Neurosurg Focus
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Petroclival meningiomas remain one of the most challenging intracranial tumors to treat surgically. This is attributable to their location deep within the skull base and their association with multiple critical neural and vascular structures. Over the years, many skull base approaches have been described that are meant to improve resection and decrease patient morbidity. ⋯ M.) between 1995 and 2005 to assess the factors used to determine the choice of surgical approach, and to assess complication rates based on the approach selected. The skull base approaches used in these patients included the middle fossa anterior petrosal, posterior petrosal, and combined petrosal approaches, and complete petrosectomy. Factors found to be important in determining the selection of approach included the size, location, and extension of the tumor, preoperative hearing evaluation, and venous sinus anatomy.
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Case Reports
Postoperative cauda equina syndrome in patients undergoing single-level lumbar microdiscectomy. Report of two cases.
Cauda equina syndrome is a well-documented complication of uneventful lumbar microdiscectomy. In the vast majority of cases, no radiological explanation can be obtained. In this paper, the authors report two cases of postoperative cauda equina syndrome in patients undergoing single-level de novo lumbar microdiscectomy in which intraoperative electrophysiological monitoring was used. ⋯ Both patients showed marked improvement after an intense course of rehabilitation. The authors' findings support the proposition that intraoperative SSEP monitoring may be useful in predicting the development of cauda equina syndrome in patients undergoing lumbar microdiscectomy. Nevertheless, further prospective clinical studies are necessary for validation of these findings.