World Neurosurg
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Review Case Reports
Resection of Pediatric Trigeminal Schwannoma Using Minimally Invasive Approach: Case Report, Literature Review, and Video Submission.
Trigeminal schwannomas are fifth cranial nerve tumors that originate from the nerve sheath. They rarely occur within the pediatric population and can cause dysfunction of the trigeminal nerve and surrounding structures. When patients become symptomatic, neurosurgeons should consider resection. ⋯ We present a rare case of pediatric trigeminal schwannoma type Mp treated surgically with a near-total resection via a novel mini-pterional approach and use of cranial nerve diffusion tensor imaging.
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Review Case Reports
Jugular bulb dysmaturation in torcular dural sinus malformation, clinical images and a review of literature.
We present unique clinical images of jugular bulb dysmaturation (JBD) in an infant with torcular dural sinus malformation (tDSM). Lasjaunias et al hypothesized that the former possess a pivoting role for development of the latter. ⋯ The combination of magnetic resonance imaging angiography, computed tomography angiography, and digital subtraction angiography imaging of JBD is unique. Moreover, we reviewed current tDSM literature and showed that the presence of JBD in tDSMs correlates significantly with a higher mortality.
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Spine surgeons at a Level 1 Trauma Center have observed a high incidence of spine and spinal cord injuries owing to falls from tree stands. These injuries have been retrospectively reviewed in the context of the Thoracolumbar Injury Classification and Severity (TLICS) and the Subaxial Cervical Injury Classification and Severity (SLICS) classification systems to assess inter-user reliability and validity. We hypothesize that the inter-rater reliability will be similar between neuroradiology and neurosurgery raters and validity of the scoring system will be maintained at our institution. ⋯ The TLICS and SLICS systems provide good-to-excellent inter-rater reliability. SLICS validity was poor, whereas TLICS was reasonable for nonoperative cases and moderate for operative cases. Systems such as the TLICS and the SLICS may be best applied in the educational setting to confirm the fracture morphology and presence or absence of ligamentous injury between surgeons and radiologists.
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Review
Vision outcomes in early vs late surgical intervention of pituitary apoplexy: a meta-analysis.
Pituitary apoplexy (PA) is defined by hemorrhage and necrosis of the pituitary gland, often acute in onset, and frequently in the setting of an existing pituitary adenoma. Our objective was to conduct a meta-analysis of the available literature on vision outcomes following surgical intervention for PA on the basis of the timing from apoplexy to surgery (ATS). ⋯ Despite readily accepted guidelines provided by the United Kingdom advocating for early surgical intervention in PA, the rates of vision outcomes we report demonstrate >80% recovery for patients in both the early and late surgical intervention group. As such, conservative management may be warranted for early stabilization before surgical intervention in PA patients with respect to vision outcomes.
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Superior cerebellar artery (SCA) aneurysms can be divided into 2 types: basilar artery (BA)-SCA junction aneurysms and peripheral SCA aneurysms. The peripheral SCA aneurysm is a distinct entity from its BA-SCA counterpart. No comprehensive literature review for endovascular management of peripheral SCA aneurysms has been conducted. ⋯ Peripheral SCA aneurysms are rare cerebrovascular lesions and should be treated as a specific entity. EVT is an efficient and safe option in peripheral SCA aneurysms. Permanent and fatal procedure-related complications are rare. Further prospective and larger-scale studies are warranted to better elucidate the role of EVT in peripheral SCA aneurysms.