World Neurosurg
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Case Reports
Rare Presentation: A Report Of Two Identical Cases With Thoracic Compressive Myelopathy In Down Syndrome.
Atlantoaxial instability, a common finding in patients with Down syndrome (DS), is attributed to laxity of ligamentous structures. Cervical spondylosis identified in these patients has a pathogenesis of ligament laxity and early degeneration compared with the normal population. No cases have been reported showing affection of thoracic or lower levels. ⋯ Degenerative changes of the spine occur earlier in DS, probably due to increased movements across the vertebrae owing to laxity in the ligaments. Routine workup of patients with DS presenting in their adult lives should keep in mind the affection of lower spinal levels. Early identification of thoracic myelopathy and lumbar canal stenosis gives a chance of cure.
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Visual dysfunction and headache are major symptoms in patients with idiopathic intracranial hypertension (IIH). We aimed to evaluate the improvement of these symptoms in patients who underwent ventriculoperitoneal (VPS) and lumboperitoneal (LPS) shunting. ⋯ VPS and LPS are effective in improving visual symptoms and headache in patients with IIH.
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Case Reports
Hypothalamic hamartoma, gray matter heterotopia and polymicrogyria in a boy: a case report and literature review.
Hypothalamic hamartomas (HHs) are rare, and it is even rarer when combined with gray matter heterotopia (GMH) and polymicrogyria (PMG). ⋯ In this extremely rare case, resection of the HH eliminated the symptoms. Nonetheless, we still need to be cautious about the possible epilepsy that may be caused by GMH and PMG.
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For posterior fixation of C2 vertebra (the axis), several fixation techniques such as pedicle screw, laminar screw, and pars screw have been reported. A pedicle screw (PS) is considered the strongest among the techniques, but certain situations make PS fixation impossible or difficult. These include patients with a narrow C2 pedicle or high-riding vertebral artery. We introduced an alternative screw technique for C2 that addressed the aforementioned problems with safely placing it, which we termed a cortical screw (CS) for C2. ⋯ C2 CS can be suitable alternative for C2 screw fixation technique in posterior high cervical spine fusion surgery.
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Review Case Reports
Arterial embolization and second-look in Spindle cell oncocytoma (SCO) of the pituitary gland: case report and review of literature.
Spindle cell oncocytomas are extremely rare neoplasms of the sellar, parasellar, and suprasellar regions that can frequently mimic pituitary adenomas. Fewer than 50 cases have been ever reported in the literature, and there is no consensus on best treatments to be provided. ⋯ We found that the oncocytoma was radiologically and clinically comparable with a pituitary adenoma, except for higher representation of vasculature. According to our recent experience and review of the literature, we believe that surgery (transsphenoidal or transcranial approach) is the recommended treatment in those who are symptomatic and preoperative embolization might be a suitable option to reduce intraoperative bleeding and increase radicality.