World Neurosurg
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Review Case Reports
Giant Malignant Peripheral Nerve Sheath Tumor of the Scalp: Case Report and Review of the Literature.
Malignant peripheral nerve sheath tumors (MPNSTs) are rare nervous system tumors that rarely appear on the scalp. About half of the scalp MPNSTs described in the literature have reached giant dimensions at the time of diagnosis. The surgical treatment is the gold standard for this type of tumor. Some authors suggest adjuvant radiotherapy for local tumor control, although there is uncertainty about its advantages and its use is not without risks. ⋯ Giant MPNSTs of the scalp are highly aggressive lesions that should primarily be treated in a surgical fashion. Although adjuvant radiotherapy has been used routinely for local tumor control, there is uncertainty about its advantages.
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The superficial temporal artery (STA) to middle cerebral artery (MCA) bypass is an effective treatment procedure for steno-occlusive severe ischemic disease of the anterior circulation. The formation of an aneurysm at the anastomosis site is a rare complication, and the mechanism underlying this condition and the appropriate treatment strategy, have not yet been established. We describe a case of an unruptured anastomosis aneurysm that was treated by endovascular embolization 7 years after bypass surgery. ⋯ Endovascular treatment is a feasible and efficacious treatment option for an aneurysm at the anastomosis site of an STA-MCA bypass.
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Atlantoaxial fusion procedures may be difficult in situations such as high-riding vertebral artery, a narrow C2 pedicle, and the presence of ponticulus posticus-arcuate foramen. With respect to vertebral artery (VA) anomalies, persistent first intersegmental artery, extracranial origin of the posterior inferior cerebellar artery at the C1-C2 level, and fenestration of the VA are all major risk factors for VA injury in C1-C2 fusion surgeries. ⋯ We combined a unilateral transarticular screw and modified Brook's procedure with sublaminar tapping for additional augmentation of fusion. We would like to highlight this C1 posterior arch screw as an alternative procedure for atlantoaxial fusion.
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Review Case Reports
Subcutaneous metastasis of an atypical meningioma: a case report and literature review.
Meningioma, a neoplasm of the meninges, is usually a benign localized tumor. Extraneural metastasis is an extremely rare complication of meningiomas, and only a few cases have been reported to date. The present study reports a case of scalp metastasis of an atypical meningioma and discusses the types of atypical meningiomas and their management options. ⋯ This study highlights that resection of meningiomas is still associated with a risk of iatrogenic metastasis. Surgeons should carefully wash out the operative field and change surgical tools frequently to avoid the potential risk of metastasis.
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Review Meta Analysis
Minimum 2-year Efficacy of Percutaneous Endoscopic Lumbar Discectomy Versus Microendoscopic Discectomy: a Meta-analysis.
Minimally invasive surgery in the treatment of lumbar disc herniation has gained popularity in recent years, as 2 dominant techniques, percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) obtained comparable short-term clinical outcomes. However, midterm and long-term efficacy and reoperative rate are still debated. ⋯ Both PELD and MED can offer relatively effective and safe treatment for low back pain and radiculopathy associated with a herniated disc. PELD could obtain better midterm and long-term clinical outcomes compared with MED.