World Neurosurg
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Review Case Reports
Delayed Pipeline embolization of a ruptured true internal carotid artery aneurysm presenting with epistaxis: Case report and review of the literature.
Massive epistaxis from rupture of an intracavernous internal carotid artery aneurysm is a potentially fatal event. Although rare, this presentation is seen most often in patients after trauma or iatrogenic injury secondary to transsphenoidal surgery or radiation therapy. ⋯ Our case highlights the importance of evaluating for intracranial pathological conditions in patients who present with refractory epistaxis. In selected patients, the use of flow-diversion technology as an adjunct or alternative to primary coil embolization for treatment should be considered.
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In vestibular schwannoma surgery, the preservation of facial and cochlear nerves is of paramount concern regarding to their effect on patients' quality of life. The rate of nerve function preservation has increased with advancements in surgical technique and neuroimaging and the introduction of intraoperative neuromonitoring. The preoperative depiction of anatomical issues between the nerves and tumor could help in surgical planning. ⋯ The results from the present review have confirmed that preoperative fiber tracking for facial nerve identification during large vestibular schwannoma surgery is valuable and reliable. However, the included studies were not comparable in terms of images, acquisitions, or postprocessing elaboration. Larger series and homogenous magnetic resonance imaging parameters are required to strengthen these findings.
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Review Case Reports
Intracranial inflammatory myofibroblastic tumor with negative expression of anaplastic lymphoma kinase: a case report and review of the literature.
Inflammatory myofibroblastic tumor (IMT) is an indolent tumor mainly affecting children and young adults. As a rare mesenchymal tumor with unknown etiology and pathogenesis, IMT has a predilection for the lung and abdominopelvic region. Previous literature featuring IMT in the central nervous system (IMT-CNS) is rare. The clinical symptoms and radiologic features of IMT-CNS are not specific; therefore, the diagnosis is predominately based on the histopathologic and immunohistochemical analysis of the specimen. ⋯ Remission of her symptoms was observed, and no recurrence was recorded during a 6-month follow-up.
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Evidence to support the use of stereotactic radiosurgery (SRS) in the treatment of epilepsy secondary to cerebral arteriovenous malformations (AVMs) is emerging. However, these studies have not clearly demonstrated the use of SRS in the treatment of drug-resistant epilepsy (DRE) in high Spetzler-Martin grade (IV-V) AVMs. ⋯ VS-SRS successfully controlled seizures (Engel Outcome Measure of 1A) in a patient with intractable, DRE secondary to a high-grade cerebral AVM.
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Review Case Reports
Severe kyphoscoliosis associated with multiple giant intraspinal epidural cysts: a case report and literature review.
Severe kyphoscoliosis associated with multiple giant spinal epidural arachnoid cysts (SEACs) is an extremely rare condition and remains a challenge in clinical practice. This study aimed to present a case of severe spinal deformity associated with multiple giant SEACs and to discuss strategies for the preoperative diagnosis and treatment. ⋯ Cyst-peritoneal shunting surgery followed by PVCR, as in our case, could be an alternative surgical strategy for multiple giant SEACs associated with severe rigid kyphoscoliosis.