World Neurosurg
-
Case Reports
MRI reveals a pronounced treatment response of a IDH- and BRAF-wildtype epithelioid glioblastoma.
We here report findings on magnetic resonance imaging from a 60-year-old patient with an epithelioid glioblastoma of the corpus callosum treated with radiotherapy in combination with concomitant and adjuvant temozolomide. Neuropathology revealed a highly aggressive molecular subtype of the epithelioid glioblastoma without an isocitrate dehydrogenase and B-Raf proto-oncogene mutation or a O6-methylguanine-DNA-methyltransferase promoter hypermethylation. This subtype is typically associated with an unfavorable clinical course and poor overall survival. Unexpectedly, the first follow-up magnetic resonance imaging 10 weeks after chemoradiation completion revealed an early and almost complete treatment response.
-
The relationship between noncontrast computed tomography (CT) markers, which predict the expansion of spontaneous intracerebral hemorrhage (sICH) under conservative treatment, and postoperative rebleeding (PR) after treatment by directly removing the sICH is unknown. This study investigated the relationship between noncontrast CT markers and PR in patients with sICH treated by endoscopic surgery. ⋯ The blend sign is likely to be a strong predictor for PR in patients who undergo endoscopic surgery for sICH. To improve the prognosis of patients with sICH, further studies are needed to establish new treatment strategies and surgical procedures.
-
Case Reports
Brainstem venous congestion caused by perimedullary drainage in anterior cranial fossa dural arteriovenous fistula.
Myelopathy develops relatively rarely in intracranial dural arteriovenous fistula (DAVF); it has only been reported in posterior cranial fossa DAVF. Herein, we report the first, to our knowledge, case of anterior cranial fossa (ACF) DAVF with myelopathy. ⋯ Myelopathy because of intracranial DAVF potentially involves diagnostic pitfalls. Even in ACF DAVF, there is a possibility of myelopathy caused by perimedullary venous drainage.
-
Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT. ⋯ Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.
-
Congenital microcephaly could result from a gene mutation. Asparagine synthetase deficiency, which is caused by the asparagine synthetase (ASNS) mutation, is a rare autosomal-recessive neurometabolic disorder. It is characterized by severe developmental delay, congenital microcephaly, and seizures. ⋯ Although there is no cure for this disorder so far, the huge progressive intracerebral cyst can be cured by a cyst-peritoneal shunt.