World Neurosurg
-
To evaluate the efficacy of combining an endonasal endoscopic skull-base approach and repair with a transcranial orbitozygomatic approach for spheno-orbital meningiomas (SOMs). ⋯ A combined cranionasal approach involving transcranial orbitozygomatic and endonasal endoscopic approaches is an effective 2-stage surgery for resecting SOMs invading into the sinuses and paranasal compartments. The ability to perform a multilayer closure involving a vascularized nasoseptal flap additionally decreases the risk of postoperative cerebrospinal fluid leak.
-
To review the management of aneurysms arising at the origin of a duplicated middle cerebral artery (DMCA), which is an extremely rare entity. ⋯ Although all previously published clinical cases of internal carotid artery-DMCA aneurysms were treated surgically, conservative management with follow-up is a viable option in very small unruptured aneurysms.
-
Case Reports
One-step fixation of atlantoaxial rotatory subluxation: technical note and report of three cases.
To describe a successful one-step intraoperative reduction of atlantoaxial rotatory subluxation (AARS) using neuromuscular blockade and intraoperative traction. ⋯ Intraoperative traction and neuromuscular blockade achieved a one-step reduction before fixation for subacute and chronic irreducible AARS. This one-step reduction obviates preoperative traction, which is often inconvenient and not tolerated by pediatric patients. Successful reduction is also demonstrated in detail intraoperatively with three-dimensional imaging.
-
The differential diagnosis for suprasellar masses includes a variety of pathologies, ranging from stable and benign lesions to aggressive and malignant ones. We report a case of a suprasellar hamartoma associated with an arachnoid cyst and review the literature surrounding the topic. ⋯ To our knowledge this is only the third case of an isolated suprasellar hamartoma described in the literature and the first of its kind to be associated with an arachnoid cyst.
-
Neurological surgery is historically among one of the most competitive residency matches, but data suggest a downward trend in neurosurgical residency applicants in the United States. In 2002, our department, in conjunction with our institution, began an initiative to increase exposure to and interest in neurological surgery, targeting both undergraduate and medical students. This study outlines and assesses the factors used by our institution to successfully prepare and recruit medical students for residency in the field of neurological surgery. ⋯ An earlier, organized involvement of the neurosurgical department in medical student education can result in an improved understanding of the role of neurosurgeons among other practitioners as well as a greater number of well-qualified residency applicants into neurological surgery.