World Neurosurg
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To date, only a few documented cases exist of complete or near-complete paraplegia of the lower extremities following collapse of a vertebral body secondary to an aneurysmal bone cyst. We describe the preceding symptoms associated with this catastrophic event along with surgical management and recovery. ⋯ The unique combination of back pain and posture change symptoms in an otherwise healthy pediatric patient should heighten clinical suspicion for a possible aneurysmal bone cyst of the spine when formulating a differential diagnosis. Additionally, despite the clinical severity at presentation, patients may still experience significant recovery following expeditious surgical intervention.
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Case Reports
Atypical cauda equina syndrome with lower limb clonus: a literature review and case report.
Cauda equina syndrome (CES) is a neurosurgical emergency warranting urgent surgical decompression. Treatment delay may precipitate permanent adverse neurological sequelae. CES is a clinical diagnosis, corroborated by radiological findings. Atypical presentations should be acknowledged to avoid inappropriately rejected diagnoses. ⋯ We conclude that the clonus was attributable to CE compression and not a second pathology. The corresponding neuroanatomical correlate remains nondelineated. The presence of clonus does not preclude a diagnosis of CES. If the clinicoradiological information otherwise correlate, surgery should not be delayed while alternative diagnoses are sought. The literature is also reviewed.
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Brain mapping by direct electrical stimulation during awake craniotomy is now a standard procedure that reduces the risk of permanent neurologic deficits. Virtual reality technology immerses the patient in a virtually controlled, interactive world, offering a unique opportunity to develop innovative tasks for perioperative mapping of complex cognitive functions. The objective of this prospective single-center study was to evaluate the tolerance and safety of a virtual reality headset (VRH) and immersive virtual experiences in patients undergoing awake craniotomy and brain mapping by direct electrical stimulation. ⋯ This study shows that it is possible during awake brain surgery to immerse the patient in a virtual environment and to interact with the patient, opening the field of new brain mapping procedures for complex cognitive functions.
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The treatments described for spinal synovial cysts range from percutaneous puncture to arthrodesis. There is a fear of postoperative instability after surgical resection of cysts, mainly when they are associated with degenerative spondylolisthesis. The objective of the article is to address the postoperative instability and recurrence rate of the symptoms after microsurgery without fusion. ⋯ The microsurgical treatment for synovial cysts without arthrodesis presented excellent and good results in the majority of cases. It is necessary to carry out prospective randomized studies to clarify the best therapeutic options.
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Case Reports
Dural Arteriovenous Fistula Complicated with Cerebral Venous Sinus Thrombosis: A Case Report.
Cerebral venous sinus thrombosis (CVST) is always confused with dural arteriovenous fistula (DAVF) in clinical practice; however, both of them are very rare cerebral vascular diseases. In this report, we provide one case of DAVF combined with CVST. ⋯ Follow-up at 6 months indicated that the patient recovered without any sequelae.