J Neurosurg Sci
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Our aim in this study was to recognize the endoscopic anatomy of the pterygopalatine fossa (PPF) and the anatomic variations of the related neurovascular structures, to define the endoscopic endonasal approach to this region. ⋯ During the endoscopic transnasal transmaxillary approach to the PPF, it is possible to face wide range of variations in every phase of the approach. Understanding the anatomy of this region and the neurovascular relations from the endoscopic view by cadaver dissections will help us to performed more controlled and safe surgery.
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Review Case Reports
Extradural meningioma presenting with severe epistaxis: a case report and review of the literature.
Extradural or ectopic meningiomas are, as previously described in the literature, very rare lesions. Extradural meningiomas may often be confused preoperatively with primary skull or soft tissue tumors. The origin of these lesions is controversial and their exact pathogenesis is unknown. ⋯ The patient underwent a left frontobasal craniotomy with total resection of extradural mass. The authors also review the literature concerning extradural or ectopic meningiomas and find 134 cases reported between 1951 and the present time. The authors emphasize that early detection and identification of the initial lesion should be coupled with total surgical resection for a complete curation.
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Giant herniated thoracic disc (HTD) is a rare disease that, unlike other thoracic disc herniations of different size, need a different surgical management. The copresence of ''giant'' volume and calcification of the herniated disc heavily affects the surgical difficulty and is not elsewhere described. ⋯ Giant calcified HTDs are particularly challenging surgical lesions and their volume and consistency are additional elements of difficulty. This article presents authors' personal experience on a small but extraordinary series of giant and calcified thoracic herniated discs and the problems encountered in the management of this peculiar pathology since an accurate surgical planning leads to better clinical results.
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Circumferential reconstruction of thoracic and lumbar vertebrae is most frequently performed in two sessions. The authors assessed feasibility, safety and results of a surgical technique in which the use of a small cage allows a less invasive strategy. In addition, since the authors perform urgent decompression in specific cases of spinal cord injury, feasibility of this technique in emergency was verified. ⋯ This technique, fairly undemanding and feasible also in emergency, proved to be safe and resistant. Two-year follow-up demonstrated thriving fusion and steady alignment. It is a valuable surgical therapy to selected cases of burst fracture.
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In patients with traumatic spinal cord injury, several studies correlate neurological impairment and radiological findings. However, little information is available about this correspondence in the particular group of acute traumatic central cord syndrome. The object of the present work was to describe the clinical and radiological features of a series of patients presenting with acute traumatic central cord syndrome and to analyze clinical and radiological correlations on admission and at last follow-up. ⋯ Elderly patients with more degenerated cervical spines commonly develop acute traumatic central cord syndrome after incidental falls. Length of spinal cord edema correlates with neurological impairment on admission and may provide significant prognostic information.