World Neurosurg
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Case Reports
Agenesis of the Anterior Falx Cerebri in a Patient with Planned Interhemispheric Approach to a Third Ventricle Mass.
Complete or partial agenesis of the falx cerebri may occur in pediatric patients with developmental anomalies. However, isolated agenesis of the falx in a developmentally normal adult is exceptionally rare. We describe the first reported case of a patient with a third ventricular mass associated with partial agenesis of the anterior falx cerebri, a circumstance that influenced surgical access to a third ventricular epidermoid cyst. ⋯ Partial agenesis of the falx cerebri is exceedingly rare in a developmentally normal adult, particularly in the presence of an anatomically normal superior sagittal sinus. If present, however, it is important to note this association preoperatively because partial agenesis of the falx cerebri precludes an interhemispheric transcallosal approach to the lateral and third ventricles.
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We report the availability of a newly developed, malleable, tin-alloyed omnidirectional retractor-supporting (OD) ring for steady and safe ventriculoperitoneal (VP) shunt laparotomy. ⋯ Our newly developed retraction system with a malleable, tin-alloyed OD ring and minihooks may allow safe and steady small laparotomy for VP shunt.
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Recognition of transdural spinal cord herniation has increased over the past decade. This condition remains little known, particularly outside the specialized fields of spinal surgery and neuroradiology, leading to a significant delay in clinical diagnosis and treatment. ⋯ We describe our surgical experience to untether the spinal cord by wrapping a dura graft around the spinal cord. Three case reports and a review of the literature are discussed.
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Two-dimensional radiographic methods have been proposed to evaluate the radiographic outcome after indirect decompression through extreme lateral interbody fusion (XLIF). However, the assessment of neural decompression in a single plane may underestimate the effect of indirect decompression on central canal and foraminal volumes. The present study aimed to assess the reliability and consistency of a novel 3-dimensional radiographic method that assesses neural decompression by volumetric analysis using a new generation of intraoperative fan-beam computed tomography scanner in patients undergoing XLIF. ⋯ Here we demonstrate a new volumetric analysis technique that is feasible, reliable, and reproducible amongst independent raters for central canal and foraminal volumes in the lumbar spine using an intraoperative computed tomography scanner.
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The age of closure of skull base synchondroses has never been analyzed in a homogenous population of children with Crouzon syndrome. ⋯ In children with Crouzon syndrome, synchondrosis closure occurs prematurely, with a time course specific to each synchondrosis.