World Neurosurg
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There are currently no imaging criteria to identify patients who would benefit from endovascular recanalization of posterior circulation strokes. Applying the Posterior Circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) to magnetic resonance imaging (MRI) has been demonstrated to be an accurate predictor of functional outcome. Here, we aimed to evaluate the accuracy of the pc-ASPECTS with preintervention MRI as a predictor of functional outcome in a cohort undergoing endovascular recanalization. ⋯ Despite longer time to intervention with MRI as the initial imaging modality in posterior circulation strokes, it does not negatively affect the functional outcome. Pc-ASPECTS is an easy to use and accurate prognostic tool for the real-time evaluation of preintervention MRI in this population.
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Review Case Reports
Primary, dural-based, Ewing sarcoma manifesting with seizure activity: Presentation of a rare tumor entity with literature review.
Primary Ewing sarcoma arising from the calvarial bone and/or underlying dura matter are relatively rarely reported in the literature. Even rarer are considered to be those that originate from the dura and proliferate in both directions, toward the brain parenchyma and through the dura invading the overlying bone. ⋯ The patient had an uneventful neurologic recovery without persistent neurologic deficit. One year after the operation, with the patient under close clinical and radiologic surveillance, no recurrence of the disease was detected. This case illustrates an extremely uncommon location of primary Ewing sarcoma, along with a constellation of clinical signs and symptoms that are fairly uncommon for this location of this rare disease entity.
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Review Case Reports
Superficial femoral artery interposition graft for repair of a ruptured mycotic common carotid artery pseudoaneurysm: case report and review of the literature.
Indications for reconstruction of the common carotid artery (CCA) include trauma, iatrogenic injury, neoplastic growth (such as invasive neck carcinomas), postoperative infection, and cervical carotid aneurysm. Although various techniques and conduits have been described, the clinical scenario may preclude the use of the most commonly used grafts. We describe a case using a superficial femoral artery (SFA) interposition graft to repair the CCA and review the available literature, highlighting the feasibility of this technique for carotid artery reconstruction. ⋯ This case highlights the feasibility of using an SFA interposition graft for short-segment CCA reconstruction, which can provide significant utility in the setting of a hostile operative field due to prior infection or radiation.
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Review Case Reports
8-Year Follow-up for Woman with Spinal Meningeal Melanocytoma in S1 Nerve Root: Case Report and Literature Review.
Primary melanocytic neoplasms in the central nervous system are rare lesions arising from leptomeningeal melanocytes. These lesions produce neural deficits that resemble those of a meningioma or a schwannoma radiologically. ⋯ Spinal meningeal melanocytoma inside the nerve root is rare and benign. It is difficult to diagnose and often misdiagnosed as schwannoma or meningioma. HMB-45 has been suggested as a significant marker for the diagnosis of meningeal melanocytoma. Complete surgical resection is recommended as the primary treatment. Radiotherapy, chemotherapy, and other treatments can be selected as adjuvant therapies, but their effects are controversial. The recurrence and metastasis rates also remain unclear.