World Neurosurg
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M2 occlusions represent 16%-41% of all middle cerebral artery occlusions, with >50% of functional independence achieved. The American Heart Association/American Stroke Association 2018 guidelines suggest that, with a level of evidence B-R, thrombectomy with stent retrievers may be appropriate for selected patients with M2 or M3 occlusions. The purpose of this study is to illustrate a new technique of distal (M2-M3) thrombectomy. ⋯ This technique allows a safe and effective distal thrombectomy for M2-M3 occlusions.
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Letter Review Case Reports
Successful Surgical Management of Traumatic Intracranial Hemorrhaging after Revascularization Surgery for Moyamoya Vasculopathy: A Case Report and Review of Literature.
Traumatic intracranial hemorrhaging associated with revascularization surgery for moyamoya vasculopathy is a potentially devastating problem that requires meticulous management, including surgery. However, only a few studies on this subject have been reported, and the clinical characteristics are poorly understood. We report a case of successful surgical management for a patient with traumatic intracranial hematoma managed with encephalo-duro-arterio-myo-synangiosis (EDAMS). The purpose of this article is to clarify the specific features of clinical scenarios, hemorrhagic sites, and operative techniques by reviewing all published cases. ⋯ In moyamoya vasculopathy, intrinsic collaterals or de novo anastomoses from revascularization surgery are easily injured, even with mild head trauma. Furthermore, the administration of antiplatelets agents increases the risk of hematoma development. Sacrifice of collaterals can lead to acute cerebral infarction. During emergency surgery for traumatic intracranial hematoma, a careful surgical strategy is needed to preserve the collateral supply.
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Review Case Reports
Trochlear schwannoma arising from transition zone of nerve sheath in the pineal region: Case report and review of the literature.
This report presents the third case of trochlear schwannoma arising from the pineal region and the first case to be resected using a paramedian infratentorial supracerebellar approach. Schwannomas of cranial nerves have traditionally been thought to arise from the transitional point where the axonal envelopment switches from glial cells to Schwann cells; however, recent temporal bone histopathologic evidence from vestibular schwannomas challenges this view. Of the 38 cases of pathology-confirmed trochlear schwannoma in the literature, there are only 2 cases arising from the pineal region, where the nerve sheath transition zone is located. Here, we discuss an unusual case of trochlear schwannoma arising from this transition zone. ⋯ Trochlear schwannoma should be considered when a mass is identified in the pineal region. This diagnosis should still be entertained for mass lesions along the free tentorial edge because the tumor may arise distant from the glial-Schwann transition zone located by the dorsal midbrain. We propose a treatment algorithm for this rare tumor that seeks to maximize functional outcome.
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Case Reports
Isolated Intracranial Rosai-Dorfman Disease: A Case Report and Review of the Literature.
Rosai-Dorfman disease (RDD) is a rare idiopathic benign proliferative disorder of histiocytes, predominantly affecting the lymph nodes. RDD can also present in extranodal tissues and is occasionally found within the central nervous system. ⋯ RDD should be considered as a differential diagnosis of dural-based lesions, more commonly meningiomas.
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Multicenter Study
Nomogram model for predicting hematoma expansion in spontaneous intracerebral hemorrhage - multicenter retrospective study.
To establish a new nomogram model and provide a new theoretical basis for the diagnosis and treatment of spontaneous intracerebral hemorrhage. ⋯ This nomogram model could accurately predict hematoma expansion of spontaneous intracerebral hemorrhage, which provided a theoretical basis for clinicians to intervene in the early stage.