World Neurosurg
-
Intradural intramedullary lipomas without dysraphism are rare tumors. Although they appear extramedullary on imaging, they invade into the intramedullary substance of the spinal cord. We present 2 cases and discuss their clinical presentation, radiologic findings, and surgical management. ⋯ Intramedullary thoracic spinal lipomas without spinal dysraphism are rare. Although these tumors may appear completely extramedullary on imaging, extreme care should be taken during surgery because the lesions eventually become intramedullary, intercalating within the substance of the spinal cord, precluding gross total resection.
-
Currently, radiologic predictors for the resectability of cervical dumbbell schwannomas remain unknown. To identify radiologic predictors for resectability, we retrospectively reviewed data from 72 patients. ⋯ The resectability of cervical dumbbell schwannomas may be predicted by MRI features, including tumor size, tumor level, and degree of VA involvement.
-
Case Reports
NECROTIZING FASCIITIS INVOLVING THE SPINE: An unusual medical emergency for the spine surgeon.
Necrotizing fasciitis (NF) is a surgical diagnosis characterized by a rapidly progressive soft tissue infection, widespread tissue necrosis, and associated systemic illness. Friability of the superficial fascia, dishwater-gray exudate, and absence of pus are surgical characteristics of this diagnosis. Due to rapid progression of the infection, early recognition and aggressive surgical debridement are crucial to reduce mortality. Despite being commonly seen by general, plastic, and orthopedic surgeons, NF is an extremely rare spine surgery emergency. Our objective is to report on a case of NF involving the spine and highlight this unusual surgical emergency for the spine surgeon. ⋯ To the best of our knowledge, the literature presents only 1 previous case reported involving the spine. Necrotizing fasciitis is an unusual surgical spine surgery emergency. Spine surgeons should be aware of this diagnosis in order to provide timely aggressive surgical debridement.
-
The increasing frequency of elderly patients with severe tortuous anatomy, especially when combined with fibromuscular dysplasia, can make intracranial canalization severely difficult or impossible. Computed tomography angiography was used to determine the feasibility of accessing the internal carotid artery (ICA) via a percutaneous translacerum approach. ⋯ Access of the ICA via the foramen lacerum can be safely performed with currently available technologies.
-
Subarachnoid hemorrhage (SAH) frequently results in severe morbidity, even mortality. Hypothermia is known to have a neuroprotective effect in ischemic injuries. The aim of this study was to determine whether nasopharyngeal (NP) perfluorochemical (PFC) cooling could be used in a rat model of SAH model for neuroprotection. ⋯ The data from this study indicate that local hypothermia by NP-PFC cooling supports return of CBF and neuronal integrity and suppresses the inflammatory response in SAH, suggestive of a promising neuroprotective approach in management of SAH.