World Neurosurg
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Review Biography Historical Article
Gangliformis Intumescentia and Beyond: Antonio Scarpa and His Core Contribution to Neuroanatomy, Neurosurgery, and Otoneurosurgery.
Nearly 250 years ago, Antonio Scarpa became a professor of anatomy and surgery only 2 years after he graduated from the University of Padua. The young lecturer soon became one of the most renowned anatomists in Italy and a director of the Faculty of Medicine at the University of Pavia. He worked in the fields of general surgery and ophthalmology. ⋯ Scarpa's magnum opus was the book Tabulae Neurologicae, in which he described the path of several cranial nerves including the vagus nerve and innervation of the heart. Since his death in 1832, Scarpa's head has been preserved at the University History Museum of the University of Pavia. In this historical vignette, we aim to describe Antonio Scarpa's troubled life and brilliant career, focusing on his core contributions to neuroanatomy, neurosurgery, and otoneurosurgery.
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Epileptogenic encephaloceles, most frequently located in the temporal lobe, are a known lesional cause of focal epilepsy. Data are limited regarding diagnosis, management, and outcomes of patients with epilepsy in the setting of an encephalocele, because the literature mostly comprises case reports, case series, and retrospective studies. We conducted a broad literature review for articles related to encephaloceles and epilepsy regardless of level of evidence. ⋯ In the temporal lobe, there is no clear consensus on the appropriate management for epileptic encephaloceles and further studies are warranted to understand the associated factors and long-term outcomes associated with epilepsy secondary to encephaloceles. Reported data suggest that these patients could be manageable with surgical procedures including lesionectomy or lobectomy. In addition, because of data suggesting similar results between procedures, a more conservative surgery with lesionectomy and defect repair rather than a lobectomy may have lower surgical risks and similar seizure freedom.
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Intraosseous pneumatocyst refers to gas-filled cystic lesions inside bone. Whereas ilium and sacrum are the commonest locations for pneumatocysts, vertebral pneumatocysts are rare. Various theories have been proposed to explain the etiopathogenesis of vertebral pneumatocysts and the most widely accepted theory is the extension of air from intervertebral disc or joint spaces into the pneumatocyst cavity. The aim of this systematic review was to study all the cases of vertebral pneumatocyst reported in the literature to understand this rare disease and its clinical importance. ⋯ The prevalence of pneumatocyst increased with increasing age, with most of the reported patients belonging to the 50-70 years age-group. Most of these patients have large pneumatocysts with degenerative changes in spine. Another less common subset of young patients with small pneumatocysts without associated degenerative changes has also been described. Pneumatocysts were most common in the cervical spine, with C5 being the most commonly affected vertebra. Most of the pneumatocysts remain stable in size on follow-up, although 3 cases of enlarging pneumatocyst have also been reported. An enlarging pneumatocyst should be closely followed up, although its benign nature has been reported in the literature.