World Neurosurg
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Review Case Reports
Encasement of the cauda equina after early childhood meningitis: case report and review of the literature.
Arachnopathy following meningitis has been described in the setting of chronic spinal arachnoiditis and more recently as shunt-related progressive myelopathy due to meningeal thickening. ⋯ It is challenging but worthwhile to recognize this separate entity because, in contrast to both shunt-related progressive myelopathy due to meningeal thickening and adhesive arachnoiditis, surgery involving microsurgical dissection of the thick arachnoid encasement of the cauda equina may be curative in medically refractory cases.
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Intrameatal cochleovestibular neurovascular conflict is a rare condition with specific clinical and therapeutic implications. Although surgery is commonly indicated in other neurovascular conflicts, for this subset of patients there is little evidence to guide treatment decisions. Moving from a case description, we performed a review of the literature on this topic to systematically present the best available evidence to guide clinical decisions. ⋯ Surgical treatment offers the best results for tinnitus and vertigo, but it seems to have no effect on hearing loss, not even at long-term follow-up. Microvascular decompression should be proposed to intrameatal symptomatic patients before the onset of hearing loss.
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Nonpenetrating titanium clips create no suture holes and thereby reduce cerebrospinal fluid leakage after dural closure. However, no data exist regarding metallic artifacts caused by these clips during postoperative neuroimaging. We aimed to evaluate clip-related artifacts on postoperative magnetic resonance (MR) images of 17 patients who underwent spinal surgery. ⋯ Metallic artifacts caused by nonpenetrating titanium clips were 200% larger than the actual clip but did not affect spinal cord and extradural tissue visualization. The use of these clips for closing the spinal dura mater does not alter postoperative radiologic evaluation quality.
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Case Reports
Seizure Freedom After Limited Hippocampal Radiofrequency Thermocoagulation: A Case Report.
Surgical interventions are often used for freedom from seizure in patients with drug-resistant mesial temporal lobe epilepsy. A patient with seizure foci in the left mesiotemporal region underwent limited-size stereotactic radiofrequency thermocoagulation (RF-TC) over the left hippocampus. ⋯ Favorable seizure control was achieved with minimally invasive RF-TC. Further use of this technique is warranted in cases of drug-resistant mesial temporal lobe epilepsy.
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Case Reports
Daughter sac formation related to blood inflow jet in an intracranial aneurysm: A case study.
We performed a hemodynamic study of an intracranial aneurysm with a newly developed daughter sac during observation to investigate the role of hemodynamics on the formation of a daughter sac. ⋯ Blood inflow jet caused local elevation of pressure, and the formation of the daughter sac occurred at the site with high pressure but without the surrounding structure, which may cancel the perpendicular wall tension.