World Neurosurg
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Pituitary macroadenomas extend into the extrasellar space, such as the sphenoid sinus, cavernous sinuses, and suprasellar region. However, factors that regulate the direction of their extensions into the surrounding anatomical structures remain unknown. ⋯ The integrity of the sella dura and the intrasphenoid septation can regulate adenoma extension by encouraging their growth towards paths of least resistance.
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Posterior lumbar fusions are performed to treat various spinal deformities, degenerative diseases, fractures, infections, and tumors. The possibility of episode-based bundled payments for spine surgery necessitates analysis of the factors predicting readmissions and postoperative complications. ⋯ Nonhome discharge patients experienced higher rates of complications and 30-day readmissions.
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Bitemporal epilepsy (BTLE) is a specific anatomoelectroclinical phenotype in the spectrum of temporal lobe epilepsy. The diagnosis of BTLE and the evaluation of the degree of seizure lateralization in BTLE patients are greatly influenced by the duration of EEG recording and the number of recorded habitual seizures. ⋯ This patient presented 1 specific subtype of BTLE that is prone to be misdiagnosed as unilateral temporal lobe epilepsy if the patient is recorded for a relatively short term, e.g., over a common EEG monitoring duration of 1 to 2 weeks.
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The insula plays a crucial role in speech planning due to its connections with cortical and subcortical areas. Surgical management of cavernous malformation (CM) of the insula consists of total resection of the lesion and the surrounding gliosis to avoid or reduce seizures. When located in the dominant hemisphere, an awake craniotomy with intraoperative mapping reduces the risk of functional damage. ⋯ The CM was exposed and completely removed without functional damage. The patient recovered from surgery without complications, and no seizures occurred at 2 months' follow-up. Postoperative imaging showed complete removal of the CM.
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Case Reports
Huge greater superficial petrosal nerve schwannoma with intradural peritumoral cyst: a case report.
Schwannoma originating from the greater superficial petrosal nerve is an extremely rare type of facial nerve schwannoma located in the middle cranial fossa around the midportion of the petrous bone. Here, we provide the first report of greater superficial petrosal nerve schwannoma presenting with contralateral facial palsy and hemiparesis due to compression of the pyramidal tract by associated intradural peritumoral cyst. ⋯ The combination of extradural and intradural approaches in the appropriate order is essential for fenestration of an intradural peritumoral cyst along with removal of an interdural tumor.