World Neurosurg
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Malignant cystic lesions in the spine are rare. In this report, we present a 65-year-old man who presented with imbalance on walking of 1-week duration with intact motor examination. ⋯ However, he died 5 months later due to progression of moderately differentiated metastatic lung cancer. To our knowledge, this is the first report showing the near-complete replacement of vertebral body and posterior elements with a malignant cystic lesion.
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Patient counseling and selection for surgical therapy in adult Chiari malformation type I (CM-1) remain debatable. We aimed to develop a clinical calculator predicting the risk of nonhome discharge and reoperation using the American College of Surgeons-National Surgical Quality Improvement Program database. ⋯ We have used a large international database to develop a simple risk calculator based on readily available preoperative variables. Following subsequent validation, this tool can help optimize patient counseling and decision making in adult CM-1.
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To investigate the incidence of superior facet joint violation (FJV) during percutaneous pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion, and assess the possible risk factors for FJV. ⋯ Body mass index ≥30 kg/m2 and pedicle screw placement at L5 were independent risk factors of superior FJV. FJV was more likely to occur in hypertrophic FJ (axial, sagittal, and coronal diameters ≥12 mm) or coronal orientation (FA ≥40°).
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Comparative Study
Outcome comparison between surgically treated brain arteriovenous malformation hemorrhage and spontaneous intracerebral hemorrhage.
Case fatality and poor outcome rates are different between brain arteriovenous malformation-associated intracerebral hemorrhage (bAVM-ICH) and spontaneous intracerebral hemorrhage (SICH). These outcome rates, however, have never been compared in patients who need neurosurgical evacuation of the intracerebral hemorrhage (ICH). ⋯ patients with a bAVM who need surgical evacuation of an ICH have a more favorable outcome than surgically treated patients with spontaneous ICH, even after correction for confounding factors, such as younger age and less premorbid hypertension.
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Review Case Reports
Spinal intramedullary epidermoid cyst: case report and updated literature review.
Epidermoid cysts are rare benign neoplasms within the neuroaxis and account for <1% of all intraspinal tumors. They can be congenital or acquired. Being a slow-growing tumor, the clinical presentation is widely variable depending on the location, size, or age of the patient. ⋯ To achieve a good outcome, an early recognition of this disease is essential. The management consists in most cases of surgical resection. Although recurrence is low, it can significantly alter the quality of life of our patients, and, therefore, gross total resection should be our goal.