World Neurosurg
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Tumefactive demyelinating lesions (TDLs) are a rare sequelae of idiopathic inflammatory demyelinating diseases of the central nervous system. Their propensity to mimic tumor and abscess poses a diagnostic challenge for the clinician. ⋯ Ensuing magnetic resonance imaging of the cord, in addition to cerebral spinal fluid analysis, supported the diagnosis of idiopathic inflammatory demyelinating diseases. This case highlights the need to consider the rare diagnosis of TDL when imaging shows cystic brain lesions in an otherwise healthy young adult.
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Review Case Reports
Primary Intraparenchymal Meningiomas: A Case Report and a Systematic Review.
Primary intraparenchymal meningiomas are exceedingly rare and often challenging to diagnose, given their misleading radiologic features. It is hypothesized that they arise from the cap cells of the pia mater that enter the brain via penetrating blood vessels during brain development. We systematically reviewed and analyzed previously reported features of primary intraparenchymal meningiomas in terms of radiography, presenting symptoms, and histopathology. ⋯ We present a comprehensive analysis of every reported primary intraparenchymal meningioma. Because of their rarity and capacity to mimic other more common intra-axial tumors, they represent a diagnostic challenge. This systematic review highlights the importance of paying attention to atypical intra-axial lesions, with a particular reflection on the discrepancy between clinical characteristics and imaging features.
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The efficacy of laser interstitial thermal therapy (LITT) in recurrent glioblastoma (rGBM) is unknown. The goal of this study was to conduct a systematic review and pooled analysis of the literature for outcomes on patients with rGBM undergoing LITT. ⋯ LITT is a novel minimally invasive procedure which, when used with optimal adjuvant therapy, may confer survival benefit for patients with rGBM.
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Review Biography Historical Article
Eponyms of cranial neurosurgical instruments: an international collaboration to optimize the field of neurosurgery.
The basic set of a cranial instrument tray is filled with eponyms of surgical instruments named after surgeons and physicians from all corners of the medical world. These include pioneers like Castroviejo, Doyen, Frazier, Gigli, Mayfield, Raney, Weitlaner, and Yaşargil. These innovators have always strived to enhance and simplify procedures, ultimately shaping the way we perform surgery today. ⋯ Additional information was obtained via personal contact with American and European medical institutions, libraries, museums, as well as with the surgeons' family members and their perspective foundations. Remembering the life stories of the inventors behind commonly used eponyms in the operating theater reminds us of the long history of even the most rudimentary neurosurgical tool. This unrelenting strive for perfection reminds us, as surgeons, of our duty to continuously assess and improve our surgical tools and processes for the benefit of our patients.
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Incidental durotomy, a known complication of spinal surgery, can lead to persistent cerebrospinal fluid leak and pseudomeningocele if unrecognized or incompletely repaired. We describe the use of ultrasound to visualize the site of durotomy, observe the aspiration of the pseudomeningocele, and guide the precise application of an ultrasound-guided epidural blood patch (US-EBP), under direct visualization in real time. ⋯ This manuscript represents the largest series in the literature describing US-EBP for the treatment of postoperative pseudomeningocele. The success rate suggests that routine utilization of US-guided EBP may allow for targeted treatment of pseudomeningoceles, without the prolonged hospitalization associated with lumbar drains or the risks of general anesthesia and impaired wound healing associated with surgical revision.