World Neurosurg
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The main objective of the study was to show the morphologic features of optic strut (OS) and prechiasmatic sulcus (PS) in the fetal skull base with a surgical anatomical perspective. ⋯ Our findings suggest that the sulcal length and angle reach adult size in utero. Taking into account the fetal and the gathered adult measurements, the high percentage of steep angle compared to flat angle show that after birth, PS become more flat, probably depending on the variations of the sphenoid sinus pneumatization. Thus, more studies conducted on the alterations in PS and OS types relative to the pneumatization are needed in terms of patient positioning, selection of appropriate surgical approach, and intraoperative decision-making.
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Pineal lesions are common causes of dorsal midbrain syndrome and typically require surgical intervention in symptomatic patients. We describe a unique case of spontaneous resolution of dorsal midbrain syndrome resulting from a pineal gland cyst. ⋯ Dorsal midbrain syndrome resulting from a pineal cyst may spontaneously improve even without a significant change in lesion size. This suggests that observation may be an appropriate initial management strategy.
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Stereotactic radiosurgery (SRS) can be used to achieve local control of metastatic brain lesions. However, the temporal response of these lesions to SRS is incompletely understood and quantified. We aimed to examine the temporal response to SRS of single brain metastases from 4 different primary cancers. ⋯ The results of this study demonstrate a consistent reduction in tumor volume following SRS over a 6-month period. Responses were modest over the first 30 days but accelerated at 3 months and varied by tumor type.
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To determine the rate and anatomical location of dural tears associated with spinal surgery using a percutaneous biportal endoscopic surgery (PBES) technique. We investigated the relationship between dural tears and the type of procedure and type of instrument used. ⋯ Most cases of incidental dural tear during PBES were treated with an endoscopic procedure. The incidence of dural tear was no greater than that associated with microscopic surgery. Our management strategy for incidental dural tears during PBES has been shown to be safe and effective.
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During surgery, shoulder traction is often used for better fluoroscopic imaging of the lower cervical spine. Traction on the C5 root has been implicated as a potential cause of C5 palsy after cervical spine surgery. Using magnetic resonance imaging, this study was undertaken to determine the impact of upper extremity traction on the C5 root orientation. ⋯ While the cause of C5 palsy is likely multifactorial, this study provides evidence that, in the awake volunteer, upper extremity traction leads to C5 root and upper trunk tension. These results suggest that shoulder traction in the anesthetized patient could lead to tension of the C5 nerve root and subsequent injury and palsy.