World Neurosurg
-
Review Case Reports
Giant Cell Ependymoma of the Lateral Ventricle: Case Report, Literature Review, and Analysis of Prognostic Factors and Genetic Profile.
Giant cell ependymoma (GCE) is a rare primary central nervous system neoplasm. We report a case of GCE arising in the lateral ventricle. ⋯ Although rare, GCE should be considered in the differential of young patients with atypical intraventricular lesions, particularly given that extent of resection is associated with increased survival and GCE is thought to be radiation resistant.
-
Review Case Reports
Remote Thoracic Myelopathy From a Spinal Dural Arteriovenous Fistula at the Cranio-Cervical Junction - Case Report and Review of Literature.
The craniocervical junction is a rare location for spinal dural arteriovenous fistulas (dAVFs). Typically, fistulas at this location present with findings related to intracranial cortical venous reflux or cervical myelopathy. We present a case of craniocervical junction dAVF with isolated clinical and radiographic findings of thoracolumbar myelopathy. ⋯ Isolated lower extremity myelopathic symptoms are a rarely reported finding in patients harboring craniocervical junction dAVFs. At our institution, noninvasive imaging with TR-MRA is routinely used to aid localization of dAVFs. This results in decreased contrast dose and radiation exposure, and inclusion of the cervical spine should be performed when thoracolumbar imaging fails to identify a dAVF prior to proceeding to invasive angiography.
-
Review Case Reports
Skull Metastasis From the Liver.Case Report and Literature Review.
Calvarial metastasis from liver cirrhosis in the absence of a primary focus is exceptionally rare. Few reports of metastases from hepatocellular carcinoma of an unknown primary focus have been published. ⋯ A calvarial mass may be an initial manifestation of hepatocellular carcinoma. Early diagnosis is important. A calvarial metastasis from the liver, although very rare, should be included in the differential diagnosis of a patient with both cirrhosis and skull mass.
-
Intradural epidermoid tumors of the spinal cord are commonly associated with spinal cord dysraphism or invasive procedures. We report the particular relationships between spinal subarachnoid compartments and thoracic intradural-extramedullary epidermoid tumor, highlighting the relevant anatomic changes that may influence microsurgery. ⋯ A thorough knowledge of spinal subarachnoid space anatomy is helpful to distinguish between tumor membranes and arachnoidal planes and to achieve a safe and complete resection to avoid recurrences.
-
Randomized Controlled Trial
Effects of transcranial direct-current stimulation on neurosurgical skill acquisition: a randomized controlled trial.
Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery require extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure the acquisition of skill proficiency. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning, but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition. ⋯ The addition of tDCS to neurosurgical training may enhance skill acquisition in a simulation-based environment. Trials of additional skills in high-skill residents, and translation to nonsimulated performance are needed to determine the potential utility of tDCS in surgical training.