World Neurosurg
-
Intramedullary spinal cord dermoid tumors are rare. Early diagnosis with appropriate imaging is of utmost importance for a good outcome. Gross total resection is the treatment of choice for optimal results. Neurosurgical intervention for any intramedullary lesion is fraught with problems because of the nature of the lesion and handling of the spinal cord, which is already compromised because of the intramedullary lesion. Recurrence of the intramedullary dermoid tumor is frequent because of incomplete resection of the tumor. Most commonly, patients present with worsening of neurologic deficits. Inadequate resection because of the fear of worsening the neurologic deficits is associated with significant complications. ⋯ This report highlights the spectrum of complications that can develop in a patient varying from worsening of the deficits to meningitis and subsequent development of hydrocephalus.
-
Historically, women have been underrepresented in medicine but nowadays the underrepresentation is more applicable to surgical disciplines. Many efforts have been made to decrease the attrition rate of women in neurosurgery and to even career opportunities to be comparable to those of male colleagues. However, it is unclear if gender disparities occur between female and male neurosurgeons. Therefore, the aim of the current study is to identify gender differences in the professional and private life of neurosurgeons. ⋯ Despite efforts to increase the amount of women enrolling into neurosurgery and despite efforts to strive for equality, the results of the current study show gender disparities in professional and private careers among neurosurgeons. Practice patterns did not differ between male and female neurosurgeons, but perceptions of career and characteristics of private life did. Program directors and chairs should focus on measures to decrease gender differences and to strive for equal career satisfaction among female and male neurosurgeons.
-
Patients who undergo decompression surgery for Chiari malformation frequently require occipitocervical fixation. This is typically performed with occipital plates, which may cause intracranial injuries due to multiple fixation points. We undertook this study to assess the feasibility of occipital condyle (OC) screw placement as an alternative method of occipitocervical fixation in this patient population. ⋯ Our findings suggest that OC screws provide a useful option for occipitocervical fixation in a substantial proportion of patients with Chiari malformation. However, rigorous preoperative analysis would be essential to identify appropriate candidates for this technique and exclude those in whom it should not be attempted. Additional study is warranted.
-
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.
-
Review Case Reports
Chronic epidural hematoma caused by traumatic intracranial pseudoaneurysm of the middle meningeal artery: review of the literature with a focus on this unique entity.
Pseudoaneurysms of the middle meningeal artery represent fewer than 1% of all intracranial aneurysms; it can be associated with different patterns of intracranial hemorrhages. A chronic epidural hematoma (CEDH) caused by post-traumatic pseudoaneurysm of the middle meningeal artery (MMA) has not yet been reported. ⋯ Pseudoaneurysms are considered unstable because of the poor support of the aneurysmal wall. They tend to progressively increase in size and ultimately rupture, leading to delayed intracranial bleeding. A univocal definition of the interval of time between the acute head trauma and the diagnosis to classify the CEDH is still debated. To our knowledge, this is the first case described of a CEDH secondary to a pseudoaneurysm of the MMA. In our study we suggest defining CEDHs as extradural hematomas diagnosed and/or treated 21 days or more after a head injury.