World Neurosurg
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Review Case Reports
Endoscopic endonasal transsphenoidal approach for the removal of optochiasmatic cavernoma: a case report and literature review.
Cavernoma of the optic chiasm is a rare disease, and the most common clinical presentation is chiasmal apoplexy. Almost all the cases reported in the literature were treated surgically with craniotomy. ⋯ Rapid diagnosis and complete resection of a symptomatic optochiasmatic cavernoma are helpful in improving visual dysfunction. EETA is an alternative, minimally invasive technique for resecting this type of lesion.
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Review Biography Historical Article
Dr. Norman Chater and Chater's point: A Historical Vignette.
Dr. Norman Chater, a University of California San Francisco-trained microvascular neurosurgeon, dedicated his career to the development of surgical bypass techniques. ⋯ He identified Chater's point, an extracranial landmark that marks the posterior extent of the Sylvian fissure, which on craniectomy reliably exposes vessels of the angular gyrus, the vasculature found to be most appropriate for bypass procedures owing to its accessibility and vascular diameter. This surgical landmark continues to be essential for the successful execution of bypass surgeries to this day.
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Review Case Reports
Cerebral venous sinus thrombosis secondary to idiopathic hypertrophic cranial pachymeningitis: A case report and review of the literature.
Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare fibrosing inflammatory process involving the dura mater. Currently, there is no consensus on the treatments for IHCP, and the usefulness of immunosuppressive agents as a first-line option remains controversial. Cerebral venous sinus occlusion (CVSO) and cerebral venous sinus thrombosis (CVST) secondary to IHCP, which may cause progressive intracranial hypertension and venous obstructive parenchymal lesions, make the diagnosis and treatment of IHCP more complicated. ⋯ We experienced a patient with CVST secondary to IHCP, who was successfully treated with cyclophosphamide pulse therapy. Because IHCP with secondary venous obstruction has various differential diagnoses, venography is necessary to avoid misdiagnosis. The use of immunosuppressive agents may be promising but needs further verification.
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Review Case Reports
Initial treatment strategy for intracranial mycotic aneurysms: Two case reports and literature review.
Intracranial mycotic aneurysm (IMA) is a rare neurovascular disease and a well-known complication after infective endocarditis. IMAs potentially carry a high mortality risk resulting from intracranial hemorrhage. Therefore, initial treatment is crucial for IMA patients, but an optimal treatment strategy remains unknown. Herein, we report 1 cases of IMA patients treated with the current usual modalities, and we provide a comprehensive literature review to propose an optimal initial treatment strategy for IMAs. ⋯ On the basis of 129 IMA cases across 54 reports published from 2006 to 2016, we propose initial surgical intervention as an optimal treatment for patients with ruptured, and even unruptured, IMAs. Regarding surgical intervention, there was no significant difference in postoperative modified Rankin scale scores between direct surgery and endovascular treatment. By contrast, because antibiotic treatment significantly decreased IMA size in unruptured IMAs, antibiotic treatment might be a reasonable alternative for patients with unruptured IMAs, depending on the patient's situation.
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Review Case Reports
Treatment Strategies of subarachnoid hemorrhage from bilateral vertebral artery dissection: A case report and literature review focusing on availability of stent placement.
Bilateral vertebral artery dissection (VAD) may result in subarachnoid hemorrhage (SAH). However, a variety of factors contribute to the difficulties with treating SAH. We report a case of bilateral VAD with SAH, as well as a literature review. ⋯ Because of the increasing use of stent therapy, there has been a shift toward this treatment choice. For cases in which stents cannot be used, treatment methods based on prestenting protocols are helpful. A literature review indicated that conservative treatment for 2 weeks, in which vasospasm and rebleeding are controlled, may be considered compared with acute-stage stent treatment. Following our literature review, in situations in which stents cannot be used, only the ruptured side should be trapped with strict blood pressure control and detailed radiological images should be observed for 2 weeks. In conclusion, patient selection is essential to subject the patient to open surgery in such cases.