World Neurosurg
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Case Reports
Adult Intramedullary Teratoma of the Spinal Cord: A Case Report and Review of Literature.
Teratomas of the spinal cord constitute 0.1% of all spinal tumors, and these lesions are extremely rare in adults. The authors describe a rare case of intradural intramedullary teratoma of the conus medullaris and perform review of literature of intramedullary teratomas seen in the thoracolumbar region. ⋯ Teratomas should be taken into consideration in the differential diagnosis of intramedullary lesions when the imaging reveals variable signal intensity because of tissue heterogeneity. A partial resection is a viable treatment option when the lesion is attached to vital structures because of the low recurrence rates reported in the literature.
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Neuroendoscopy is increasingly being used in the management of intraventricular brain tumors. The role of endoscopy in diagnostic biopsy is well established. Expansion of these techniques may allow for definitive resection of intraventricular tumors. We report the feasibility and outcomes of endoscopic resection of select intraventricular tumors in children. ⋯ Neuroendoscopic gross-total resection of solid intraventricular tumors is a safe and efficacious procedure in carefully selected pediatric patients.
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Case Reports
Combined transzygomatic and pterional approach for resection of a dermoid cyst of the foreman ovale.
Dermoid cysts are rare, benign intracranial lesions commonly located in the posterior fossa. We describe a uniquely located dermoid cyst in the foreman ovale resected via a combined pterional and transzygomatic approach.
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Surgical access to the third ventricle is challenging, given the depth of the operative field and close proximity of vital neural structures that must be traversed. For anterior third ventricular lesions, approach options include anterior transcallosal or transcortical, subfrontal, frontotemporal, or endonasal. The subcallosal approach, a translamina terminalis approach, is unique in that the surgical corridor is just below the corpus callosum, minimizes retraction and preserves corpus callosum integrity. Case examples are provided, and an anatomical study delineating the dimensions of the surgical corridor is performed. ⋯ The anterior subcallosal approach is a safe approach for lesions of the third ventricle that avoids splitting the corpus callosum and resecting unnecessary brain and minimizes brain retraction. This corridor is superior to the traditional subfrontal approach in terms of working space and compares favorably to the anterior transcallosal approach without disrupting the corpus callosum.