World Neurosurg
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Gunshot wound (GSW) injuries are among the leading causes of penetrating spinal column injury (pSI). Patients with pSI often have concurrent polytrauma that complicates management. ⋯ Management of pSI in urban trauma centers is complex, as these victims routinely have polytrauma that takes precedence. Indications for surgical intervention are narrow and secondary to surgery for polytrauma. External bracing may be overutilized. The efficacy of prophylactic antibiotics remains unclear. MRI can contribute valuable information but is limited by uncertainty regarding bullet compatibility. Lack of follow-up limits the study of this population.
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Case Reports
Multiple occipital bone lytic lesions containing ectopic cerebellar parenchyma mimicking neoplasia.
Nonlethal neural tube defects are developmental malformations with complex pathogenesis usually manifested at birth or in childhood. ⋯ To our knowledge, this study describes the oldest individual presenting with ectopic cerebellar tissue and the only instance in which oncologic workup for malignancy was carried out prior to resection. It also proposes surgical resection as a diagnostic and curative approach for this complex basicranium and neural developmental defect, and discusses retinoic acid toxicity as a possible cause of its occurrence.
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Atlantoaxial tuberculosis (TB) is rare in clinical practice, accounting for only about 0.3%-1% of spinal TB. An anterior-only surgical approach cannot provide strong fixation, whereas a posterior approach cannot achieve complete removal of lesions. A method combining anterior and posterior approaches to treat atlantoaxial TB is advisable. The aim of this study was to evaluate the effectiveness of anterior transoral débridement combined with posterior fixation and fusion for atlantoaxial TB. ⋯ Anterior transoral débridement combined with posterior fixation and fusion is an effective treatment for atlantoaxial TB, achieving removal of lesions and stability.
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Complications of ventriculoperitoneal (VP) shunts include migration into various anatomic compartments and even extrusion through tissue layers. ⋯ Dermacoccus is a gram-positive skin organism with rare human pathogenicity and not previously known to cause shunt infections.
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Recent literature has shown significant differences in meningioma incidence among different races, but minimal conclusive data exist on the role of race and ethnicity in overall survival for patients with high-grade intracranial meningioma. We conducted a systematic review to investigate the impact of race and ethnicity on survival in patients with high-grade intracranial meningioma. ⋯ The limited data available suggest that White patients have improved measures of survival compared with nonw-White patients, for reasons that are likely complex and multifactorial. Further studies are needed to explore these survival differences seen.