World Neurosurg
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Intramedullary spinal cord cavernous malformations (ISCCMs) are a rare entity. Most commonly, ISCCMs present with neurologic decline from lesion hemorrhage, which can be catastrophic and irreversible irrespective of surgical intervention. Given the challenging anatomic location of these lesions in highly critical neurologic areas, precise surgical localization and visualization is necessary to limit collateral damage during resection particularly for deep ISCCMs that do not present to a pial surface. ⋯ The approach represents a novel application of intraoperative CT navigation assistance in the resection of deep ISCCMs.
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Granular cell tumors (GCTs), pituicytomas, and spindle cell oncocytomas are rare, nonfunctioning pituitary tumors sharing positive staining of thyroid transcription factor 1. We present our series, the first single-institutional report with long-term surgical follow-up of all 3 tumor types. ⋯ We present a single-institution series of rare thyroid transcription factor 1-staining posterior pituitary tumors of the sellar region. Key novel findings include gross total resection with no tumor recurrence at nearly 5 years of mean follow-up and no cases of excess or uncontrolled blood loss. Our findings reinforce the observation that GCTs present in the suprasellar space.
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Intracranial extraskeletal mesenchymal chondrosarcoma is a rare, malignant variant of chondrosarcoma that is characterized by undifferentiated mesenchymal cells interspersed with pockets of mature hyaline cartilage. ⋯ Intracranial extra-skeletal mesenchymal chondrosarcomas are very aggressive tumors, and their management should emphasize attempting gross total resection followed by adjuvant treatment modalities, including radiation therapy and/or chemotherapy.
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Mirror distal anterior cerebral artery aneurysms (DACAAs) are a rare finding in patients with subarachnoid hemorrhage, with only a few cases reported. ⋯ Rapid identification of the rupture site in patients with subarachnoid hemorrhage and multiple aneurysms is crucial for initiating optimal treatment. In patients with mirror aneurysms in close proximity to each other, this is not easily accomplished, complicating treatment decisions. Although clipping has been the standard for DACAA occlusion, coiling should be taken into consideration as a viable alternative.
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To evaluate the 30-day outcomes of using the Enterprise stent to treat patients with hypoperfusion of symptomatic severe intracranial stenosis. ⋯ Enterprise stents were relatively safe in treating patients with hypoperfusion of symptomatic severe intracranial stenosis.