A unique presentation of Crouzon-like syndrome: Complex craniosynostosis in the absence of genetic mutations or familial predisposition – A case report

Hariom Vaja, Shubham Nayankumar Patel, Abhishek Vadher, Masum Patel, Megh Bhaveshkumar Patel, Jaimin Shah

Date of publication: 08-Dec-2023

Background: Crouzon syndrome is a rare genetic disorder characterized by premature fusion of skull sutures during skull development, resulting in various craniofacial abnormalities and complex craniosynostosis is a condition in which more than one such sutures of the skull fuse prematurely.

Letter to editor regarding “Neurosurgical emergencies during pregnancy-management dilemmas”

Ajay Nair, Andrew Waack, Soumya Sharma, Alastair Hoyt, Jason Schroeder

Date of publication: 08-Dec-2023

Stereotactic intensity-modulated radiotherapy for skull base meningioma using the HybridArc with Novalis STx system

Takashi Shuto, Shigeo Matsunaga, Jo Sasame

Date of publication: 08-Dec-2023

Background: Skull base meningiomas are often difficult to remove completely with preserved nerve function and may require radiation therapy. However, the Gamma Knife is unsuitable for large tumor volume or the optic nerve, which is difficult to identify on imaging. We report the results of stereotactic radiotherapy with HybridArc using Novalis STx for skull base meningiomas.

Exploring neurosurgical oncology in medical school

Christopher Markosian, Rachel E. Yan, Michael S. Rallo

Date of publication: 08-Dec-2023

Late intrathecal retraction of a lumboperitoneal shunt

Young Ju Kim, Atsushi Fujita, Masahiro Maeyama, Tatsuo Hori, Kazuhiro Tanaka, Takashi Sasayama

Date of publication: 08-Dec-2023

Background: Lumboperitoneal (LP) shunt placement is a good option for treating elderly patients with communicating normal pressure hydrocephalus (NPH) who are also on antiplatelet therapy following endovascular treatment of unruptured bilateral internal carotid artery aneurysms. Here, in an 80-year-old male with an LP shunt, the catheter was “pinched” between adjacent spinous processes, resulting in laceration of the catheter and intrathecal catheter migration.

Isolated fourth ventricle craniopharyngioma: Representative case illustration and review of literature

Nazmin Ahmed, Md. Isma Azam

Date of publication: 08-Dec-2023

Background: Sella and suprasellar areas are frequently affected by craniopharyngiomas. In this article, eight occurrences have been documented. One is new, and the remaining seven are from previously published articles. Their prevalence in the posterior fossa without expansion from the suprasellar area is unusual.

Surgical salvage for recurrent vestibular schwannoma after primary stereotactic radiosurgery

José Orlando de Melo Junior, Victor H. C. Benalia, José Alberto Landeiro

Date of publication: 08-Dec-2023

Background: The management of vestibular schwannoma has evolved over the past hundred years. In the last decades, surgery has been gradually replaced by radiation therapy as a primary treatment modality, particularly for small tumors, due to the less invasive nature and the compared reported outcomes in tumor control and hearing preservation. However, irradiation sometimes fails to stop tumor growth. In a long-term follow-up after primary fractionated stereotactic radiotherapy, the rate of treatment failure was reported as 3% and needed surgical salvage. For single-fraction modality, Hasegawa et al. reported salvage treatment after primary Gamma Knife radiosurgery in 8%, where 90% of these underwent surgery and 50% of those who were treated with a second gamma knife surgery required surgical intervention later. An increase in tumor volume by more than 10–20%, tumor growth after three years, and no return to pretreatment volume after transient swelling have been considered as tumor recurrence rather than pseudoprogression, a transient increase in tumor volume after radiotherapy that occurs up to 30% of cases. It has been reported that microsurgery after radiotherapy is more difficult, with most authors reporting a loss of defined arachnoid planes and worse cranial nerve outcomes, especially for hearing and facial nerve function.

Bilateral basal ganglia hemorrhage in a 2-year-old child

Mohammed A. Alrawi, Muthanna N. Abdulqader, Hayder R. Salih, Saleh Abdulkareem Saleh, Mohammedbaqer Ali Al-Ghuraibawi, Mustafa M. Altaweel, Mustafa Ismail, Samer S. Hoz

Date of publication: 01-Dec-2023

Background: Basal ganglia hemorrhage (BGH) is an intracerebral subtype of hemorrhage located in the caudate nucleus, putamen, globus pallidus, or adjacent structures such as the thalamus or internal capsule. Bilateral involvement of both basal ganglia is exceedingly infrequent. Herein, we report a case of a 2-year-old female who was discovered to have spontaneous bilateral BGH with a unique hemorrhagic extension.

Hands-on neuroendovascular practice for nonselective undergraduate medical students increases interest and aspirations in pursuing neurosurgery as a specialization

Yuhei Michiwaki, Fumitaka Yamane, Hiroshi Itokawa, Tatsuya Tanaka, Kazuaki Shimoji, Akira Matsuno

Date of publication: 01-Dec-2023

Background: The number of medical students aspiring to become neurosurgeons has decreased worldwide, mainly due to poor work-life balance among neurosurgeons; therefore, recruiting students for neurosurgery is essential to ensure the availability and appropriate quality of neurosurgical treatment. This study aimed to evaluate the efficacy of hands-on neuroendovascular practice for nonselective undergraduate medical students to determine whether this increases their interest in neurosurgery and contributes to their aspirations of becoming neurosurgeons.

Bilateral posterior fossa chronic subdural hematoma as a cause of hydrocephalus

Domagoj Dlaka, Petar Marčinković, Marina Raguž, Dominik Romić, Darko Orešković, Darko Chudy

Date of publication: 01-Dec-2023

Background: Infratentorial chronic subdural hematoma (cSDH) is still a rather elusive neurosurgical entity, which, due to its proximity and likely compression of the cerebellum and brainstem, can lead to devastating consequences. To establish standardized treatment, more studies and reports regarding its therapy are needed. We report a case of a simultaneous unilateral supratentorial and bilateral infratentorial cSDH, with the latter causing hydrocephalus and successfully treated with a bilateral burr-hole trepanation of occipital bone and placement of subdural drains.