World Neurosurg
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Tolosa-Hunt syndrome (THS), a nonspecific chronic inflammation of the cavernous sinus, is a rarely needed surgical manipulation, even for diagnosis, because corticosteroid therapy is markedly effective against this condition. ⋯ This article presents details of surgical findings of THS that have not been demonstrated in any previous reports.
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Review Case Reports
What is the utility of postoperative antihelminthic therapy after resection for intraventricular neurocysticercosis?
Neurocysticercosis (NCC) is the most common worldwide parasitic infection of the central nervous system, and ventricular cysts are particularly problematic, carrying the risk of acute obstructive hydrocephalus. Herein, we present a typical case in which complete resection was possible and explore the evidence supporting the use of postoperative oral antihelminthic therapy. ⋯ This review produced surprising results: 1) the generous proportion of patients who underwent medical therapy as first-line treatment for intraventricular NCC (20.8%), and 2) the significant overall mortality. The data found in this review also provided for a strong consensus for the use of postresection antihelminthic therapy, and thus we elected to treat our index case with albendazole, assuming the risk to be low and the potential benefit meaningful.
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Case Reports
Atypical presentation of primary central nervous system non-Hodgkin lymphoma in immunocompetent young adults.
Primary central nervous system non-Hodgkin lymphoma (PCNSL) is a malignant lymphoma limited to the cranial-spinal axis in the absence of systemic lymphoma. Historically, PCNSL accounts for fewer than 5% of all cases of primary intracranial neoplasms. PCNSL is rare in immunocompetent young adults. Although the prognosis for PCNSL is poor, approximately 20%-30% percent of cases achieve a cure. ⋯ To our knowledge, this is the first report of primary CNS lymphoma of the choroid plexus and septum pellucidum in otherwise healthy, immunocompetent young adults.
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To understand better the scope of wrong-level lumbar spine surgery and current practices in place to help avoid such errors. ⋯ There is substantial heterogeneity in approaches used to localize operative levels in the lumbar spine. Existing safety protocols may not be mitigating wrong-level surgery to the extent previously thought.