World Neurosurg
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Obstructive hydrocephalus secondary to posterior cranial fossa space-occupying lesions is common, and treatment includes shunting or removal of the causative lesion. The list of posterior fossa space-occupying lesions is exhaustive and includes tumors, cysts, and tumor-like conditions. ⋯ However, unrelated pathologies could coexist and may be overlooked. We hereby describe an unusual case of a posterior fossa cystic, suspected metastatic lesion presenting with moderate to severe hydrocephalus in a patient with oral cavity cancer on chemotherapy, which turned out to be cysticercosis on excision, leading to a diagnostic dilemma; hence the adage "cyst with a twist"!
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To retrospectively review the clinicopathologic features and computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbosacral intraspinal paragangliomas (PGLs). ⋯ Lumbosacral intraspinal PGLs should be considered when a mass appears as well defined or oval, and when a striated solitary homogeneous or heterogeneous mass is characterized by a tadpolelike appearance with a marked enhancement pattern. The fluctuation of blood pressure before and after surgery is an interesting clinical feature of lumbosacral intraspinal PGLs.
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Case Reports
Intraoperative Hypoglossal Nerve Mapping during Carotid Endarterectomy: Technical Note.
Hypoglossal nerve deficit is a possible complication caused by carotid endarterectomy (CEA). The accidental injury of the hypoglossal nerve during surgery is one of the major reasons for permanent hypoglossal nerve palsy. In this study, we investigated the usefulness of intraoperative mapping of the hypoglossal nerve to identify this nerve during CEA. ⋯ Intraoperative hypoglossal nerve mapping enabled us to locate the invisible hypoglossal nerve during the exposure of the internal carotid artery accurately without retracting the posterior belly of the digastric muscle and other tissues in the vicinity of the internal carotid artery.
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The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. ⋯ Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve.