World Neurosurg
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Interest in the relational anatomy of the anterior neck among spine surgeons increased after the popularization of anterior cervical discectomy and fusion in the 1950s. Five surface landmarks and their relationship to specific spinal levels have been routinely described, comprising the angle of the mandible for the C2-C3 interspace, the hyoid bone for the C3 body, the thyroid cartilage for the C4-C5 disc, and the cricoid cartilage and carotid tubercle for the C6 body. We aimed to investigate the origins of these anatomic relationships and their application in modern practice.
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A 37-year-old man with a history of head trauma surgery 8 years previously was admitted because of persistent pulsatile exophthalmos and intracranial murmur. Angiography results showed that blood from the right internal carotid artery flowed directly into the cavernous sinus , with the arterial system above the cavernous sinus not visualized; early visualization of the right venous sinus system; dilation of the right superior ophthalmic vein and the medial canthal vein. ⋯ After a comprehensive preoperative assessment, we chose spring coil embolization treatment, which resulted in the disappearance of symptoms after treatment. Three months later, on follow-up, the patient reported no longer hearing intracranial murmur, and auscultation of the right temporal region showed no abnormal sounds.
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Choriocarcinoma (CC) is a rare and aggressive form of germ cell tumor. There is limited evidence describing clinical outcomes in patients with primary CC and brain metastases (BM). Only a few single case reports have documented the use of stereotactic radiosurgery (SRS) for CC BM. ⋯ SRS is a feasible and viable approach for CC BM, particularly in cases where immediate surgical management is not necessary. This is the largest report to date evaluating the outcome of CC BM treated with SRS.