World Neurosurg
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Tolosa-Hunt syndrome (THS), a nonspecific chronic inflammation of the cavernous sinus, is a rarely needed surgical manipulation, even for diagnosis, because corticosteroid therapy is markedly effective against this condition. ⋯ This article presents details of surgical findings of THS that have not been demonstrated in any previous reports.
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Case Reports
Atypical presentation of primary central nervous system non-Hodgkin lymphoma in immunocompetent young adults.
Primary central nervous system non-Hodgkin lymphoma (PCNSL) is a malignant lymphoma limited to the cranial-spinal axis in the absence of systemic lymphoma. Historically, PCNSL accounts for fewer than 5% of all cases of primary intracranial neoplasms. PCNSL is rare in immunocompetent young adults. Although the prognosis for PCNSL is poor, approximately 20%-30% percent of cases achieve a cure. ⋯ To our knowledge, this is the first report of primary CNS lymphoma of the choroid plexus and septum pellucidum in otherwise healthy, immunocompetent young adults.
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To understand better the scope of wrong-level lumbar spine surgery and current practices in place to help avoid such errors. ⋯ There is substantial heterogeneity in approaches used to localize operative levels in the lumbar spine. Existing safety protocols may not be mitigating wrong-level surgery to the extent previously thought.
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To report a single case of malignant transformation of a vestibular schwannoma after radiosurgery and review the growing body of literature describing patients with malignant transformation of primary benign tumors after radiosurgery, including vestibular schwannoma. ⋯ Malignant vestibular nerve tumors are extremely rare; only 18 cases have been reported in the literature. Our patient is the sixth pathologically confirmed case of malignant transformation after radiosurgery, supporting the contention that radiosurgery itself may play a causative role in transformation. In a histologically benign lesion, the presence of an elevated MIB-1 labeling index may predispose toward malignant transformation in the setting of adjuvant radiosurgery.