World Neurosurg
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Review Case Reports
Transformation of grade II to grade III rhabdoid-papillary meningioma: Is SRS the culprit? A case report and literature review.
In the management of meningiomas, single-fraction stereotactic radiosurgery (SRS) is an established alternative treatment to surgical resection. However, its effects on tumorigenesis and malignant transformation are still uncertain. ⋯ To the best of our knowledge, this is the first report to describe malignant transformation of a grade II to grade III meningioma after SRS to date.
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Review
Causes, Complications, and Costs Associated with External Ventricular Drainage Catheter Obstruction.
Ventricular catheter obstructions in patients treated with external ventricular drains (EVDs) have the potential to substantially impact the cost of patient care. There is a paucity of literature that directly addresses catheter obstruction over large numbers of patients with EVDs in multiple centers. Contemporary literature was reviewed to characterize causes, complications, and costs of EVD catheter obstruction. ⋯ The estimated diagnostic, procedural, and material cost of EVD replacement is in the range of approximately $1300-$3200 per replacement. The diagnosis and treatment of ventricular catheter obstruction, along with associated complications, creates a substantial cost burden. Further research should focus on strategies to reduce the incidence of ventricular catheter obstruction.
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Review Case Reports
Variant Type of Posterior Reversible Encephalopathy Syndrome Associated with Deep Brain Hemorrhage: A Case Report and Literature Review.
Various radiologic patterns of posterior reversible encephalopathy syndrome (PRES) have been reported. Among them, PRES involving brainstem, thalamus, or deep white matter and lacking parieto-occipital edema is rare. Although PRES in general has a benign course, PRES-related intracranial hemorrhage has been associated with a poor prognosis. We report a case of variant type of PRES associated with deep brain hemorrhage and discuss the characteristics of PRES-related intracranial hemorrhage via a literature review. ⋯ Although hemorrhage in the thalamus, basal ganglia, or brainstem is uncommon in patients with PRES, it may occur in patients with variant type of PRES involving these lesions. It is important to recognize the presence of variant patterns of clinical features and radiologic findings of PRES to allow for early identification and appropriate treatment.
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Review Case Reports
Adult atypical teratoid/rhabdoid tumor in the pineal region Case report and literature review.
Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant embryonal central nervous system tumor with a poor prognosis. Its occurrence in the pineal region is extremely rare, with only 6 cases in adults reported so far. ⋯ This case highlights the importance of immunohistochemistry in the diagnosis of the disease and the importance of an aggressive treatment.
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Review Case Reports
Severe neuromuscular scoliosis implicated by dysfunction of intrathecal Baclofen pump. Case report and literature review.
Complex spinal deformities are a common issue in pediatric patients with an underlying neurologic diagnosis or syndrome. Management of neuromuscular scoliosis is an awesome responsibility, because these patients present with the most challenging pathologies of the deformed spine. Along with surgical correction of the underlying deformity, an intrathecal baclofen (ITB) pump is considered effective in managing the associated spasticity. ⋯ The association of cerebral palsy and relevant disorders with the relentless progression of scoliosis is analyzed, along with the possible offending mechanisms. The efficacy of an ITB pump in controlling intractable spasticity associated with neuromuscular scoliosis is reviewed, as well as its potential to accentuate the clinical progression of neuromuscular scoliosis. Although this is an extremely infrequent situation, we must always bear in mind the possibility that malfunction of an ITB pump could be related to obstruction of CSF flow, owing to the extreme severity of the curves established during the course of, most likely untreated, neuromuscular scoliosis.