World Neurosurg
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This paper explores the diagnosis of deep invasive endometriosis through retrospective data analysis, including deep infiltration and magnetic resonance imaging. The literature retrospectively collected data from 21 patients with deep invasive endometriosis who were admitted from 2012 to 2018. The patients were confirmed to have pain and nerve growth factor (NGF) receptor expression levels after operation and underwent vaginal color ultrasound and magnetic resonance imaging before surgery. ⋯ Through research it has been found that deep invasive endometriosis mainly involves the uterine fibula ligament, vagina, uterus rectum, rectum, ureter, and so forth. Patient pain is related to the expression level of NGF receptor, and its magnetic resonance mainly manifests as signals and structural obstacles, irregular thickening of the affected area, or nodular formation and deformation of adjacent tissues and organs. Through research and demonstration of deep invasive endometriosis, transvaginal color ultrasound and magnetic resonance imaging can not only accurately locate the expression levels of pain and NGF receptors, but also show the extent of the lesions, thereby studying pain and NGF receptor expression, which is an important method for preoperative examination and postoperative follow-up.
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Case Reports
Calcifying pseudoneoplasm of the neuraxis (CAPNON) in the posterior third ventricle - a challenge for neuroendoscopy.
We report the first case of a purely intraventricular calcifying pseudoneoplasm of neuraxis (CAPNON) in the posterior third ventricle. ⋯ When encountering such calcified lesions within the ventricular system, especially in proximity to eloquent regions, the decision making process should include the hard consistency and parenchymal adhesions as obstacles to neuroendoscopic removal. Even for biopsy, a higher morbidity rate compared with typical soft tumors should be assumed. Although data on intraventricular CAPNON is limited, biopsy of the lesion and treatment of associated hydrocephalus appear to be the primary neurosurgical goals, followed by imaging surveillance.
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The operative microscope, a commonly used tool in neurosurgery, is critical in many supratentorial tumor cases. However, use of operating microscope for supratentorial tumor varies by surgeon. ⋯ Use of operative microscope for supratentorial resections varies by state and is associated with higher cost of surgery. Microscope use may be associated with lower rates of intraoperative cerebral edema and some cerebrovascular complications, but is not associated with significant differences in other complications, readmissions, or 30-day costs.
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Atlantoaxial tuberculosis (TB) is rare in clinical practice, accounting for only about 0.3%-1% of spinal TB. An anterior-only surgical approach cannot provide strong fixation, whereas a posterior approach cannot achieve complete removal of lesions. A method combining anterior and posterior approaches to treat atlantoaxial TB is advisable. The aim of this study was to evaluate the effectiveness of anterior transoral débridement combined with posterior fixation and fusion for atlantoaxial TB. ⋯ Anterior transoral débridement combined with posterior fixation and fusion is an effective treatment for atlantoaxial TB, achieving removal of lesions and stability.
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Trigeminal neuralgia (TN) is one of the neuropathic pain syndromes, most commonly caused by vascular compression in the root entry zone of the trigeminal nerve in the cerebellopontine angle. It was rare as offending artery that primitive trigeminal artery and primitive trigeminal artery variant (PTAv) as an anomaly that occurs carotid-basilar anastomosis. We report a case of TN caused by the PTAv, and usefulness of fusion images of magnetic resonance imaging (MRI) and computed tomography angiography (CTA). ⋯ The fusion image created by CISS MRI and 3-dimensional CTA was useful to identify the offending vessel and to clearly understand the neurovascular structure preoperatively.