World Neurosurg
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Case Reports
Contiguous Diastematomyelia with lipomyelomeningocele in each hemicord-An exceptional case of spinal dysraphism.
Split cord malformation (SCM) is a rare congenital anomaly of the spinal cord. Rarely, SCM coexists with a variety of dysraphic pathologies that occur at the same or different spinal level in a patient. Exceptionally rare is the occurrence of SCM type 1 and lipomeningomyelocele of each hemicord. ⋯ Management of such complex cases of spinal dysraphism is challenging. Delineating their embryologic basis, detailed radiologic assessment, and meticulous microneurosurgical techniques are the cornerstone for successful management.
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Superficial siderosis (SS) associated with craniopharyngioma is an extremely rare occurrence. To our knowledge, only 3 cases have been reported in literature. Two of the cases occurred following resection of the tumor. Similar to the present case, 1 of the cases was discovered before surgical intervention, "pure tumor-related" SS. The clinical presentation, diagnosis, management, and outcome are discussed in this article. ⋯ In the present case, SS could be associated with craniopharyngioma on the basis of CSF findings and clinical symptoms. Detection and early treatment aimed at eliminating the bleeding source offer the best chance of halting the disease process.
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Compression of the trigeminal nerve by vessels and tumors causes trigeminal neuralgia. However, a tethering effect, provoking an abnormal root-stretching force, has been previously reported to play a role in trigeminal nerve hyperexcitability. We report 2 patients with vestibular schwannomas treated by stereotactic radiosurgery (SRS) who presented with typical manifestations of trigeminal neuralgia after tumor shrinkage. Furthermore, we discuss the mechanisms of trigeminal neuralgia. ⋯ The present cases demonstrate a tethered effect of tumor shrinkage after SRS, which was considered to play a role in trigeminal neuralgia. Surgical dissection surrounding the nerve root is effective for medically resistant neuralgia, even if the tumor shrinks. Partial tumor removal is adequate in such cases, as the tumor has been controlled by radiosurgery.
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The Pipeline embolization device (PED) has expanded the range of aneurysms amenable to endovascular treatment, including some that were previously untreatable. The PED contains several metals, including nickel, cobalt, chromium, platinum, and tungsten. The safety of PED implantation in patients with cutaneous metal allergy is unknown. The aim of this study was to assess clinical and angiographic outcomes of PED treatment in patients with cutaneous metal allergy. ⋯ Preliminary results suggest that PED implantation in patients with cutaneous metal allergy is safe and effective.
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Historical Article
The Retrotransverse foramen of the atlas is not a modern anatomic variation.
The retrotransverse foramen (RTF) is a nonmetric variant of the atlas vertebra that consists of an abnormal accessory foramen located on the posterior root of the transverse process and it extends from the posterior root of the transverse process to the root of the posterior arch. Its presence has been related to regional variations of the venous circulation. It is currently unknown whether the RTF is a modern or an ancient anatomic variation. ⋯ The RTF is not a modern anatomic variation. As a result, ancient individuals had the same modifications in the regional circulation as modern subjects present today.