World Neurosurg
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We have reported an extremely rare case of a frontal convexity tumor diagnosed as IgG4-related disease (IgG4-RD) with unique neuroradiological images. ⋯ Intracranial IgG4-RD with smoldering monoclonal gammopathy of undetermined significance is extremely rare. We reviewed the differential diagnosis of plasma cell granuloma and plasmacytoma, therapeutic implications, and clinical outcomes. Complete resection of a conspicuous and solitary IgG4-RD lesion in the frontal convexity is simple and could provide a cure with less-aggressive adjuvant therapy.
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To retrospectively analyze clinical and surgical data of a consecutive series of 26 patients with unilateral cystic vestibular schwannomas. ⋯ According to the literature and the results of our series, microneurosurgery of cystic vestibular schwannomas is associated with good outcomes in terms of extent of resection and FN function. In particular, long-term FN function is much more satisfactory than short-term function. In most cases, microsurgery represents the treatment of choice of cystic vestibular schwannomas.
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Lumbar drains (LDs) are often used for temporary cerebrospinal fluid (CSF) diversion. However, limited data are available on the risk factors associated with complications. We reviewed our institutional LD data to identify the common indications and outcomes, including the risk factors associated with the occurrence of complications. ⋯ The most common complications in our institution were meningitis and low pressure headaches. Minimizing LD manipulation during CSF sampling could potentially decrease the risk of meningitis. Our protocol of continuing routine prophylactic antibiotics for patients with an indwelling LD might reduce the risk of meningitis; however, the results from a prospective cohort study would provide stronger evidence.
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Stereotactic radiosurgery (SRS) as a treatment for cerebral cavernous malformation (CCM) has been controversial, but there are few pathological reports showing its long-term therapeutic effect, and literature reporting the CCM cyst formation after SRS is also rare. ⋯ Recurrent hemorrhage after SRS for CCM could be related to incomplete occluded vessels and newly formed capillaries. Repeated hemorrhage from CCM newly formed capillaries into the small cavity increased the osmotic pressure, resulting in fluid entering the cavity and cyst enlargement.
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Case Reports
Nicolau Syndrome, Masquerader of Post Injection Sciatic Nerve Injury: Case Report and Review of Literature.
Sciatic nerve injury after inadvertent intramuscular gluteal injection is a well-described entity. We have presented a case of a rare and probably underdiagnosed pathological entity, Nicolau syndrome, which can be confused with injection palsy. ⋯ Before diagnosing injection sciatic nerve injury, the possibility of medically treatable Nicolau syndrome should be considered. Neurosurgeons' familiarity with this pathology and a timely diagnosis is essential to plan appropriate treatment strategies.