World Neurosurg
-
Case Reports
Sellar xanthogranuloma: a quest based on nine cases assessed with anterior pituitary provocation test.
Xanthogranuloma is a chronic inflammatory mass characterized by cholesterol crystal deposition, which is rarely seen in the sellar region. The objective of this study is to identify the clinical features and cause of sellar xanthogranulomas. ⋯ Xanthogranuloma seems to be the last stage of the chronic inflammation affecting Rathke cleft cyst or craniopharyngioma presenting with severe anterior pituitary insufficiency.
-
Oligodendrogliomas, the third most common primary gliomas, have a strict molecular definition, characterized by the combined presence of isocitrate dehydrogenase mutation and 1p19q codeletion. Herein, we describe an extremely unusual case of molecularly defined anaplastic oligodendroglioma with transdural extension into the frontal and ethmoid sinuses, without prior neurosurgical intervention or radiotherapy. The molecular profile of the tumor is also provided. ⋯ Most of the previously reported glial tumors with transdural extension were cases of histologically proven glioblastomas and gliosarcomas, typically seen in the context of prior neurosurgical intervention and/or radiotherapy. This case adds to the limited literature on oligodendrogliomas with transdural extension. Further studies are necessary to elucidate the relationship between the incidence of transdural extension and molecular subtypes of oligodendrogliomas.
-
Delayed cerebral ischemia (DCI) is related to the major causes of morbidity and mortality in patients following subarachnoid hemorrhage (SAH); however, little is known about the role of epigenetics in the pathogenesis of DCI. We investigated the specific DNA methylation profile that may affect the expression of inositol 1-,4-,5-trisphosphate receptor (ITPR3) responsible for cerebral vasospasm following SAH. ⋯ Hypermethylation of the distal IGR located upstream of ITPR3 is related to greater DCI development in patients with SAH. Further studies of the precise mechanisms of methylation degree and DCI development using in vitro and in vivo models are needed.
-
To analyze the safety and efficacy of skipping instrumentation at the C7 vertebra during posterior cervicothoracic fusions. ⋯ Skipping C7 in a multilevel posterior cervicothoracic fusion demonstrates significantly reduced estimated blood loss and faster operative times compared with the control group. In addition, postoperative assessment yielded similar rates of fusion in both groups. Serious negative outcomes of skipping C7 were not found in this retrospective study. Our study results illustrate the clinical benefits of skipping instrumentation at C7 to minimize surgical risk in patients undergoing posterior cervical fusion across the cervicothoracic junction.
-
Some mechanical thrombectomy techniques for acute ischemic stroke use a combination of an aspiration catheter and stent retriever. We experienced a rare case of aspiration catheter coil breakage and subsequent retrieval using a stent retriever. ⋯ The combined use of an aspiration catheter and a stent retriever may cause unexpected device breakage, especially when the catheter is bent.