World Neurosurg
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The anterior petrosectomy approach is among the most popular for exposure of the petroclival region. However, the complexity of the anatomy, drilling time required, and risk of injury to neurovascular structures have made this procedure especially challenging. We have proposed a novel combined extradural-intradural technique for en bloc anterior petrosectomy-or one-piece Kawase-and have charted the landmarks that define its surgical boundaries. ⋯ The advantages of this technique include the wide exposure of the petroclival region, extensive visualization of critical structures via extradural and intradural corridors, and minimization of bone drilling, which could reduce heat damage. Clinical application of the illustrated technique is required to test its reliability in different pathological subsets.
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Malignant transformation of vestibular schwannoma after stereotactic radiosurgery (SRS) is a fatal complication with a relatively less uncommon frequency over the past 5 years. Although SRS has been shown to be an alternative to microsurgical resection of vestibular schwannoma, this complication is disregarded most of the time. In this paper, we present a patient with left cerebellopontine angle vestibular schwannoma that was transformed into a malignant peripheral nerve sheath tumor after receiving SRS following microsurgical resection.
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Dumbbell-shaped tumor is a type of inner and outer cervical spinal canal tumor, and most of these are neurogenic. Desmoid tumors are rare, and, to the best of our knowledge, no case of desmoid tumors involving intervertebral foramen formed dumbbell-shaped tumors in the cervical spine have been reported before in English literature. Here we report a case of a desmoid tumor occurring in the cervical spine that is presented as a typical dumbbell-shaped tumor. ⋯ Desmoid tumors in the head and neck may present as cervical dumbbell-shaped tumors. Before the treatment plan was made, thorough examinations, including surgical pathology, were necessary.
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To evaluate surgical outcomes of homogeneous spinal-shortening axial decompression (HSAD) for reoperation in pediatric patients with tethered cord syndrome. ⋯ Outcomes of HSAD for revision surgery of tethered cord syndrome were satisfactory. HSAD improved neurologic function of patients significantly. HSAD could become an alternative surgical treatment of reoperation for tethered cord syndrome.
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Mechanical thrombectomy for acute ischemic stroke recently proved its superiority to standard medical management alone. With the increasing number of procedures, practitioners are exposed to unexpected situations that may lead to failure of access and significantly worse clinical outcome. Being able to plan the procedure and use alternative techniques may be useful in case of peculiar anatomy. ⋯ Absence of viable access to perform mechanical thrombectomy during acute ischemic stroke is a rare but pejorative event. Direct common carotid puncture, even in its distal segment, when necessary is a feasible technique to perform internal carotid catheterization.