Surg Neurol
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Case Reports
Cerebello-Pontine angle (CPA) lymphoma with perineural extension into the middle fossa: case report.
Tumors of the cerebello-pontine angle are most commonly schwannoma and meningioma. Primary central nervous system (CNS) lymphoma usually presents deep within the cerebral hemispheres, occasionally is found in the cerebellum, and rarely occurs in the cerebello-pontine angle. We report a rare case of primary CNS lymphoma involving the right cerebello-pontine angle and the middle cranial fossa mimicking a tentorial meningioma. ⋯ Imaging and surgery disclosed a cerebello-pontine lymphoma with perineural extension along the 7(th) nerve to reach the middle cranial fossa. Because of the unusual imaging characteristics of this tumor, as well as special considerations with respect to treatment, preoperative consideration of this entity is important in planning direct surgical biopsy rather than an extensive resection.
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Anterior cranial fossa dural arteriovenous fistulas (DAVFs), unlike those in other locations, form a distinct subgroup because of a high incidence of intracerebral hemorrhage and their unique anatomy. We surgically obliterated an unruptured anterior cranial fossa DAVF because the venous aneurysm in the DAVF increased in size during the follow-up period and we present the clinical symptoms, the natural history for a 7-year period before operation, the radiologic findings, and surgical management. This is the first case report in which the growth of a preexisting venous aneurysm in an anterior fossa DAVF was identified. The possible pathogeneses of the rupture of anterior cranial DAVFs are discussed. ⋯ In this case, we confirmed an increase in the size of a venous aneurysm of an anterior cranial fossa DAVF. Our findings support the belief that the catastrophic intracranial hemorrhage in an anterior cranial fossa DVAF may occur in the setting of increased hemodynamic pressure of its draining venous channel.
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Elevated intracranial pressure (ICP) is significantly associated with high mortality rate in severe head injury (SHI) patients. However, there is no absolute agreement regarding the level at which ICP must be treated. The objective of this study was to compare the outcomes of severe head injury patients treated by setting the ICP threshold at >or=20 mm Hg or >or=25 mm Hg. ⋯ This study supported a recommended ICP threshold of 20 to 25 mm Hg in SHI management. However, in cases with an absence of basal cisterns on initial CT scan, the probability of good outcome may be higher using an ICP threshold of >or=20 mm Hg.
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Case Reports
Common peroneal nerve palsy as a complication of anterior cervical operation: a case report.
Common peroneal nerve palsy is a well-recognized complication following orthopedic procedure in and around the knee region. In neurosurgical practice, however, this kind of injury with regard to the patients' position is seldom reported. ⋯ We propose that such palsy may result from immobilization in a certain position instead of direct compression or traction of the corresponding nerve, although this is not proven. In this report, we suggest the possible risk factors, preventive measures, therapeutic options, and relevant outcome of this unwanted result.