World Neurosurg
-
The radiological imaging features of easily misdiagnosed epithelioid glioblastoma in seven patients.
We review the radiological imaging features and report histopathological findings of 7 adult patients with epithelioid glioblastoma (eGBM), which was a newly revised subtype of glioblastoma. ⋯ eGBMs that were predominantly located in cortex with mild peritumoral edema, white matter collapse, encapsular sign, and dura mater tail sign could be easily misdiagnosed as cortex-involved intracranial brain tumor such as meningioma, whereas multifocal tumors could be easily misdiagnosed as metastatic tumor and lymphoma. Multimodal images were helpful for the differential diagnosis.
-
We redesigned decompressive craniectomy and cranioplasty procedures to decrease the inherent risk of complications. This novel technique, called decompressive cranioplasty, not only may decrease the complication rate but also may improve the cosmetic result, obviate the need for artificial skull implant, and increase the decompressive volume compared with traditional craniectomy. ⋯ Decompressive cranioplasty is a safe and effective method in the management of patients with brain edema and intracranial hypertension. It is simple to perform and may reduce the morbidity associated with traditional decompressive craniectomy and subsequent cranioplasty.
-
Management of vascular malformations requires microcatheter manipulation through distal tortuous arterial feeders <1 mm in diameter to permit safe and effective embolization at the fistula or nidus location. The ASAHI CHIKAI 008 microguidewire (ACM) recently introduced in the United States was used to evaluate microcatheter torque, support, and safety in distal microcatheter navigation. ⋯ The ACM is a safe, sturdy microguidewire that provides good torque in distal arterial anatomy, while providing microcatheter support and maintaining tip configuration on repeated use.
-
Most gaseous lumbar pseudocysts have been previously reported to be located in the spinal canal and successfully treated by several therapeutic methods. By comparison, a gas-containing pseudocyst in the lumbar extraforaminal area is rare. Here, the authors report a case of symptomatic gas-containing cyst located in the lumbar foramen. It was successfully treated with unilateral biportal endoscopic (UBE) surgery. ⋯ A gas-containing pseudocyst in the lumbar foraminal area is not common. Combined use of preoperative magnetic resonance imaging and computed tomography can help diagnose a gaseous pseudocyst and differentiate other pathologies. A UBE technique that provides good operative visualization and delicate operative manipulation is a less invasive therapeutic method to treat a foraminal gas-containing pseudocyst.