World Neurosurg
-
The premamillary artery (PMA) usually arises from the posterior communicating artery. Thus, an internal carotid artery (ICA) origin for PMA is rare. We report a rare case of a patient who presented with subarachnoid hemorrhage resulting from kissing aneurysms arising from the origin of the anterior choroidal artery and the aberrant origin of PMA and was successfully treated with coil embolization. ⋯ To the best of our knowledge, the present study is the first report of a ruptured saccular PMA aneurysm arising from ICA that was successfully treated with coil embolization. Three-dimensional digital subtraction angiography and cone-beam CT were useful for confirming the precise vasculature of the PMA.
-
Case Reports
Diffusion Tensor Imaging (DTI) characteristics in Hirayama's Disease (HD): Case Report and Review of Literature.
Hirayama disease (HD) is a rare focal amyotrophy, commonly reported in adolescent Asian males and characterized by unilateral or asymmetric distal upper extremity weakness. This disease exhibits an indolent course of progression over the initial 3-4 years, followed by a stage of stabilization. The diagnosis is confirmed by demonstration of enhanced posterior epidural space and dynamic spinal cord compression on cervical flexion magnetic resonance imaging. Diffusion tensor imaging (DTI) is a functional imaging modality, which can potentially be utilized in the diagnosis of HD. ⋯ DTI tractography and reduced fractional anisotropy in cervical flexion can serve as potential indicators for the diagnosis of HD. Large-scale studies in the future are necessary to identify the potential role of this modality in surgical decision-making and in the assessment of prognosis in patients with HD.
-
Ossifying fibroma (OF) is a benign tumor commonly occurring in the mandible and maxilla. Spinal involvement of OFs is of great rarity. To the best of our knowledge, only 3 cases in the thoracic and lumbar spine have been reported. ⋯ Spinal involvement of OFs seldom occurs. To the best of our knowledge, we have reported the first OF involving the cervical spine. Differentiating OFs from primary spinal tumors is necessary. OFs have locally aggressive behavior and a high risk of recurrence. Complete resection, followed by regular examinations, should be the ideal choice for treatment.
-
Xanthomas are benign lipomatous deposits that can be found systemically in various tissues including bones. Their presence in the skull remains a rare entity. Despite their benign characteristics, imaging modalities are often unable to distinguish them from malignant lesions. This leads to a diagnostic dilemma in patients with underlying malignancy. This case report highlights such a case where clinical history of prostate cancer and image findings were concordant with that of metastatic deposit in the parietal skull region. ⋯ Xanthomas are benign lesions that can be seen deposited in appendicular and axial skeleton. Skull lesions are rare with most case descriptions focusing on their presence in the frontoorbital regions and mandible and temporal bone. They usually have a benign course but may present with symptoms due to localized mass effect. Surgical intervention and histologic diagnosis may still be required in these lesions due to their lack of imaging characteristics that confirm their diagnosis through noninvasive methods.
-
Spinal arteriovenous fistula (AVF) may rarely associate with spinal dysraphism, that is, tethered spinal cord and spinal intradural lipoma. Spinal extradural angiolipoma coexisting with spinal AVF has not been reported in the literature. We reported an extremely rare case of sacral angiolipoma associated with tight filum terminale and sacral spina bifida coexisting with spinal AVF within this tumor. ⋯ Sacral extradural angiolipoma in the present case may be congenital in origin with development of an acquired spinal AVF within the tumor.