World Neurosurg
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Intraventricular schwannoma is extremely rare, with only 35 cases reported to date in the literature. Consequently, its etiology and pathogenesis are still unclear, and therefore require further investigations. Here, we report on and discuss a rare case of intraventricular schwannoma to elucidate on this matter. ⋯ Although intraventricular schwannomas are rare, 35 cases have already been reported to date. We emphasize the importance of diagnosing such cases correctly to increase knowledge on the origin and pathogenesis of intraventricular tumors, which would facilitate disease management.
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Case Reports
Facial nerve schwannoma complicated by acute hemorrhage post treatment with stereotactic radiosurgery.
Facial nerve schwannomas (FNSs) are rare benign tumors that arise from Schwann cells of the facial nerve. FNSs are similar to vestibular schwannomas in many aspects, yet their infiltrative nature into the facial nerve fascicles warrants a more conservative management approach. In the last decade, stereotactic radiosurgery (SRS) has shown promise in stabilizing or shrinking FNSs. ⋯ SRS has led to better facial nerve function and outcomes and is currently considered a reasonable alternative to microsurgical resection in patients with FNSs. This is the first report to our knowledge of an acute, life-threatening hemorrhage after SRS in a patient with FNS.
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Mastery of the microsurgical anastomosis is an indispensable component of neurosurgical training. However, in many resource-limited countries, the training, materials, and equipment to obtain these surgical and decision making skills are severely lacking. This study aimed to compare different suturing techniques for microvascular anastomosis and to complete a comparative assessment of the performance of a young neurosurgeon when using the various techniques. ⋯ Suturing time was the only statistically significant difference among the 3 anastomotic techniques, with the lid technique apparently the quickest to perform. Such techniques can be designed to assess microsurgical abilities and help neurosurgery residents in developing countries improve their surgical skills and techniques.
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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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Comparative Study
Minimally Invasive Technique (Nummular Craniotomy) for Mesial Temporal Lobe Epilepsy: a Comparison of Two Approaches.
To describe our series of a minimally invasive technique using a small scalp incision and keyhole craniotomy for the removal of mesial temporal lobe structures through a transcortical approach in patients with medically intractable mesial temporal lobe epilepsy (MTLE). Studies that directly compare the clinical outcomes between minimally invasive and conventional techniques are scarce, and this information is lacking in the literature. ⋯ The nummular technique was associated with faster recovery, early hospital discharge, and fewer complications than the standard technique. No differences were observed in postoperative seizure control. Keyhole craniotomy is a safe, easy, and effective treatment option for medically intractable MTLE.