World Neurosurg
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Case Reports
Dural and Pial Arteriovenous Fistulas Connected to the Same Drainer in the Middle Cranial Fossa: A Case Report.
Dural arteriovenous fistulas (AVFs) in the middle cranial fossa are rare. Pial AVFs are similarly rare but differ from dural AVFs in that they derive their arterial supply from pial or cortical arterial vessels and do not lie within the intradural region. We report an extremely rare case of dural and pial AVF connected to the same drainer in the middle cranial fossa. ⋯ We report an extremely rare case of dural and pial AVF connected to the same drainer in the middle cranial fossa. To our knowledge, this is the first such case report described in the literature.
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Hemodynamics plays an important role in aneurysm rupture. Microsurgical clipping provides the best chance to confirm the rupture point. The aim of this study was to explore the associations between the rupture point and hemodynamics. ⋯ The hemodynamic characteristics at the rupture point were different from the aneurysm sac, and the WSS was significantly lower at the rupture point. Further study on the rupture risk assessment is still needed with more data and detailed information.
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Classical trigeminal neuralgia (cTN) is rarely caused by ectatic vertebrobasilar artery compression of the trigeminal nerve. These patients present a surgical challenge and often are not considered for microvascular decompression (MVD) due to assumed risk. ⋯ Patients with cTN due to a dolichoectatic vertebrobasilar artery compression present a unique surgical challenge. Mobilizing the vessel can be difficult because it may be firm from atherosclerosis, maintaining its separation from the nerve is similarly difficult, and manipulating the vessel can be dangerous because of its brainstem perforators. Our case series provides some evidence to support the safety and efficacy of MVD for patients with vertebrobasilar ectasia for those that major surgery is not contraindicated.
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Hydatid cysts (HCs) are caused by parasites, the larvae of Echinococcus granulosus. They usually affect the liver and lung, but primary brain involvement is rarely seen. HCs may cause a mass effect in the brain. For this reason, surgical excision must be performed. Complications may rarely occur after surgery. Recognition of complications is of vital importance. ⋯ Surgical resection should be applied carefully in the treatment of cerebral cysts. Complications may occur later in patients who do not develop complications at the time of operation. For this reason, follow-up of the patients should definitely be done by magnetic resonance imaging.
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Spinal dermoid cysts are uncommon tumors, and their spontaneous rupture into the syrinx cavity alone is extremely rare. The treatment strategy for this condition has not been described. ⋯ Staging operations should be considered according to the patient's symptoms. Syrinx aspiration surgery is an effective treatment for the symptomatic lipid syrinx.