World Neurosurg
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To evaluate the effectiveness of bypass surgery for moyamoya disease, electrocorticography was first evaluated. ⋯ The spectral power of the beta band on electrocorticography was focally suppressed in patients with moyamoya disease, and the suppression was reversible by revascularization surgery. Steno-occlusive ischemic changes in moyamoya disease might cause suppression of neurophysiologic activity, and the present results provide insight into the potential neuromodulatory role of revascularization surgery.
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The authors present reports of 2 cases in which there was manifest atlantoaxial instability and presence of retro-odontoid pseudotumor. The retro-odontoid tumor disappeared in the immediate postoperative phase after surgery, which involved facetal distraction and atlantoaxial fixation. The cases are discussed. Although regression of the retro-odontoid pseudotumor has been reported after atlantoaxial fixation, its disappearance in the immediate postoperative phase has not been recorded. ⋯ The retro-odontoid pseudotumor appears to be related to buckling of the posterior longitudinal ligament. Distraction of the facets probably assists in stretching of the posterior longitudinal ligament. Our experience reconfirms that retro-odontoid pseudotumor could be a manifestation of atlantoaxial instability and need not be directly handled by surgery.
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Primary intraosseous calvarial hemangiomas (PICHs) are generally rare and predominate (3:1) in women. Occurrence in the frontal and parietal bones is most common, but involvement of the occipital bone is exceedingly rare, representing 3 of 125 cases in a series of PICHs studied by Heckl et al. in 2000. Histopathology establishes the diagnosis of cavernous hemangioma, which represents the most common subtype of intraosseous hemangiomas. Others include sclerosing, cellular, and capillary. When they do occur in the calvarium, they are most often asymptomatic and discovered incidentally or due to a palpable defect in the skull. ⋯ Primary intraosseous hemangiomas are rarely symptomatic but must be considered in the differential for calvarial lesions as part of safe surgical planning. Formulating an accurate differential diagnosis by acquiring proper imaging studies and specifically recognizing the classical "starburst" appearance, as well as considering the highly vascular pathology to avoid excess blood loss, is important. This unique case of a hemangioma-induced venous sinus compression and subsequent elevated intracranial pressure illustrates that hemangiomas can arise from any part of the calvarium and cause a wide variety of clinical symptoms.
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Treatment-related chronic neuropathic pain represents a major and increasing cause of discomfort in cancer survivors. Unfortunately, in approximately 10%-15% of cases, pain is scarcely relieved by opioids and common painkillers. Thus, alternative measures to manage pain have recently been adopted in these patients. ⋯ To the best of our knowledge, this is the first report in literature describing peripheral nerve field stimulation as a treatment option for intractable cancer treatment-related chronic neuropathic pain. Peripheral nerve field stimulation appears to be a safe and effective procedure.
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To use three-dimensional (3D) printed craniocerebral models to guide neurosurgery and design the best operative route preoperatively. ⋯ 3D printing provides neurosurgeons with solid craniocerebral models that can be observed and operated on directly and effectively, which further improves the accuracy of neurosurgeries.