World Neurosurg
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Case Reports
Encountering a basal vein of Rosenthal variant during the anterior transpetrosal approach.
The basal vein of Rosenthal (BVR) is important in intracranial surgery, including skull base surgery. We report a case of petroclival meningioma in which a BVR variant drained into the tentorial sinus. ⋯ To our knowledge, this is the first study to describe surgery using the ATPA and involving a BVR variant, in which the vein was imaged successfully preoperatively using sliding-thin-slab MIP.
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Case Reports
Oblique positioning of the stereotactic frame for biopsies of cerebellar and brainstem lesions.
Frame-based stereotactic biopsy has proven to be a safe procedure with a high diagnostic yield for patients. Different supratentorial localizations can easily be accessed by standardized stereotactic approaches. Cerebellar and brainstem lesions, however, are not easy to reach because the positioning of the frame pins often makes it impossible to address the entry point properly. ⋯ Modification of the standardized positioning of the frame allows for safe and straightforward stereotactic access even to cerebellar and brainstem lesions.
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Long-lived inhabitants of the plateau region have a higher hemoglobin concentration, which is the leading cause of damage in various organs, especially the nervous system. The aim of this study was to investigate the effect of hemoglobin concentration on mortality and neural functions after decompressive craniectomy in patients with hypoxia. ⋯ Elevated hemoglobin concentration has a serious impact on neurologic recovery and mortality, as seen in patients with acute severe head trauma after decompressive craniectomy.
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Cervical spine sagittal malalignment has been demonstrated to correlate with the severity of disease in patients with cervical spondylotic myelopathy (CSM). The impact of spinal alignment on neurologic recovery has not been investigated thoroughly. The goal of this study was to evaluate the variable impact of preoperative sagittal alignment on neurologic recovery among surgical myelopathic patients. ⋯ The majority of patients with CSM showed postoperative neurologic improvement. Patients with preoperative lordotic alignment exhibited greater improvement than those with preoperative kyphotic alignment. Furthermore, the choice of surgical approach impacted neurologic recovery among kyphotic patients, with those patients who were approached anteriorly or with a combined approach faring better.
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Case Reports
Ventriculoperitoneal shunt infection with Mycobacterium abscessus: a rare cause of ventriculitis.
Mycobacterium abscessus is a rapidly growing atypical mycobacterium implicated in chronic lung disease, otitis media, surgical site infections, and disseminated cutaneous diseases. It is typically seen in patients with some degree of immunosuppression. Only 1 previous case has been reported in the setting of ventriculoperitoneal (VP) shunt infection. We report a case of M abscessus as the causative organism in a VP shunt infection in an immunocompetent adult. ⋯ Nontuberculous mycobacteria are rare, atypical organisms in the setting of VP shunt infection. Patients with ventriculitis secondary to atypical mycobacteria may exhibit drug-resistant cerebrospinal fluid pleocytosis in the face of standard antibiotic regimens.