosis of any patient presenting with intracranial hemorrhage. This case raises questions regarding the benefit of early versus late intervention for patients known to have LGG.