A rare case of an expansile spinopelvic aneurysmal bone cyst managed with embolization, excision, and fusion

Rudra Mangesh Prabhu, Tushar N. Rathod, Akash Vasavda, Shivaprasad S. Kolur, Punit Tayade

Date of publication: 30-Nov-2021

Background: Aneurysmal bone cysts (ABC) are benign osteolytic lesions of the metaphyseal regions of long bones that typically contribute to rapid bony expansion. Here, we present an ABC involving the spinopelvic region in a 15-year-old male that required embolization, surgical excision, and fusion.

Limb-shaking syndrome derived from the contralateral hemisphere following unilateral revascularisation for moyamoya disease

Munehiro Demura, Masahiro Oishi, Naoyuki Uchiyama, Masanao Mohri, Katsuyoshi Miyashita, Mitsutoshi Nakada

Date of publication: 23-Nov-2021

Background: Moyamoya disease is a rare chronic steno-occlusive cerebrovascular disease. It may have variable clinical symptoms associated with cerebral stroke, including motor paralysis, sensory disturbances, seizures, or headaches. However, patients with moyamoya disease rarely present with involuntary movement disorders, including limb-shaking syndrome, with no previous reports of limb-shaking syndrome occurring after revascularization procedures for this disease. Although watershed shifts can elicit transient neurological deterioration after revascularisation, symptoms originating from the contralateral hemisphere following the revascularization procedure are rare. Here, we report the case of moyamoya disease wherein the patient developed limb-shaking syndrome derived from the contralateral hemisphere after unilateral revascularisation.

Cerebrospinal fluid leak as a driving factor in chronic subdural hematoma formation: A histological study

Antonio Colamaria, Matteo Sacco, Savino Iodice, Nicola Pio Fochi, Francesco Carbone

Date of publication: 23-Nov-2021

Background: Chronic subdural hematoma (CSDH) represents the most common neurosurgical disease. Given the demographic shift toward an aging population, the overall incidence of this condition is increasing. Nevertheless, clarity in the pathophysiological process is yet to be made. Several etiological mechanisms have been proposed to initiate and consequently promote fluid collection in the subdural space. Traumatic injury of the bridging veins has long been considered the primum movens of the pathology but increasing evidence shows that trauma is not the only factor involved. Along with recent advances we sought to understand the role of the cerebrospinal fluid (CSF) in the buildup of the intense inflammatory reaction that characterizes CSDH.

Trigeminal paresthesia secondary to responsive neurostimulation (RNS) lead migration

Zulfi Haneef, Alexandr Karimov, Vaishnav Krishnan, Sameer A. Sheth

Date of publication: 23-Nov-2021

Background: The responsive neurostimulation system (RNS) is used in patients with drug-resistant epilepsy who are not candidates for surgical resection of a seizure focus. As a relatively new therapy option, the adverse effects of long-term implantation are still being clarified. We present a series of two patients who presented with similar symptoms which were attributable to migration of the intracranially implanted subdural leads.

Perspective on the true incidence of bowel perforations occurring with extreme lateral lumbar interbody fusions. How should they be treated?

Nancy E. Epstein

Date of publication: 23-Nov-2021

Background: What is the risk of bowel perforation (BP) with open or minimally invasive (MI) extreme lateral lumbar interbody fusion (XLIF)? What is the truth? Further, if peritoneal symptoms/signs arise following XLIF/MI XLIF, it is critical to obtain an emergent consultation with general surgery who can diagnose and treat a potential BP.

Clinical outcome of selective amygdalectomy in a series of patients with resistant temporal lobe epilepsy

Guive Sharifi, Mohammad Hallajnejad, Samaneh Sadat Dastgheib, Mahmoud Lotfinia, Omidvar Rezaei Mirghaed, Arsalan Medical Amin

Date of publication: 23-Nov-2021

Background: Selective amygdalohippocampectomy is one of the main approaches for treating medial temporal lobe epilepsy (TLE). We herewith describe seven cases of amygdala lesions treated with selective amygdalectomy with the hippocampus saving procedure. Furthermore, we explain the trans-middle temporal gyrus transventricular approach for selective amygdalectomy.

Surgical safety criteria for burr hole surgery with urokinase in patients with acute subdural hematoma: Retrospective comparison between burr hole surgery and craniotomy

Airi Miyazaki, Takashi Nakagawa, Jin Matsuura, Yoshihiro Takesue, Tadahiro Otsuka

Date of publication: 23-Nov-2021

Background: Acute subdural hematoma (ASDH) is a common disease and craniotomy is the first choice for removing hematoma. However, patients for whom craniotomy or general anesthesia is contraindicated are increasing due to population aging. In our department, we perform burr hole surgery under local anesthesia with urokinase administration for such patients. We compared the patient background and outcomes between burr hole surgery and craniotomy to investigate the surgical safety criteria for burr hole surgery.

Building a microneurosurgical laboratory in Latin America: challenges and possibilities

Marcelo Augusto Acosta Goiri, Bruno Loof de Amorim, Talita Helena Martins Sarti, Marcos Devanir Silva da Costa, Feres Chaddad-Neto

Date of publication: 23-Nov-2021

Background: Training in microsurgical neuroanatomy is a priority for neurosurgical education. During the 20th century, microsurgical laboratories arose and provided a way to develop surgical skills. Few reports addressed the assembly, construction, and details of a training laboratory.

Cerebellopontine angle ependymoma presenting as isolated hearing loss in an elderly patient: A case report and literature review

Khaled Dibs, Rahul Neal Prasad, Kajal Madan, Kevin Liu, Will Jiang, Jayeeta Ghose, Dukagjin M. Blakaj, Joshua D. Palmer, Peter Kobalka, Daniel M. Prevedello, Raju R. Raval

Date of publication: 23-Nov-2021

Background: Ependymoma is an uncommon tumor accounting for approximately 1.9% of all adult central nervous system tumors. Ependymomas at the cerebellopontine angle (CPA) are even more rare and only previously described in isolated case reports. Typically, acoustic neuromas and meningiomas represent the bulk of adult CPA tumors. Diagnosis can be challenging, as ependymomas have clinical findings and imaging characteristics that overlap with more common tumor histologies at the CPA.

Hematoma expansion unrelated to rebleeding in ruptured anterior cerebral artery aneurysms treated by early endovascular embolization

Kazuaki Okamura, Yoichi Morofuji, Nobutaka Horie, Tsuyoshi Izumo, Kei Sato, Takashi Fujimoto, Takayuki Matsuo

Date of publication: 23-Nov-2021

Background: Whether hematoma expansion after aneurysmal rupture is always a sign of rerupture remains unclear. Hence, the present study aimed to assess the incidence and risk factors of hematoma expansion unrelated to aneurysmal rerupture after endovascular embolization for ruptured cerebral aneurysms.