World Neurosurg
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Review Case Reports
Abducens nerve schwannoma: a case report and literature review.
Abducens nerve function seldom shows complete recovery after removal of abducens nerve schwannoma. No cases with unclear course of the abducens nerve during surgery have been reported to achieve complete recovery of nerve function. ⋯ This represents the first description of abducens nerve schwannoma in which the course of the abducens nerve was intraoperatively unclear but complete recovery was achieved. In such cases, intentional subcapsular dissection may potentiate functional recovery.
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A 47-year-old male patient presented at our neurosurgery unit with neurogenic claudication symptoms. The patient had a history of low back pain and lower extremity pain for 2 years. ⋯ The patient was treated conservatively, and after weight loss in 13 months (body mass index of 29) he had full recovery of neurologic symptoms. A follow-up magnetic resonance image obtained 14 months after showed complete resolution of spinal epidural lipomatosis.
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Case Reports
Diverticular enlargement of the foramen of Luschka and hydrocephalus in a child with Noonan syndrome.
We present an unusual association between Noonan syndrome and tetraventricular hydrocephalus, caused by fourth ventricle outlet obstruction, in a 5-year-old boy. Magnetic resonance imaging showed a diverticular enlargement of the left foramen of Luschka, with compression of the facial nerve that resolved following treatment of hydrocephalus by endoscopic third ventriculostomy.
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Vascular injury complications during lumbar discectomy are rare but potentially life-threatening. Therefore, an early diagnosis and effective treatment management is required for these complications. ⋯ Although lumbar discectomy is one of the most commonly performed neurosurgical procedures, the routine rules of discectomy should not be neglected. Early detection and a multidisciplinary approach can help prevent mortality in the event of vascular injury.
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Neurosurgical interventions frequently occur in an emergency setting. In this setting, patients often have impaired consciousness and are unable to directly express their values and wishes regarding their treatment. The limited time available for clinical decision making has great ethical implications, as the informed consent procedure may become compromised. ⋯ Potential solutions to these challenges are presented that may help to improve ethical patient management in emergency settings. Emergency neurosurgery challenges the respect of autonomy of the patient. The outcome in most scenarios will rely on the neurosurgeon acting in a professional way to manage each unique situation in an ethically sound manner.