World Neurosurg
-
Intracerebral hemorrhage (ICH) remains a devastating diagnosis. While the ICH Score continues to be used in the clinical setting to prognosticate outcomes, contemporary improvements in management have reduced mortality rates for each scoring tier. The aims of this study were to examine mortality rates within ICH Score strata and examine if these findings are stable when major disability is included in categorizing poor outcomes. ⋯ Though the original ICH Score overestimates mortality for low-grade and moderate-grade hemorrhages, it may underpredict severe disability.
-
Brainatomy: A novel way of teaching sphenoid bone anatomy with a simplified three-dimensional model.
The diagnosis and treatment of diseases at and around the sphenoid bone demands throughout understanding of its anatomy in 3-dimensional (3-D) space. However, despite the complex anatomic nature of the sphenoid bone, the current educational resources for its 3-D anatomy are insufficient for fast and long-term retention of the anatomic relationships. ⋯ This simplified 3-D model, along with the video lecture, will enhance the efficiency of studying sphenoid bone anatomy. The educational resources of this study can be obtained by medical students, radiologists, neurologists, neurosurgeons, neuroscientists, or anyone else seeking for fundamental understanding of sphenoid bone anatomy.
-
Cervical meningiomas are uncommon intradural-extramedullary tumors that have a tendency to be situated anterior to the spinal cord. The optimal surgical corridor to reach purely ventral cervical meningiomas has not been established. This article presents a series of patients with ventral cervical meningiomas treated via 1 of 2 microneurosurgical approaches: the anterior approach with corpectomy and fusion or the posterolateral approach. ⋯ Purely ventral cervical meningiomas are uncommon and pose unique technical challenges for neurosurgeons. We document favorable outcomes from 2 cases of lower cervical meningioma treated via an anterior approach and 6 cases of upper cervical tumors treated via a posterolateral approach. This series demonstrates operative considerations for effectively managing ventral cervical meningiomas.
-
Brainstem cavernous malformations are uncommon vascular lesions that require complex surgical approaches. The case described in this video involved a 23-year-old male who presented with repeated, symptomatic episodes of bleeding of pontomedullary cavernous malformation, which was resected. ⋯ Postoperative imaging depicted complete resection of the cavernoma. Six months after surgery, the patient reported complete resolution of his symptoms.
-
Case Reports
Progressively enlarged convexity arachnoid cysts in elderly patients: A report of two cases.
Generally, enlargement of arachnoid cysts (ACs) has been found mostly in cases occurring during early childhood. Therefore, progressively enlarged ACs found to be symptomatic in elderly patients are extremely rare, and the mechanisms have remained unexplored. ⋯ The establishment of stable communication between a cyst and the normal cerebrospinal fluid space is important to treat symptomatic ACs characterized by progressive enlargement, even in elderly patients. The 1-way entry of the cerebrospinal fluid into the cyst and the closure of the surrounding subdural space might result in AC enlargement internally.