Surg Neurol
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A case of craniopagus twins is presented. The twins were attached to each other at the parietal vertex with an interaxis angle of 180 degrees and an interface angle of 90 degrees. To assess the bony, vascular, and nervous system interconnections, the twins underwent computerized tomographic scanning and cerebral angiography under inhalational general anesthesia. ⋯ This case was quite different as regards cerebral anatomy compared to those already reported in the literature.
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Case Reports
Preoperative PET activation for assessment of motor cortex area in precentral chondroma.
A main problem in the preoperative planning for precentral tumors is the exact assessment of the spatial relationship between the tumor and the functionally relevant brain areas, which may be difficult using only morphologically oriented imaging (CT, MRI). Therefore, we applied motor activation PET and PET/MRI overlay in a patient with a precentral tumor. ⋯ This case shows that biomodal imaging (PET/MRI) provides a noninvasive exact assessment of functionally important cortex areas for preoperative planning in patients with cerebral lesions.
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Case Reports
Persistent trigeminal neuralgia after removal of contralateral posterior cranial fossa tumor. Report of two cases.
Contralateral trigeminal neuralgia as a false localizing sign in patients with posterior cranial fossa tumors is rare. Persistent contralateral trigeminal neuralgia after removal of the posterior fossa expanding lesion with microsurgical exploration of the affected trigeminal nerve root has been described in only a few reports. Displacement of the brainstem and the trigeminal nerve root, arachnoid adhesions, and vascular compression of the nerve root entry zone have been reported as causes of persistent contralateral trigeminal neuralgia. ⋯ Persistent contralateral trigeminal neuralgia after removal of a posterior fossa tumor is caused by distortion of the fifth nerve root by the displaced brainstem. Partial trigeminal rhizotomy can be performed for alleviation of facial neuralgic pain in cases without neurovascular compression.
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Seven geriatric patients presented with displaced Type II odontoid fractures. All patients underwent a posterior C1-C2 transarticular fixation between November 1994 and December 1996. Ages ranged between 63 and 88 years. ⋯ Posterior transarticular screw fixation is a reasonable option in treating these controversial fractures. Seven geriatric patients tolerated this surgery well, and were mobilized early, avoiding complications related to external immobilization.