World Neurosurg
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Case Reports
Shunt-related intracranial abscess caused by Staphylococcus lugdunensis in a hydranencephalic patient.
Staphylococcus lugdunensis is a coagulase-negative staphylococcus with aggressive and rapidly progressive infectious behavior. This organism has emerged as an important pathogen implicated in both community-acquired and nosocomial infections, including meningitis, brain abscess, catheter-related bacteremia, and ventriculoperitoneal shunt infection. ⋯ This case suggests that if Staphylococcus lugdunensis is identified, a virulent and prolonged clinical course with the production of destructive lesions, similar to those with S. aureus, should be expected. A course of antibiotic therapy and aggressive management that may include surgical treatment will be needed.
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To review the management of aneurysms arising at the origin of a duplicated middle cerebral artery (DMCA), which is an extremely rare entity. ⋯ Although all previously published clinical cases of internal carotid artery-DMCA aneurysms were treated surgically, conservative management with follow-up is a viable option in very small unruptured aneurysms.
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Intramedullary spinal sarcoidosis is a difficult diagnosis to make because of its nonspecific clinical and imaging features and its imitation of other common spine disorders. We present a patient with intramedullary spinal sarcoidosis that mimicked spinal cord injury from a cervical disk herniation. ⋯ Spinal sarcoidosis can mimic more common disease processes, such as cervical spondylosis. It is an important consideration in the diagnosis of intramedullary or intradural lesions of the spinal cord because early medical treatment may improve the course of the disease process. Surgery should be limited to biopsy for diagnostic purposes.
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Dural arteriovenous fistulas (DAVFs) have traditionally been approached through a bilateral laminectomy procedure with intradural exploration and ligation of the fistulae. A minimally invasive approach for DAVF ligation may be associated with fewer complications and a shorter recovery than the traditional laminectomy procedure. Our objective was to determine the feasibility, safety, and efficacy of intradural DAVF ligation via the use of a minimally invasive microsurgical technique. ⋯ The minimally invasive approach for intradural ligation of DAVFs appears to be a reasonable alternative to bilateral full laminectomies. Although no direct comparison with the more extensive bilateral laminectomy approach has been performed, our initial experience suggests that this novel approach may reduce blood loss and length of hospital stay.
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Historical Article
Ottoman surgical treatises and their influences on modern neurosurgery in Turkey.
To introduce the authors of 6 prominent Ottoman surgical treatises, to present the chapters that relate to present-day neurosurgery, and to discuss their influence on the establishment of modern Turkish neurosurgery. ⋯ These treatises, including sections on neurosurgery-related topics, were important influences on the establishment of contemporary neurosurgery in modern Turkey.