World Neurosurg
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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.
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Review Case Reports
Epidural lipomatosis and syringomyelia in the adulthood: Case and literature review.
We review 2 previously published cases of epidural lipomatosis associated with syringomyelia. We also present the case of a 42-year-old woman with a medullary syrinx from C1 to T3, initially only with upper limb paresthesias that presented after 10 years of follow-up for left hemiparesis and paresthesias in the tongue. Chiari malformation and cerebral or spinal space-occupying lesions were ruled out, as were other causes of syrinx except the presence of epidural lipomatosis extending from T1 to T12. ⋯ This is the third case of a patient with a spinal syrinx and no other related causes except from spinal lipomatosis, although with only 3 cases it is not possible to completely state that lipomatosis caused the syrinx. Our case supports the trend established by the 2 previous cases. For treatment, initially patients should be managed conservatively, trying to correct the underlying etiologies of spinal lipomatosis. In case of failed conservative treatment, removal of adipose epidural excess in the most appropriate way is preferred.
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Review Historical Article
History of Integral Fixation for Anterior Lumbar Interbody Fusion (ALIF): The Hartshill Horseshoe.
Anterior lumbar interbody fusion (ALIF) is a common spinal fusion option for different spinal pathologies. In the early years, implant migrations/expulsions were potential complications of ALIFs due to the lack of integral fixation. We present a historical vignette on the inception and development of the first stand-alone ALIF (SA-ALIF) implant-the Hartshill Horseshoe (HH). ⋯ The HH was the first synthetic SA-ALIF implant developed. Since the HH, multiple SA-ALIF implants have been designed. The benefits of integral fixation in a SA-ALIF device include immediate implant stability, ability to reduce and correct deformity postimplantation, prevention of implant migration, and increased implant-bony endplate contact for early osseointegration.
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Review
A bibliometric study of the most cited papers in central nervous system arteriovenous malformations.
We performed a bibliometric analysis of studies reporting cases of brain and spinal arteriovenous malformations (AVMs). ⋯ Brain and spinal AVM research was centralized in the United States, has been mainly reported in specific neurosurgical journals, and has been more often related to treatment and natural history and/or clinical features. It is possible that high impact AVM research has been decreasing recently. Because the best approach to these pathological entities remains controversial, research stimulation within this field should be encouraged.
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To analyze the three-dimensional relationships of the operculoinsular compartments, using standard hemispheric and white matter fiber dissection and review the anatomy of association fibers related to the operculoinsular compartments of the Sylvian fissure and the main white matter tracts located deep into the insula. The secondary aim of this study was to improve the knowledge on this complex region to safely address tumor, vascular, and epilepsy lesions with an integrated perspective of the topographic and white matter fiber anatomy using 2D and 3D photographs. ⋯ Complementing topographic anatomy with detailed study of white matter fibers and their integration can help the neurosurgeon to safely approach lesions in the insular region, improving postoperative results in the microsurgical treatment of aneurysmal lesions, insular tumors, or epilepsy surgery.