World Neurosurg
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Intracerebral hematomas (ICH) is a common disease in the developing countries, and minimally invasive transportal resection of ICH is a widely accepted surgical technique. Many port systems are available, but most are disposable and expensive. We present a safe and cost-effective glove-syringe substitute for endoscopic hematoma evacuation, suitable for developing countries such as China. ⋯ The glove-syringe port is a convenient, safe, and cost-effective tubular port system for endoscopic surgery of ICH. Such ports can be used as substitutes when commercial sleeves are unavailable, especially in rural areas and developing countries.
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Malignant craniopharyngioma is a rare clinical entity; most patients with this disease show transformation from an initially benign craniopharyngioma. The rare prevalence of the disease, nonspecific presenting symptoms, and imaging features that overlap with benign craniopharyngiomas make preoperative identification challenging. ⋯ Malignant craniopharyngioma should not be overlooked in patients with a giant sellar mass, especially in young patients who have experienced multiple recurrences of craniopharyngioma and patients who received radiologic therapy.
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Case Reports
SHH-activated Large cell/Anaplastic medulloblastoma with myogenic differentiation - case report.
Medulloblastoma (MB) with myogenic differentiation is a rare histologic variant. ⋯ The case is being reported to document this rare variant of MB that had myogenic differentiation. Molecular characterization of this variant has been analyzed in few cases so far.
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Case Reports
Intracardial catheter migration of a ventriculoperitoneal shunt: Pathophysiology and interdisciplinary management.
Intracardial migration of a ventriculoperitoneal (VP) shunt (ICMVP) is a rare complication that has been described in only single case reports. Here we report the successful interdisciplinary management of an ICMVP and provide a review of the relevant literature. ⋯ The management of an ICMVP is complex and carries a high risk for severe potential complications. Two different pathophysiological mechanisms have been discussed in the literature, including gradual erosion into an adjacent vein and transvenous catheter placement of the initial shunt secondary to subcostal placement of shunt tunneling instruments. The suction effect of the venous system results in gradual pulling of the catheter into the venous system.
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Proximal anterior cerebral artery (A1) aneurysms are rare among all intracranial aneurysms and are regarded as difficult to treat endovascularly. Treatment is even more challenging in patients with ruptured aneurysms and acute subarachnoid hemorrhage owing to the small size and proximity to perforators. Though challenging, endovascular treatment can provide favorable outcomes in such patients. We report our case series of endovascular treatment in ruptured proximal A1 aneurysms. ⋯ Ruptured proximal A1 aneurysm is a rare condition and is highly associated with multiple aneurysms. Despite being a more difficult and complicated technique, endovascular coiling performed in high-volume, experienced medical centers is an effective modality with excellent clinical outcomes.