World Neurosurg
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Some petroclival meningiomas cause trigeminal nerve compression, leading to disabling trigeminal neuralgia (TN). Tumor resection and nerve decompression can offer pain relief but might not be feasible in all patients. Simultaneous stereotactic radiosurgery (SRS) to the tumor and nerve is another option. SRS is an effective means of treating meningiomas and TN separately, but data on the efficacy and outcomes of their concomitant treatment are limited. ⋯ This series highlights the benefits and safety of simultaneous treatment of petroclival tumors and the trigeminal nerve in a single session for patients affected by tumor-related TN.
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Malignant cystic lesions in the spine are rare. In this report, we present a 65-year-old man who presented with imbalance on walking of 1-week duration with intact motor examination. ⋯ However, he died 5 months later due to progression of moderately differentiated metastatic lung cancer. To our knowledge, this is the first report showing the near-complete replacement of vertebral body and posterior elements with a malignant cystic lesion.
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The Coronavirus disease 2019 (COVID-19) outbreak has left a lasting mark on medicine globally. ⋯ We believe that recovery following the COVID-19 pandemic offers unique opportunities to disrupt and rebuild the historical patient and office experience as we evolve with modern medicine in a post-COVID-19 world.
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The goal of this study is to show using 5 illustrative cases that the transcortical route for resection of mediobasal temporal region (MBTR) lesions is safe and effective when performed with awake functional mapping and knowledge of the relevant subcortical anatomy. Although several have been proposed, there is a paucity of reports on transcorticosubcortical approaches to these lesions, particularly in patients with posterior-superior extension. We present a case series of 5 patients with left posterior MBTR gliomas and summarize the relevant subcortical anatomy knowledge of what is a prerequisite for safe resection. ⋯ The transcorticosubcortical approach is a safe and effective approach to lesions of the posterior MBTR. The approach is safe and effective even in patients with superior extension, if the surgical approach is predicated on knowledge of individual functional anatomy. Awake resection with cortical and axonal mapping with well-selected paradigms is invaluable in maximizing extent of resection and ensuring patient safety.
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Never in history has the fabric of African neurosurgery been challenged as it is today with the advent of the novel coronavirus identified in 2019 (COVID-19). Even the most robust and resilient neurosurgical educational systems in the continent have been brought to their knees with neurosurgical trainees and young neurosurgeons bearing the brunt. ⋯ This unfortunate event presents an innovative opportunity for neurosurgical education in Africa. Herein, we detail the framework of an online neurosurgical education initiative to advance the education of African residents and young neurosurgeons during and after the COVID-19 pandemic.