World Neurosurg
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Case Reports
Rosette forming glioneuronal tumor in the optico-chiasmatic region-a novel entity in a new location.
Rosette-forming glioneuronal tumour [RGNT] is a relatively rare entity first identified as a separate entity in 2002. We are reporting the second case of RGNT in the opticochiasmatic region. ⋯ Although initial reports were predominantly in the fourth ventricle, many recent reports have identified the possibility of its occurrence outside fourth ventricle in pineal gland, spinal cord, septum pellucidum, lateral ventricle, and suprasellar region. To date, only 1 case of RGNT involving the opticochiasmatic region has been reported in a patient with neurofibromatosis type 1. Genetic analysis of this rare tumor identified 3 hotspots involving somatic mutations of FGFR-1 and PIK3CA and a germline mutation involving PTPN11, which can be targets for therapeutic intervention in cases where complete resection is not possible. To the best of our knowledge, we report the first case of RGNT involving the opticochiasmatic region without any syndromic association. Other cases of RGNT with syndromic associations provide us with insight into possible therapeutic interventions.
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Gamma Knife radiosurgery was introduced in the 1960s and is currently used worldwide. The internet has become a foremost source of information used by patients and their families. In this study, we aim to evaluate the accuracy and reliability of the Gamma Knife radiosurgery-related YouTube videos. ⋯ Patients and caregivers turn to online sources to gather information about the disease. However, the available YouTube published videos are published without proper academic monitoring, as in such a free platform, published videos tend to catch a general audience for different purposes, which leads to diminishing quality control. Academic medical institutions should consider a proper monitoring process for videos to improve the accuracy of the published information for the patients.
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Subclavian steal phenomenon can cause retrograde flow through the ipsilateral vertebral artery as a result of atherosclerosis of the subclavian artery. Clinically this can present as intermittent vertebrobasilar ischemia or claudication of the affected extremity, but rarely it poses a serious risk of neurologic morbidity or mortality. Aneurysm formation at the vertebrobasilar junction is rare but may occur as a sequela of increased flow through 1 vertebral artery, as occurs in subclavian steal syndrome. Here, we present a rare case of subarachnoid hemorrhage from a vertebrobasilar junction aneurysm related to subclavian steal syndrome.
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Fall with head injury is a pervasive challenge, especially in the aging population. Contributing factors for mortality include the development of cerebral contusions and delayed traumatic intracerebral hematoma. Currently, there is no established specific treatment for these conditions. ⋯ Tranexamic acid was identified by univariate analysis as an independent factor associated with lower mortality in cerebral contusions or traumatic subarachnoid hemorrhage. Further prospective studies are needed to validate this finding.
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Traumatic brain injury (TBI) is major contributor to the global burden of disease, especially in low- and middle- income countries, where most TBIs are traffic-related. Evidence shows that helmets protect against severe TBI. Cambodia continues to have the greatest motorcycle fatality rate in Southeast Asia. We investigated whether the National Motorcycle Helmet Law introduced in January 2016 had an impact on the epidemiology of motorcycle-related TBI in a neurosurgical referral center in Phnom Penh. ⋯ With growing urbanization and motorization, TBI is a significant cause of morbidity and mortality in Cambodia. Two years after helmets became compulsory, most patients with TBI are still unhelmeted. Likely contributing factors are low penalty for noncompliance and inconsistent law enforcement. TBI is a major public health problem warranting further efforts to understand how to improve prevention strategies and advocate for change.