World Neurosurg
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Extracerebral neuroglial heterotopias are rare manifestations of cerebral tissue outside the brain whose most common form is the so-called nasal glioma. In this case report we illustrate the first case of heterotopic neuroglial tissue within the bone of the skull. ⋯ The pathogenesis of cerebral heterotopias is diverse. Most of the midline lesions are probably residuals of former meningoencephaloceles. The pathogenesis of extracranial nonmidline lesions is more questionable. Their cause might be a former trauma, inflammatory disease, or surgery. Another option is that they represent primary neuroglial heterotopias, as it is supposed for manifestations of the lung. The coexistence of a heterotopia and a meningioma in this case is probably a coincidence. It is also debatable whether the broad tumor extension within the bone and/or the heterotopia might go back to alterations of the bone structure.
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Patients undergoing surgical resection of meningioma are at increased risk for developing venous thromboembolism (VTE). The aim of this study was to assess occurrence of VTE in patients who underwent surgical resection of meningioma to determine risk factors and associated complications of VTE. ⋯ Risk factors of VTE and associated complications were identified. Understanding these risk factors provides physicians with further insight in managing this subgroup of patients in a personalized fashion in the perioperative period to minimize the incidence and morbidity of VTE.
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An epidermoid cyst is a rare tumor of the cerebellopontine angle region. It usually presents with ipsilateral compressive symptoms. The contralateral trigeminal neuralgia is an unusual presentation in such cases. We did not find such case reports in the literature. ⋯ The possible mechanism leading to the contralateral trigeminal neuralgia is discussed here along with the diagnosis and management of the case.
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Bow hunter syndrome describes a mechanical compression of the vertebral artery on head rotation leading to reversible symptomatic vertebrobasilar insufficiency. Patients are commonly presenting with syncope, vertigo, dizziness, and visual disturbances. These symptoms usually resolve when the head is turned back into neutral position. Treatment options involve surgical decompression with or without fusion, bypass surgery, or endovascular intervention. ⋯ The reported case is unique as the bow hunter syndrome was further complicated by a pseudoaneurysm of the V3 segment. Surgical intervention proved to be an efficient treatment by stabilizing the affected segment in this patient.
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Hirayama disease (HD) is a rare disease traditionally treated with nonsurgical procedures. Surgical treatment, which is performed by decompression and/or fusion of the cervical spine, is generally considered for rapidly progressive or advanced cases, and the choice of surgical technique is debatable. We describe the first severe case of HD that was successfully treated by posterior lateral mass screw fixation without decompression or fusion. ⋯ Nondecompression and nonfusion surgery was successful and achieved satisfactory results in this case; therefore, it serves as a promising candidate for the surgical treatment of HD.