World Neurosurg
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The aim of this study was to identify the risk factors for subsequent hemorrhage in patients with untreated cerebellar arteriovenous malformations (AVMs). ⋯ Childhood at diagnosis, large AVM size, and AVMs with exclusively deep venous drainage are independent risk factors for subsequent hemorrhage in patients with cerebellar AVMs. Previous rupture may increase the hemorrhagic risk during the first 5 years after diagnosis but may not significantly increase the risk in the following years.
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To highlight the management nuances in addressing mirror aneurysms (MirAns) in a subset of multiple aneurysms. ⋯ MirAns are not significantly associated with risk factors such as age, hypertension, and diabetes. Intraoperative rupture, vasospasm, and infarct are less common, with a tendency towards better neurologic outcome compared with nMirAns.
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Timely detection of intraorbital and skull base wooden foreign bodies is crucial. Wooden foreign bodies are difficult to detect on imaging. The radiologist may fail to identify wooden foreign bodies on two thirds of initial scans and can miss them in almost one third of total cases. ⋯ This case indicates that intraorbital and skull base wooden foreign bodies are elusive, demanding a high index of suspicion from both clinicians and radiologists to identify retained material in the setting of ocular or sinus trauma. For better identification of wooden foreign bodies, bone windows on CT should have a width of -1000 Hounsfield units with a soft tissue window level of -500 Hounsfield units.
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Preoperative delineation of normal tissue displacement patterns in Lhermitte-Duclos disease has not been feasible with conventional imaging means. Surgical resection of this type of lesion remains challenging, because the boundaries of the lesion are indistinguishable during surgery. ⋯ This case report suggests that HDFT may be a powerful surgical planning tool in cases of Lhermitte-Duclos disease, in which the pattern of normal tissue displacement is not evident with conventional imaging, allowing maximal lesion resection without damage to the unaffected tracts. Therefore, this report contributes to solving the greatest challenge when operating on this type of lesion, which has not been resolved in any previous report in our review of the English literature.
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The Rhoton Collection is an archive of Dr. Al Rhoton Jr.'s anatomical images and video lectures, as well as an anatomical reference. ⋯ Surgical cases are cross-referenced to further enhance the usefulness of this collection, which is available at http://rhoton.ineurodb.org. The features of the Rhoton Collection website are described in this article.