Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Although prostate adenocarcinoma is the most commonly diagnosed cancer in men, intracranial metastases are rare. We describe a 72-year-old patient with known metastatic prostate cancer, presenting with a dural-based parafalcine lesion on radiological imaging, following a seizure. Total macroscopic excision of the lesion was achieved at surgery, with histopathology confirming prostate adenocarcinoma embedded in an atypical (World Health Organization Grade II) meningioma, fulfilling all the criteria for true tumour-to-tumour metastasis. To our knowledge, this is the first report of prostate cancer metastasising to an atypical meningioma.
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We used PubMed, Medline, and EMBASE to conduct a meta-analysis to determine the significance of high signal intensity on T2-weighted MRI for predicting postoperative prognosis in patients with cervical spondylotic myelopathy (CSM). Although patients with CSM with high signal intensity on T2-weighted MRI usually had a poor prognosis even after undergoing surgery, some researchers have argued recently that high-intensity signals are not associated with postoperative prognosis. Data consistent with the inclusion criteria of this study were cited for meta-analysis using Review Manager 5 Software. ⋯ Five articles (one prospective; four retrospective) involving 309 patients with CSM were included. The aggregate WMD with regard to the postoperative JOA recovery ratio between the T2-weighted high signal intensity positive (+) group and the T2-weighted high signal intensity negative (-) group was -6.56, and the 95% confidence interval (CI) was -12.15 to -0.97 (p=0.02). Thus, we concluded that in patients with CSM, the postoperative JOA recovery ratio in the T2-weighted (+) group was lower than that in the T2-weighted (-) group.
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Stent-based mechanical thrombectomy was recently proposed as an effective alternative to other mechanical techniques to achieve recanalization of large-vessel embolic occlusions in the anterior circulation. To our knowledge, there are no reports of the use of this technique in acute basilar artery occlusion (ABAO). ⋯ Advantages and limitations of this technique in the management of ABAO are discussed. The stent-thrombectomy technique is promising, and will need further evaluation in posterior circulation stroke.
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Anterior cervical decompression and fusion is most successful when bone graft is combined with stabilizing instrumentation. The use of bioresorbable anterior cervical plates has been reported recently instead of the traditional titanium plate. ⋯ Successful fusion is visualized on CT imaging at 8-year follow-up. To our knowledge this is the first report of long-term follow-up showing successful fusion with this technology.
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Lumbar discectomy is the most commonly performed spine surgery and in recent years, minimally invasive tubular discectomy has become increasingly popular among surgeons and patients. However, recent reports have raised the question of whether or not patients have shorter hospitalizations following minimally invasive discectomy. From 2005 to 2010, we analyzed 109 patients who underwent elective, single-level lumbar discectomy for central or paracentral disc herniations. ⋯ Tubular discectomy was not associated with increased rates of durotomy, nerve root injury, wound complications, or recurrent disc herniations requiring additional surgery. Minimally invasive tubular discectomy in the lumbar spine results in a small, but statistically significant, advantage in length of stay compared to conventional open microdiscectomy. While small on an individual basis, this difference may translate to substantial economic savings over time when one considers how many discectomies are performed in aggregate.