World Neurosurg
-
To report a single case of malignant transformation of a vestibular schwannoma after radiosurgery and review the growing body of literature describing patients with malignant transformation of primary benign tumors after radiosurgery, including vestibular schwannoma. ⋯ Malignant vestibular nerve tumors are extremely rare; only 18 cases have been reported in the literature. Our patient is the sixth pathologically confirmed case of malignant transformation after radiosurgery, supporting the contention that radiosurgery itself may play a causative role in transformation. In a histologically benign lesion, the presence of an elevated MIB-1 labeling index may predispose toward malignant transformation in the setting of adjuvant radiosurgery.
-
The use of dural grafts is very useful when primary dural closure cannot be achieved. Our primary objective was to study the incidence of postoperative cerebrospinal fluid leak, including fistula and pseudomeningocele, and postoperative infection by comparing autologous material and a new collagen graft. ⋯ The new collagen-based product derived from porcine cells (Peridry), compared with an autologous tissue, is safe, effective, easy to use, as well as time saving in cranial neurosurgery.
-
The purpose of this study is to investigate trends in the incidence of subarachnoid hemorrhage (SAH) in South Korea from 2006-2009. ⋯ The age-adjusted incidence rates of SAH were slightly decreased in South Korea. Further research should be conducted to identify the clinical risk factors to reduce SAH incidence rates even more, especially in younger people.
-
Accurate image guidance is an essential component of percutaneous procedures in the head and neck. The combination of preprocedural magnetic resonance imaging (MRI) with cone-beam computed tomography (CBCT) and real-time fluoroscopy (the "triple-overlay" technique) could be useful in image-guided targeting of lesions in the head and neck. ⋯ The combination of MRI, CBCT, and real-time fluoroscopy provides detailed anatomical information for 3D image-guided percutaneous procedures of the head and neck, especially for small lesions or lesions with features visible only by MRI.
-
This study sought to describe a patient with a slowly progressive cauda equina syndrome (CES) who had imaging findings of the CES that occurs as a rare complication of ankylosing spondylitis (AS), but whose spinal fusion was due to thoracolumbosacral instrumentation, not spondyloarthropathy. ⋯ This case strongly suggests that extensive surgical thoracolumbosacral fusion can, rarely and after many years, be associated with lumbosacral nerve root damage and a slowly progressive CES that is similar to that seen in patients with spinal fusion due to longstanding AS.