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Journal of Neurological Surgery Reports

Corey Savard, Gregory Epps, Voichita Bar Ad, Joseph Curry, James J Evans, Christopher J Farrell, Gurston Nyquist, Adam Luginbuhl
Background  Recurrent malignancy of the skull base poses a treatment challenge due to a lack of treatment options and potential for damage to surrounding structures. Methods  Case report of two patients with recurrent nasopharyngeal carcinoma (NPC) of skull base previously treated with adjuvant chemoradiotherapy using intensity-modulated radiation therapy (IMRT). Results  In both cases, the recurrent tumor was treated with endoscopic surgical resection and intraoperative cesium-131 (Cs-131) interstitial brachytherapy (IBT)...
April 2019: Journal of Neurological Surgery Reports
Hiroyuki Mishima, Junichi Ayabe, Masahide Watanabe, Sota Togin, Yuusuke Tsuchiya, Taisuke Kawasaki, Naoyuki Noda, Takumi Maruyama, Yoshihide Tanaka
Histologically, hepatocellular carcinoma (HCC) and atypical pituitary adenoma are similar, posing a potential clinical problem. A 76-year-old woman, whose past medical history was significant for hepatitis C virus (HCV), positivity without liver cirrhosis was presented with abducens nerve (CN VI) palsy. Contrast-enhanced magnetic resonance imaging (MRI) showed a clival tumor with infiltration of the right cavernous sinus. Subtotal resection was performed using a right anterior petrosal approach. Histological diagnosis was pituitary adenoma...
January 2019: Journal of Neurological Surgery Reports
Dominik Romić, Marina Raguž, Petar Marčinković, Patricija Sesar, Martina Špero, Zrinka Čolak Romić, Domagoj Dlaka, Darko Chudy
Introduction : Primary intracranial teratoma is a subtype of germ cell tumors, classified into three subtypes. They occur very rarely, with only several reported individual cases in adults. Case Description  We present a patient with an intermittent headache in the right frontal region. Magnetic resonance imaging (MRI) revealed a right sided high frontal parasagittal mass that compressed the falx, the right lateral ventricle, as well as the brain parenchyma. Patient underwent surgical treatment. Histopathological analysis described mature teratoma...
January 2019: Journal of Neurological Surgery Reports
Yening Feng, Neil S Patel, Anthony M Burrows, John I Lane, Aditya Raghunathan, Jamie J Van Gompel, Matthew L Carlson
Objectives  To present a rare case of traumatic facial neuroma involving the geniculate ganglion and review relevant literature. Patient  Thirty-year-old man. Intervention  Microsurgical resection via combined mastoid-middle fossa approach with great auricular nerve interpositional graft. Main Outcome Measures  Patient demographics and pre- and postoperative facial nerve function. Results  A 30-year-old man with a reported history of prior Bell's palsy developed progressive complete (House-Brackmann VI) right facial paralysis following blunt trauma...
January 2019: Journal of Neurological Surgery Reports
Anand V Kasbekar, Yu Chuen Tam, Robert P Carlyon, John M Deeks, Neil Donnelly, James Tysome, Richard Mannion, Patrick R Axon
Objectives  A decision on whether to insert a cochlear implant can be made in neurofibromatosis 2 (NF2) if there is objective evidence of cochlear nerve (CN) function post vestibular schwannoma (VS) excision. We aimed to develop intraoperative CN monitoring to help in this decision. Design  We describe the intraoperative monitoring of a patient with NF2 and our stimulating and recording set up. A novel test electrode is used to stimulate the CN electrically. Setting  This study was set at a tertiary referral center for skull base pathology...
January 2019: Journal of Neurological Surgery Reports
Ali Kord Valeshabad, Lekui Xiao, Sepideh Amin-Hanjani, Alaa Alsadi, Tibor Valyi-Nagy, Jinsuh Kim
Objectives  To describe an extremely rare case of sporadic hemangioblastoma (HB) within the cavernous sinus and Meckel's cave with extension to the cerebellopontine angle (CPA) cistern. Methods  A 73-year-old male presented with hearing loss, unilateral ptosis, and facial numbness. Results  The imaging showed a complex cystic-solid mass centered at the left cavernous sinus and Meckel's cave with extension to the CPA cistern. Patient underwent retrosigmoid craniectomy for partial resection of the CPA angle component of the mass...
October 2018: Journal of Neurological Surgery Reports
Serge Marbacher, Alexander Spiessberger, Michael Diepers, Luca Remonda, Javier Fandino
Microsurgical clip ligation is considered a definitive treatment for intracranial aneurysms (IAs), resulting in low rates of local recurrence that range from 0.2 to 0.5% and a latency period that averages about a decade. Our case report describes an early asymptomatic recurrence (i.e., without sentinel headache or seizure) less than 1 year after this 20-year-old woman underwent clip ligation of a ruptured anterior communicating artery (AComA) aneurysm. At recurrence, the patient underwent coiling of the regrowth; follow-up imaging at 6 and 18 months demonstrated complete IA occlusion...
October 2018: Journal of Neurological Surgery Reports
Jeremiah Maupin, Zackary Burrow, Cameron Shirazi, Santaram Vallurupalli
This is the case of a 66-year-old male with cervical myelopathy secondary to severe cervical stenosis manifesting as worsening dexterity and numbness in his right hand. The patient underwent C3-C6 laminoplasty with bilateral foraminotomies. During the procedure an incidental durotomy occurred which was patched intraoperatively with Duragen and Tisseel. At 1 month follow-up, the patient reported that he was doing well and skin sutures were removed. Two days later, the patient presented to the emergency department with postoperative wound dehiscence, cerebrospinal fluid (CSF) drainage, altered mental status and lethargy...
October 2018: Journal of Neurological Surgery Reports
F Banaz, I Edem, I D Moldovan, S Kilty, G Jansen, F Alkherayf
Introduction  Surgical treatment of petrous apex chondrosarcoma is challenging due to the location of the tumor. Using an endoscopic technique for tumor resection is favored since it provides a minimally invasive approach. Case Presentation  A 57 years old female was admitted for acute onset of left abducens nerve palsy and occasional headache mainly on the left side of the retro-orbital area with some radiation to the left occiput. Magnetic resonance imaging (MRI) and computed tomography (CT), at the time of admission, were showed lytic lesion on the left petrous apex and left part of the clivus...
October 2018: Journal of Neurological Surgery Reports
Buse Sarigul, Ece Uysal, İdris Avci, Halil Peker, Suat Celik
Ewing's sarcoma (EWS) is the second most common primary bone tumor seen in children and adolescents, first being osteosarcoma. Skull lesions are seen in 6 to 9% of cases. The tumor tends to reside most frequently on frontal and parietal bones. In the literature, majority of papers on calvarial EWS present cases with intracranial involvement; extracranial extension is reported in only eight cases. The case that we are presenting in this report is a 23-year-old male patient with multiple infiltrations in femur, costal bones, and calvarium which had been diagnosed radiologically and histopathologically as EWS...
October 2018: Journal of Neurological Surgery Reports
Timothy C Blood, Fausto J Rodriguez, Norris Nolan, Murugappan Ramanathan, Shaun C Desai
Calcifying pseudoneoplasms of the neuroaxis (CAPNON) are rare, benign tumors of unknown histogenesis. CAPNON generally are found intracranially or within the spinal column in symptomatic patients. We present the case of an asymptomatic patient with an incidentally discovered right anterior cranial fossa mass with extension through the posterior and anterior table of the right frontal sinus and right superior orbital roof. Open biopsy was performed via a transblepharoplasty incision with pathological diagnosis of CAPNON...
July 2018: Journal of Neurological Surgery Reports
Ryan Adams, Sarah Herrera-Nicol, Arthur L Jenkins
Background  Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, 3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion...
July 2018: Journal of Neurological Surgery Reports
Andriy Sirko, Lyudmila Dzyak, Dmytro Romanukha, Grigoriy Pilipenko, Yuri Cherednychenko
Here we report the case of a 56-year-old woman who presented with a highly unusual combination of three pathologies, namely a giant left-sided vestibular schwannoma, severe stenosis of the left internal carotid artery, and a right anterior cerebral artery aneurysm. The chosen approach comprised three consecutive surgical procedures, namely (1) aneurysm embolization, (2) carotid stenosis stenting, and (3) vestibular schwannoma excision. This approach avoided complications and achieved a satisfactory functional outcome...
April 2018: Journal of Neurological Surgery Reports
Anita P Bhansali, Melissa M Stamates, John M Lee, Ricky H Wong
We report the case of a solitary meningioma infiltrating the trochlear nerve, the first in a patient without a neurocutaneous disorder or cavernous sinus involvement. The patient presented with diplopia was found to have a focal enhancing mass encompassing the trochlear nerve. Following surgical resection, pathological examination showed meningioma infiltrating the nerve itself, demonstrated on the included pathology images. A review of the literature and discussion of meningiomas infiltrating cranial nerves are included...
April 2018: Journal of Neurological Surgery Reports
Mirza Pojskić, Blazej Zbytek, Kenan I Arnautović
Background  We report a case of isolated metastasis on the anterior clinoid process (ACP) mimicking meningioma. Clinical Presentation  A 58-year-old male presented with headaches, right-sided visual disturbances, and blurred and double vision. The cause of double vision was partial weakness of the right III nerve, resulting from compression of the nerve by "hypertrophied" tumor-involved right anterior clinoid. Medical history revealed two primary malignant tumors-male breast cancer and prostate cancer (diagnosed 6 and 18 months prior, respectively)...
April 2018: Journal of Neurological Surgery Reports
Nicholas T Gamboa, Brenden Ronna, Christina T Gamboa, Cheryl A Palmer, Min S Park, Richard K Gurgel, William T Couldwell, M Yashar S Kalani
Giant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base...
April 2018: Journal of Neurological Surgery Reports
Vincent John Anagnos, Ricardo A Hanel, Iman Naseri
A pituitary abscess is an often-overlooked diagnosis in the clinical presentation of a sellar mass. Due to its rare incidence and nonspecific presentation, diagnosis and treatment is often delayed. The authors describe a 56-year-old male patient presenting with acute onset of severe headache, visual field deficit, and radiologic findings of an expansile sellar lesion. The presenting symptoms were unremarkable for the diagnosis of meningitis, cavernous sinus thrombosis, and septicemia. Recent medical history included symptoms of rhinosinusitis on the days preceding his acute presentation...
April 2018: Journal of Neurological Surgery Reports
Joshua Wood, Jaron Densky, John Boughter, Merry Sebelik, Courtney Shires
Objectives  This article aims (1) to determine whether there is any difference in cerebrospinal fluid (CSF) leak rate after anterior skull base autologous fat reconstruction based on how the fat is prepared, and (2) to measure impact on surgical times by reconstruction type. Design  Translational animal model surgical technique 3-arm trial, comparing two different methods of autologous fat skull base reconstruction versus a nonreconstructed control group. Setting  Animal study. Subjects  Adult Sprague-Dawley rats...
April 2018: Journal of Neurological Surgery Reports
Dylan A Noblett, Jennifer Chang, Atrin Toussi, Arthur Dublin, Kiarash Shahlaie
Introduction  Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are diagnosed with a combination of imaging and biopsy. We describe the clinical presentations, imaging findings, and management of two male patients with CSHs. Case Report  Case 1 describes a 57-year-old man who presented with vision changes and cranial nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m tagged red blood cell (RBC) imaging supported CSH diagnosis. He was treated with surgical resection and radiotherapy...
April 2018: Journal of Neurological Surgery Reports
Aikaterini Solomou, Pantelis Kraniotis, George Bonanos, Constantine Constantoyannis
A 69-year-old man was admitted to the emergency department with headache and dizziness. He was submitted to brain computed tomography (CT) which showed a tumor in the right cerebellar hemisphere, findings which were subsequently confirmed with magnetic resonance imaging (MRI). He underwent a paramedian suboccipital craniotomy for removal of the mass. Histology confirmed the presence of a hemangiopericytoma. The patient was discharged 5 days postoperatively with improvement in his symptoms. Fifteen days later, he presented with gait difficulties...
April 2018: Journal of Neurological Surgery Reports
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