World Neurosurg
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Case Reports
Rare presentation of Rosai-Dorfman disease mimicking a cervical intramedullary spinal cord tumor.
Rosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy, is a rare, benign, lymphoproliferative disorder that commonly manifests as a massive painless cervical lymphadenopathy with associated fever and weight loss. Central nervous system involvement is extremely rare, and cervical spinal cord manifestation has not been reported. ⋯ This cervical presentation of Rosai-Dorfman disease with central nervous system involvement suggests variation in the clinical manifestations of the disease, necessitating greater surgical awareness.
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Fusiform aneurysms involving the A2 or distal A1-A2 segment of the anterior cerebral artery are uncommon and difficult to manage surgically with simple coiling or clipping. ⋯ These techniques may involve endovascular and surgical options in an attempt to obtain the best overall outcome. Bypasses in the interhemispheric fissure, while difficult, are important, even necessary, adjuncts to treatment of these complex lesions.
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The optimal management of asymptomatic children with small, nonenhancing intracranial lesions presumed to be low-grade gliomas (LGGs) is not entirely clear in the literature. However, surgical intervention via resection or biopsy is not without risk and is of questionable long-term benefit in children with stable lesions. We present a series of 12 patients with incidentally detected, small, nonenhancing, intracranial lesions that were managed with watchful waiting and serial magnetic resonance imaging (MRI) scans. ⋯ Our case series suggests that conservative management and close follow-up of incidental radiographic lesions consistent with LGGs is a safe and effective initial strategy in the pediatric population. In cases in which lesion size or quality changes, surgical resection may be necessary to confirm diagnosis. Further studies that include a larger number of patients and longer follow-up period are required to compare outcomes between this approach and initial surgical, radiation, or chemotherapy management strategies.
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To evaluate the attitudes and perceptions of medical student toward neurosurgery. ⋯ The findings identify some areas that may be targeted to stimulate and improve medical students' interest and passion toward the pursuit of neurosurgery as a specialty and ultimately to improve their learning experience.
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Prognosis of tinnitus after acoustic neuroma surgery--surgical management of postoperative tinnitus.
Tinnitus is a bothersome symptom for patients with acoustic neuroma. We studied the possibility of surgical control of postoperative tinnitus associated with acoustic neuroma. ⋯ Deciding whether to cut the cochlear nerve during acoustic neuroma surgery by referring to a flowchart, we proposed in cases where hearing preservation is not intended or judged less possible contributes to controlling postoperative tinnitus. However, regardless of whether the cochlear nerve was cut intraoperatively, tinnitus remained unchanged in 37% of patients, suggesting that their tinnitus originates in the brainstem or post-brainstem pathways before surgery, and it is considered difficult to control postoperative tinnitus in these cases.