World Neurosurg
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Ventriculostomy-related infection with multidrug-negative strains are challenging to treat. We report the use of new antibiotics in such a case. ⋯ We observed than even in the case of mild meningeal inflammation, ceftaroline penetration in CSF, although moderate, enabled efficient bacterial clearance and clinical efficacy, in adjunction to correct ventriculoperitoneal shunt management.
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Case Reports
CO-OCCURRENCE OF CRANIOPHARYNGIOMA AND IgG4-RELATED HYPOPHYSITIS: AN EPIPHENOMENON OR A MERE CO-INCIDENCE?
Craniopharyngiomas are sellar-suprasellar tumors that commonly present in children, with nonspecific symptoms of increased intracranial pressure, visual disturbances, and pituitary insufficiencies. Rarely has secondary hypophysitis (lymphocytic and xanthogranulomatous) been reported in association with craniopharyngioma. ⋯ The present case might represent the first ever report, to the best of our knowledge, of secondary IgG4-related hypophysitis due to craniopharyngioma, or it might, perhaps, be a chance association of these 2 entirely different disease entities.
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Spinal dural arteriovenous fistulas (DAVFs) are usually associated with neurologic dysfunction adjacent to the shunt point; however, the symptoms are uncommon far from the site of the fistula. To our knowledge, this is the first report of a patient with rapidly progressive isolated pseudobulbar palsy because of thoracic DAVF. ⋯ Although rare, thoracic DAVFs may present symptoms resembling brainstem infarction. Prompt surgical intervention is necessary for patients with thoracic DAVF presenting with rapidly progressive pseudobulbar palsy.
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Spinal cord herniation in the cervical spine is an exceptionally rare occurrence. It is most often cited in association with surgery and almost exclusively with a posterior approach. Herniation with an anterior approach has been reported in 3 cases after multilevel corpectomy, all of which involved herniation through a dural defect sustained during surgery. ⋯ We present a case of cervical cord herniation that occurred into the ventral corpectomy site without obvious dural defect. We hypothesize that cerebral spinal pulsations over time degraded the corpectomy site and ultimately promoted herniation of the spinal cord. Here, we discuss the successful surgical management of this unique pathology and discuss a relevant review of the literature.
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Infratentorial multinodular lesions resembling multinodular and vacuolating neuronal tumor of the cerebrum (MVNT) have been indicated in literature with 2 different names reflecting alternative perspectives: multinodular and vacuolating posterior fossa lesions of unknown significance (MV-PLUS), suggesting that these lesions may belong to a new entity, and MVNT of the brain, assuming that they actually correspond to infratentorial MVNT. Because of the limited number of cases reported and the absence of histopathologic data, it is unclear which denomination should be used. ⋯ Infratentorial lesions show nodules with cystic or cyst-like signal intensity on MRI, a feature infrequently reported in supratentorial MVNT, and may involve the cortex. No variations were noted during a prolonged follow-up supporting the benign behavior of these lesions.