World Neurosurg
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Occipital neuralgia is a chronic pain syndrome characterized by sharp, shooting pains in the distribution of the occipital nerves. Although relatively rare, it associated with extremely debilitating symptoms that drastically affect a patient's quality of life. Furthermore, it is extremely difficult to treat as the symptoms are refractory to traditional treatments, including pharmacologic and procedural interventions. A few previous case studies have established the use of a neurostimulation of the occipital nerves to treat occipital neuralgia. ⋯ Despite complications, the results suggest, overall, that occipital nerve stimulation is a safe and effective procedure for refractory occipital neuralgia and should be in the neurosurgical repertoire for occipital neuralgia treatment.
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Severe traumatic brain injury (TBI) is a major cause of death and disability worldwide. Prospective TBI data from sub-Saharan Africa are sparse. This study examines epidemiology and explores management of patients with severe TBI and adherence to Brain Trauma Foundation Guidelines at a tertiary care referral hospital in Tanzania. ⋯ Mortality of patients with severe TBI at Bugando Medical Centre, Tanzania, is approximately twice that in high-income countries. Intensive care unit care, computed tomography imaging, and continuous arterial blood pressure and intracranial pressure monitoring are underused or unavailable in the tertiary referral hospital setting. Improving outcomes after severe TBI will require concerted investment in prehospital care and improvement in availability of intensive care unit resources, computed tomography, and expertise in multidisciplinary care.
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Case Reports
Endoscopic removal of a bullet migrated to the third ventricle causing hydrocephalus: A case report.
Hydrocephalus caused by an intraventricular bullet is a rare event. We report a case of endoscopic removal of an intraventricular bullet. ⋯ Hydrocephalus may develop in patients with intraventricular foreign objects. When such objects must be removed, the endoscopic approach is a safe, efficient, and minimally invasive procedure. To our knowledge, this is the first case in the literature of foreign object removal from the ventricle via a transcortical endoscopic approach.
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Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, and primary skeletal or extradural disease resulting in compressive myeloradiculopathy. There are 2 previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor. ⋯ To our knowledge, this is the first reported case of incidental primary intradural spinal carcinoid tumor. Even though intradural spinal carcinoid tumors are exceedingly rare, they should be included in the differential diagnosis of enhancing intradural lesions.
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To explore risk factors affecting surgical results of Hirayama disease. ⋯ Age of patient, duration of the disease, physiologic reflex, and pathologic reflex are the main risk factors affecting surgical results of Hirayama disease. Receiver operating characteristic analysis shows that good reference value was obtained for the risk factors.