World Neurosurg
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Review Case Reports
Sciatica Caused by Venous Varix Compression of the Sciatic Nerve.
The authors report the case of a 76-year-old woman presenting with leg pain, numbness, and weakness mimicking a lumbosacral radiculopathy. ⋯ Variceal compression is a rare cause of extraspinal origin of lower extremity radicular pain. It should be considered if there is lack of correlation between radiologic findings and the clinical picture or if there is a failure of response to treatment of the assumed spinal cause.
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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
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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Multicenter Study
Tailoring Endoscopic Approach to Colloid Cysts of the Third Ventricle: A Multicenter Experience.
Endoscopic removal of third ventricular colloid cysts has grown in popularity. The biggest issues concern radicality, cure or at least long-term control of the disease, and endoscopic remnants. Technologic advances in instrumentation and introduction of novel tools have greatly improved endoscopic results. Deeper knowledge of surrounding anatomy and awareness that colloid cysts vary in their position (foraminal or retroforaminal) can further improve with the selection of a tailored approach for each patient. ⋯ A traditional precoronal transforaminal approach should be considered only for pure foraminal cysts (group A), as the retroforaminal component is poorly controlled. Retroforaminal cysts (groups B and C) should be resected through a retroforaminal transpellucidum interfornicialis route. A supraorbital transforaminal approach is a more versatile approach suitable for most cases.
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Surgical resection of parasellar meningiomas is a challenging operation that traditionally has been performed with a large pterional or orbitozygomatic craniotomy. In this study, we report patient outcomes and detail our surgical approach when resecting these tumors with a smaller, less invasive "mini-pterional" craniotomy. ⋯ The mini-pterional craniotomy can be used to resect parasellar meningiomas with good results and a low complication profile. This approach provides an efficacious method of resecting these tumors without sacrificing Simpson grade or patient safety.