World Neurosurg
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Review Meta Analysis Comparative Study
Accuracy of Pedicle Screw Insertion among Three Image-Guided Navigation Systems: A Systematic Review and Meta-Analysis.
Many retrospective studies of pedicle screw placement have revealed that intraoperative navigation systems provide higher accuracy rates and safety than do free-hand techniques. The accuracy of various image-guided navigation systems has been studied; however, differences have not been well defined due to the lack of adequate evidence-based comparative studies. ⋯ Significant differences exist among CT Nav, 3D FluoroNav, and 2D FluoroNav. Our review suggests that 3D FluoroNav may be superior to the other 2 methods in reducing pedicle violation and that clinicians should consider 3D FluoroNav as a better choice.
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Review Case Reports
Primary Diffuse Large B-Cell Lymphoma in a patient with Rubinstein-Taybi Syndrome: case report and review of literature.
Rubinstein-Taybi syndrome (RSTS) is a rare, congenital syndrome that is known to be associated with neoplasms of various organ systems. Evaluation and treatment of such patients is challenging, given the cognitive delay and heterogeneity of pathologic presentations that define this syndrome. ⋯ To the best of our knowledge, this is the first reported case of a primary central nervous system lymphoma presenting in a patient with RSTS. This was confirmed through microscopic and histologic studies. The large size attained by this mass in our patient highlights the increased scrutiny and surveillance needed to provide the best care for these patients. A multidisciplinary team approach is ideal as successful treatment of our patient using surgical debulking, appropriate chemotherapy, and close postoperative follow-up has resulted in an excellent clinical outcome.
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Review Case Reports
Cerebral aneurysm associated with an arachnoid cyst: three case reports and a systematic review of literature.
Arachnoid cysts and intracranial aneurysms are not rare, but it is unusual for an aneurysm to be associated with an arachnoid cyst. The objective of this study was to reveal the association between arachnoid cysts and intracranial aneurysms. ⋯ It was difficult to diagnose a ruptured aneurysm in some cases with an arachnoid cyst because computed tomography scan showed atypical findings, such as no hemorrhage, intracystic localized hemorrhage, or subdural hematoma. This review revealed that aneurysms and arachnoid cysts were significantly located ipsilaterally and that they occurred together in relatively young patients.
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Review Case Reports
Low Pressure Hydrocephalus: A Case Report and Review of the Literature.
The entity of low-pressure hydrocephalus remains poorly understood and thoroughly debated. Symptomatic improvement accompanied by decrease in ventricular size after prolonged subatmospheric drainage has been well documented, and this method has been considered the criterion standard of management. Few studies have examined alternative treatment options, either to avoid the risks associated with prolonged external ventricular drainage or because of the failure of traditional methods. ⋯ MRE may prove to be effective in studying LPH because of its ability to quantify viscoelastic properties in response to therapy. Additionally, ETV should be considered in cases of LPH, although there is little evidence in the current literature to support its use. There are suggestions that it may lead to fewer shunt-dependent patients. Future studies are needed because there are few documented examples.
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Review Case Reports
Sporadic intradural extramedullary hemangioblastoma of the cauda equina: case report and literature review.
Spinal hemangioblastomas account for 1%-5% of all spinal cord tumors. Although spinal hemangioblastomas are rare, it is exceedingly rare to have a case of intradural extramedullary hemangioblastoma of the spine, especially in isolation without von Hippel-Lindau syndrome. The purpose of this report is to present a rare case of intradural extramedullary hemangioblastoma of the cauda equina and a literature review. ⋯ Literature review revealed cauda equina intradural extramedullary spinal hemangioblastoma to be a rare diagnosis. Furthermore, this was a sporadic case without associated von Hippel-Lindau syndrome. Only 20 previous cases have been reported. Immunohistopathologic analysis was required to make the diagnosis. Radiosurgery appears to be useful in cases of residual tumor after subtotal tumor resection.