World Neurosurg
-
Rathke's cleft cysts (RCCs) may have various anatomic, clinical, and radiologic characteristics, which may be related to their differences in texture or consistency. The purpose of the study was to investigate RCCs based on consistency. ⋯ The proposed novel consistency classification of RCCs will provide a practical tool for more accurately estimating the nature of the pathology, because each type has its own specific characteristics. Furthermore, the new classification of RCCs may aid in planning a consistency-specific surgery.
-
Cranioplasty is a technically simple procedure intended to repair defects of the skull to provide protection after craniectomy, improve functional outcomes, and restore cosmesis. Several materials have been used for the restoration of skull defects, including autologous bone grafts (AGs), polymethyl methacrylate (PMMA) flaps, and titanium mesh (T-mesh). However, the long-term results of cranioplasty after use of these materials are controversial. ⋯ Complications after cranioplasty are high, and the various types of cranioplasty materials used are associated with different complications. Surgeons need to be aware of these potential complications and should choose the appropriate material for each individual patient.
-
Case Reports
An unusual cause of trigeminal neuralgia: The first report of intracranial migration of a spinal cord stimulator.
Spinal cord stimulation has been shown to be an effective treatment for some patients diagnosed with chronic pain and failed back syndrome. However, lead migration from the implantation site is a potential complication that may reduce treatment efficacy, produce unintended symptoms, and require invasive and costly surgical replacement or removal. ⋯ Although spinal cord stimulation has demonstrated effectiveness as a treatment for chronic pain, care must be taken to ensure that the spinal cord stimulator leads are properly placed within the epidural space and are firmly anchored to avoid migration. Intracranial migration of a spinal cord stimulator lead poses significant risks for injury to adjacent cortical structures and may produce pain syndromes including trigeminal neuralgia.
-
Case Reports
Tumor-to-tumor metastasis of hepatocellular carcinoma to a vestibular schwannoma: case report.
Intracranial metastasis is a common complication of systemic malignancy. A rare subset of intracranial masses constitutes tumor-to-tumor metastasis, in which an extracranial neoplasm hematogenously spreads to an existing intracranial lesion. ⋯ Tumor-to-tumor metastasis is an important consideration in the diagnostic work-up and treatment of patients with known systemic malignancy who present with a new intracranial lesion. This pathologic entity could be missed if this patient were treated with single-fraction radiosurgery such as Gamma Knife.
-
Skull base chordoma can be a challenging surgical entity because of its invasive nature. ⋯ This study shows that iMRI is a safe method for intraoperative assessment of the degree of resection and the volume and location of residual tumor when resecting skull base chordomas. When gross total resection of the tumor is not feasible, iMRI can be a useful tool for targeted tumor resection.