World Neurosurg
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Review Biography Historical Article
Edwin Boldrey and Wilder Penfield's homunculus: a life given by Mrs. Cantlie (in and out of realism).
For nearly 90 years, notions of the brain have been inextricably associated with a homunculus that has become embedded within medical education as the precise representation of rolandic cortical function. We sought to define the history, evolution, accuracy, and impact of this pictorial means of showing cortical representation. ⋯ Discrepancy between cortical perpendicular length attributed to a particular function on 1937 diagrams was greater than that attributed on the 1950 homunculus (motor: mean, 74%; range, 63%-96%; sensory: mean, 66%; range, 17%-92%) (P < 0.05). The homunculus, if truly drawn according to cortical mapping evidence, could never have been recognized as near humanoid, yet it has attained epic educational and practical longevity.
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Review Case Reports
Intracranial multiple pseudotumor due to immunoglobulin G4-related disease without other lesion: case report and literature review.
Immunoglobulin (Ig)G4-related disease (IgG4-RD) was defined only recently and can be found in many organs. As intracranial lesions, hypophysitis and pachymeningitis are well known, whereas intracranial pseudotumor is unusual. This case involved multiple intracranial pseudotumors without extracranial lesions, mimicking multiple meningioma. ⋯ This case demonstrates IgG4-RD mimicking meningioma with multiple masses but without extracranial lesions. This case and previous descriptions suggest the possibility of pseudotumor due to IgG4-RD in the presence of multiple extra-axial lesions at the dura and supplying artery, hard nodules with thickening of the artery, and frozen section findings of lymphoplasmacytes surrounded by rich collagen fibers. In such cases, the pseudotumor due to IgG4-RD should be resected, and total resection might not be warranted.
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Review Historical Article
Re-Resection And Intraoperative Radiotherapy For Malignant Gliomas Of The Brain: A History And Review Of Current Techniques.
The degree of primary resection of malignant brain gliomas (MBGs) has correlated positively with progression-free and overall survival. The indications for surgery and reoperation in MBG relapse remain controversial. ⋯ We reviewed the reported studies with respect to repeat resection and the various methods of intraoperative radiotherapy for MBGs from the initial experience with high-energy linear accelerators in Japan to modern, integrated brachytherapy solutions using solid and balloon applicators. Because of the findings from our review, we have begun to research into the use of intraoperative balloon brachytherapy for recurrent MBGs.
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Review Case Reports
Adult-onset mixed germ cell tumor composed mainly of yolk sac tumor around the pineal gland: a case report and review of the literature.
Mixed germ cell tumors (MGCTs) usually occur in children. In the present report, we discuss an extremely rare case of adult-onset MGCT composed mainly of yolk sac tumor (YST) around the pineal gland. ⋯ The present case highlights the need for clinicians to include YST in the differential diagnosis of acute progressive lesions around the pineal region, even in adult patients.
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Review Case Reports
Flow-Diverter Stent for an Unruptured Aneurysm at the Junction of the Internal Carotid Artery and Persistent Primitive Trigeminal Artery: A Case Report and Literature Review.
Persistent primitive trigeminal artery (PPTA), which is a fetal carotid-basilar anastomosis, is the most common embryologic vascular remnant persisting in adults. Aneurysms can arise between the internal carotid artery (ICA) and PPTA. Here we present a case of ICA-PPTA aneurysm treated with a flow-diverter stent. ⋯ This is the first case report of ICA-PPTA aneurysm successfully treated with a flow-diverter stent. We could stop blood flow from the posterior circulation by embolizing the PPTA with a coil, allowing the use of a flow-diverter stent. This report can be used as a reference for the procedure in future work.