World Neurosurg
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Review Case Reports
Brainstem Congestion due to Dural Arteriovenous Fistula at the Craniocervical Junction: case report and review of the literature1.
Dural arteriovenous fistulas (DAVFs) at the craniocervical junction are rare. Clinical manifestations range from acute or chronic myelopathy to subarachnoid hemorrhage to brainstem dysfunction. We encountered 4 cases of DAVFs at the craniocervical junction with progressive brainstem dysfunction and investigated the typical magnetic resonance imaging (MRI) features using T2-weighting imaging, susceptibility-weighted imaging, diffusion-weighted imaging, and contrast-enhanced imaging. Literature review revealed 10 case reports of DAVFs at the craniocervical junction manifesting with brainstem dysfunction. ⋯ Susceptibility-weighted imaging, diffusion-weighted imaging, or contrast-enhanced scanning should be used during MRI examination of patients with progressive brainstem dysfunction to differentiate DAVFs at the craniocervical junction from other diseases, such as glioma or infection. Prompt diagnosis using MRI is of great significance in producing good functional outcomes of the patients.
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Review Case Reports
Intractable Hiccups Associated with Chiari Type I Malformation: Case Report and Literature Review.
The authors report the case of a 34-year-old man who presented with intractable hiccups. The imaging examination showed that the patient was suffering from syringomyelia associated with Chiari type I malformation. ⋯ Intractable hiccups as the main symptoms of Chiari type I malformation are extremely rare in the clinic. Decompression surgery should be an appropriate method to relieve the symptoms.
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Increased restrictions on working hours and the resultant decrease in theater time coupled with greater scrutiny to demonstrate proficiency at surgical tasks has resulted in the incorporation of simulators for surgical training. This literature review describes the use of cadaveric simulators in postgraduate neurosurgical training, with the aim to analyze their effectiveness in improving surgical performance. ⋯ Most studies identified in this review failed to provide strong objective evidence for effectiveness in achieving competency and good outcomes in the theatres. Lack of use of validated skills assessment tools prevented studies from associating cadaveric training with improvement in operating skills. Future studies should aim to address these shortcomings and focus on validating cadaveric simulation, ensuring only those that improve performance of both technical and nontechnical skills are pursued.
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Review Case Reports
Successful Conservative Management of Delayed Cervical Spondylodiscitis with Epidural Abscess Caused by Esophageal Diverticulitis: A Case Report and Review of Literature.
Cervical spondylodiscitis with spinal epidural abscess (SEA) is not a rare medical condition and usually requires urgent decompression of neural structures and stabilization of the spine followed by antibiotic therapy for the prevention of severe neurologic deficits. ⋯ Physicians need to be aware of this rare case of SEA secondary to esophageal diverticulitis. An early diagnosis and prompt administration of antibiotics is a key factor to avoid neurologic deterioration for the treatment of SEA caused by diverticulitis. Endoscopic or surgical repair of diverticulum may be warranted to avoid the recurrence of such infection.
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Bilateral occlusion of the foramen of Monro with aqueductal stenosis is a rare entity. Only 1 previous case has been reported in the literature. ⋯ Bilateral occlusion of foramen of Monro with aqueductal stenosis and tonsillar herniation is rare cause of obstructive hydrocephalus, and can be managed effectively with neuroendoscopic procedure.