World Neurosurg
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Intradural spinal arachnoid cysts (SACs) are among many etiologies for syringomyelia. Consequentially, neurologic symptoms arise such as pain, gait disturbance, and bladder dysfunction. Identification of SAC on magnetic resonance imaging (MRI) can be challenging, as SACs can be fenestrated or in the form of fine webs. ⋯ Careful evaluation of the MRI can demonstrate subtle indentation of the cord at the caudal or cephalad end of the syringomyelia and may obviate the need for additional imaging. Meticulous arachnoid dissection and establishment of good CSF flow is sufficient for resolution of the syringomyelia, averting the need for more aggressive procedures.
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Recent reports have validated the use of retrosigmoid approach extensions to deal with posterior fossa lesions extending laterally extracranially or superiorly into the petroclival areas. The purpose of our research is to describe the topographic retrosigmoid anatomy of the petrous pyramid and provide guidelines for neurovascular sparing drilling (hence for a functional petrosectomy), via this surgical route. ⋯ Knowledge of the topographic anatomy of the labyrinthine structures examined may be useful (combined with careful assessment of the preoperative imaging and with the use of neuronavigation and endoscopy) to accomplish a retrosigmoid neurovascular sparing petrosectomy.
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Lumbar arthrodesis is a surgical option for treatment of lumbar pathologies. Stability of the spinal construct partly depends on load-bearing support from back muscles. Despite the role of the psoas muscle in upright spinal stabilization, data describing its clinical significance are scarce. We evaluated the effects of the psoas muscle thickness on outcomes after lumbar fusion surgery. ⋯ This study shows that the psoas muscle can be beneficial in overall postoperative rehabilitation with early ambulation and greater improvement in functional outcomes. Given the role of the psoas muscle in spinal stabilization, the effect of psoas muscle thickness on postoperative functional outcomes warrants further investigation.
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Head and neck tumors are a heterogeneous group and often invade the skull base. Various radiation techniques can be used for these tumors when surgery is unavailable. This study investigated the indications for gamma knife radiosurgery (GKRS) in benign head and neck tumors. ⋯ GKRS is a reasonable alternative to surgery that can effectively control tumor growth and preserve functions of the head and neck in primary, residual, or recurrent benign head and neck tumors.
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Meningiomas arising in pediatric populations are rare neoplasms with distinct biological and clinical features. A rare case of a 2-year-old boy with extremely large intracranial parasagittal meningioma is presented. To our knowledge, this case is the largest parasagittal meningioma to be reported to date in the pediatric age group. ⋯ The patient's postoperative recovery was unremarkable, and the previously compressed brain rebounded. There was no evidence of recurrence after two years of follow-up. Every effort should be exerted to achieve radical resection of the tumor, which can result in a satisfactory prognosis and a low recurrence rate.