World Neurosurg
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We aimed to identify the factors that can predict the risk of occipital lobe damage preoperatively when resecting tumors located at the tentorial or pineal regions with the occipital-transtentorial approach (Poppen approach). ⋯ The risk of occipital lobe damage increases in the presence of a steep tentorial angle during the Poppen approach for tentorial or pineal area tumors. Awareness of such anatomic features preoperatively is important for minimizing operative complications.
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Case Reports
Medullary decompression by sling repositioning of the Vertebral Artery with operative video: Technical Case Report.
Vascular compression of the medullary pyramid resulting in neurologic compromise is rare; therefore diagnosis is difficult and ultimately delayed. Most patients present with a combination of cranial nerve, autonomic, and/or motor and sensory dysfunction. Presentation with a single sign such as hemiparesis is rare. The low number of cases reported has made it impossible to define a standard treatment for this unusual disorder. ⋯ Vascular decompression using a sling has proven to be a valuable option for treatment of symptomatic vascular brainstem compression.
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Case Reports
Rotational Vertebral Artery Dissection Secondary to an Anomalous Entrance into Transverse Foramen: Case Report.
Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. ⋯ In the setting of codominant vertebral circulation and unilateral bony compression, the authors propose that neck rotation led to vertebral artery trauma, causing dissection complicated by thromboembolism. This is a novel and unusual entity that is different from Bowhunter's syndrome.
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Case Reports
Acute Bilateral Foot Drop as a Presenting Symptom of Hemorrhagic Synovial Cyst of the Lumbar Spine.
Acute bilateral foot drop is a rare clinical presentation. ⋯ Here, we describe a unique case of a hemorrhagic synovial cyst with a presenting symptom of acute bilateral foot drop.
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A hydatic cyst (HC) is a zoonotic infection affecting the liver and lungs, with rare spinal involvement. We discuss the long-term results in 8 patients with spinal HC who were monitored at our clinic for 7 to 15 years. ⋯ Spinal HC treatment is difficult, particularly in patients with vertebral and paraspinal involvement, spinal instability, and recurrence. Long-term follow-up is critical, and patients require medical and surgical treatment, with regular clinical, radiologic, and serologic examinations. The cysts must be removed without rupture during surgery, and the surgical area must be irrigated with hypertonic saline solution to reduce the risk of recurrence.