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Thunderclap headache: It is always sub-arachnoid hemorrhage. Is it? – A case report and Review
Date of publication: 21-Feb-2014
Background:Spontaneous intracranial hypotension (SIH) is one of the relatively misdiagnosed pathophysiological entities by virtue of its presentation. SIH is a condition involving reduced intracranial pressure usually secondary to dural tear. There is recent increase in reporting of its varied presentation in literature. Critical care physicians and neurosurgeons are recognizing it in higher numbers than before. SIH is characterized by sudden onset of orthostatic headache and may be associated with neck stiffness, nausea, vomiting, tinnitus, deafness, and cognitive abnormalities. Since its imaging characteristics resemble classic subdural hematoma from other causes wrong diagnosis and intervention might have devastating outcome.
Dolichoectasia of the vertebrobasilar complex causing neural compression
Date of publication: 18-Feb-2014
Dural adhesion to porous cranioplastic implant: A potential safety concern
Date of publication: 18-Feb-2014
Background:Patient-specific implants are used for cranioplastic skull reconstruction when large bone flaps must be replaced or where there are complex or critical contours, especially near the face. These implants have a low complication rate, with poor fit and postoperative infection being the most common complications. We report here a potentially serious hazard that may arise from the use of porous implants.
Giant clival chordoma causing pathological laughter
Date of publication: 17-Feb-2014
Background:Chordomas are rare slowly growing tumors that originate from remnants of the notochord. They have a malignant local behavior, causing symptoms due to bone infiltration and compression of neurovascular structures. Only a few cases of brain tumors associated with pathological laughter have been reported in the literature.
Sudden unexpected nocturnal death in Chiari type 1 malformation and potential role of opioid analgesics
Date of publication: 12-Feb-2014
Background:Chiari malformation type 1 (CM1) is a common congenital anomaly of the craniocervical junction. CM1 is reported to run a usually benign course and patients typically experience no symptoms or chronic, slowly progressive symptoms. However, recent reports indicate that a subset of patients with CM1 may present with acute deterioration and sudden unexpected death (SUD). We report a case of SUD during sleep in a young man with CM1, which we believe was related to the administration of common and therapeutic doses of narcotic analgesics for the management of pain. We will clarify the pathophysiology of acute deterioration and SUD in CM1 and the possibility that the adverse effects of opiate analgesics likely were the leading cause of death in our patient.
Sudden unexpected nocturnal death in Chiari type 1 malformation and potential role of opioid analgesics
Date of publication: 12-Feb-2014
Background:Chiari malformation type 1 (CM1) is a common congenital anomaly of the craniocervical junction. CM1 is reported to run a usually benign course and patients typically experience no symptoms or chronic, slowly progressive symptoms. However, recent reports indicate that a subset of patients with CM1 may present with acute deterioration and sudden unexpected death (SUD). We report a case of SUD during sleep in a young man with CM1, which we believe was related to the administration of common and therapeutic doses of narcotic analgesics for the management of pain. We will clarify the pathophysiology of acute deterioration and SUD in CM1 and the possibility that the adverse effects of opiate analgesics likely were the leading cause of death in our patient.
Bilateral telovelar approach: A safe route revisited for resections of various large fourth ventricle tumors
Date of publication: 30-Jan-2014
Background:Tumors located in the posterior fossa and especially in the middle and upper fourth ventricle are comparatively rare and technically very challenging. For some lesions, the telovelar approach has been shown to be a suitable approach. The unilateral approach is sufficient in most cases of small lesions. However, large fourth ventricle tumors are more problematic since they distort the normal anatomy with both vermis and cerebellar peduncles thinned and stretched out. This puts the patient at increased risk for a neurological deficit, which is minimized with a bilateral telovelar approach. By illustrating the adequacy of this technique, we emphasize the suitability of a rather unusual bilateral approach, which will provide excellent panoramic visualization of entire fourth ventricle and thus avoids complications usually associated with resections of large fourth ventricle tumors.
The “extended” endoscopic endonasal approach for the removal of a mixed intrasuprasellar germinoma: Technical case report
Date of publication: 29-Jan-2014
Background:Intracranial germ cell tumors (GCTs) represent less than 5% of pediatric brain tumors. Neurosurgical treatment remains essential in the management of patients with intracranial nongerminomatous GCT.
The “extended” endoscopic endonasal approach for the removal of a mixed intrasuprasellar germinoma: Technical case report
Date of publication: 29-Jan-2014
Background:Intracranial germ cell tumors (GCTs) represent less than 5% of pediatric brain tumors. Neurosurgical treatment remains essential in the management of patients with intracranial nongerminomatous GCT.
