Neurosurgery
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The etiological factors involved in idiopathic intracranial hypertension are not easy to identify. This case of idiopathic intracranial hypertension was associated with a capillary hemangioma growing in the lumen of the superior sagittal sinus. ⋯ A tumor growing into a venous sinus is a rare cause of venous outflow impairment and may generate the clinical signs of idiopathic intracranial hypertension. This case emphasizes the importance of multiple complementary imaging modalities and the efficacy of a direct surgical approach, which allowed resolution of symptoms.
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Comparative Study Clinical Trial
Ten-year experience with the supraorbital subfrontal approach through an eyebrow skin incision.
More than ever before, the priority in contemporary neurosurgery is to achieve the greatest therapeutic effect while causing the least iatrogenic injury. The evolution of microsurgical techniques with refined instrumentation and illumination and the enormous development of preoperative and intraoperative diagnostic tools enable neurosurgeons to treat different lesions through limited and specific keyhole approaches. ⋯ In our experience, the supraorbital craniotomy allows a wide, intracranial exposure for extended, bilaterally situated, or even deep-seated intracranial areas, according to the strategy of keyhole craniotomies. The supraorbital craniotomy offers equal surgical possibilities with less approach-related morbidity owing to limited exposure of the cerebral surface and minimal brain retraction. In addition, the short skin incision within the eyebrow and careful soft tissue dissection result in a pleasing cosmetic outcome.
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The posterior subscapular approach to the brachial plexus is commonly indicated in patients with neural entrapment (neurogenic thoracic outlet syndrome, especially when associated with a large C7 transverse process or cervical rib) and paraspinal tumors or lacerating injuries involving the spinal nerves close to the spine. This approach is also preferred in patients with previous anterior neck operations and/or morbid obesity. We describe the anatomy and operative technique of this approach, which has been used by the senior author (DGK) for the past 25 years.
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Case Reports
Thalamic stimulation as a treatment for primary erythromelalgia: technical case report.
We report the use of bilateral thalamic stimulation in a case of primary erythromelalgia with immediate and important pain relief for 3 years. ⋯ We conclude that thalamic stimulation was successful in this case of primary erythromelalgia.
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Review Case Reports
Spinal arachnoid cyst related to a nonaneurysmal perimesencephalic subarachnoid hemorrhage: case report.
We report the first case of a delayed symptomatic spinal arachnoid cyst related to a nonaneurysmal perimesencephalic hemorrhage. We review the literature concerning posthemorrhagic spinal arachnoid cysts. ⋯ This extremely rare complication should be kept in mind when delayed lower-limb neurological deficits appear after subarachnoid hemorrhage, even in a perimesencephalic form.