World Neurosurg
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Review Case Reports
Glioneuronal Heterotopia Presenting as Cerebellopontine Angle Tumor of Cranial Nerve VIII.
Vestibular schwannomas and meningiomas account for the great majority of lesions arising in the cerebellopontine angle. In this report, we present a case of glioneuronal heterotopia, also known as glioneuronal hamartoma, arising from cranial nerve VIII, which is an extremely uncommon lesion. Important radiologic and surgical aspects are reviewed, which may help in early recognition and intraoperative decision making when these lesions are encountered. ⋯ Ectopic glioneuronal tissue of cranial nerve VIII is a rare non-neoplastic lesion and should be considered in the differential diagnosis of unusual-appearing intracanalicular and cerebellopontine angle lesions. The congenital and benign nature of this entity makes observation a valid option for these cases, although they are so infrequent that they are often presumptively managed as vestibular schwannomas. Attempts to radically resect these lesions may result in higher rates of hearing loss or facial palsy due to their continuity with cranial nerves.
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Review Case Reports
Primary Spinal Malignant Mesothelioma: A Case Report and Literature Review.
Malignant mesotheliomas are aggressive and rapidly fatal neoplasms arising from the mesothelial cells. The most common sites of origin are the pleural and peritoneal cavities; the pericardium and the tunica vaginalis are infrequently involved, and malignant mesothelioma in the spinal canal is extremely rare. Here we report a case of primary spinal malignant mesothelioma. We also report the results of a literature search conducted in PubMed with specific key terms, inclusion criteria, and exclusion criteria, with a comparison of elected case studies and case series, and statistical analysis as appropriate. ⋯ Spinal malignant mesothelioma is an extremely rare but highly aggressive entity. Preoperative identification is challenging, and definitive diagnosis depends on histopathological evidence. Surgical resection can help relieve the symptoms, but the overall prognosis is poor.
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Aberrant medial retropharyngeal prevertebral course of the internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries, like transoral odontoidectomy (TOO), this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. We describe this aberrant course of ICAs in a patient with a craniovertebral junction (CVJ) anomaly with a dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case. ⋯ Identification of this rare aberrant prevertebral course of ICAs in a patient with a CVJ anomaly is critical because it precludes TOO as a treatment option. Correction of BI and AAD is possible even with a unilateral C1-C2 joint spacer when placement of a joint spacer on the other side is not technically feasible.
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Comparative Study
Comparison of Clinical and Radiologic Outcome of Three-Dimensional Correction in Lenke 5C Curve: Uniplanar Versus Polyaxial Pedicle Screws.
To evaluate radiologic and clinical outcome of three-dimensional correction using the uniplanar pedicle screw (UPS) combined with vertebral body derotation technique for treatment of Lenke 5C adolescent idiopathic scoliosis. ⋯ The application of UPS combined with vertebral body derotation technique can reduce vertebral rotation and obtain better patient self-image score when favorable coronal and sagittal realignment is achieved. This improvement remains superior during 2-year follow-up. This combined application is a promising option to achieve spinal three-dimensional correction in treating Lenke 5C curve.
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We sought to report a minimum 12 months' follow-up results of our improved bone graft method for upper cervical surgery with the posterior approach. ⋯ Good bone graft bed, enough bone graft material, solid local fixation, and effective bone graft method are prerequisites for a successful bone graft. By analyzing postoperative follow-up in the consecutive cases in this study, our bone graft method describing a new bone graft structure is a reliable posterior fusion technique. It is worth considering, and further research is needed.