Surgical neurology international
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Osmotherapy is the frequently used for the treatment of intracranial pressure. The purpose of the study was to compare the effect of equiosmolar solution of 3% hypertonic saline and 20% mannitol on brain relaxation in supratentorial tumor surgery. ⋯ 3% hypertonic saline and 20% mannitol are equally effective for brain relaxation in elective supratentorial tumor surgery and compared with mannitol, hypertonic saline was associated with less diuretic effect.
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Case Reports
Glossopharyngeal neuralgia caused by a complex neurovascular conflict: Case report and review of the literature.
Glossopharyngeal neuralgia (GN) is a rare condition characterized by severe, paroxysmal episodes of pain mainly localized to the external ear canal, pharynx, and tongue, usually caused by a neurovascular conflict between postero-inferior cerebellar artery (PICA) and IX cranial nerve. Sometimes there is also a compression of X c.n. ⋯ The surgical treatment of patients with GN caused by complex neurovascular conflicts can be safely performed with the classical MVD of IX c.n. A double MVD of both IX and X c.n. has a role only in patients presenting symptoms from both nerves. Rhizotomy, in our opinion, has to be avoided in all cases. The authors review the literature concerning GN caused by complex neurovascular conflicts.
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Transforaminal lumbar interbody fusion (TLIF) is a well-accepted fusion technique that uses unilateral facet removal as an oblique corridor for inserting an interbody spacer. This manuscript focused on five cases of endoscopic foraminotomy for patients presenting with recurrent radiculopathy after TLIF procedures. ⋯ Lifespan: IRB Study # 600415.
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Gilles de la Tourette Syndrome (GTS) is a complex neuropsychiatric disorder, characterized by chronic motor and vocal tics, associated in 50-90% of cases with psychiatric comorbidities. Patients with moderate and severe clinical picture are treated with psychotherapy and pharmacological therapy. Deep brain stimulation (DBS) is reserved for pharmacological refractory GTS patients. As GTS tends to improve with time and potentially resolves in the second decade of life, the major concern of DBS in GTS is the age at which the patient undergoes surgical procedure. Some authors suggest performing DBS after 18 years, others after 25 years of age. ⋯ DBS is a therapeutic option reserved for severe and refractory GTS cases. In our opinion DBS might be considered as a temporary application in GTS.
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Cavernous malformations (CMs) of the optic chiasm are rare lesions often presenting with acute chiasmal syndrome or a progressive visual loss. The case of a 48-year-old female with an intrachiasmatic CM is presented. ⋯ The clinical, neuroradiological, and intraoperative findings are presented, along with a review of the literature.