World Neurosurg
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Malignant transformation of vestibular schwannoma after stereotactic radiosurgery (SRS) is a fatal complication with a relatively less uncommon frequency over the past 5 years. Although SRS has been shown to be an alternative to microsurgical resection of vestibular schwannoma, this complication is disregarded most of the time. In this paper, we present a patient with left cerebellopontine angle vestibular schwannoma that was transformed into a malignant peripheral nerve sheath tumor after receiving SRS following microsurgical resection.
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The Sextant percutaneous pedicle screw fixation system is a commonly used technique. In this system, the pedicle screw and the sharp rod are placed through stab incisions. The unique mechanism of action of this system may cause unprecedented adverse effects, such as iatrogenic sacroiliac (SI) joint syndrome. ⋯ Surgeons need to be aware of iatrogenic SI joint syndrome using the Sextant system when performing percutaneous pedicle screw fixation. An endoscopy-based technique may be an effective alternative to conventional corrective surgery when treating iatrogenic SI joint syndrome using the Sextant system.
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Mechanical thrombectomy for acute ischemic stroke recently proved its superiority to standard medical management alone. With the increasing number of procedures, practitioners are exposed to unexpected situations that may lead to failure of access and significantly worse clinical outcome. Being able to plan the procedure and use alternative techniques may be useful in case of peculiar anatomy. ⋯ Absence of viable access to perform mechanical thrombectomy during acute ischemic stroke is a rare but pejorative event. Direct common carotid puncture, even in its distal segment, when necessary is a feasible technique to perform internal carotid catheterization.
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Solitary fibrous tumors (SFTs) are rare tumors derived from mesenchymal tissues. Notably, despite the widespread reports of SFT in various parts of the body, it is extremely rare in the spine, especially the lumbosacral spine, with only 4 previously reported cases. ⋯ To our knowledge, this is the fifth reported case of lumbar spine SFT, and its diagnosis is a difficult challenge. However, accurate diagnosis and complete resection of SFT in a patient suspected of having SFT could extend life or improve quality of life.
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The purpose of this study was to evaluate the advantages of endoscopy and navigational assistance in the intradural subtemporal keyhole approach and the intradural Kawase approach by studying anatomic exposure and surgical freedom in the posterior cranial fossa. ⋯ The EISKA provides greater anatomic exposure and surgical freedom primarily in the superior, inferior, and medial directions of the brainstem region. Maximum anatomic exposure and surgical freedom of the posterior cranial fossa was obtained by navigational assistance with fewer complications.