World Neurosurg
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Secretory meningioma (SM) is a rare histologic subtype known to cause disproportional peritumoral brain edema. Although meningiomas are defined by slow growth and mostly manifest with benign clinical symptoms, SMs can cause life-threatening deterioration. The aim of this study was to characterize the potential pitfalls in treatment of SMs by illustrating their characteristic clinical features. ⋯ Our results illustrate the complicated clinical course of this rare histologic meningioma subtype. The increased frequency of seizures may enable raised awareness of clinicians for potential complications and treatment adjustments perioperatively early at clinical admission.
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Recent decades have seen a rapid expansion of involvement of medical students in biomedical research during medical school training. Research within medical school has been shown to influence medical students with regard to medical knowledge, career development, and residency specialty choice. The objective of this study was to evaluate the impact of neurosurgery medical student research grants on neurosurgery residency choice and provide an insight on the demographics of grant awardees. ⋯ Neurosurgery grants for medical students are highly successful in producing future neurosurgeons with >50% of grant recipients matched into neurosurgery. Women are underrepresented in neurosurgery grants and neurosurgery residency programs. This situation can be improved by providing insight about the field early in medical school, perhaps through increased use of neurosurgery medical student grants.
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Complex skull base approaches are often used to treat lesions within the middle incisural space; yet the well-known retrosigmoid route may provide an effective avenue to this difficult-to-reach region. The purpose of this study was to quantify the exposure advantages on the middle incisural space provided by cutting of the tentorium cerebelli via a standard suboccipital retrosigmoid approach (i.e., via the cerebellopontine cistern route). Also, 2 illustrative cases are presented. ⋯ Tentorial incision may be useful to extend the rostral exposure of the middle incisural space via a simple retrosigmoid approach, avoiding the need for more complex skull base routes.
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Primary leptomeningeal melanomatosis (PLM) is a rare and aggressive form of nonmetastatic invasion of leptomeninges by malignant melanocytic cells. Clinical presentation includes nonspecific meningism with various forms of cerebrospinal fluid circulation or absorption disorders leading to hydrocephalus. ⋯ To the best of our knowledge, this is the first report of an amelanotic form of PLM without association of neurocutaneous melanosis in a child. This case report illustrates the difficulty of diagnosis in the absence of cutaneous lesions and lack of melanin.
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Endoscopic endonasal skull base surgery has become widely accepted in neurosurgery and otolaryngology over the last 15 years. However, there has yet to be a formal curation of the most impactful articles for an introductory curriculum to its technical evolution. ⋯ Identification of the most cited works within endoscopic endonasal skull base surgery shows greater anatomic access and safety over the last 2 decades. These articles can serve as an educational tool for novices or midlevel practitioners wishing to obtain a greater understanding of the field.