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Surgical Neurology International

Joham Choque-Velasquez, Juha Hernesniemi
Background: In this video abstract, we present a double-clip technique for the management of small (≤5 mm) and very small (≤3 mm) aneurysms with a suitable configuration to apply two clips. This is a parallel duplication clipping technique of booster clipping which uses mini-clips that have a smaller closing force compared to standard clips. This technique prevents the slippage of the applied clips, was developed along the career of the senior author (Juha Hernesniemi), and has been previously proved to be safe and effective for aneurysm clipping...
2018: Surgical Neurology International
Nathalie Chivoret, Eric Arnaud, Kim Giraudat, Frazer O'Brien, Leslie Pamphile, Philippe Meyer, Dominique Renier, C Collet, Federico Di Rocco
Background: Bilambdoid and sagittal synostosis (BLSS), also called "Mercedes Benz synostosis," is a multisutural craniosynostosis that has been described as a specific entity. However, this synostotic pattern can also be found in syndromic craniostenosis. To better define this entity we reviewed our experience with bilambdoid and sagittal synostosis. Methods: We searched our prospective database for cases of bilambdoid and sagittal synostosis among all types of craniosynostosis...
2018: Surgical Neurology International
Saif Yousif, Guy Lampe, Ananthababu Pattavilakom
Background: We present one of the first documented cases in the literature of an adult with Klippel-Trenaunay syndrome (KTS) with a large frontal osseous hemangioma. Case Description: A 30-year-old male presented with a rapidly enlarging frontal skull lesion that had developed in only 3 months. Radiological investigation revealed a highly vascular lesion attached to the frontal bone. The lesion was surgically resected with the patient making complete recovery. Histopathology was consistent with an osseous hemangioma...
2018: Surgical Neurology International
(no author information available yet)
[This corrects the article on p. 172 in vol. 9, PMID: 30210905.].
2018: Surgical Neurology International
Yang Wang, Dasheng Wang, Dingyi Li, Ruobing Qian, Xianming Fu, Chaoshi Niu, Jinghua Huang, Xiaohong Wen, Xiangping Wei
Background: Refractory epilepsy is a common and troublesome neurosurgical disease. This study is designed to compare seizure control and degrees in intellectual outcome in children with refractory epilepsy after surgical treatment. Methods: 20 children with refractory epilepsy were treated with tailored epilepsy surgery or vagus nerve stimulation (VNS). We used the Engel Epilepsy Surgery Outcome Scale to evaluate seizure control and the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV), to test the children's intellectual outcomes 7-day preoperative and 3-, 6-, and 12-month postoperative...
2018: Surgical Neurology International
Yuki Kuranari, Ryota Tamura, Shuji Mikami, Kentaro Ohara, Masahiro Toda, Kazunari Yoshida
Background: Meningiomas originate from meningothelial cells of the arachnoid membrane. Few cases of meningioma with infiltration of inflammatory cells, such as lymphocytes and plasma cells, have been reported, and the mechanisms underlying meningioma-induced inflammatory reactions have not been fully elucidated. Case Description: In this study, we report an extremely rare case of meningioma with infiltration of both IgG4-positive plasma cells and eosinophils showing extensive dural tail and reactive inflammation of the surrounding arachnoid tissue...
2018: Surgical Neurology International
Diogo Simão, Joaquim C Teixeira, Alexandre R Campos, Domingos Coiteiro, Maria M Santos
Background: Neurocysticercosis (NCC) is the most common helminthic disease of the nervous system in humans and it is caused by the larvae of the pork tapeworm, Taenia solium . We present a case of microsurgical removal of a fourth ventricle NCC cyst combined with an endoscopic third ventriculostomy (ETV) to treat hydrocephalus. Case Description: A 36-year-old woman presented to the emergency room with headache and decreased visual acuity over the last 4 months. A brain magnetic resonance imaging showed obstructive hydrocephalus apparently correlated to a mobile, cystic lesion of the fourth ventricle...
2018: Surgical Neurology International
Vasilije Stambolija, Martina Miklic Bublic, Marin Lozic, Josip Paladino, Miroslav Šcap
Background: Etomidate may be given in continuous infusion for maintenance of general anesthesia, although that practice is rarely seen due to beliefs that it has possibility of interfering with cortisol synthesis. However, etomidate is sometimes preferable choice as it has least influence on hemodynamics and rarely causes allergic reactions. Case Description: We describe a case of 13-year-old boy with aneurysm of left middle cerebral artery, planned for aneurysmal clipping, and previously treated for ruptured aneurysm of right middle cerebral artery...
2018: Surgical Neurology International
Youssef Fares, Jawad Fares, Moustafa M Kurdi, Mohamad A Bou Haidar
Background: Empirical studies that explore whether hospitals with physician leadership perform better than hospitals led by nonphysician managers are scarce. This study looks at the leaders currently being hired by hospitals in the Arab World and explores whether chief executive officers (CEOs) in hospitals ranked higher are typically physician leaders or nonphysician managers. Furthermore, we discuss whether physicians, especially neurosurgeons, are equipped to lead hospitals and healthcare institutions worldwide...
2018: Surgical Neurology International
Albert Vincent B Brasil, Ruy Gil Rohrmoser, Guilherme Gago, Eduardo Cambruzzi
Background: Hemangiomas are benign vascular malformations that can involve the spine. Pure epidural hemangiomas are rare and represent only 4% of all epidural lesions. Most hemangiomas are of the cavernous type; the capillary variant is atypical, and only ten cases have been reported in the literature. Case Description: A 69-year-old female presented with nonspecific dorsal pain. Magnetic resonance imaging (MRI) showed a spinal epidural tumor at the T9-T10 level...
2018: Surgical Neurology International
Tamara A Strohm, Seby John, Muhammad S Hussain
Background: Current management of acute spinal cord infarction (SCI) is limited. Lumbar cerebrospinal fluid drainage (CSFD) with blood pressure augmentation is utilized in the thoracic/thoracoabdominal aortic repair and thoracic endovascular aortic repair (TEVAR) populations to increase spinal perfusion pressure. Case description: We identified 3 patients who sustained acute SCI and underwent CSFD and maintenance of elevated mean arterial pressure (MAP) within 24 hours of injury...
2018: Surgical Neurology International
Anderson Alexsander Rodrigues Teixeira, Lucas Fernandes Ferreira, Bruno Nunes Ferraz De Abreu, Euler Nicolau Sauaia Filho, Francisco Ramos Junior
Background: The posterior longitudinal ligament (PLL) extends from the foramen magnum to the sacrum. In some cases, it becomes calcified/ossified; the term for this is ossification of the PLL (OPLL). Case Description: A 50-year-old female presented with acute sphincter dysfunction and paraparesis attributed to T2-T4 OPLL. The patient underwent a C7-T5 laminectomy to decompress the spinal cord. After 1 postoperative week, and certainly by 6 months postoperatively, the patient's motor and sensory deficits showed improvement...
2018: Surgical Neurology International
Sean P Polster, Shirlene Obuobi, Victor J Del Brutto, Kenneth Avner, Aikaterini Markopoulou, Ricky H Wong
Background: Pneumocephalus is a common finding following intracranial procedures, typically asymptomatic and resolves within several days. However, in some cases, pneumocephalus presents with headache, encephalopathy, or symptoms of elevated intracranial pressure. Here, we present a case of iatrogenic tension pneumocephalus following endoscopic sinus surgery, presenting as abnormal involuntary movements resembling a movement disorder with choreiform movements. Case Description: A 67-year-old previously healthy male presented with new onset chorea and dystonia associated with headache, encephalopathy, and postural instability 4 days after undergoing endoscopic sinus surgery for chronic sinusitis and nasal polyps...
2018: Surgical Neurology International
Motohiro Nomura, Eiichi Baba, Kazutaka Shirokane, Atsushi Tsuchiya
Background: An aneurysm of distal lenticulostriate artery is very rare. The natural course and management of this rare aneurysm are not clear. Case Description: An 81-year-old woman developed consciousness disturbance. Computed tomography revealed hemorrhage in the right caudate nucleus and lateral ventricles. Three-dimensional computed tomographic angiography demonstrated only an aneurysm at the basilar artery. On angiography, on the sixth day, an aneurysm at the right lenticulostriate artery was demonstrated...
2018: Surgical Neurology International
Tridu R Huynh, Conrad Lu, Doniel Drazin, Gregory Lekovic
Background: Myxopapillary ependymoma (MPE) with anaplastic features is extremely rare, with only three case reports in the literature. Case Description: We report the case of a MPE with anaplastic features in a 24-year-old female who presented with a dominant lumbar mass along with intracranial and sacral metastases. Upon gross total resection of the dominant tumor located at L2-L3, it appeared to arise from the filum terminale, and had a solid component in addition to soft or necrotic areas...
2018: Surgical Neurology International
G Sudhir, Nitin Maruti Adsul, Shankar Acharya, Rupinder S Chahal
Background: Compartment syndromes have been reported in nearly every anatomical area of the extremities. Similarly, in the lumbar spine, there is a risk of a compartment syndrome following either direct or indirect injury to the paraspinal muscles. In this study, we present a case of lumbar paraspinal compartment syndrome after percutaneous pedicle screw fixation for a spine fracture. Case Description: A 27-year-old obese female sustained a fall and an L1 fracture...
2018: Surgical Neurology International
Enrico Affonso Barletta, Renato Lazarin Ricci, Renato Di Gugliemo Silva, Ranieri Henrique Moraes Lopes Gaspar, João Flávio Mattos Araújo, Maick Willen Fernandes Neves, José Luis Braga de Aquino, Telmo Augusto Barba Belsuzarri
Background: This study aims to present the most important considerations when it comes to patients features, clinical presentation, localization, and morphology of the aneurysm and the treatments outcomes of the fusiform aneurysms. Methods: We performed a literature review using PubMed. The search was limited to the studies published in English, from 2003 to 2017. Results: The studies analyzed that showed data about the patient features, clinical presentation, the aneurysm localization, morphology, and pathogenesis didn't present much divergence...
2018: Surgical Neurology International
Enrique de Font-Réaulx Rojas, Edith Elizabeth Martínez Ochoa, Ramón López López, Luis Guillermo López Díaz
Background: Infrared thermography (IT) is a noninvasive, real-time diagnostic method that requires no contact with the patient and has a broad spectrum of potential applications in neurosurgery. It has been previously demonstrated the high sensitivity and specificity that IT has to detect brain blood flow changes. Case Description: The case is based on a 64-year-old diabetic and hypertensive male, to whom an anterior communicating artery (ACoA) incidental aneurysm was discovered...
2018: Surgical Neurology International
Akihide Kondo, Osamu Akiyama, Mario Suzuki, Hajime Arai
Background: The effectiveness of microvascular decompression in treating hemifacial spasm is widely accepted. However, some experience recurrence of hemifacial spasm after successful decompression surgery. Especially, delayed recurrence more than 5 years after surgery is rare and the cause of this phenomenon is unknown. Case Description: A female underwent microvascular decompression to treat her hemifacial spasm 6 years ago. Six years later, her hemifacial spasm recurred and she underwent a second surgery...
2018: Surgical Neurology International
Joham Choque-Velasquez, Juha Hernesniemi
Background: In this video abstract, we present an unedited microsurgical resection of a fourth ventricular ependymoma performed by a senior author (JH). Currently, the goal of a standard treatment of a fourth ventricular ependymoma is based on microsurgical resection followed by radiochemotherapy. Our aim is to demonstrate the efficiency and safety of our microsurgical technique in deep brain territories under the principle "simple, clean, and preserving the normal anatomy." For this, a midline suboccipital approach and a proper praying sitting position are essential...
2018: Surgical Neurology International
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