World Neurosurg
-
Case Reports
Obstructive hydrocephalus secondary to enlarged Virchow-Robin spaces: A rare cause of pulsatile tinnitus.
Obstructive hydrocephalus secondary to enlarged Virchow-Robin Spaces (VRS) is a rare entity, with only a few cases reported in the literature. Presenting symptoms vary widely from headaches to dizziness. ⋯ This is the first case of obstructive hydrocephalus secondary to enlarged VRS, presenting with pulsatile tinnitus.
-
Case Reports
Recrudescence of symptoms of remote ischemic stroke after a cerebral angiogram: Report of a case.
Ischemic stroke recrudescence, or reappearance of previously resolved symptoms of ischemic stroke, may occur after physiologic stress. Although generally thought to be uncommon, this syndrome may account for a significant proportion of stroke mimics. ⋯ Recrudescence of symptoms of a previous stroke may be initiated by subarachnoid hemorrhage and/or a cerebral angiogram. The possibility of ischemic stroke recrudescence should be kept in mind as a possible stroke mimic.
-
It is sometimes difficult to make a differential diagnosis between brain metastases and hemangioblastomas in the posterior fossa. We assessed whether high b value diffusion-weighted image (DWI) at b = 4000 could differentiate these tumors. ⋯ High b value DWI reflects diffusion more accurately than does regular b value. Our results showed that ADC calculation by high b value (b = 4000) DWI at 3-T magnetic resonance imaging is clinically useful for differentiating hemangioblastomas from brain metastases.
-
Intraoperative electrophysiology is increasingly used for various lesion resections, both in adult and pediatric brain surgery. Subcortical mapping is often used in adult surgery when lesions lie in proximity to the corticospinal tract (CST). We describe a novel technique of continuous subcortical mapping using an electrified Cavitron UltraSonic Aspirator (CUSA) in children with supratentorial lesions. ⋯ Continuous CUSA-based subcortical stimulation is a feasible mapping technique for assessing proximity to the CST during resection of supratentorial lesions in children. Future studies should be performed to better correlate the current threshold for eliciting a motor response with the distance from the CST, as well as the effect of age on this technique.
-
Brain abscesses cause substantial morbidity and mortality even after appropriate therapy, and no underlying cause is found in 25% of cases. We investigated the added utility of contrast-enhanced chest computed tomography (CT) in the diagnostic work-up of patients presenting with cerebral abscesses and no history or prior trauma or cranial surgery. ⋯ Contrast-enhanced chest CT is useful for identifying treatable causes of cerebral abscesses in patients with a cerebral abscess and no history of surgery or trauma.