World Neurosurg
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Case Reports
A Rare Case Documenting Endoscopic Fenestration of a Symptomatic Porencephalic Cyst in an Adult.
A porencephalic cyst is an aberrant accumulation of cerebrospinal fluid within the brain parenchyma. Its occurrence is rare, with an incidence of 3.5 per 100,000 live births. Etiology is considered the result of perinatal cerebral ischemia or hemorrhage, leading to parenchymal loss. ⋯ Our case depicts a porencephalic cyst presenting with nondominant parietal lobe symptoms in adulthood. We hypothesize that a membrane between the cyst and ventricle allowed formation of a 1-way valve that led to slowly progressive cyst enlargement, eventually causing mass effect and nondominant parietal lobe symptoms. Endoscopic fenestration of the cyst membrane into the lateral ventricle was successful in reducing cyst volume and improving mass effect.
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Clinical Trial
Comprehensive Aneurysm Management (CAM): An all-inclusive care trial for unruptured intracranial aneurysms.
In the absence of randomized evidence, the optimal management of patients with unruptured intracranial aneurysms (UIA) remains uncertain. ⋯ Patients with unruptured intracranial aneurysms can be comprehensively managed within the context of an all-inclusive care trial.
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We present a case of symptomatic heterotopic bone formation following revision of posterolateral lumbar fusion/instrumentation and "off-label" use of recombinant human bone morphogenetic protein-2, treated successfully with the use of a minimally invasive tubular approach.
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Extracranial-to-intracranial bypass surgery is a well-established technique that has been practiced for over 50 years. Since then, numerous technical variants have developed nationally and internationally. ⋯ The results of this electronic survey will help to identify common patterns in STA-MCA bypass surgery and will serve as a guide to other neurosurgeons to modify and improve their technique. Cerebrovascular bypass is still widely practiced, including by young neurosurgeons, who are actively learning from established masters who share their experience.