World Neurosurg
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Case Reports
Clinical Image: A meningoencephalocele caused by a chronic growing skull fracture in a 76-year old patient.
We present a case of a growing skull fracture in adult male, with an interval of 43 years after initial trauma. This finding is extremely rare, especially because growing skull fractures are mostly seen as an uncommon complication of pediatric head trauma with calvarial fracture. In our patient, this finding was incidental, existed for many years, and had no clinical consequences. Therefore, we advised a conservative treatment for our patient.
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Case Reports
A traumatic spinal perimedullary arteriovenous fistula induced by a cervical glass stab injury.
In the literature, perimedullary arteriovenous fistula (AVF) is an uncommon spinal vascular malformation that is generally regarded as a congenital lesion. To our knowledge, only a few cases of traumatic perimedullary AVF have been reported in the literature so far. ⋯ Cervical trauma should be considered as a possible cause of de novo perimedullary AVF. Recognition of this phenomenon is important.
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Neurenteric cysts are rare central nervous system lesions derived from an endodermal origin. There is no consensus concerning pathogenesis because of the paucity of occurrences. We report an immunohistochemical study of 10 cases with neurenteric cysts and postulate its pathogenesis. ⋯ We postulate that the cystic tumor was derived from multipotent endodermal cells that migrated and traveled along the neuroectoderm, with incomplete differentiation into various cell types as a result of an unsuitable microenvironment. Because the neurenteric canal was only the channel of migration rather than a component of the cysts, the term neuroendodermal cysts is more precise in presenting the embryopathogenesis.
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Case Reports
Adjunct to embolize the high-flow fistula part of AVM using double lumen balloon catheter.
The purpose of this study is to report our initial experience of Onyx embolization of the high-flow fistula part of arteriovenous malformation (AVM) using a double-lumen balloon catheter. ⋯ The double-lumen Scepter balloon appears to be a safe and convenient device for Onyx embolization of high-flow fistulas.
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For older patients (>65 years) who undergo surgical treatment of vestibular schwannoma (VS), the reported rates of facial nerve preservation, hearing preservation, and complications are inconsistent. Many surgeons believe that older patients have worse outcomes than their younger counterparts and advise against surgical treatment. We analyzed a consecutive series of patients with VS treated with surgery to determine whether age was a factor in outcome. ⋯ With no difference in surgical complications, facial nerve outcome, or hearing preservation rates between older and younger patients in our series, age alone may not be an absolute contraindication to surgical management of VS.