World Neurosurg
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To present a case of a cavernous malformation presenting with a subdural hematoma. ⋯ The clinical course, radiologic, and intraoperative findings suggest that the subdural hemorrhage was caused by extralesional hemorrhage of the cavernous malformation.
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Lipomatosis of nerve (LN) is a condition of massive peripheral nerve enlargement due to proliferation of fibrous and adipose tissue within the nerve, the natural history of which is currently unknown. We measured the pattern of growth in individuals with long-term radiologic follow-up. ⋯ Serial MRI reveals progressive enlargement of LN. The rate of growth was more profound in youth, but also occurred in early adulthood.
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Neurenteric cysts (NECs) are uncommonly encountered lesions of the central nervous system with heterogeneous imaging characteristics. The object of this study was to review the preoperative imaging findings represented among a cohort of surgically treated posterior fossa NECs. These findings are considered in the context of surgical technique, and inform an understanding of aberrant neuroembryological development associated with NECs. ⋯ Posterior fossa NECs display variable patterns of MRI signal and are commonly considered as part of a broad differential of cystic posterior fossa masses. We identified tumor insinuation between the ventral brainstem and vertebrobasilar system as a highly sensitive and specific radiographic sign for NECs. This finding was not observed among a large cohort of posterior fossa masses representative of other multiple pathologies.
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Telemedicine has always been used as a teleconsultation tool in neurological emergencies (e.g., triage in head injuries, stroke, and cerebrovascular accidents). At Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India, we have been operating two teleconsultation sessions per week for the postoperative patient population, addressing routine follow-up and semiemergent conditions in this cohort of patients. At our center more than 80% of the neurosurgical procedures are conducted in patients traveling more than 1500 km. ⋯ There are very few reports of telemedicine use in routine outpatient teleconsultations in the available neurosurgical literature; those that are present do not differentiate or analyze the use in routine versus emergency neurosurgery. We discuss the role of this underused resource in the developing countries and retrospectively analyze the clinical data in more than 1500 patients and 3000 teleconsultations during a period of 6 years. We address the financial implications, psychosocial factors, and several other factors that could make this relatively modest technology an indispensible tool in current neurosurgical practice, especially in a developing country like India.
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Hunterian ligation is performed to reduce and to change the flow of an aneurysm; it is a surgical option for a complex aneurysm that cannot be managed by either clipping or coiling. However, it may be associated with adverse effects. This study was carried out to analyze how Hunterian ligation changed the flow dynamics of a particular cerebral aneurysm. ⋯ Hunterian ligation is a useful flow diversion surgery, but it might worsen the flow dynamics in specific cases.