World Neurosurg
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The authors present cases of childhood moyamoya disease successfully treated with bilateral superficial temporal artery to anterior cerebral artery (ACA) direct anastomoses and describe the surgical techniques used in this vascular reconstruction method. ⋯ The described technique can be considered an effective and uncomplicated revascularization procedure for the ACA regions, which are crucial for normal intellectual growth in the pediatric population.
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Case Reports
Glioblastoma Multiforme in a Patient with Celiac Disease: Management of Seizures after Gross Total Tumor Resection.
A 55-year-old woman with a history of celiac disease presented with focal seizures and a mass lesion located at the left frontal lobe. Management of seizures in these patients is challenging. ⋯ A patient suffering from glioblastoma multiforme who presents with seizures and has a history of celiac disease must be treated more aggressively than usual, with dual or triple anticonvulsant scheme therapy, and provided a strict gluten-free diet after tumor resection.
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Hypoglossal nerve injury may result in swallowing and speech problems. To reduce this morbidity and allow the performance of the hypoglossal-facial nerve anastomosis bilaterally, a technique that includes partial splitting of the hypoglossal nerve and skeletonization of the facial nerve within the mastoid process has been applied. The aim of this study is to present clinical results regarding the facial and hypoglossal nerves after the procedure. ⋯ HHFA is an effective technique for facial nerve reanimation with acceptable morbidity related to tongue function. Patients with a longer duration of facial palsy still have a good chance for restoration of facial movement but require longer recovery periods.
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To investigate prognostic factors of clival chordoma using the largest patient set to date. ⋯ GTR rates were comparable in different surgical approaches. GTR was a significant predictor of longer PFS and OS in clival chordoma.
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Autonomic nervous system dysfunction is a known entity in strokes involving insula. It causes significant morbidity and mortality. No study to date has demonstrated autonomic nervous system dysfunction in patients with insular glioma. This is an exploratory study to identify the subclinical autonomic dysfunctions in insular glioma. ⋯ Patients with insular gliomas have significant impairment of autonomic functions, with left insular glioma showing sympathetic dominance. Suppression of autonomic function is greater in those presenting with seizures.