World Neurosurg
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Difficulties are associated with the diagnosis and management of patients with coma because of intracranial hypotension. ⋯ The patient represents the first described case, to our knowledge, of intracranial hypotension with coma because of a CSF leak caused by a spinal ventral dural tear. In the setting of failed EBP attempt, our technique may be a treatment option for severe intracranial hypotension.
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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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Case Reports
Precocious Solitary Cervical Metastasis from Endometrial Cancer Presenting as Cervical Radicular Pain.
Bone metastases from endometrial cancer are rare. To our knowledge, only 2 cases of solitary vertebral metastases from endometrial cancer presenting with osseous and/or neurologic symptoms before the diagnosis of the primary endometrial cancer have been reported; however, in both cases, the metastases were thoracic. Thus, cervical vertebral metastases are extremely rare. ⋯ We describe an extremely rare case of a precocious solitary cervical metastasis from an endometrial cancer presenting as cervical radicular pain. In our review of published reports, we found that solitary spinal metastases are significantly associated with longer overall survival than are multiple lesions. Resection of the spinal lesion with rigid spinal reconstruction followed by radical hysterectomy may be beneficial in such patients.
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To compare transcallosal-transchoroidal and transcallosal-subchoroidal approaches to the ipsilateral and contralateral edges of the floor of the third ventricle using quantitative analyses. ⋯ The transcallosal-transchoroidal approach, compared with the transcallosal-subchoroidal approach, may provide better exposure and require less retraction for removal of ipsilateral or contralateral lesions located in the midbrain or hypothalamus and situated near the floor of the third ventricle. The contralateral transcallosal approach with either the transchoroidal or subchoroidal approach may provide good surgical freedom for removal of lesions located near the floor of the third ventricle, such as lesions in the midbrain.
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To investigate how frameless navigational techniques can be implemented to support standard frame-based stereotactic procedures. ⋯ In a setting with intraoperative imaging, the combination of frameless and frame-based techniques offers new possibilities. Because of the high registration accuracy, the additional navigation provides improved safety and redundancy. Furthermore, the stereotactic procedure is supported by enhanced intuitive intraoperative visualization during the advancement of a biopsy needle or electrode. However, further technical refinements are necessary, such as possibilities to track microelectrodes during the advancement with a microdrive.