World Neurosurg
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Dural arteriovenous fistulas (DAVFs) of the sinus of the lesser sphenoid wing (SLSW) with leptomeningeal drainage are rare. We report a patient with a DAVF of the SLSW draining into the basal vein of Rosenthal (BVR) presenting with pontine hemorrhage. ⋯ A DAVF of the SLSW presenting with pontine hemorrhage is extremely rare, and DAVFs with deep leptomeningeal drainage should be included among a variety of etiologies of pontine hemorrhage.
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Even although microvascular decompression is the standard treatment for hemifacial spasm (HFS), the treatment is not always 100% successful. Some patients experience the reappearance of HFS after temporary relief after surgery. We analyzed our data to elucidate the reasons for and prognosis of HFS reappearance, specifically focusing on exact compressive location of the facial nerve. ⋯ After microvascular decompression for HFS, almost half of the patients experienced transient HFS recurrence despite sufficient decompression of the facial nerve. However, in most cases, recurrent HFS gradually resolved over a period. Based on the compression location, the surgeon could anticipate recurrence of transient HFS.
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Case Reports
Successful insular glioma removal in a deaf signer patient during an awake craniotomy procedure.
Resection of tumors located within the insula of the dominant hemisphere represents a technical challenge because of the complex anatomy, including the surrounding vasculature, and the relationship to functional (motor and language) structures. We report here the case of a successful resection of a left insular glioma in a native deaf signer during an awake craniotomy. ⋯ The methodology used also provides the first evidence of the actual anatomo-functional organization of language in deaf signers.
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The primary auditory cortex, which was previously considered to be unisensory, has been shown to be multisensory. However, the temporal details of processing nonauditory stimuli in the human auditory cortex remain unclear, owing to the low temporal and spatial resolution of the adopted imaging techniques. ⋯ These findings provide novel evidence for multisensory interplay within human auditory cortex at an early stage of cortical processing, which extends the understanding of multisensory mechanisms of human brain functions.
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Standard translaminar approaches for intradural extramedullary (IDEM) tumors require extensive soft tissue dissection and partial facet removal. Ventral lesions may necessitate wider bone resection with subsequent possible spinal instability. Any manipulation of an already compromised spinal cord may lead to neurological injury. We describe an image-guided minimal access technique for IDEM tumor resection. ⋯ Image merge tailored access resection appears to be at least equivalent in terms of tumor resection, blood loss, and complications to other tubular techniques. It may reduce risks of neurological deficit and spine instability. Image merge tailored access resection is a novel application of merging intraoperative fluoroscopic images with preoperative magnetic resonance images for tailored IDEM resection.