World Neurosurg
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The intravenous application of sodium fluorescein (SF) for brain tumor surgery goes back to the late 1940s. The development of specific fluorophore filters significantly reduced the required dosage of SF and therefore diminished possible side effects. This study investigates the application of SF in benign peripheral nerve sheath tumors (PNSTs), concentrating on its feasibility during microsurgical removal. ⋯ SF reveals increased fluorescence in schwannomas compared with normal nerve tissue. Intraoperative differentiation of tumor and normal nerve tissue becomes possible using a low dose of SF (0.5-1 mg/kg). No side effects occurred. Secure microsurgical preparation is feasible during application of the YELLOW 560 nm filter.
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Transseptal puncture has been widely used by cardiologists to reach the left side of the heart through a transvenous access. Rarely, it also can be used to pass into the supra-aortic arteries from the venous side when conventional transarterial access pathways (transfemoral, transradial/brachial routes, or direct carotid puncture) are likely to fail. ⋯ Transvenous-transseptal access enabled treatment of both cases easily and without complications. On follow-up computed tomography angiograms, both flow diverters were patent, there were no residual aneurysms, and no neurologic or cardiac adverse events in either patient.
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We report a patient with primary central nervous system mixed malignant germ cell tumor (GCT) who presented with recurrent malignant germinomatous infiltration of the retina. ⋯ Loco-regional extension of suprasellar GCT to the optic nerve is not uncommon; however, to the best of our knowledge, infiltration of the tumor into the retina is not reported in the literature. Early detection of optic pathway involvement and proper delineation of the irradiation field may prevent GCT infiltration of the retina with subsequent vision loss.
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To identify clinical factors predicting the development of myelopathy in cervical ossification of the posterior longitudinal ligament (OPLL) patients with radiculopathy. ⋯ Nonmyelopathic OPLL patients with radiculopathy and a high occupying ratio were at higher risk of developing myelopathy, and surgical intervention should be recommended in these cases. However, for elderly patients with significant comorbid conditions, the risks and benefits of surgery should be carefully considered.
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Ligaments of the craniocervical junction play a critical role in stabilizing this region. Gerber's ligament has more or less been forgotten and, to our knowledge, never studied. ⋯ A good understanding of all ligaments of the craniocervical junction is important to surgeons and physicians treating patients with injury to the upper cervical spine.