World Neurosurg
-
Grade III Spetzler-Martin brain arteriovenous malformations (AVMs) are a specific set of AVMs with high variability in terms of site, size, angioarchitecture, flow dynamics, and involvement of eloquent areas. Surgery preceded by preoperative embolization has been reported as a useful treatment option for these lesions. The aim of this study is to report outcomes and personal experience of combined preoperative Onyx embolization and surgical resection on a consecutive series of grade III brain AVMs. ⋯ In our experience, preoperative Onyx embolization helped the surgical management of grade III Spetzler-Martin brain AVMs. Careful evaluation of the angioarchitecture, a tailored strategy in the embolization process, and full cooperation within the neurosurgical-neuroendovascular team are mandatory.
-
Endoscopic endonasal surgery has evolved in recent decades, requiring comparable advances in reconstructive techniques. This study aimed to retrospectively review outcomes of endoscopic anterior skull base reconstruction and to analyze factors associated with failures. ⋯ Endoscopic surgery is safe and effective for anterior skull base reconstruction. Refinements in surgical technique and increasing experience have contributed to improved success rates.
-
Case Reports Comparative Study
A Comparative Report on Intracranial Tumor-to-Tumor Metastasis and Collision Tumors.
The incidence of 2 distinct tumor types occupying the same anatomic location is rarely observed and may be accounted for by 2 separate mechanisms: tumor-to-tumor metastasis and collision tumors, where 2 adjacent tumors invade one another. These rare phenomena arise from distinct mechanisms, which may affect their preoperative recognition, surgical approach, and postoperative care. We review 2 cases, highlighting their identification and perioperative management. ⋯ Preoperative recognition of collision tumor and tumor-to-tumor metastasis is imperative for surgical planning, including selecting regions for tissue biopsy and goals of care. Meticulous evaluation of history and imaging and thorough pathologic analysis allow for effective diagnosis and optimal patient outcomes.
-
To investigate the incidence, distribution characteristics, and radiographic features of the ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the nuchal ligament (ONL) and to analyze the correlation between the location of ONL and degree of ossification in patients with cervical OPLL. ⋯ The incidence of ONL was 54.4% in patients with cervical OPLL, and male patients were affected more than female patients. ONL occurred most in segment C5-C6. The location of local-type ONL commonly corresponded to the segment with the largest COR of OPLL when type of OPLL was circumscribed.
-
Metastatic vertebral compression fractures pose a significant clinical problem to cancer patients including pain, spinal deformity, and neurologic deficit. Treatment of metastases to the spine is complex and challenging and may require local and systemic therapies. ⋯ Complications of PVP in malignant compression fractures are more common than in nonmalignant ones. We present 1 case of tumor seeding along the needle tract of a breast cancer patient who had undergone PVP.