World Neurosurg
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Anatomic compression of the optic nerve secondary to a dolichoectatic cerebrovascular compression is a rare clinical entity. Because of the limited number of published cases and variable clinical presentation, the natural history remains ambiguous and no consensus exists regarding management. In addition, there is an ongoing debate regarding whether a dolichoectatic cerebral blood vessel can actually cause optic neuropathy, or it merely represents an incidental finding. As a result, it is thought that a diagnosis of compressive optic neuropathy from an adjacent dolichoectatic internal carotid artery (ICA) should be considered only after other possible etiologies are excluded. Although this might seem straightforward, the clinical scenario becomes complex if the patient is also found to have additional incidental pituitary lesions. Such coexistence has not been reported previously in the literature. ⋯ The compression of the optic nerve by dolichoectatic ICA is commonly thought to be a diagnosis of exclusion. However, the presence of a coexisting pathology should not prompt the exclusion in every case and a case-based approach is highly recommended to correctly manage this rare clinical condition.
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We report a case of an 18-year-old patient who presented with late progressive deterioration of neurologic condition 8 weeks after a penetrating injury to the back. Investigations revealed a dorsally located post-traumatic spinal cord herniation. Urgent exploration, decompression, and repair were performed. We reviewed the literature and found only 19 similar cases previously reported. Pathophysiology and presentations were variable and even poorly understood. ⋯ Late-onset post-traumatic spinal cord herniation is a potentially curable cause of neurologic deterioration after spinal trauma and should be considered in all cases with late neurologic deterioration after spinal trauma.
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To identify if there are cultural, medical, educational, economic, nutritional and geographic barriers to the prevention and treatment of spina bifida and hydrocephalus. ⋯ Our study highlights some of the cultural, educational, geographic, nutritional, and economic difficulties in the prevention and management of spina bifida and hydrocephalus in Tanzania.
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Neurenteric cysts rarely present in infancy. Compressive myelopathy or meningitis are the usual presenting features of these cysts in infants. ⋯ Although rare, compressive lesions such as neurenteric cysts may present with acute flaccid paralysis in very young children. Differentiating from other causes and timely intervention bears an excellent outcome.
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The conventional retrosigmoid and lateral supracerebellar approach was used for surgery in 5 select cases of large chordomas. ⋯ Radical resection of all the tumors was achieved.