World Neurosurg
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Case Reports
Management of Recurrent Glossopharyngeal Neuralgia Following Microvascular Decompression Surgery.
Glossopharyngeal neuralgia (GPN) is a rare condition, commonly misdiagnosed as trigeminal neuralgia. Microvascular decompression (MVD) is considered the first line of treatment in medically refractive idiopathic GPN, and the recurrence rate is reported to be 7.1%. We present our first case report on the surgical management of a patient with recurrent GPN and analyze the possible causes for recurrence after MVD. ⋯ MVD is considered the first line of treatment in drug-resistant idiopathic GPN. Thorough exploration of REZ for small arteries and veins is mandatory to prevent recurrence. Vascular compression can occur at the cisternal portion or at the REZ. In recurrent cases, splitting of the glossopharyngeal nerve rootlets adds to the good outcome.
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Case Reports
Minimally Invasive Translaminar Endoscopic Approach to Percutaneous Vertebroplasty Cement Leakage: Technical Note.
Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty are 2 common procedures that could be applied simply in treatment of vertebral compression fractures. Despite simplicity and safe application of these procedures, there are some drawbacks as well. Cement leakage into the spinal canal is the most common complication of PVP and PKV procedures. The aim of this article is to present a minimally invasive alternative technique for removing cement leakage fragment after the PVP. ⋯ Endoscopic translaminar approach could be safely performed in patients with symptomatic cement leakage after PVP or a percutaneous kyphoplasty procedure.
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Vestibular schwannomas (VSs) can cause serious neurological defects including hearing loss and facial paralysis. The aim of this study is to identify whether Hippo signaling could be a potential targetable pathway for clinical treatment in VSs. ⋯ Our findings implicate that deregulation of the Hippo pathway as a molecular mechanism of pathogenesis in human VSs, and suggest inhibition of this pathway as a potential treatment strategy.
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The optimal treatment of recurrent primary central nervous system lymphoma (PCNSL) has not yet been determined. We report a patient with recurrent PCNSL who has been successfully treated with stereotactic brachytherapy (SBT) with iodine-125 seeds plus temozolomide (TMZ). ⋯ To our knowledge, this is the first case of recurrent PCNSL successfully treated with SBT plus TMZ. Further randomized studies are needed to confirm the therapeutic impact of this new method.
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Case Reports
Unusual Clinical Sequelae of Kawasaki Disease-Symptomatic Extracranial Internal Carotid Stenosis in Young Adult.
Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects the coronary artery, but it does not commonly affect the carotid artery. Cerebral infarction (CI) with internal carotid artery stenosis (ICS) in patients with KD has not been reported until now. We report a patient with CI as a remote-phase complication of KD. ⋯ KD in childhood may cause symptomatic ICS as a sequela of a remote phase.