World Neurosurg
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Therapeutic strategies for managing hemorrhagic moyamoya disease (MMD) remain controversial. In this study, we investigated the optimal therapy for hemorrhagic MMD. ⋯ Surgical revascularization, especially a direct bypass regimen, may be the optimal strategy for treating hemorrhagic MMD.
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Good knowledge of the anatomy of veins is of crucial importance for the functional surgery of cranial nerve (CN) disorders, especially microvascular decompression for trigeminal neuralgia (TN), hemifacial spasm (HFS), and vagoglossopharyngeal neuralgia (VGPN). Although controversial, veins may be involved in neurovascular conflicts and may constitute dangerous obstacles to access to the CNs. With the aim of estimating the implications of veins in those diseases and evaluating the linked surgical difficulties, we carried out a review of the literature from 2000 to the end of February 2018. ⋯ The percentages of a venous conflict alone were calculated at 10.8% for TN, 0.1% for HFS, and 2.9% for VGPN. We review the complications considered in relation with venous sacrifices. Precautions to minimize these complications are given.
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Review Case Reports
Spontaneous Regression of an Intraparenchymal Cyst Following Deep Brain Stimulator Electrode Implantation: Case Report and Literature Review.
The development of an intraparenchymal cyst following deep brain stimulation (DBS) surgery is an uncommon complication that lacks a clearly defined management strategy. The pathophysiology is not known and may be related to perielectrode edema or cerebrospinal fluid tracking. Previous case reports have described various therapies for symptomatic cysts, including hardware removal or conservative treatment with steroids. ⋯ Only 15 additional cases have been reported in the literature, although the true incidence may be underreported because of varying practices in obtaining postoperative scans. Cysts were identified in symptomatic patients on average 6.2 months after surgery. All symptomatic cysts were treated with hardware removal or steroid therapy. Observation alone may be sufficient when a DBS-associated cyst is identified. More reports are needed to characterize this rare complication.
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Review Case Reports
Spinal Epidural Inflammatory Pseudotumor: A Case Report and Review of Literature.
Inflammatory pseudotumor is a histologically proven benign tumor-like lesion of unknown etiopathogenesis. It is less commonly found in central nervous system, and least commonly in the spinal canal. Spinal epidural inflammatory pseudotumor is a rarely reported entity. ⋯ It was a radiologic dilemma; thus, complete excision was required for diagnosis and a better outcome.
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The paramastoid process is a rare variation found on the occipital bone as an extension of its jugular process. In the literature, this process has been called many names including the paraoccipital, paracondylar, or parajugular process. The paramastoid process can articulate with the lateral aspect of the transverse process of the atlas creating clinical consequences and potentially resulting in diminished range of motion of the head. Herein, we describe the anatomy, embryology, prevalence, imaging, and clinical consequences of the paramastoid process in order to improve our understanding of this rare anatomic variation.