World Neurosurg
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Case Reports
Two Cases of Large Filar Cyst Associated with Terminal Lipoma: Relationship with Retained Medullary Cord.
A small, incidental filar cyst associated with terminal lipoma is thought to be caused by failure of secondary neurulation; however, the precise embryologic background is not fully understood. Retained medullary cord (RMC) also originates from late arrest of secondary neurulation. The central feature of RMC histopathology is a central canal-like ependyma-lined lumen with surrounding neuroglial core. ⋯ The present findings support the idea raised by Pang et al that entities such as filar cyst, terminal lipomas, and RMC can all be considered consequences of a continuum of regression failure occurring during late secondary neurulation.
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Pneumorrhachis is the presence of air within the spinal canal and is most often traumatic or iatrogenic in etiology. Rarely, a small amount of pneumorrhachis can be seen with spontaneous pneumomediastinum. Here we describe a case of asymptomatic longitudinally extensive pneumorrhachis associated with spontaneous pneumomediastinum. ⋯ In cases of spontaneous pneumomediastinum, air can be entrained within the spinal canal. Special attention should be paid to any patient with pneumomediastinum with neurologic symptoms, as this could be due to pneumorrhachis.
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Vascular reconstruction is required to treat infectious intracranial aneurysms (IIAs) on arteries supplying the eloquent area. However, extracranial-intracranial bypass is sometimes impossible because IIAs are frequently located distally on arteries and the length of a donor artery is limited. We report a rare case of an unruptured Gemella morbillorum IIA, which was successfully treated by intracranial-intracranial (IC-IC) bypass using a Y-shaped superficial temporal artery (STA) interposition graft. ⋯ This case suggests that end-to-side IC-IC bypass using a Y-shaped STA graft can be a good option for surgical treatment of IIAs, which are located in eloquent areas.