World Neurosurg
-
To determine preoperative factors contributing to postoperative hemorrhage after stereotactic brain biopsy (STB), clinical implications of postoperative hemorrhage, and the role of postoperative imaging in clinical management. ⋯ Postbiopsy hemorrhage was associated with higher risk of immediate and delayed postoperative deficit and seizure. Postoperative computed tomography should be used to determine whether STB patients can be discharged same day or admitted for observation; clinical evaluation should determine return to OR for evacuation.
-
Space-occupying cerebellar ischemic strokes (SOCSs) often lead to neurological deterioration and require surgical intervention to release pressure from the posterior fossa. Current guidelines recommend suboccipital decompressive craniectomy (SDC) with dural expansion when medical therapy is not sufficient. However, no good-quality evidence is available to support this surgical practice, and the surgical timing and technique both remain controversial. We have described an alternative to SDC, surgical evacuation of infarcted tissue (necrosectomy) and its clinical outcomes. ⋯ Necrosectomy appears to be a suitable alternative to SDC for SOCS, achieving comparable mortality and functional outcomes. Further trials are necessary to evaluate which surgical technique is more beneficial in the setting of SOCSs.
-
Case Reports
A case of spontaneous regression of radiologically diagnosed epidermoid cyst originated from cerebellopontine angle.
Generally, asymptomatic epidermoid cysts (ECs) or ECs with minor symptoms controlled by medication are not treated further. Although epidermoid carcinomas are only sporadically reported, the possibility of malignant transformation of ECs is of concern. ⋯ The reduction of an EC is extremely rare. We report a case of spontaneous regression of an EC and consider similar previous cases.
-
Case Reports
Dural Arteriovenous Fistula Formation as Eagle Jugular Syndrome: A Case Report and Literature Review.
An elongated styloid process can less frequently lead to symptomatic compression of the internal jugular vein (IJV). We present the first case of dural arteriovenous fistula (DAVF) in association with compressed IJV by an elongated styloid process. ⋯ The present case suggests that venous hypertension by compressed IJV can induce the development of DAVF. It is helpful for the diagnosis and treatment of DAVF to keep in mind the possibility of IJV stenosis owing to an elongated styloid process.
-
Craniocervical junction arteriovenous fistula (CCJAVF) has a variety of forms, including dural and perimedullary arteriovenous fistulas. Owing to this anatomic variety, the terminologies for classifying CCJAVF, most of which aim to describe angiographic structures, have yet to be firmly established, and the current taxonomic classifications do not facilitate surgical strategies. Herein we focused on the existence of intradural feeder vessels, allowing the identification of 2 types of CCJAVF. This retrospective study aimed to assess the usefulness of our diagnostic classification for CCJAVF surgery. ⋯ Our results indicate that our diagnostic classification for CCJAVF has the potential to simplify CCJAVF treatment without compromising patient outcomes.