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Francisco Vaz-Guimaraes, Maria Koutourousiou, John R de Almeida, Elizabeth C Tyler-Kabara, Juan C Fernandez-Miranda, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE Epidermoid and dermoid cysts may be found along the cranial base and are commonly resected via open transcranial approaches. The use of endoscopic endonasal approaches for resection of these tumors has been rarely reported. METHODS The authors retrospectively reviewed the medical records of 21 patients who underwent endoscopic endonasal surgery for epidermoid and dermoid cyst resection at the University of Pittsburgh Medical Center between January 2005 and June 2014. Surgical outcomes and variables that might affect the extent of resection and complications were analyzed...
March 16, 2018: Journal of Neurosurgery
Tsang Chun On Anderson, Yeung Wan Lung Ryo, Mak Ka Fung, Lui Wai Man
We report a case of unique location of an aneurysm at the atlanto-axial extradural segment of a unilateral aberrant vertebral artery. The MRI vessel wall imaging findings and possible mechanism of aneurysm formation were discussed. A 5 mm extracranial vertebral artery aneurysm located at the interlaminar space between C1 and C2 was diagnosed in a woman presenting with occipital headache. The index vertebral artery ran an aberrant course at the V3 segment, where it entered the dura between C1 and C2 instead of the usual atlanto-occipital space...
March 2018: Neurointervention
Talha Maqbool, Adam Binhammer, Paul Binhammer, Oleh M Antonyshyn
PURPOSE: Titanium mesh is used to reconstruct the neurocranium in cranioplasties. Though it is generally well-tolerated, erosion of the overlying soft tissue with exposure of the implant is a complication that adversely affects patient outcomes. The purpose of this study is to investigate potential risk factors for titanium mesh exposure. METHODS: This study comprises all consecutive patients who underwent titanium mesh cranioplasty between January 2000 and July 2016...
March 12, 2018: Journal of Craniofacial Surgery
Christine Senneca, Gabriel Garcia, Justin F Rosenberg, Darryl Heard, Erin Porter, Lilian Olivera, Lisa Farina
A neutered male Siberian tiger ( Panthera tigris altaica) presented with paraplegia of 5 days' duration. Thoracolumbar magnetic resonance imaging (MRI) revealed a focal, linear T2-W hyperintense intramedullary lesion at the level of T10-11 as well as reduced size of the nucleus pulposus of the T10-11 intervertebral disc. The animal was humanely euthanatized as a result of the severity of clinical signs and the poor prognosis. Gross necropsy revealed a dark red, firm focus on the spinal cord at the level of the T11 nerve roots...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Norman Ma, Sarah Mills, Craig McBride, Roy Kimble, Michael Redmond
BACKGROUND: Skateboarding is a popular recreation among children and adolescents. Injuries that result in presentation to emergency departments are varied including head injuries. The study aims to assess the type and severity of neurological damage to the brain and spine in children from injuries incurred while using a skateboard. METHODS: After obtaining Ethics approval, a retrospective case review was performed of all admissions to all Brisbane, Australia public hospital neurosurgery departments of children 18 years and less who experienced injuries to the brain and spine for the years 2010-2014...
March 6, 2018: ANZ Journal of Surgery
Kaan Yağmurlu, Michael A Mooney, Kaith K Almefty, Baran Bozkurt, Necmettin Tanriover, Andrew S Little, Mark C Preul
OBJECTIVE: To describe an endoscopic anterolateral surgical route to the lateral portion of Meckel's cave. METHODS: A sublabial transmaxillary transpterygoid approach was performed in 6 cadaveric heads (12 sides). A craniectomy was drilled between the foramen rotundum (FR) and foramen ovale (FO) with defined borders. Extradural dissection was performed up to the V2-V3 junction of the trigeminal ganglion. The working space was analyzed using anatomical measurements...
March 3, 2018: World Neurosurgery
Dong Keon Yon, Tae Keun Ahn, Dong Eun Shin, Gwang Il Kim, Moon Kyu Kim
BACKGROUND: Germ cell tumors (GCTs) in children are rare neoplasms with diverse pathological findings according to the site and age of presentation. The most common symptoms in children with mediastinal GCTs, which are nonspecific, are dyspnea, chest pain, cough, hemoptysis, vena cava occlusion syndrome, and fatigue/weakness. Because of these nonspecific symptoms, it is difficult to suspect a mediastinal mass. A posterior mediastinal tumor causing spinal cord compression is an important example of an oncologic emergency arising from a neurogenic tumor...
March 5, 2018: BMC Pediatrics
Xiaoping Yi, Moling Zhou, Shenghui Liao, Guanghui Gong, Hongling Yin, Yongheng Chen, Weihua Liao
AIM: To summarize the imaging features of spinal peripheral primitive neuroectodermal tumor (spPNET) patients. MATERIAL AND METHODS: The computed tomography (CT) and magnetic resonance imaging (MRI) features of ten spPNET patients were retrospectively analyzed, and the clinicopathological data were reviewed. RESULTS: Four men and six women with a mean age of 24.7 years (range, 3-44 years) were included. A total of ten spPNET lesions were found in the ten patients, including six extradural and four intradural extramedullary lesions...
January 9, 2018: Turkish Neurosurgery
Silky Chotai, Yi Liu, Songtao Qi
The lesions involving cavernous sinus (CS) and lateral sellar region includes tumors, vascular lesions, infection, inflammation, and trauma. Tumors associated with CS cause significant distortion of the microanatomy posing an additional surgical challenge to the neurosurgeons. The surgical approach and microsurgical anatomy with respect to the origin and growth of the tumor within the CS region have not been comprehensively described in recent years. We conducted a review of literature concerning CS and associated tumors, complied through MEDLINE/OVID and using cross-references of articles on PubMed with the keywords cavernous sinus, CS tumors, pituitary adenoma, meningioma, schwannoma, chordoma, CS hemangiomas, extradural, interdural, intradural, skull base, gamma knife radiosurgery, endoscopic endonasal approach...
January 2018: Asian Journal of Neurosurgery
Kiona Sharon de Nies, Ralph Alexander Edwards, Niklas Bergknut, Martijn Beukers, Björn Petrus Meij
BACKGROUND: Spinal cysts are rare findings in veterinary medicine, but they are increasingly recognized due to the availability of advanced imaging techniques. Extradural meningeal cysts in French Bulldogs have not been reported previously and arachnoid cysts (diverticula) have not been reported at the caudal lumbar (L6-L7) region in dogs. CASE PRESENTATION: Two French Bulldogs, aged 5 and 8 years, were referred for evaluation of lower back pain and bilateral hind limb neurological deficits...
March 1, 2018: Acta Veterinaria Scandinavica
Dane H Slentz, Sunil Bellur, M Reza Taheri, M Isabel Almira-Suarez, Jonathan H Sherman, Tamer N Mansour
An elderly female with progressive proptosis was found to have an aggressive retrobulbar solid orbital mass. The mass was distinct from the optic nerve sheath and intracranial meninges, and produced concave erosion of the sphenoid wing. Operative findings demonstrated an orbital mass adherent to the dura of the superior orbital fissure. The mass did not demonstrate meningeal violation, infiltrate the superior orbital fissure, or display intracranial spread. The dura remained intact after gross total resection...
February 27, 2018: Orbit
I Tulloch, M C Papadopoulos
Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscectomy technique. This is the first report to date of a giant central L3/4 disc protrusion being successfully treated through a transdural microdiscectomy approach. Prior to this report, there have been just two cases describing its application in the lumbar spine...
February 27, 2018: Annals of the Royal College of Surgeons of England
Kazuyoshi Kobayashi, Kei Ando, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Naoki Ishiguro, Shiro Imagama
OBJECTIVES: Frozen sections are used to provide gross and rapid microscopic pathological information for guidance on intraoperative management and therapeutic decision-making. Many studies have shown the accuracy of frozen section diagnosis for intracranial lesions, but there are no studies focusing on spinal cord lesions. The purpose of this study is to evaluate the accuracy of intraoperative rapid diagnosis using frozen sections and to investigate limitations of this approach for spinal cord lesions...
February 16, 2018: Clinical Neurology and Neurosurgery
Ali Tayebi Meybodi, Michael T Lawton, Sonia Yousef, Xiaoming Guo, Jose Juan González Sánchez, Halima Tabani, Sergio García, Jan-Karl Burkhardt, Arnau Benet
Anterior clinoidectomy is a difficult yet essential technique in skull base surgery. Two main techniques (extradural and intradural) with multiple modifications have been proposed to increase efficiency and avoid complications. In this study, the authors sought to develop a hybrid technique based on localization of the optic strut (OS) to combine the advantages and avoid the disadvantages of both techniques. Ten cadaveric specimens were prepared for surgical simulation. After a standard pterional craniotomy, the anterior clinoid process (ACP) was resected in 2 steps...
February 23, 2018: Journal of Neurosurgery
Gorka Zabalo, Daniel de Frutos, Juan Carlos García, Rodrigo Ortega, Juan José Guelbenzu, Idoya Zazpe
We report a case of a 41 years old patient complaining of chronic dorsalgia. MRI showed a well defined intradural extramedular dumbbell-shaped lesion, associated to a left paravertebral tumor at D5-D6 level. The tumor was embolizated prior to surgery. Following she underwent a D4-D6 laminotomy, left D5-D6 costotransversectomy and resection of the intracanal extradural part of the lesion with section of the left D5 nerve. Posteriorly, complete resection of the extracanal portion of the tumor was performed by a postero-lateral approach...
February 19, 2018: Neurocirugía
Kaixiang Yang, Hongtao Chen, Jian Tang, Dawei Ge, Sheng Zhang, Tao Sui, Xiaojian Cao
STUDY DESIGN: Anatomic study in 6 formalin-fixed cadavers. OBJECTIVE: To determine the anatomical feasibility of transferring the S2 and S3 ventral roots (VRs) to S1 VR as a method for restoring bladder dysfunction in spinal cord injury. SUMMARY OF BACKGROUND DATA: A large quantity of researches of neuroanastomosis methods have been used for treating the bladder dysfunction in spinal cord injury (SCI). However, some limitations retard the development of those studies...
February 21, 2018: Spine
Michiari Umakoshi, Takao Yasuhara, Atsuhiko Toyoshima, Susumu Sasada, Akira Kusumegi, Jun Morimoto, Kyohei Kin, Yousuke Tomita, Isao Date
The spinal extradural arachnoid cyst is a rare entity. Obtaining the correct diagnosis and detecting the fistula location are critical for providing effective treatment. A 41-year-old man had numbness in the soles of his feet for 2 years with accompanying gait disturbance, and a defecation disorder. Computed tomography myelography performed at another hospital revealed an epidural arachnoid cyst from Th11 to L2. He received a subarachnoid-cyst shunt at the rostral part of the cyst. However, his symptoms worsened and he was admitted to our hospital...
February 2018: Acta Medica Okayama
Yoji Ogura, Shoji Yabuki, Shunsuke Fujibayashi, Eijiro Okada, Akio Iwanami, Kota Watanabe, Masaya Nakamura, Morio Matsumoto, Ken Ishii, Shiro Ikegawa
BACKGROUND: Spinal extradural arachnoid cyst (SEDAC) is a cystic lesion that protrudes into the epidural space from a small dural defect. Early diagnosis of SEDAC is important because its expansion causes neurological damage. Two types of SEDAC, syndromic and sporadic, are present. Syndromic SEDAC is inherited as a part of lymphedema-distichiasis syndrome caused by mutations in the FOXC2 gene; however, it is often mistaken as sporadic because of low penetrance. It is not reasonable to conduct a genetic testing for all SEDAC patients and their family members...
February 16, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Sahra Durnford, Harry Bulstrode, Andrew Durnford, Aabir Chakraborty, Nicholas T Tarmey
We report the case of a 69-year-old man admitted to the emergency department of a UK district general hospital with an extradural haematoma following closed head injury. He deteriorated rapidly before transfer to the regional neurosurgical centre and was treated with decompression of the extradural haematoma through an EZ-IO™ intraosseous needle in our department, with telephone guidance from the neurosurgeon. We believe this to be the first reported use of this technique in a district general hospital.
February 2018: Journal of the Intensive Care Society
Kazuaki Morizane, Shunsuke Fujibayashi, Bungo Otsuki, Takeshi Sakamoto, Ryosuke Tsutsumi, Seiichi Odate, Akira Kusuba, Shuichi Matsuda
BACKGROUND: Although a valve-like mechanism has been proposed for expansion of spinal extradural arachnoid cysts (SEACs), the detailed mechanism remains unclear. Moreover, closure of the communication site is essential during surgery, but the method to identify the communication site remains unclear. The aim of this study was to determine the detailed mechanism of expanding SEACs through retrospective analysis of SEAC cases undergoing surgery and to elucidate the characteristics of the communication sites...
February 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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