World Neurosurg
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Review Case Reports
Pituitary Blastoma in a 19-Year-Old Woman: A Case Report and Review of Literature.
Pituitary blastoma is a malignant neoplasm of the pituitary gland that was recognized by the World Health Organization in 2017. It is commonly diagnosed in children before 24 months of age. Here, we report the first case of a young adult patient who was diagnosed with pituitary blastoma with increased levels of growth hormone instead of adrenocorticotropic hormone and provide a review of the literature. ⋯ Although in this case the patient was a young adult, pituitary blastoma should be taken into consideration when children have an enhanced sellar and suprasellar mass with peripherally located cysts.
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Case Reports
FIP1L1-PDGFRA positive hypereosinophilia presenting with bilateral extracranial carotid artery aneurysms.
To describe a case of an adult female Filipino with hypereosinophilia and bilateral carotid artery aneurysms who subsequently developed bilateral cerebral hemisphere strokes following aneurysm stenting. ⋯ This patient's prothrombotic state from FIP1L1-PDGFRA-positive hypereosinophilia may have led to large carotid artery aneurysm formation and intramural thrombosis. This case demonstrates a possible and heretofore undocumented neurovascular sequela of hypereosinophilic syndrome.
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The caudate nucleus is a C-shaped structure that is located in the center of the brain and is divided into 3 parts: the head, body, and tail. ⋯ Understanding of the functional anatomy and connections of the distinct parts of the caudate nucleus is essential for deciding the extent of resection of lesions involving the caudate nucleus and the types of deficits that may be found postoperatively.
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Review Case Reports
Metal hypersensitivity after spinal instrumentation: when to suspect and how to treat.
Metal hypersensitivity is a rare complication after spinal implant placement but is related to significant clinical challenges including implant failure and poor wound healing. The incidence is likely underreported secondary to challenges with diagnosis and retreatment options. ⋯ Metal hypersensitivity is likely an underreported complication in spine literature that is associated with poor outcomes. Further research to create evidence-based guidelines on diagnosis and retreatment options will facilitate diagnosis, reduce time to revision surgery, and ultimately decrease patient suffering.
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Decompressive hemicraniectomy (DHC) is well established as an effective life-saving intervention. Although literature documents a correlation between mortality and hemicraniectomy flap size, no literature exists demonstrating whether a larger flap may be achieved with 3-pin fixation devices versus nonfixed positioning (e.g., occipital headrest, gel donut). Therefore, positioning for DHC remains the preference of the institution and attending physician. ⋯ This is the first large-scale single-institution study evaluating whether operative positioning for DHC affects the size of a hemicraniectomy flap. Positioning in 3-point fixation led to a statistically significant larger average diameter compared with nonfixed positioning. This indicates that the risks associated with pin fixation as well as additional time spent in positioning in this fashion are offset by the ability to obtain a larger hemicraniectomy flap, which is associated with decreased mortality.