World Neurosurg
-
The angioarchitecture of the spinal cord and microvascular changes after acute and subacute spinal cord injury (SCI) have been reported in rodents. Microvascular changes after chronic SCI have not been explored. We characterized three-dimensional microvascular changes during the chronic phase of cervical hemicontusion SCI in rats. ⋯ Blood supply to the cervical spinal cord is insufficient during the chronic phase of cervical hemicontusion SCI, especially in microvessels with diameters <40 μm. These results may provide a basis to explore microvascular changes of SCI during the chronic phase.
-
Endoscopic endonasal surgery is a rapidly evolving field that offers the possibility of treating a wide variety of skull base lesions. Reconstruction of the osteodural defect is of utmost importance, as an effective and watertight closure is mandatory. Over the years, various techniques and materials have been adopted in an effort of providing a resilient and reliable method of closure. ⋯ The 3F skull base reconstruction is a safe and effective method in achieving watertight closure after extended endoscopic endonasal approaches. Despite this study reporting a preliminary experience in a small series of patients, it seems that the 3F technique can be considered as a viable solution among the wide kaleidoscope of available skull base reconstruction methods.
-
Traumatic brain injury (TBI) is a major health issue in developing nations such as India along with underreporting of TBI data because of a lack of major studies targeting the population with TBI. Various lacunae from field to tertiary centers are responsible for this significant burden of TBIs. We studied the epidemiologic profile of 1150 patients with TBI including the predictors of the outcome of TBIs in a tertiary health care institution in North India to identify the modifiable factors that could be used to improve the outcome and reduce the TBI burden. ⋯ Knowledge about the causes, pattern, and distribution of patients with TBI from this study is helpful in policy making, research, health management, and rehabilitation at the national level in ours and in other nations.
-
Spheno-orbital meningioma (SOM) is a rare intracranial tumor that arises at the sphenoid wing, extends into the orbit, and is associated with hyperostosis of the sphenoid bone. These tumors often invade important neurovascular structures around the orbital apex, superior orbital fissure, and cavernous sinus. Aggressive tumor removal could achieve acceptable control; however, residual tumor can regrow. In this article, our surgical management and long-term outcomes are described. ⋯ SOM follows a relatively benign clinical course given the invasive radiologic findings. Abnormal bone resection is paramount to prevent early-stage recurrence. Although intradural residual tumor might regrow, additional surgery could achieve reasonable long-term tumor control with better outcome.
-
When distinct pituitary hypersecretory manifestations coexist, the differential diagnosis includes plurihormonal or double pituitary adenomas. We describe a rare case of hypercortisolemia and hyperprolactinemia caused by 2 noncontiguous adenomas that required 2 surgeries. ⋯ A complete clinical and biochemical evaluation is necessary in patients with pituitary adenomas. Repeat surgery may be necessary for noncontiguous double adenomas.