World Neurosurg
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Review Biography Historical Article
Andreas Vesalius, the predecessor of neurosurgery: How his progressive scientific achievements affected his professional life and destiny.
Andreas Vesalius, the father of modern anatomy and a predecessor of neuroscience, was a distinguished medical scholar and Renaissance figure of the 16th Century Scientific Revolution. He challenged traditional anatomy by applying empirical methods of cadaveric dissection to the study of the human body. His revolutionary book, De Humani Corporis Fabrica, established anatomy as a scientific discipline that challenged conventional medical knowledge, but often caused controversy. ⋯ Vesalius' ideas helped free medicine from the limitations of the 16th Century and advanced scientific knowledge. His influence is still felt more than 500 years later. In this article, we acknowledge Vesalius' neuroanatomic contributions and we discuss the historical facts and political circumstances that influenced his scientific career and personal life, emphasizing the conditions of his pilgrimage to the Holy Land that led to his untimely death.
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Review Case Reports
Surgical management of Gorham-Stout disease in cervical compression fracture with cervico-thoracic fusion: A Case report and review of literature.
Gorham-Stout disease (GSD) or "vanishing bone" disease is characterized by progressive osteolysis with intraosseous lymphangiomatosis (hemangiomatosis). Given its rarity, with about 300 reported cases, its pathophysiology, etiology, and treatment guidelines are not established yet. ⋯ Spinal GSD can cause severe deformity and neurologic deficits such as paralysis. Although treatment for GSD is not established, surgical treatment is recommended in severe deformity or aggravated neurologic deficit. The appropriate timing of surgery is after the arrest of osteolysis. Magnetic resonance imaging could be helpful in determining stable GSD.
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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 Case Reports
Pediatric Rhabdoid Meningioma with extension to the heart, a first case report and literature review.
Meningiomas are the most common benign intracranial neoplasms in adults, but they have a lower incidence in children. Rhabdoid meningioma is a rare subtype of meningioma and is classified as World Health Organization grade III. ⋯ Rhabdoid meningioma is a malignant subtype of meningioma that occurs very rarely in pediatric patients. Additionally, rhabdoid meningioma, when it does occur in pediatric patients, has a high tendency to recur. Radical surgical resection with adjuvant radiotherapy is essential to prolonging survival. This is the first case with extracranial extension to the mediastinal veins and heart.
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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.