Surg Neurol
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Superficial vascular anatomy of the medial prefrontal cortex, which is exposed after craniotomy for the anterior interhemispheric approach, has received little attention in the anatomy literature. This study focuses on the precise vascular anatomy of the medial part of the prefrontal cortex and provides more detailed information for surgery. ⋯ The surface of the medial prefrontal cortex has a rich and complex vascular network and represents the first obstacle for surgery. The upper part of the medial prefrontal cortex seems safer than the lower part; the CS is a reliable and crucial landmark in planning and performing surgery in this region.
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The efficacy and the minimally invasive nature of the fully transnasal endoscopic procedure in the treatment of pituitary adenomas and other lesions of the sellar area have been widely reported in the literature. Many authors observed similar results in terms of the correction of hormonal hypersecretion in functioning pituitary adenomas using endoscopic endonasal surgery or the traditional microscopic technique. We report the endocrinologic outcome in 2 series of patients operated on at the same institution for functioning pituitary adenomas using these 2 different techniques. ⋯ In our experience, fully endoscopic transsphenoidal surgery for functioning pituitary adenomas leads to a better endocrinologic outcome for noninvasive macroadenomas compared to the traditional microsurgical technique. However, morbidity with the endoscopic technique was higher in terms of the rate of postoperative CSF leaks.
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We evaluated the role of Gamma Knife SRS in the multidisciplinary management of metastatic cancer to the pituitary gland. ⋯ Development of a pituitary metastasis is an ominous finding in the context of systemic cancer. Stereotactic radiosurgery is an effective palliative approach for most patients with pituitary metastasis.
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Case Reports
High cervical spinal cord stimulation after failed dorsal root entry zone surgery for brachial plexus avulsion pain.
Many patients had intractable pain after brachial plexus avulsion. This article describes a feasible method of high cervical SCS for a patient who failed in DREZ surgery to treat the pain. ⋯ Stimulating the high cervical spinal cord is effective for treating intractable pain after brachial plexus avulsion, which the DREZ surgery failed to relieve.
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Review Case Reports
Intracranial aneurysms in sickle cell patients: report of 2 cases and review of the literature.
The sickle cell disease has different neurologic complications, including cerebral aneurysms. This disease may lead to endothelial damage, which favors the development of cerebral aneurysms. Only a few cases demonstrated by cerebral angiography or surgery have been reported in the English literature referring to cerebral aneurysms in sickle cell patients. ⋯ Sickle cell patients have a high occurrence of multiple aneurysms, and a high prevalence of posterior circulation aneurysms. This must be interpreted with caution, and further studies are needed to confirm this association.