World Neurosurg
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Case Reports
Amateur Endurance Athletes: at higher risk of suffering dural arteriovenous fistulas? Report of 3 cases.
The present study aims to draw attention to the fact that endurance sport could be a risk factor for dural arteriovenous fistula (DAVF) development. DAVFs have been correlated with acquired dural venous sinus anomalies owing to trauma, infection, neoplasia, or other classic risk thrombogenic factors. Here we report 3 cases of intracranial DAVF in young healthy patients who had no known thrombogenic risk factors other than amateur intensive sports practice. ⋯ Dehydration, microfractures, muscular contractures, low heart rate, long distance travel, and high altitudes are all well documented thrombogenic risk factors affecting endurance sports amateur athletes and might represent a plausible mechanism for the development of DAVF. Despite its limitations, to our knowledge, this is the first work suggesting a possible link between such sport practice and DAVF development. Further prospective research from larger dedicated vascular centers might shed further light on this hypothetic but intriguing link.
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To investigate the biomechanical effect of C1 lateral mass-C2 pedicle screw-rod (C1LM-C2PS) fixation with and without transverse connectors (TC) in an atlantoaxial instability (AAI) model. ⋯ Adding TCs to C1LM-C2PS can effectively decrease the axial rotation ROM and enhance the stability of C1-C2 segment. Therefore, it is necessary to use TC-strengthened C1 lateral mass -C2 pedicle screw-rod fixation in patients with instability of C1-C2.
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Fungal mass lesions in the central nervous system rarely reach a size large enough to directly cause neurologic deterioration. In terms of the etiologic incidence of fungal mass lesions in the central nervous system, whereas cryptococcomas may be the most common, they rarely reach any appreciable size. One form of this specific fungal infection, namely the granulomatous form of cryptococcomatosis, challenges this paradigm, and these lesions can reach an alarming size. ⋯ According to our review of the English literature, to our knowledge, this is the first report of recurrent granulomatous cryptococcomas occurring in the contralateral hemisphere within 6 months of surgery. The case illustrates the importance of the adjuvant antifungal medial therapy if recurrence is to be avoided.
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The ability to hold an endoscope is an important skill for surgeons and assistants performing endoscopic neurosurgery. Motion tracking can provide an objective assessment for surgical skills and may aid in endoscopic neurosurgery. We developed a cost-effective system to study the feasibility of objectively distinguishing performance levels for operating an endoscope. ⋯ The simple low-cost video motion tracking system can provide an objective assessment of an endoscope holding skill, which allows for discrimination between an expert and a novice, and can be used by clinical neurosurgeons to select a qualified assistant.
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Case Reports
Isolated Bilateral Hypoglossal Palsy Complicating a Fourth Ventricle Ependymoma Surgery.
Isolated bilateral hypoglossal palsy is a rare condition that has never been described after surgery in the lower part of the fourth ventricle. In this article, we discuss various possible etiologies and relevant anatomy considerations of the rhomboid fossa. ⋯ Intraoperative neurophysiologic monitoring of hypoglossal nerves, in addition to facial nerves, should be performed for tumors in this location.