World Neurosurg
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The objectives of this study were to report 4 cases diagnosed with trigeminal schwannomas (TS), among whom tumor in epidural space of middle fossa broke through dura mater into subdural space, and to analyze the potential reason for recurrence of TS in middle fossa after surgical removal by endoscopic endonasal approach (EEA) or interdural approach. ⋯ TS in middle fossa has been widely believed to be totally located at epidural space, whereas we found that it could occasionally breach into subdural space and accept blood supply from the pial artery. We believe this could be the potential reason for recurrence after tumor resection by EEA and interdural approach.
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Superior cerebellar artery (SCA) aneurysms can be divided into 2 types: basilar artery (BA)-SCA junction aneurysms and peripheral SCA aneurysms. The peripheral SCA aneurysm is a distinct entity from its BA-SCA counterpart. No comprehensive literature review for endovascular management of peripheral SCA aneurysms has been conducted. ⋯ Peripheral SCA aneurysms are rare cerebrovascular lesions and should be treated as a specific entity. EVT is an efficient and safe option in peripheral SCA aneurysms. Permanent and fatal procedure-related complications are rare. Further prospective and larger-scale studies are warranted to better elucidate the role of EVT in peripheral SCA aneurysms.
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The neutrophil-to-lymphocyte ratio (NLR) reflects the balance between innate and adaptive inflammatory responses. This study intended to evaluate parameters associated with admission high NLR and its impact on clinical outcome in patients with primary intraventricular hemorrhage (PIVH). ⋯ NLR tended to be associated with 90-day clinical outcomes of patients with PIVH and exhibited independent predictive power for pneumonia in PIVH.
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Comment Letter
Cerebral granuloma mimicking malignant neoplasm in a patient with seizures 21 years after head trauma.
Chronic posttraumatic cerebral granuloma is a rare, delayed complication of traumatic brain injury. Because of its late onset of symptoms and atypical appearance, the correct diagnosis of this rare lesion is difficult. ⋯ Chronic cerebral granuloma should be considered in the differential diagnosis of a novel or recurrent mass detected in patients with a history of traumatic brain injury or prior surgery. Moreover, the retained foreign bodies in the superficial or nonfunctional area of the brain should be thoroughly examined and removed at the time of injury, particularly in open brain trauma.
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Very small intracranial aneurysms (VSIAs) are challenging to treat because aneurysm tearing and clip slippage can occur during neurosurgical clipping. In this study, we introduce and share our experience with cotton-assisted clipping of VSIAs. ⋯ Cotton-assisted clipping could prevent aneurysm clip slipping and aneurysm rupture and facilitate the repair of aneurysm neck tears. This technique is a useful alternative therapy for VSIAs.