World Neurosurg
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Case Reports
Endoscopic Transnasal Transclival Resection of Endodermal CYST of the Ventral Brainstem: Case Report.
Endodermal cysts are a rare pathology of the central nervous system located mostly in the upper thoracic or cervical regions. Seldomly, the cysts are found intracranially, most often in the subtentorial area (on the ventral surface of the brainstem, pontocerebellar angle, and fourth ventricle). Traditional approaches to the ventral surface of the brainstem are complicated and traumatic, and they do not provide a good view of the tumor's central and contralateral parts. In this case report, we present an alternative approach for resection of the endodermal cyst on the ventral surface of the brainstem. ⋯ The main advantage of the transclival transnasal approach is the direct access to the clivus and ventral surface of the brainstem without traction of the cerebral structures. If the transsphenoidal transclival approach is used, the cranial nerves are out of the approach area that minimizes the risk to damage it. An extended transsphenoidal transclival endonasal endoscopic approach is an alternative to traditional microsurgical approaches to pathologic processes on the ventral surface of the brainstem (cavernomas, endodermal cysts), located centrally.
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We report a case of ruptured massa intermedia (MI) as a sequela of hydrocephalus. ⋯ Absent MI is not uncommon in hydrocephalic patients, and it is assumed to be the result of rupture from acute dilatation of the third ventricle. Our case report proves this assumption and documents the presence and absence of the MI before and after developing hydrocephalus.
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The purpose of this study is to discuss the causes of implant migration after cervical arthroplasty with clinical cases. ⋯ The following situations should be considered in the prevention of dislocation and migration of the implant in cervical arthroplasty: protection of the structure of the end plate, selection of the appropriate implant size, and proper surgical construction. In the preoperative period, computed tomography scan may be useful for determining the implant size and details of the bone structure. Foreign body reactions or postoperative trauma may be a rare and unpreventable reason for prosthesis dislocation despite all of the preoperative and perioperative measures and well-made prosthesis designs.
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Case Reports
Mutational analysis of recurrent meningioma progressing from atypical to rhabdoid subtype.
Rhabdoid meningioma is rare aggressive meningioma histological subtype that develops predominantly through progression from less malignant tumors. Owing to its low incidence, this tumor's biological background is unknown. The aim of this study was to profile somatic mutations in 4 meningioma samples from the same patient, derived previously from 4 subsequent tumor resections. ⋯ The mutation of ARID1A that encodes the subunit of the SWI/SNF complex represents the most likely driver of the tumor's malignant potential. It also may be involved in the acquisition of the rhabdoid phenotype, given that mutations in chromatin remodeling proteins are the hallmark of atypical teratoid/rhabdoid tumors.