World Neurosurg
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Intradural lumbar disc herniation is rare, with an incidence of 0.3%-1%, but has been well reported in the literature. Transdural migration of the disc penetrating both ventral and dorsal dura is extremely rare, and there is a dearth of literature in the pathophysiology and surgical management of transdural herniation. Lack of knowledge on this type of presentation can cause intraoperative surprises and inadvertent cauda equina root injuries and lead to prolonged operative time. We report 1 such case, describe our surgical experience, and discuss the pathological mechanisms and signs. ⋯ Transdural herniation of a lumbar disc is very rare presentation. It can be effectively managed with laminectomy, extension of durotomy, discectomy and repair of both dorsal and ventral dura. It can be diagnosed by magnetic resonance imaging preoperatively only if read with suspicion of such presentation.
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Intracranial meningioma is the most common brain tumor operated in the 2 teaching hospitals in Ethiopia. This study reviews the clinical outcome of intracranial meningiomas in a resource-limited setup. ⋯ Meningioma size determines the outcome of the patients. It was shown that the functional outcome of patients is encouraging even though further improvement on neurosurgical care is needed.
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To present an adaptation of the anaglyph photography technique to be used with radiological images from computed tomography angiograms, enabling stereoscopic visualization of a patient's individual abnormal vascular anatomy for teaching, case discussion, or surgical planning purposes. ⋯ Anaglyph display of computed tomography angiograms is an effective and low-cost alternative for the stereoscopic visualization of a patient's individual intracranial vascular anatomy.
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Arterial dissections are a common cause of stroke in second decade-fourth decade patients, but may occur at any age. There are no previous reports of an intracranial carotid artery dissection that evolved spontaneously into both complications (i.e., stroke, pseudoaneurysm). To our knowledge, this is the first case of arterial dissection complicated by an occlusion and a pseudoaneurysm occurring at the same site. ⋯ Intracranial dissection/occlusion is a frequent cause of brain infarction, especially in mid-adulthood. Clinical signs of subarachnoid hemorrhage, compressive nerve palsies, and epistaxis in a patient who had endovascular treatment for an intracranial arterial dissection occlusion should be considered as signs for pseudoaneurysm formation, and an angiography should be obtained as soon as possible.
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Papillary glioneuronal tumors (PGNTs) are rare World Health Organization grade I neoplasms that are characterized by a benign course and excellent response to surgical resection. A few reports exist of tumors with more aggressive clinical and histologic features. In this report we detail the case of an unusually aggressive PGNT in a 67-year-old woman. ⋯ PGNTs, while typically benign, can rarely recur after surgery. Molecular testing should be performed on all PGNTs to help possibly identify more aggressive tumors and potentially reveal novel treatment options.