Journal of neurosurgery
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Journal of neurosurgery · Apr 2004
Metastatic prostate carcinoma to the intradural extramedullary spinal compartment. Case report.
Despite the relatively high incidence of prostate carcinoma involving the spinal column, those that are associated with spinal intradural extramedullary metastases are rare. The role of surgery for metastases to this spinal compartment is limited and palliative because presentation tends to be late in the course of the disease, particularly for prostate carcinoma. It is also considered to be part of the spectrum of leptomeningeal carcinomatosis and is associated with a high incidence of brain metastases. The authors review a rare case of prostate carcinoma metastatic to the spinal intradural extramedullary space and discuss its clinical presentation, imaging features, and surgical management.
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Journal of neurosurgery · Apr 2004
Case ReportsCough induced by ossification of the ligamentum flavum in the high cervical spine. Case report.
The authors report a very rare case of high cervical ossification of the ligamentum flavum (OLF) in a 40-year-old woman who developed an intractable cough after a traffic accident. The patient's symptoms subsided immediately after decompressive laminectomy and removal of the lesion. To the authors' knowledge, this is the first reported case of high cervical OLF in a patient who presented with a cough. The pathophysiological mechanism underlying the cough was determined to be symptomatic of high cervical spine OLF.
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Journal of neurosurgery · Apr 2004
Clinical TrialCombined treatment of advanced stages of recurrent skin cancer of the head.
The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head. ⋯ Advances in skull base surgery and free-flap reconstruction allowed the authors to treat patients with advanced-stage RSC of the head in a rather satisfactory manner. Only when it is impossible to achieve no or minimal residual disease should aggressive treatment be considered.
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Little has been written about the appropriate diagnosis, investigation, and management of subarachnoid-pleural fistula (SPF). The authors report a series of patients with SPF that developed after resection of spinal tumor and discuss the diagnosis and treatment of this entity. ⋯ After spinal surgery in which the thorax is entered, a diagnosis of SPF should be considered in any patient with abnormal chest tube output, persistent pleural effusion, or clinical evidence of intracranial hypotension. The diagnosis should be confirmed by performing a radionuclide-labeled CSF study. Definitive open repair is required in most cases and preferentially consists of a vascularized tissue graft, which is most easily obtained from an intercostal muscle flap.
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Journal of neurosurgery · Apr 2004
Case ReportsOligodendroglioma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors. Case report with histological and molecular differentiation of the tumors and review of the literature.
Multiple metastatic brain tumors and multifocal primary brain tumors of a single histological type are well described in the literature. The concurrent presence of multiple primary brain tumors with different histological characteristics, however, is very rare. The authors describe the first known case in which an oligodendroglioma and a juvenile pilocytic astrocytoma (JPA) presented as synchronous primary brain tumors in the same patient. ⋯ His condition remains stable both neurologically and according to imaging studies. The authors describe the first known case in which a low-grade oligodendroglioma and a JPA presented as synchronous primary brain tumors. They review the literature on multiple primary brain tumors with different histological characteristics and discuss potential mechanisms for the development of these lesions.