Neurosurgery
-
Neurinomas of the hypoglossal nerve are very rare. They are mostly located intracranially or combined intra- and extracranially, resulting in the so-called dumbbell shape. The isolated extracranial localization of the neurinoma of the hypoglossal nerve adjacent to the cranial base as described in this case report is extremely rare. ⋯ Pathologies of the hypoglossal nerve as such are very rare within the clinical landscape. When a tumor occurs, its shape and location must be analyzed to establish whether, or by which approach, surgical removal is feasible. Although very unusual, the mere extracranial occurrence of a hypoglossal neurinoma at the cranial base should be considered a differential diagnosis.
-
We present a case of syringomyelia attributed to a transverse thoracic arachnoid web at T4. The cerebrospinal fluid pressure caudal to the web was higher than the cerebrospinal fluid pressure rostral to the web, causing a syrinx in the thoracic and cervical spinal cord above the web. ⋯ In patients with presumed idiopathic syringomyelia, imaging studies should be closely inspected for the presence of a transverse arachnoid web. Surgical resection of a transverse thoracic arachnoid web with syringomyelia can result in resolution of the syringomyelia and improvement in neurological function. Syrinx formation in patients with these webs may occur in the area of the spinal cord where there is lower cerebrospinal fluid pressure, which may be either rostral or caudal to the arachnoid web. We evaluate this hypothesis by comparing our case with other published cases.
-
Much has been written about the accomplishments of Walter E. Dandy, and he remains one of the seminal figures in neurosurgery. ⋯ What is not as well known is that Dandy was the first to accurately describe and treat lumbar disc herniation. He published a thorough clinical, operative, and pathological description in a 1929 Archives of Surgery article, titled "Loose Cartilage from Intervertebral Disk Simulating Tumor of the Spinal Cord." His publication predates by 5 years the well-known 1934 Mixter and Barr article "Rupture of the Intervertebral Disc with Involvement of the Spinal Canal."