World Neurosurg
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Keyhole craniotomy is a type of pterional craniotomy that involves a minimally invasive approach for the treatment of cerebral aneurysms. Currently, the minipterional keyhole craniotomy and supraorbital keyhole craniotomy procedures are frequently performed. ⋯ The success solely depends on careful selection of patients and the experience of the surgical team.
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Focal cortical dysplasia (FCD) is one important cause of drug-resistant epilepsy potentially curable by epilepsy surgery. We investigated the options of using neuronavigation and intraoperative magnetic-resonance tomographical imaging (MRI) to avoid residual epileptogenic tissue during resection of patients with FCD II to improve seizure outcome. ⋯ Excellent seizure outcome after surgery of patients with FCD II positively correlated with the amount of resection, histologic subtype, and the use of intraoperative MRI, especially when intraoperative second-look surgeries were performed.
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Bilateral trigeminal neuralgia is a relatively rare disease. Microvascular decompression (MVD) is a safe and effective treatment for unilateral trigeminal neuralgia; however, its utility in bilateral trigeminal neuralgia is unclear. Here, we report our experience with MVD in 13 cases of primary bilateral trigeminal neuralgia. ⋯ Vascular compression plays a causative role in bilateral and unilateral trigeminal neuralgia. MVD appears to be a safe and effective treatment option in patients who are refractory to pharmacotherapy.
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Although a subdural fluid collection frequently is observed, diagnostic methods that differentiate between the subdural collection caused by external hydrocephalus and that caused by subdural hygroma have not been established. Here, we report a case of external hydrocephalus caused by Gliadel-induced eosinophilic meningitis that has been previously reported in only 1 case and can be diagnosed by time-spatial labeling inversion pulse magnetic resonance imaging (time-SLIP MRI). ⋯ In the present case, time-SLIP MRI was a useful and noninvasive method for diagnosing external hydrocephalus which was caused by eosinophilic meningitis because of Gliadel-induced eosinophilic meningitis.
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We report a case of Mikulicz disease (MD), an immunoglobulin G4 (IgG4)-related disease that affects the lacrimal and salivary glands. IgG4-related disease is a relatively new clinical entity and is not commonly encountered by neurosurgeons. MD sometimes mimics intraorbital tumors such as malignant lymphoma but responds well to corticosteroid treatment. Thus it is important to recognize the clinical and radiographic features of MD.