Delayed onset of generalized tonic—clonic seizures as a complication of halo orthosis

Case report

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✓ The authors report on the case of a 29-year-old man who presented with new-onset, generalized tonic—clonic seizures 11 years after being treated with a halo orthosis for a neurologically intact C-7 fracture. Neuroimaging and surgical findings indicated that the epileptic focus was scar tissue, which developed secondary to halo pin penetration of the skull. This complication of halo orthosis has not yet been reported in the literature.

Article Information

Address reprint requests to: Eric William Nottmeier, M.D., Division of Neurosurgery, Department of Surgery, University of Missouri Health Sciences Center, One Hospital Drive, Columbia, Missouri 65212. email: NottmeierE@health.missouri.edu.

© AANS, except where prohibited by US copyright law.

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    Axial MR images. Upper: Contrast-enhanced T1-weighted image revealing a punctate-enhancing area in the right posterior parietal cortex. Lower: T2-weighted image demonstrating edema in the right posterior parietal area.

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    Photomicrograph demonstrating acute and chronic inflammation with hemosiderin deposition and focal calcific debris. H & E, original magnification × 100.

References

1.

Adams RDVictor M: Principles of Neurologyed 4. New York: McGraw-Hill1989 p 260Adams RD Victor M: Principles of Neurology ed 4. New York: McGraw-Hill 1989 p 260

2.

Baron S (ed): Medical Microbiologyed 2. Menlo Park, CA: Addison-Wesley1986 p 411Baron S (ed): Medical Microbiology ed 2. Menlo Park CA: Addison-Wesley 1986 p 411

3.

Berenson CSBia FJ: Proprionibacterium acnes causes postoperative brain abscesses unassociated with foreign bodies: case reports. Neurosurgery 25:1301341989Berenson CS Bia FJ: Proprionibacterium acnes causes postoperative brain abscesses unassociated with foreign bodies: case reports. Neurosurgery 25:130–134 1989

4.

Dormans JPCriscitiello AADrummond DSet al: Complications in children managed with immobilization in a halo vest. J Bone Joint Surg Am 77:137013731995Dormans JP Criscitiello AA Drummond DS et al: Complications in children managed with immobilization in a halo vest. J Bone Joint Surg Am 77:1370–1373 1995

5.

Dove JHsu LCYau AC: The cervical spine after halo-pelvic traction. An analysis of the complications of 83 patients. J Bone Joint Surg Br 62-B:1581611980Dove J Hsu LC Yau AC: The cervical spine after halo-pelvic traction. An analysis of the complications of 83 patients. J Bone Joint Surg Br 62-B:158–161 1980

6.

Garfin SRBotte MJTriggs KJet al: Subdural abscess associated with halo-pin traction. J Bone Joint Surg Am 70:133813401988Garfin SR Botte MJ Triggs KJ et al: Subdural abscess associated with halo-pin traction. J Bone Joint Surg Am 70:1338–1340 1988

7.

Garfin SRBotte MJWaters RLet al: Complications in the use of the halo fixation device. J Bone Joint Surg Am 68:3203251986Garfin SR Botte MJ Waters RL et al: Complications in the use of the halo fixation device. J Bone Joint Surg Am 68:320–325 1986

8.

Glaser JAWhitehill RStamp WGet al: Complications associated with the halo-vest. A review of 245 cases. J Neurosurg 65:7627691986Glaser JA Whitehill R Stamp WG et al: Complications associated with the halo-vest. A review of 245 cases. J Neurosurg 65:762–769 1986

9.

Goodman MLNelson PB: Brain abscess complicating the use of halo orthosis. Neurosurgery 20:27301987Goodman ML Nelson PB: Brain abscess complicating the use of halo orthosis. Neurosurgery 20:27–30 1987

10.

Hann Jde Bakker HM: Brain abscess as a complication of halo traction: role of CT in diagnosing penetration of the skull. AJNR 10:4461989Hann J de Bakker HM: Brain abscess as a complication of halo traction: role of CT in diagnosing penetration of the skull. AJNR 10:446 1989

11.

Jakab EZbinden RGubler Jet al: Severe infections caused by Propionibacterium acnes: an underestimated pathogen in late postoperative infections. Yale J Biol Med 69:4774821996Jakab E Zbinden R Gubler J et al: Severe infections caused by Propionibacterium acnes: an underestimated pathogen in late postoperative infections. Yale J Biol Med 69:477–482 1996

12.

Kaplan KWeinstein L: Diphtheroid infections of man. Ann Intern Med 70:9199291969Kaplan K Weinstein L: Diphtheroid infections of man. Ann Intern Med 70:919–929 1969

13.

Kaplan SLRocco TPTun CGet al: Acute pulmonary edema following removal of a spinal orthosis: an unusual complication of a halo vest. Arch Phys Med Rehabil 71:2552571990Kaplan SL Rocco TP Tun CG et al: Acute pulmonary edema following removal of a spinal orthosis: an unusual complication of a halo vest. Arch Phys Med Rehabil 71:255–257 1990

14.

Perry JNickel VL: Total cervical-spine fusion for neck paralysis. J Bone Joint Surg Am 41:37601959Perry J Nickel VL: Total cervical-spine fusion for neck paralysis. J Bone Joint Surg Am 41:37–60 1959

15.

Richards JIngham HRHickman Jet al: Focal infections of the central nervous system due to Propionibacterium acnes. J Infect 18:2792821989Richards J Ingham HR Hickman J et al: Focal infections of the central nervous system due to Propionibacterium acnes. J Infect 18:279–282 1989

16.

Senneville ESavage CLamy Oet al: Failure of antibiotic therapy of multiple temporal brain abscesses due to Propionibacterium acnes requiring temporal lobectomy. J Infect 34:2692711997Senneville E Savage C Lamy O et al: Failure of antibiotic therapy of multiple temporal brain abscesses due to Propionibacterium acnes requiring temporal lobectomy. J Infect 34:269–271 1997

17.

Skinner PRTaylor AJCoakham H: Propionibacteria as a cause of shunt and postneurosurgical infections. J Clin Pathol 31:108510891978Skinner PR Taylor AJ Coakham H: Propionibacteria as a cause of shunt and postneurosurgical infections. J Clin Pathol 31:1085–1089 1978

18.

Vertullo CJDuke PFAskin GN: Pin-site complications of the halo thoracic brace with routine pin re-tightening. Spine 22:251425161997Vertullo CJ Duke PF Askin GN: Pin-site complications of the halo thoracic brace with routine pin re-tightening. Spine 22:2514–2516 1997

19.

Victor DIBresnan MJKeller RB: Brain abscess complicating the use of halo traction. J Bone Joint Surg Am 55:6356391973Victor DI Bresnan MJ Keller RB: Brain abscess complicating the use of halo traction. J Bone Joint Surg Am 55:635–639 1973

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