World Neurosurg
-
Endoscopic endonasal transsphenoidal surgery (EETS) is a widely accepted technique for sellar tumors. Common findings during preoperative assessment include septal deviations and turbinate hypertrophy. This study evaluated quality of life changes after concurrent septoplasty and/or inferior turbinoplasty during EETS. ⋯ Patients who underwent concurrent septoplasty and/or turbinoplasty with EETS had a significantly improved quality of life compared with preoperative assessment, specifically regarding psychological and sleep symptoms.
-
Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, including most importantly systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is underrecognized. We report a case of lumboperitoneal shunt-induced IH resulting in PRES with the goal to increase awareness and elaborate on the potential biologic mechanism, based on the Monro-Kellie hypothesis. ⋯ IH appears to be a distinct cause of PRES not previously reported in the neurosurgical literature. It occurs in susceptible patients, on average 1-5 days after the IH trigger, and seems clinically and radiologically similar to more common hypertensive cases in terms of initial presentation and prognosis. Increased vigilance is required for prompt recognition and management.
-
Multicenter Study
Transforaminal resection of cervical dumbbell schwannomas in patients with additional tumors.
It is rare for 2 primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible. ⋯ In most patients, the stability of the cervical spine can be preserved with low invasive microsurgical or endoscopic transforaminal resection. CTs could be surgically treated sequentially after microscopic- and endoscopic-assisted resection of CDSs.
-
Review
The Woven Endobridge (WEB) device for treatment of intracranial aneurysms: a systematic review.
The Woven Endobridge (WEB) device is an innovative endovascular device for treatment of intracranial aneurysms, especially bifurcation and wide-neck aneurysms. Although not approved by the U.S. Food and Drug Administration, it has been available in Europe since 2011. The aim of this review is to evaluate the outcomes of WEB device use for intracranial aneurysm treatment. ⋯ Despite initial promising results, the WEB device should be used with caution given its potentially large learning curve and because it has primarily been investigated only in wide-neck and bifurcation aneurysms. In addition, currently available prospective studies have short follow-up, and the device has not been directly compared with other treatment modalities.
-
Spinal arteriovenous shunts are a common spinal vascular disorder. However, they can have a misleading clinical presentation and poor prognosis. They are classified into 4 types according to shunt points and drainage route, among which extradural arteriovenous fistula (eAVF) is the most rare, comprising only 1% of all spinal arteriovenous shunts. We report an extremely rare case of coexistent eAVF at the craniocervical junction and soft tissue arteriovenous malformation within the same metamere. ⋯ This case indicates that transvenous embolization can be an effective treatment for eAVF and supports some hypotheses of arteriovenous malformation development. Additionally, it emphasizes the importance of examining a lesion with multiple modalities, including angiography, three-dimensional angiography, and cone-beam computed tomography, to understand the anatomy of the lesion.