World Neurosurg
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Chiari malformation results from a bony structural anomaly of the skull base. The structural defect causes downward displacement of the cerebellar tonsils through the foramen magnum. The herniated tonsils block the normal flow of cerebrospinal fluid, which causes a wide spectrum of clinical symptoms. ⋯ In cases of progressive symptoms of Chiari malformation, surgical decompression is important and should be considered after shunt insertion to the hindbrain.
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Postoperative hemorrhage is a serious complication of intracranial surgery. Epidural hematomas (EDHs) are one of the common forms of bleeding after surgery, with ≤12% of patients requiring re-exploration. However, distant or remote site EDHs have been rare, in particular, those in a supratentorial location after infratentorial surgery. ⋯ We wished to highlight this unusual complication of posterior fossa surgery, with an emphasis on rapid computed tomography scanning of the brain for patients in the early postoperative period with any neurological deterioration. Early radiological detection and timely intervention can be lifesaving.
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We aimed to discuss the surgical strategies, safety and clinical efficacy of percutaneous endoscopic transforaminal decompression for the treatment of patients with migrated lumbar disc herniation. ⋯ We consider that percutaneous endoscopic decompression via transforaminal approach provided a safe, effective and minimally invasive alternative for the treatment of patients with migrated lumbar disc herniation.
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Ganglioneuroma is a well-differentiated benign tumor that develops from the ganglion cells of the posterior mediastinum, retroperitoneum, cervical spine, and adrenal glands. The paravertebral body, in which the sympathetic trunk exists, is a common tumor site, and tumor sometimes invades the spinal canal through the intervertebral foramen. There have been no reports regarding tumors with intradural and extradural continuity. We report a paravertebral ganglioneuroma extending between the intradural and extradural spaces and its surgical treatment. ⋯ This is the first known reported case of paravertebral ganglioneuroma presenting in continuity between the intradural and extradural spaces.
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The rectus capitis lateralis (RCL) is a small cervical muscle that arises from the transverse process of C1 and is intimately related to the jugular process and jugular foramen. We describe its morphology, neurovascular relationships, and its utility as one of the key surgical landmarks in approaches to the jugular foramen. ⋯ The RCL usually is preserved unless jugular process needs to be removed to expose the jugular foramen. The RCL is an important surgical landmark for the early identification of the vertebral artery, internal jugular vein, facial nerve, and CNs IX-XII in approaches to the jugular foramen.