World Neurosurg
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Infundibular dilations are funnel-shaped widenings at the origin of a cerebral artery, most commonly the posterior communicating artery. Controversy exists as to whether an infundibulum represents a normal anatomic variant or a lesion with the potential for rupture and subarachnoid hemorrhage (SAH). ⋯ The literature, and our own experience, do not support the treatment of infundibula, even in SAH patients. Treatment should be directed toward an associated aneurysm, not the infundibulum.
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Review Case Reports
Non-traumatic myositis ossificans as an uncommon cause of scoliosis: a case report and discussion of literature.
A 5-year-old pediatric patient developed scoliosis associated with nontraumatic myositis ossificans in the lumbar region. Although there have been reports in literature of syndromes leading to widespread muscle ossifications resulting in shoulder deformities owing to impaired movement in the facet joints, to the best of our knowledge there has been no report of scoliosis associated with myositis ossificans. ⋯ Nontraumatic, paravertebral myositis ossificans at an early age is a very rare pathology. Therefore, it must be recognized that spine deformities such as scoliosis and kyphosis can develop in neglected cases of paravertebral myositis ossificans. In addition, there is a high risk of confusion with malignant pathologies, such as osteosarcoma, in this area. Removal of the mass eliminates both the pain of myositis ossificans and prevents the development of scoliosis.
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Review Case Reports
Intra-neural Ewing's sarcoma of the fibular nerve - Case report, radiological findings and review of literature.
Intraneural Ewing sarcoma (ES) was first described in 1918 by Stout in a tumor of the ulnar nerve. These tumors are in the category of ES family of tumors, together with ES of bone, extraosseous ES, and primitive neuroectodermal tumor. ES typically occurs in the second decade of life; only 20% of cases affect elder people. The most frequently involved sites are the craniospinal vault and cauda equina, while the peripheral nerve location is extremely rare (only 11 cases mentioned in the literature to date). ⋯ The challenge of intraneural extraosseous ES consists of the right balance between the necessity to consider a potential malignant nature of the lesion and perform adequate surgical excision in a relatively brief time from the first clinical examination and the fact that these are extremely rare pathologic entities among most frequent cases of completely benign tumors, which could even have the same clinical and radiologic presentation. For this reason, a multidisciplinary setting with a team of neurosurgeons, orthopedic specialists, radiologists, pathologists, and oncologists should manage these cases as soon as a pathologic diagnosis is available. More attention should be focused on other therapies that effectively manage microscopic pathologic involvement, without increasing the risk of postoperative morbidity.
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Review Case Reports
Anterior Column Realignment in Adult Spinal Deformity: A Case Report and Review of the Literature.
Anterior column realignment (ACR) is a new emerging minimally invasive surgical technique for adult spinal deformity (ASD) that has the potential to provide similar corrective ability to traditional posterior approaches. This article reviews the current literature on the clinical efficacy and safety of ACR and illustrates an additional use of this technique in a case of sagittal imbalance after posterior spinal fusion with segmental instrumentation. ⋯ Radiographic and clinical outcomes after ACR have been promising so far. In addition to primary ASD surgery, ACR can also be effectively used in cases with prior posterior instrumented spinal fusion to correct sagittal imbalance.
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Review Case Reports
Post-Exercise Death due to a Hemorrhagic Colloid Cyst of the Third Ventricle: A Case Report and Literature Review.
Colloid cysts of the third ventricle are rare, slow-growing lesions of neuroepithelial origin. Although histopathologically benign, third ventricular colloid cysts are a well-known cause of sudden, unexpected coma and death. Several theories have been proposed to describe the rare, sudden onset of severe symptomatology and rapid clinical decline due to colloid cysts. Moreover, there is currently no clear consensus regarding the most suitable neurosurgical technique or the most effective approach for resection, nor do guidelines or standardized clinical indications exist to recommend observation versus intervention and/or resection in the asymptomatic patient. To highlight this conundrum, we present a clinical case of a hemorrhagic colloid cyst that resulted in fatality and discuss the relevant literature. ⋯ To our knowledge, this is the only case report to describe sudden-onset coma and death due to a hemorrhagic third ventricular colloid cyst occurring after exercising. We review the literature on fatal colloid cysts emphasizing the proposed mechanisms of sudden death and current neurosurgical management in both asymptomatic and symptomatic patients.