World Neurosurg
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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.
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Lesions affecting the sciatic nerve (SN) can mimic lumbar radiculopathy. In patients presenting with sciatica, approximately 10% have a nondiscogenic etiology. Through neurological examination and imaging, it may be possible to confirm nondiscogenic sciatica (NDS). This study aims to present a series of 6 patients with infragluteal NDS, highlighting clinical and imaging aspects that may suggest this diagnosis. ⋯ Differentiating between discogenic and NDS can be challenging for clinicians. When patients present with sciatic pain, a Tinel's sign related to the SN elicited at the deep infragluteal region, tenderness to deep infragluteal palpation, occasionally with an SN motor deficit and imaging findings of the lumbar spine that do not justify a discogenic source, the cause should be considered nondiscogenic and they should be scheduled for magnetic resonance imaging of the gluteal and pelvic region.
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Case Reports
Overshunting-Associated Myelopathy Treated with Endoscopic Third Ventriculostomy: A Case Report.
Overshunting-associated myelopathy (OSAM) is a rare complication of cerebrospinal fluid shunt placement. Previous reports have recommended removal or ligation of the shunt and use or revision of a pressure programmable valve to treat OSAM. We present a rare case of OSAM successfully treated with endoscopic third ventriculostomy (ETV). ⋯ This is the first case of OSAM treated with ETV. ETV might be a useful treatment option for OSAM after treatment for obstructive hydrocephalus.
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Case Reports
Awake Craniotomy for a Left Pan-Hippocampal Diffuse Low Grade Glioma in a Deaf-Mute Patient Using Sign Language.
Awake craniotomy is becoming an essential technique, especially for intrinsic brain tumors which have no clear margins and where extent of resection (EOR) matters. However, intraoperative monitoring for awaken patients requires voice feedback in regular settings. Resection of hippocampal glioma is challenging because of its deep-seated location, its extension in an anterior-posterior axis, and being covered with eloquent cortex. We present a native deaf and mute patient, who has been diagnosed of a left pan-hippocampal glioma, who underwent an awake craniotomy using sign language during intraoperative monitoring. ⋯ We demonstrated using sign language for intraoperative monitoring is feasible in a native deaf and mute patient. We also showed a navigation-assisted minimal transcortical approach to achieve >90% EOR for a pan-hippocampal glioma in a single-stage operation.
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This study investigated the retroperitoneal oblique corridor and trajectory of L1-L5 as the lateral surgical access to the intervertebral disks in the Chinese population and detected the potential relationship between the corridor or trajectory and vertebral parameters, including disk axis, psoas muscle, and retroperitoneal vessel. ⋯ Compared with previous studies, the safe surgical area of the Chinese is generally smaller than that of Caucasian. The position of the retroperitoneal vessel is the vital potential to limit the corridor and trajectory. Preoperative assessment of vertebral parameters, especially vascular structure, is essential for planning surgical process.