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Matthieu Delion, Mickael Dinomais, Philippe Mercier
Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA)...
October 20, 2016: Cerebellum
Javier Quillo-Olvera, Javier Quillo-Reséndiz, Carlos-Francisco Gutiérrez-Partida, Manuel Rodríguez-García
BACKGROUND: Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. CLINICAL CASE: A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously...
October 14, 2016: Cirugia y Cirujanos
Rintaro Yokoyama, Satoshi Iihoshi, Kei Miyata, Kentaro Toyama, Katsuya Komatsu, Masahiko Wanibuchi, Nobuhiro Mikuni
OBJECT: We report a relatively rare case of pediatric iatrogenic extradural vertebral arteriovenous fistula. CASE: A five-year-old boy with a history of multiple surgeries for Total Anomalous Pulmonary Venous Return(TAPVR)exhibited vascular engorgement of his right neck from about 4 years old. We thought that this was caused by his past operations. He demonstrated swollen blood vessels in the right neck and pulmonary hypertension with increased right heart load...
October 2016: No Shinkei Geka. Neurological Surgery
Trevor W Moore, R Timothy Bentley, Sarah A Moore, Michele Provencher, Emma E Warry, Rebecca Kohnken, Hock Gan Heng
Published information regarding canine vertebral column mast cell tumors (MCTs) is limited. The objectives of this study were to report clinical and advanced imaging findings for a group of dogs with confirmed spinal MCT. Inclusion criteria for this retrospective case series were dogs with spinal magnetic resonance imaging (MRI) or computed tomography (CT) scans and a histological diagnosis of spinal MCT. Clinical, imaging, treatment, and outcome data were recorded. Four dogs met inclusion criteria. One dog had primary spinal MCT and three dogs had metastatic spinal MCT...
October 9, 2016: Veterinary Radiology & Ultrasound
Malte Mohme, Klaus Christian Mende, Theresa Krätzig, Rosemarie Plaetke, Kerim Beseoglu, Julian Hagedorn, Hans-Jakob Steiger, Frank W Floeth, Sven O Eicker
Spinal cord or cauda equina compression (SCC) is an increasing challenge in clinical oncology due to a higher prevalence of long-term cancer survivors. Our aim was to determine the clinical relevance of SCC regarding patient outcome depending on different tumor entities and their anatomical localization (extradural/intradural/intramedullary). We retrospectively analyzed 230 patients surgically treated for SCC. Preoperative status for pain and neurological impairment were correlated to the degree of compression, tumor location, and early as well as short-term follow-up outcome parameters...
October 7, 2016: Neurosurgical Review
Alexander Mason, Alan T Villavicencio, Ewell L Nelson, Robert C Forsythe, Sigita Burneikiene
Only four primary gliosarcoma case reports are described in the literature with transcranial (intradural to extradural) penetration into the region of the infratemporal fossa. This is the first report of a primary glioblastoma (GBM) that evolved into secondary or post-treatment gliosarcoma without evidence of a second de novo tumor and with extension into the left pterygomaxillary fossa.
July 18, 2016: Curēus
Bhavanam Hanuma Srinivas, Megha Shantveer Uppin, Sateesh Killi, Malladi Venkata Surya Subbalaxmi, Madhusudan Patil, Alugolu Rajesh
Tuberculous osteomyelitis of skull is very rare, even in areas where tuberculosis is endemic. We herein describe an elderly woman who was apparently immunocompetent and presented with left frontal scalp swelling and right cervical lymphadenopathy. CT scan showed irregular bony destruction of the frontal bone. MRI revealed a large extradural, multiseptate, solid-cystic lesion with peripheral enhancement. FNAC from the lesion showed granulomas with caseation suggestive of tuberculosis. The lesion was debrided and she was started on anti-tubercular therapy...
October 2016: Asian Journal of Neurosurgery
Ayman A El Shazly, Mohammed A El Wardany, Tamer A Abo El Ezz
CONTEXT: Many reconstructive techniques have been proposed to prevent postoperative cerebrospinal fluid (CSF) leakage after trans-sphenoidal pituitary surgery. However, no total agreement has been reached to the best technique. AIM: Assessment of the efficacy of sellar repair with autologous muscle and composite septal cartilage grafts for treatment of intraoperative and delayed postoperative CSF leakage following trans-sphenoidal pituitary surgery without the use of postoperative external lumbar CSF drain...
October 2016: Asian Journal of Neurosurgery
David O Udoh, Emmanuel Ibadin, Mojisola O Udoh
BACKGROUND: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not. OBJECTIVES: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria...
October 2016: Asian Journal of Neurosurgery
E Royaux, V Martlé, K Kromhout, E Van der Vekens, B J G Broeckx, L Van Ham, I Gielen
Compressive hydrated nucleus pulposus extrusion (HNPE) in dogs is defined as acute extradural compression by hydrated nucleus pulposus material at the level of the associated intervertebral disc. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosis of HNPE. The aims of this study were to determine the usefulness of unenhanced computed tomography (CT) and contrast enhanced CT (CE-CT), and the sensitivity and specificity of CE-CT, for detection of compressive HNPE. Using CE-CT, HNPE was visualised as a hypodense extradural compressive lesion with rim enhancement immediately dorsal to the intervertebral disc space, with a sensitivity of 91% and a specificity of 100%...
October 2016: Veterinary Journal
Maria Teresa Mandara, Luca Motta, Pietro Calò
In cats, lymphoma (lymphosarcoma) is the most common neoplasm affecting the spinal cord and the second most common intracranial tumour. Although lymphoma commonly develops in the spinal cord as a part of a multicentric process, a primary form may occur. Lymphoma can exhibit a wide range of morphological patterns, including intraparenchymal brain mass, lymphomatosis cerebri, intravascular lymphoma, lymphomatous choroiditis and meningitis, extradural, intradural-extramedullary or intramedullary lymphoma in the spinal cord, or neurolymphomatosis in the peripheral nerves...
October 2016: Veterinary Journal
Alberto Schreiber, Davide Mattavelli, Marco Ferrari, Vittorio Rampinelli, Davide Lancini, Francesco Belotti, Luigi Fabrizio Rodella, Piero Nicolai
BACKGROUND: Over the past decade, the treatment of complex intradural and extradural pathologies via expanded endonasal approaches has been made possible by progresses and refinements in skull base reconstruction techniques. The aim of this anatomic study is to describe a novel endonasal flap, the turbinal flap (TF), based on the middle and superior turbinate mucosa and pedicled on the ethmoidal arteries system. METHODS: Three fresh-frozen (6 sides) cadaver heads previously injected with colored silicone were dissected...
September 21, 2016: International Forum of Allergy & Rhinology
Soheila Raysi Dehcordi, Alessandro Ricci, Alessandro Chiominto, Danilo De Paulis, Hambra Di Vitantonio, Renato J Galzio
BACKGROUND: Extradural spinal mass lesions are most commonly metastatic tumors. Extradural meningiomas are rare, accounting for approximately 2.5-3.5% of spinal meningiomas; intraoperatively, they are easily mistaken for malignant tumors, especially in the en plaque variety, resulting in inadequate surgical treatment. CASE DESCRIPTION: Our case is one of the first to describe a patient with two purely extradural meningiomas, one each between D3-D4 and between D5-D6 vertebral levels...
2016: Surgical Neurology International
A Najjar, F Zairi, T Sunna, A Weil, L Estrade, A Weill, D Shedid
BACKGROUND: Vascular lesions of the spinal cord are increasingly recognized. The most common types of these lesions are dural arteriovenous fistulas (AVFs) whereas, extradural AVFs are a very rare type of spinal AVF and can be associated with either extradural or intradural venous reflux. This results in neurological deficits through congestive or compressive myeloradiculopathy. These lesions must be treated to allow stabilization or improvement of neurologic status, either by endovascular therapy or microsurgical interruption...
September 8, 2016: Neuro-Chirurgie
Mouna Khmou, Abderrahmane Malihy, Najat Lamalmi, Lamia Rouas, Zaitouna Alhamany
BACKGROUND: Peripheral primitive neuroectodermal tumors are extremely rare tumors in the spine; only 18 cases of extra-dural peripheral primitive neuroectodermal tumor cervical region have been reported. The aim of this report is to highlight the challenges in diagnosis and management of this condition. CASE PRESENTATION: We present a case of 5-year-old Moroccan boy, who presented with torticollis for 1 month. Computed tomography scan and Magnetic resonance imaging of the cervical spine revealed an extradural, dumbbell-shaped mass with extra-spinal extension at the left C1-C6 level...
2016: BMC Research Notes
R S Satter, S H Shantana, D S Asif, K Bhowmick, S S Gaddam
Extradural and epicranial pneumatocele is a rare condition. It may complicate with CSF rhinorrhoea and meningitis which can have a fatal outcome. We present a case of delayed post-operative extradural and epicranial pneumatocele in the frontal region following primary repair of the anterior skull base for a traumatic compound craniofacial injury with CSF leakage. There was no evidence of meningitis or raised ICP. As the patient was neurologically stable; he was managed conservatively and had a spontaneous resolution of the pneumatocele...
July 2016: Mymensingh Medical Journal: MMJ
Mark Bustoros, Cheddhi Thomas, Joshua Frenster, Aram S Modrek, N Sumru Bayin, Matija Snuderl, Gerald Rosen, Peter B Schiff, Dimitris G Placantonakis
Background. Extraosseous Ewing's sarcoma in the spinal epidural space is a rare malignancy, especially in adults. Case Presentation. A 40-year-old male presented with back pain and urinary hesitancy. MRI revealed a thoracic extradural mass with no osseous involvement. He underwent surgery for gross total resection of the mass, which was diagnosed as Ewing's sarcoma. He was subsequently treated with chemoradiotherapy. He remains disease-free 1 year after surgery. Review of the literature indicated only 45 previously reported cases of spinal epidural extraosseous Ewing's sarcoma in adults...
2016: Case Reports in Neurological Medicine
Atsushi Arai, Hirohito Miyamoto, Ryoji Shiomi, Shotaro Tatsumi, Eiji Kohmura
Spontaneous cerebrospinal fluid leak and intracranial hypotension associated with cervical spondylosis have rarely been observed, and only a few cases are reported. A 69-year-old woman, previously treated for rectal and thyroid cancer, complained of a non-postural persistent headache. The patient regularly practiced aerobic exercise, but a month earlier she had started experiencing headache and neck pain while exercising. Computed tomography(CT)showed bilateral chronic subdural hematomas, and magnetic resonance imaging(MRI)revealed diffuse dural enhancement and tonsillar herniation...
September 2016: No Shinkei Geka. Neurological Surgery
Omur Gunaldi, Hakan Kina, Osman Tanriverdi, Uzay Erdogan, Lütfi Şinasi Postalci
OBJECTIVE: In recent years, endoscope started to be used for the excision of the brainstem lesions or those localized in the anterior part of the brainstem. In this paper a case of clival meningioma resected through endoscopic endonasal transclival route has been presented with illustrations, live surgery videos demonstrating the surgery step by step. CASE REPORT: A 35-year-old male patient consulted to us with dysphagia,and impaired consciousness. MR imaging detected a mass lesion with a wide base localized clivus and anterior part of brainstem...
May 25, 2016: Turkish Neurosurgery
Erhan Emel, Anas Abdallah, Özden Erhan Sofuoğlu, Ali Ender Ofluoğlu, Müslüm Güneş, Betül Güler, Bilge Bilgiç
AIM: Spinal schwannomas (SS) represent the most common intradural extramedullary lesions, accounting for approximately 24% of all nerve sheath tumors in adults. In this study, long-term outcomes of 49 consecutive SS have been presented. MATERIAL AND METHODS: Medical records were retrospectively reviewed in 371 cases of spinal tumors who underwent surgery between the years 2005 and 2014. Cases which confirmed as schwannoma histopathologically were included in this study...
October 22, 2015: Turkish Neurosurgery
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