World Neurosurg
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Due to suboptimal pain control under conventional local anesthesia, percutaneous endoscopic interlaminar discectomy is typically performed under general anesthesia. The purpose of this study was to develop a stepwise approach of local anesthesia for endoscopic interlaminar discectomy and evaluate its efficacy. ⋯ The stepwise local anesthesia can achieve satisfactory pain control and seems to be a good choice for endoscopic interlaminar discectomy.
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Case Reports
Imaging and radiological-pathological correlation in granular cell astrocytomas. Report of two cases.
Granular cell astrocytoma is a rare and aggressive subtype of astrocytoma that is histopathologically well defined in the literature. It is formed by polygonal cells with granular cytoplasm mixed with neoplastic astrocytes and usually a perivascular infiltrate of lymphocytes. Despite its unusual histologic appearance, relevant radiologic features have not yet been described. ⋯ Granular cell astrocytomas can show unusual aggressive radiologic features that do not correspond to their histopathologic grade of malignancy. The presence of perivascular lymphocytic infiltrate may alter the typical radiologic appearance of common astrocytomas.
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Case Reports
Ruptured tentorial AV fistula: endoscopic-assisted microsurgical disconnection using ICG-VA guidance.
Tentorial dural arteriovenous fistulas are rare causes of intracranial hemorrhage and nervous tissue venous congestion. Due to their extensive arterial supply and difficult transvenous endovascular navigation, they are frequently managed microsurgically. Precise identification of the venous drainage, its retractorless exposition, and real-time verification of arteriovenous disconnection are the mainstays of surgery. ⋯ Postoperative angiograms confirmed the elimination of the fistula. The patient was discharged to a rehabilitation facility 5 days postoperatively and regained functional independence, with a modified Rankin Scale score of zero by the third month after surgery. Relevant teaching points are exposed at the end of the case narration.
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The findings from several studies have confirmed that signal transducer and activator of transcription 3 (STAT3) is constitutively phosphorylated in primary central nervous system lymphoma (PCNSL). However, the underlying mechanism and prognostic significance of STAT3 activation have not yet been clarified. ⋯ Our results have indicated that STAT3 activation is closely related to IL-10 expression and that p-STAT3 might be a novel biomarker predictive of poor survival in those with PCNSL.
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Case Reports
Possible Empirical Evidence of Glymphatic System on CT after Endovascular Perforations.
The glial-lymphatic pathway is a fluid-clearance pathway consisting of a para-arterial route for the flow of cerebrospinal fluid along perivascular spaces and subsequently toward the brain interstitium. In this case series, we aim to investigate an empirical demonstration of glymphatic clearance of extravasated iodine following perforation incurred during endovascular therapy on serial computed tomography. ⋯ We described a likely in vivo computed tomography correlate of the glymphatic system in a cohort of patients who sustained intraprocedural extravasation during thrombectomy for acute ischemic stroke.