World Neurosurg
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Review Case Reports
Non-resectable thoracic Rosai-Dorfman disease: a case report and review of the literature.
Rosai-Dorfman disease (RDD) is a rare disease that can be triggered by either viral or bacterial infection. Several parts of the body can be involved, from the central nervous system to the pelvic regions had been reported. At present, there is a serious lack of guidelines as to how to treat cases of RDD involving the spine. Current trends show that surgery remains the first method of choice to cure this disease, but in refractory or recurrent RDD, repeat surgery cannot guarantee total resection. Under such circumstances, adjuvant therapy can be very useful. Here, we share our experience of treating recurrent spinal RDD. ⋯ RDD is a rare disease and can be misdiagnosed easily. Although it may resolve spontaneously, recurrence is possible. Hence, extensive follow-up is necessary. Surgery remained the first choice of surgery, however, when encountered recurrent or nonresectable RDD, adjuvant therapy such as corticosteroids, thalidomide, and radiotherapy could help. In this article, we shared our experience using thalidomide in treating nonresectable RDD.
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Review Historical Article
Wounds in the head from Kitāb al-Dhakhīra fī 'Ilm al-Ṭibb by Thābit b. Qurra in the 9th century.
Kitāb al-Dhakhīra fī 'Ilm al-Ṭibb is one of Thābit b. Qurra's most noteworthy books on medicine in Arabic in the ninth century. This study aims to present and discuss the section subtitled "wounds in the head" in the 24th chapter of Kitāb al-Dhakhīra considering the information in the literature. ⋯ Kitāb al-Dhakhīra presents interesting knowledge regarding wounds in the head, reflecting the medical paradigm of that era.
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Review Case Reports
Oblique Lumbar Interbody fusion in a Patient with Persistent Left-sided Inferior Vena Cava- a Case Report and Review of the Literature.
Oblique lumbar interbody fusion takes advantage of the wide interval between the aorta and left-sided psoas muscle to access the lumbar spine, allowing a minimally invasive approach for interbody fusion with lower associated morbidity. As this approach is gaining popularity among spine surgeons, it is important to understand the potential pitfalls that may arise in patients with congenital anomalies of the vascular anatomy. ⋯ Thorough preoperative imaging evaluation is essential to identify vascular anomalies that may hinder oblique prepsoas retroperitoneal approach to the lumbar spine. Although rare, double IVC or isolated left IVC may complicate the oblique approach.
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Atypical and anaplastic meningiomas, unlike their benign counterparts, are highly aggressive, locally destructive, and likely to recur after treatment. These diseases are difficult to definitively treat with traditional radiotherapy without injuring adjacent brain parenchyma. The physical properties of ion radiotherapy allows for treatment plans that avoid damaging critical neural structures. The objectives of this systematic review were to evaluate the use and efficacy of ion radiotherapy in the treatment of atypical and anaplastic meningiomas. ⋯ Proton and carbon ion radiotherapy maintain comparable rates of local control to conventional photon therapy and allow for more targeted treatment plans that may limit excess radiation damage. Although additional prospective trials are needed, ion therapy represents a burgeoning field in the treatment of atypical and anaplastic meningiomas.
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The flexion of the skull base (basal angle [BA]) is the inclination between the anterior fossae and the basilar ramp of the occipital and sphenoid bones. An increased BA, termed platybasia, is usually associated with basilar invagination. BA reference values in the magnetic resonance imaging (MRI) era and the diagnosis of platybasia are of clinical importance. The transnasal approach has been the surgical technique of choice to remove the odontoid process in cases of ventral brainstem compression in patients with platybasia. The knowledge of normal BA values has been influenced by technological image acquisitions. The aim of this study was to determine the normal BA values in normal subjects in the MRI era. ⋯ Platybasia can be defined as a value >129 from the basal angle.