World Neurosurg
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Dermoid and epidermoid cysts are among the most frequent lesions of the scalp in the pediatric population. Optimal management of a suspected dermoid or epidermoid cyst in children is debated: Some authors advocate conservative management on the basis of the benign histology of these entities, while others prefer surgical excision. ⋯ Excision of dermoid and epidermoid cysts is a safe procedure for neurosurgeons dealing with this disease, even in young patients. Early resection is recommended due to the potential adverse effects that may occur if these cysts are left untreated.
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Review Case Reports
A rare case of spinal cavernous hemangioma dumbbell shaped and a literature review.
Spinal epidural cavernous hemangiomas are rare vascular malformations. Exceptionally, they present with dumbbell-shaped morphology. When they happen, it's mandatory to include their pathology in the differential diagnosis because of their similarity to schwannomas. ⋯ Surgery is safe and effective in both improving patient condition and preventing acute hemorrhage that can worsen the outcome, causing neurologic and potentially irreversible deficits. The favorable result we obtained in our patient suggests that surgery should be evaluated as the first option, even in patients with large epidural cavernous hemangiomas.
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Review Case Reports
Shunt surgery for neurocutaneous melanosis with hydrocephalus: case report and review of the literature.
Neurocutaneous melanosis is a rare phakomatosis characterized by large or multiple pigmented nevi and melanosis of the leptomeninges. It is often complicated by hydrocephalus due to melanotic deposits interfering with cerebrospinal fluid reabsorption in the basal cisterns or causing foraminal or aqueductal obstruction. In 10% of cases, it will be associated with the Dandy-Walker complex. ⋯ The results of the present case and the findings from a review of related data suggest that shunt insertion (ventriculoperitoneal or cystoperitoneal) is an effective palliative measure for patients with neurocutaneous melanosis with associated hydrocephalus. Despite treatment, however, the prognosis of these patients remains poor owing to malignant progression and leptomeningeal spread of lesions, in particular, in cases associated with the Dandy-Walker complex.
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Low-grade glioma (LGG) usually occurs in young patients who enjoy an active family, social, and professional life. Because awake surgery for patients with LGG has resulted in significant improvement in both functional and oncological outcomes and because the surgery per se is not very expensive, it is currently performed in many countries worldwide. Nonetheless, in addition to the necessity of tailoring the surgical strategy to the patient (e.g., neurological and cognitive status) and tumor (e.g., brain location and volume) characteristics, the legal, cultural, and socioeconomic parameters could also play a key role in the therapeutic strategy. ⋯ These criteria are relevant with respect to the diagnosis, surgery, functional remediation, and long-term follow-up for patients who now benefit from a longer life expectancy. However, although such factors are essential to resume an active life, including returning to work, they vary greatly across countries. Therefore, they should be considered more systematically to allow for greater reproducibility of results of awake surgery worldwide.
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The purpose of the present study was to assess for gender-based differences in the usage and cost of maximal nonoperative therapy before spinal fusion surgery in patients with symptomatic lumbar stenosis or spondylolisthesis. ⋯ These results suggest that gender differences exist in the use of nonoperative therapies for symptomatic lumbar stenosis or spondylolisthesis before fusion surgery.