World Neurosurg
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A 39-year-old man presented with a large left paramedian frontal lobe intracerebral hemorrhage. Computed tomography angiography and magnetic resonance imaging revealed a tangle of vessels arising from the anterior cerebral arteries (ACAs) and dilated draining veins entering the superior sagittal sinus. Angiography confirmed a Spetzler-Martin grade 3, supplemented 2 arteriovenous malformation (AVM) with predominant supply from branches of the left ACA with superficial and deep drainage (Video 1). ⋯ Once the AVM was disconnected and skeletonized from the A2s, the draining vein was clipped and the nidus was removed. Indocyanine green angiography confirmed patency of the A2s and pericallosal arteries. Postoperative angiography demonstrated no residual shunting, and the patient was discharged in good condition.
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We present an image of a patient's skull characterized by dark, irregular discoloration. This was discovered incidentally in a 66-year-old man who underwent craniotomy for resection of a glioblastoma. This image demonstrates cranial black bone disease. This is an abnormal bone pigmentation associated with long-term tetracycline use, as occurred in this patient.
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Invasive aspergillosis of the central nervous system, a saprophytic infection with a unique vascular tropism, carries the burden of increased morbidity and mortality. Early clinical and imaging findings can masquerade as an innocuous condition before a secondary inexorable progression. We highlight the clinical and imaging phenotype of a patient with fatal invasive granulomatous aspergillosis. ⋯ Diffuse holohemispheric, progressive presentation of a granulomatous form of invasive aspergillosis is a rare entity. The miliary pattern of heterogenous enhancement, holohemispheric conglomerate T2 hypointensities, interspersed hemorrhage, juxtacortical punctate T2 hyperintense foci, low perfusion, and the relative absence of diffusion abnormality are distinctive features. Early diagnosis of this atypical imaging phenotype of Aspergillus infection and appropriate treatment is critical for better prognosis.
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The aim of this study was to investigate the structural and functional changes in the visual cortex in patients with suprasellar tumor with recovery of visual field defects at different times before and after surgical decompression of the optic nerves. ⋯ The postoperative visual improvement can be reflected in the increased GMV and ALFF of the bilateral pericalcarine cortex at 1 month postoperation, which suggests that an experience-dependent plasticity of the visual cortex was induced by an increase in sensory input.