World Neurosurg
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To trace anatomic variations of the lateral femoral cutaneous nerve (LFCN) in its intrapelvic course. ⋯ Considerable variability in the origin and the course of the LFCN was observed, which should be taken into account during clinical assessment of nerve lesions and during surgery via transpsoas approaches to the lumbar spine.
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Microvascular decompression for hemifacial spasm is performed at the root exit zone. More proximal segments of the facial nerve, defined as the root emerging zone (REmZ), may also be susceptible to neurovascular compression. Consequently, detailed knowledge of the microanatomy around facial nerve fibers at the pontomedullary junction is essential for consistent success of microvascular decompression. ⋯ Facial nerve fibers are susceptible to vascular compression on emerging onto the deep brainstem surface at the pontomedullary sulcus. The key procedure in microvascular decompression is full dissection of the lower cranial nerves down to the brainstem origin to explore both the root exit zone and the REmZ.
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Neuroglial cysts (also known as glioependymal cysts) are rare, benign, epithelial-lined cystic lesions that can potentially occur anywhere in the neuraxis. They can be intra, or within, a cranial nerve with the former being more common. The frontal lobe is thought to be the most common location. ⋯ The keyhole supraorbital approach was selected to provide a direct route to the pathology with minimal soft tissue disruption. The patient was discharged on postoperative day 2 without any complications. Follow-up at 6 weeks demonstrated near-complete resolution of her quadrantanopsia and good cosmesis with no frontalis palsy.
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Craniotomy has been performed in neurologic surgery for over a century. Replacement of free bone flaps in routine craniotomies is widely practiced, however, the rate of fusion after free flap replacement is unknown. ⋯ As expected, craniotomy fusion rates after free flap replacement increased steadily over time. We were not able to demonstrate that clinical factors such as age, sex, body mass index, diagnosis, fixation material, and radiation had an impact on fusion rate when time to fusion was accounted for. Patients receiving radiation, however, experienced fusion less frequently. Because of the scarcity of previous studies in this area, this current study serves as a platform for future studies on fusion rates after free flap replacement.
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Case Reports
Isolated Dorsal Thoracic Neuroenteric Cyst with Spinal Cord Compression: A Case Reports in Pediatrics.
Neuroenteric cysts are rare developmental anomalies of the central nervous system that account for approximately 0.7%-1.3% of all spinal cord lesions. The majority of spinal neuroenteric cysts are located ventral to the spinal cord. Dorsally located neuroenteric cysts are rare and are almost always associated with other spinal anomalies. Isolated dorsal spinal neuroenteric cysts, without other associated spinal anomalies, are extremely rare. These lesions can be mistaken for the more commonly encountered spinal cysts (e.g., arachnoid cysts, ependymal cysts, cystic teratomas). ⋯ Neuroenteric cysts can occur dorsal to the spinal cord without any associated spinal anomalies. The gold standard treatment for neuroenteric cysts is surgical resection, and the goal of surgery is complete resection.