Surgical neurology international
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Case Reports
Resection and imbrication of symptomatic sacral Tarlov cysts: A case report and review of the literature.
Symptomatic Tarlov cysts are extremely rare, and there is no consensus regarding their optimal surgical management. Here, we encountered a patient with a symptomatic sacral Tarlov cyst and reviewed the appropriate literature. ⋯ Here, we present a 40-year-old male who was symptomatic from a right S2 Tarlov cyst compressing the S2-S3 perineural sheaths and successfully underwent microscopic cystectomy with obliteration of the subarachnoid connection. Additionally, the appropriate Tarlov cyst literature was reviewed.
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Accessory anterior cerebral artery (ACA), a type of median artery of anomalous triplicate ACA, is not rare, but aneurysms of the anterior communicating artery (ACoA) associated with accessory ACA can be a considerable challenge to treat surgically based on the morphological features of the ACoA complex. ⋯ In treating this aneurysm via the pterional approach, selection of approach side it is critical to preserve prevent the patency of the accessory ACA and to simultaneously perform aneurysm clipping without leaving a neck remnant. Selecting the optimal approach based on preoperative neuroimaging of which side will allow both these actions is important.
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Pineal cysts are benign lesions of the pineal gland without a clear etiology. Currently, different approaches are described to deal with pineal region lesions and particularly with pineal cysts. Although endoscopic procedures are becoming more frequent, some technical advantages of the microsurgical resection still make it the gold standard. Our aim was to demonstrate the efficiency and safety of our microsurgical technique into deep brain territories under the principle "simple, clean, and preserving the normal anatomy." Herein, we present an unedited microneurosurgery of a histologically confirmed large benign pineal cyst. ⋯ http://surgicalneurologyint.com/videogallery/pineal-cyst/.
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A wide opening of the Sylvian fissure (SF) regarding the treatment of middle cerebral artery (MCA) aneurysm allows us to ensure early proximal control by the proximal start of Sylvian dissection and enough comfort for the microsurgical manipulation and aneurysm clipping. However, major mechanical manipulation of arteries associated with blood oozing into the surgical field may increase the incidence of postoperative vasospasm. The risk of Sylvian venous injury is bigger, and the damage of the superior temporal gyrus increases the risk of postoperative epilepsy as well. A focused opening of the SF based on 18 years experience of a senior author is an alternative technique we present in this video abstract. ⋯ http://surgicalneurologyint.com/videogallery/focused-opening-of-the-syvian-fissure/.
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The management of traumatic upper thoracic spine fractures (T1-T6) is complex due to the unique biomechanical/physiological characteristics of these levels and the nature of the injuries. They are commonly associated with multiple other traumatic injuries and severe spinal cord injuries. We describe the safety and efficacy of surgery for achieving stability and maintaining reduction of upper thoracic T1-T6 spine fractures. ⋯ Surgical treatment of upper thoracic spine fractures (T1-T6), although complex, is safe and effective. Reduction and fixation of these fractures decreases the risk of further neurological complications, allows for earlier mobilization, and correlates with shorter hospital LOS and improved outcomes.