World Neurosurg
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Review Case Reports
Endoscopic management of spontaneous clival CSF leaks: case series and literature review.
Spontaneous cerebrospinal fluid leaks are most commonly located along the anterior skull base. Sphenoidal localization is less common, and clival localization is even rarer. We analyzed a group of patients with spontaneous leaks and selected patients with clival localization. This article discusses surgical management of these entities and provides a brief literature review regarding spontaneous clival leaks. ⋯ This series, although numerically limited, suggests that a minimally invasive endoscopic repair of idiopathic clival leaks may be accomplished with an acceptable rate of morbidity and excellent outcomes. Moreover, the pedicled nasoseptal flap has been confirmed to be the "workhorse" for the reconstruction of clival defects.
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Comparative Study
Comparison of outcomes of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for young adults: a retrospective matched cohort study.
There have been only a few studies on surgical treatment of lumbar disc herniation (LDH) in young adults. In addition, previous studies do not provide detailed information on the surgical outcomes for young adults with LDH. The purpose of this study was to compare the outcome of transforaminal percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy for active, young adults (age 20-25 years). ⋯ Although a learning curve is needed in order to become familiar with PELD, PELD seemed to be a good choice for disc herniation in the lumbar spine for active, young adults.
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Case Reports
Encountering a basal vein of Rosenthal variant during the anterior transpetrosal approach.
The basal vein of Rosenthal (BVR) is important in intracranial surgery, including skull base surgery. We report a case of petroclival meningioma in which a BVR variant drained into the tentorial sinus. ⋯ To our knowledge, this is the first study to describe surgery using the ATPA and involving a BVR variant, in which the vein was imaged successfully preoperatively using sliding-thin-slab MIP.
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Giant serpentine aneurysms are complex intracranial lesions, associated with a poor prognosis if left untreated. Treatment usually involves surgical trapping of the aneurysm with arterio-arterial anastomosis; however, recent endovascular management has been implemented for the management of such aneurysms. ⋯ Thrombosed giant serpentine aneurysms can show dramatic resolution of mass effect with endovascular treatment.