World Neurosurg
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Because damage or sacrifice of venous drainage during supratentorial basal cistern and skull base approaches may have severe and harmful consequences, methods to identify preoperatively veins at risk are of paramount importance. Among methods, a codified assessment with a venous topogram is helpful, with practical implications. ⋯ This is, to our knowledge, the only topogram described in the scientific literature. Any well-defined approach should be adapted to the individual patient according not only to location and type of lesion but also to the venous drainage to be encountered along the way.
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Second Window Indocyanine Green (SWIG) is a novel technique for real-time, intraoperative tumor visualization using a high-dose infusion of indocyanine green (ICG) 24 hours before surgery. Due to pathologic diversity found in the pineal region, tissue diagnosis in patients with pineal region mass is essential to optimize further clinical management. ⋯ We report on a novel application of near-infrared fluorescence for tumor identification of pineal region tumors, using the "SWIG technique."
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Case Reports
Transforaminal Endoscopic Approach for Lumbar Extraforaminal Synovial Cysts: Technical Note.
Lumbar facet cysts are commonly seen in degenerative lumbar conditions causing stenosis and radiculopathy. Extraforaminal lumbar facet cysts are a rare entity and present a surgical challenge because of their location. Transforaminal endoscopic spine surgery is an emerging technique in spine surgery but has never been described as a treatment option for lumbar radiculopathy in the setting of extraforaminal lumbar facet cyst. ⋯ Transforaminal endoscopic surgery for a lumbar radiculopathy in the setting of an extraforaminal lumbar facet cyst is presented as a unique minimally invasive approach for the treatment of extraforaminal lumbar facet cyst that avoids facet resection and fusion.
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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.