G. Matis, O. Chrysou, T. Birbilis, Danilo Silva, A. Bernardo, P. Stieg
Let’s take the Microneurosurgery Skull Base Laboratory of Weill Cornell Medical College (WCMC, New York, NY, USA) as an example (Figure 1). In its website it is clearly stated that the three-dimensional SBL helps residents acquire dexterity with surgical instrumentation through limited corridors containing vital structures, teaching them how be proficient not only with the complex anatomy but also with the tools to be used.
让我们以威尔康奈尔医学院的微神经外科颅底实验室(WCMC, New York, NY, USA)为例(图1)。在其网站上明确指出，三维SBL帮助住院医生通过包含重要结构的有限走廊获得手术器械的灵活性，教会他们如何不仅精通复杂的解剖结构，而且熟练使用工具。
{"title":"Setting-Up A Skull Base Laboratory: A Wise Investment","authors":"G. Matis, O. Chrysou, T. Birbilis, Danilo Silva, A. Bernardo, P. Stieg","doi":"10.5580/8f","DOIUrl":"https://doi.org/10.5580/8f","url":null,"abstract":"Let’s take the Microneurosurgery Skull Base Laboratory of Weill Cornell Medical College (WCMC, New York, NY, USA) as an example (Figure 1). In its website it is clearly stated that the three-dimensional SBL helps residents acquire dexterity with surgical instrumentation through limited corridors containing vital structures, teaching them how be proficient not only with the complex anatomy but also with the tools to be used.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127524358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafael Modkovski, Robert E. Elliott, Benjamin A. Rubin, D. Zagzag, J. Jafar, I. Mikolaenko
Giant cell tumors (GCTs) and aneurysmal bone cysts (ABCs) are locally aggressive but benign lesions typically of the long bones of the extremities or spine and rarely involve the cranial vault or skull base. Although they are distinct entities pathologically and cytogenetically, GCTs can occur with secondary ABCs, which are likely reactive in nature. The reported cases have primarily involved bones of the extremities and, to our knowledge, there has been only one case of coexisting GCT and ABC of the calvarium or skull base. We describe a 27-year old woman who underwent complete resection of a GCT with secondary ABC of the left occipital bone and condyle. We discuss the significance of the co-occurrence of these lesions and their optimal management.
{"title":"Giant Cell Tumor of the Occipital Bone and Secondary Aneurysmal Bone Cyst: Case Report and Review of Literature","authors":"Rafael Modkovski, Robert E. Elliott, Benjamin A. Rubin, D. Zagzag, J. Jafar, I. Mikolaenko","doi":"10.5580/641","DOIUrl":"https://doi.org/10.5580/641","url":null,"abstract":"Giant cell tumors (GCTs) and aneurysmal bone cysts (ABCs) are locally aggressive but benign lesions typically of the long bones of the extremities or spine and rarely involve the cranial vault or skull base. Although they are distinct entities pathologically and cytogenetically, GCTs can occur with secondary ABCs, which are likely reactive in nature. The reported cases have primarily involved bones of the extremities and, to our knowledge, there has been only one case of coexisting GCT and ABC of the calvarium or skull base. We describe a 27-year old woman who underwent complete resection of a GCT with secondary ABC of the left occipital bone and condyle. We discuss the significance of the co-occurrence of these lesions and their optimal management.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130763029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vishal Rathod, A. Bhole, Mahendra Chauhan, H. Ramteke, Bhushan N Wani
Objective: To study the clinico-radiological and clinico-pathological correlation of intracranial space occupying lesions at AVBRHMethods: The primary method of case ascertainment was detailed neurological examination and review of all CT with contrast of the head performed on the patients between 1 July 2004 to 31 December 2006 at rural centre after suspecision of intracranial space occupying lesions on clinical presentation.Result: In our study of 52 cases the clinicoradiological and clinicopathological correlation of intracranial space occupying was founded in 61.5% Amongst all the ICSOL the maximum number of cases was of neoplastic tumors i.e. 63% next to this was infective group i.e. 21% & rest of the cases were of traumatic group i.e. 15%.Conclusion: CT scan is the diagnostic and the most accurate investigation in localization of ICSOL. CT guided biopsy is helpful in diagnosing the histopathology of various ICSOLs. X ray skull studies are not of much value as a diagnostic tool in ICSOL. The overall incidence of correct clinical localization of the lesion to the final diagnosis after investigations and surgery was seen to be 61.5% cases.
{"title":"Study of clinico-radiological and clinico-pathological correlation of intracranial space occupying lesion at rural center","authors":"Vishal Rathod, A. Bhole, Mahendra Chauhan, H. Ramteke, Bhushan N Wani","doi":"10.5580/ba1","DOIUrl":"https://doi.org/10.5580/ba1","url":null,"abstract":"Objective: To study the clinico-radiological and clinico-pathological correlation of intracranial space occupying lesions at AVBRHMethods: The primary method of case ascertainment was detailed neurological examination and review of all CT with contrast of the head performed on the patients between 1 July 2004 to 31 December 2006 at rural centre after suspecision of intracranial space occupying lesions on clinical presentation.Result: In our study of 52 cases the clinicoradiological and clinicopathological correlation of intracranial space occupying was founded in 61.5% Amongst all the ICSOL the maximum number of cases was of neoplastic tumors i.e. 63% next to this was infective group i.e. 21% & rest of the cases were of traumatic group i.e. 15%.Conclusion: CT scan is the diagnostic and the most accurate investigation in localization of ICSOL. CT guided biopsy is helpful in diagnosing the histopathology of various ICSOLs. X ray skull studies are not of much value as a diagnostic tool in ICSOL. The overall incidence of correct clinical localization of the lesion to the final diagnosis after investigations and surgery was seen to be 61.5% cases.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120973360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Choriocarcinoma is a highly malignant rare tumor known to metastatise to the brain. We describe a case of a twenty-two year old unmarried female who did not have past history of pregnancy presenting to us with intra-cerebral haemorrhage with angiographic findings suggestive of arteriovenous malformation (AVM). Histology of the high parietal lesion confirmed it to be a choriocarcinoma. Bleeding in a metastatic choriocarcinoma should therefore be considered in the differential diagnosis of intracerebral bleeding in females of child bearing age.
{"title":"Metastatic Choriocarcinoma Masquerading As An Intracerebral Arteriovenous Malformation Bleed","authors":"P. Shrestha, U. Devkota, R. Panth","doi":"10.5580/17f3","DOIUrl":"https://doi.org/10.5580/17f3","url":null,"abstract":"Choriocarcinoma is a highly malignant rare tumor known to metastatise to the brain. We describe a case of a twenty-two year old unmarried female who did not have past history of pregnancy presenting to us with intra-cerebral haemorrhage with angiographic findings suggestive of arteriovenous malformation (AVM). Histology of the high parietal lesion confirmed it to be a choriocarcinoma. Bleeding in a metastatic choriocarcinoma should therefore be considered in the differential diagnosis of intracerebral bleeding in females of child bearing age.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125083776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a 54-year-old man who underwent excision of sacrococcygeal chordoma via a posterior approach, ideal for low sacral lesions as preservation of pelvic integrity can be maintained. This case emphasises the importance of preserving sacral nerve roots S3 and above if normal post-operative sphincter function is to be maintained.
{"title":"Low Sacral Resection Of Sacrococcygeal Chordoma Via Posterior Approach – Good Post-Operative Neurological Outcome With Bilateral Preservation Of S3 Nerve Roots","authors":"J. Dimou, A. Adamidis, Jeremy Russell, R. Jithoo","doi":"10.5580/148d","DOIUrl":"https://doi.org/10.5580/148d","url":null,"abstract":"We report a 54-year-old man who underwent excision of sacrococcygeal chordoma via a posterior approach, ideal for low sacral lesions as preservation of pelvic integrity can be maintained. This case emphasises the importance of preserving sacral nerve roots S3 and above if normal post-operative sphincter function is to be maintained.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115010676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mayur Sharma, V. Velho, Pranav Ghodgaonkar, D. Palande
Objective: Subependymomas of the lateral ventricle are very rare, benign, noninvasive and slowly growing tumors. The most common site being fourth ventricle followed by lateral, third ventricles, septum pellucidum and spinal cord. Many cases are asymptomatic and discovered at autopsy in elderly patients. Symptomatic cases often present in middle aged patients with hydrocephalus.This tumor was first described by Scheinker in 1945 as a separate entity. Settings: Grant Medical College & Sir J.J Group of Hospitals, byculla, Mumbai, Maharashtra, India. Methods: A 25 year old male presented with a history of sudden onset headache and giddiness. CT scan and MRI scans with contrast were suggestive of a heterogeneous mass lesion in the atria of lateral ventricle. Patient was operated upon with craniotomy and complete excision of lesion. Results: Patient had a stormy course post-operatively. He has been following up regularly with gradual recovery. Conclusion: Subependymal tumors are rare especially in the lateral ventricles. Complete surgical excision with follow up should be the goal to achieve cure.
{"title":"Symtomatic Subependymoma Of The Lateral Ventricle: A Rare Entity –A Case report and review of literature","authors":"Mayur Sharma, V. Velho, Pranav Ghodgaonkar, D. Palande","doi":"10.5580/139f","DOIUrl":"https://doi.org/10.5580/139f","url":null,"abstract":"Objective: Subependymomas of the lateral ventricle are very rare, benign, noninvasive and slowly growing tumors. The most common site being fourth ventricle followed by lateral, third ventricles, septum pellucidum and spinal cord. Many cases are asymptomatic and discovered at autopsy in elderly patients. Symptomatic cases often present in middle aged patients with hydrocephalus.This tumor was first described by Scheinker in 1945 as a separate entity. Settings: Grant Medical College & Sir J.J Group of Hospitals, byculla, Mumbai, Maharashtra, India. Methods: A 25 year old male presented with a history of sudden onset headache and giddiness. CT scan and MRI scans with contrast were suggestive of a heterogeneous mass lesion in the atria of lateral ventricle. Patient was operated upon with craniotomy and complete excision of lesion. Results: Patient had a stormy course post-operatively. He has been following up regularly with gradual recovery. Conclusion: Subependymal tumors are rare especially in the lateral ventricles. Complete surgical excision with follow up should be the goal to achieve cure.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124102276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tracy S. Ma, Benjamin A. Rubin, B. Grobelny, Robert E. Elliott, D. Zagzag, D. Harter, I. Mikolaenko
Neurocysticercosis (NCC) is the most common parasitic infection of the CNS. Surgical intervention is often required to treat for hydrocephalus with neuroendoscopy emerging as a logical alternative to craniotomies. While cranial NCC cases have increased in the United States, spinal NCC incidences have remained relatively low. We report a case of trapped fourth ventricle and myelopathy from both concomitant cranial and spinal NCC. This patient exhibited a subacute thoracic myelopathy and acute deterioration from a trapped fourth ventricle (TFV) from aqueductal and fourth ventricular outflow occlusion. She underwent urgent posterior fossa exploration. A fourth ventricular lesion consistent with NCC was removed from the distal aqueduct and the aqueduct was opened via aqueductoplasty with a ventricular catheter and balloon dilatation. She improved following surgery without extraoccular dysfunction. Intraoperative visualization and postoperative MRI flow-studies confirmed patency of the aqueduct and there was complete resolution of her fourth ventricle dilatation. With antiparasitic and corticosteroid therapy, her myelopathy has slowly improved over 9 months of follow-up.
{"title":"Management of Trapped Fourth Ventricle in Patient with Cerebral and Spinal Neurocysticercosis","authors":"Tracy S. Ma, Benjamin A. Rubin, B. Grobelny, Robert E. Elliott, D. Zagzag, D. Harter, I. Mikolaenko","doi":"10.5580/1a74","DOIUrl":"https://doi.org/10.5580/1a74","url":null,"abstract":"Neurocysticercosis (NCC) is the most common parasitic infection of the CNS. Surgical intervention is often required to treat for hydrocephalus with neuroendoscopy emerging as a logical alternative to craniotomies. While cranial NCC cases have increased in the United States, spinal NCC incidences have remained relatively low. We report a case of trapped fourth ventricle and myelopathy from both concomitant cranial and spinal NCC. This patient exhibited a subacute thoracic myelopathy and acute deterioration from a trapped fourth ventricle (TFV) from aqueductal and fourth ventricular outflow occlusion. She underwent urgent posterior fossa exploration. A fourth ventricular lesion consistent with NCC was removed from the distal aqueduct and the aqueduct was opened via aqueductoplasty with a ventricular catheter and balloon dilatation. She improved following surgery without extraoccular dysfunction. Intraoperative visualization and postoperative MRI flow-studies confirmed patency of the aqueduct and there was complete resolution of her fourth ventricle dilatation. With antiparasitic and corticosteroid therapy, her myelopathy has slowly improved over 9 months of follow-up.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124441008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Rasras, A. Soltani, Reza Bahrami Ilkhchi, M. Panahbekhoda, M. A. Mashari, S. Fallahpour
Spinal dissemination of intracranial ependymomas through cerebrospinal pathway is not rare and has been reported in approximately 10% of the cases. However, the reverse is an uncommon phenomenon. We report one case that was initially treated for spinal ependymoma but later presented with intracranial metastasis.
{"title":"Intracranial Spread Of Intramedullary A Spinal Cord Ependymoma","authors":"S. Rasras, A. Soltani, Reza Bahrami Ilkhchi, M. Panahbekhoda, M. A. Mashari, S. Fallahpour","doi":"10.5580/26ff","DOIUrl":"https://doi.org/10.5580/26ff","url":null,"abstract":"Spinal dissemination of intracranial ependymomas through cerebrospinal pathway is not rare and has been reported in approximately 10% of the cases. However, the reverse is an uncommon phenomenon. We report one case that was initially treated for spinal ependymoma but later presented with intracranial metastasis.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122821916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this paper is to review the anterior interhemispheric subfrontal approach for resection of suprasellar meningiomas and to study the use of endoscope in achieving near complete resection. Methods: All cases of suprasellar meningiomas operated trans-cranially during last 13 years were analyzed retrospectively. Majority presented with visual complaints. The outcome was assessed after surgery and at follow up (ranging from 1-12 yrs) in terms of visual outcome, extent of resection and mortality & morbidity of the procedure. There were a total of 36 cases of which 15 were planum sphenoidale, 7 were tuberculum sellae, 4 were anterior clinoidal, 1 was a diaphragma sellae meningioma. In 9 cases there was a wider attachment to more than one place.25 patients underwent anterior interhemispheric subfrontal approach, 9 were operated from pterional approach and 2 were operated from unilateral sub-frontal approach. Endoscopy was used whenever required.Results: The meningiomas were excised completely in 33 cases (Simpson grade I and II) while subtotal excision was done in 3 cases. The visual recovery was observed in 60% of the patients while it was preserved in 40% cases. One patient died after 1 month of an uneventful discharge due to a seizure episode while bilateral anosmia was seen in 2 patients.Conclusions: Anterior interhemispheric subfrontal approach for suprasellar meningiomas is one of the key surgical approaches for management of larger midline lesions. The use of endoscope can further help in achieving near total resection. Although this approach has not been amongst the preferred ones off late, meticulous technique and adequate precautions can help in achieving optimal results with little morbidity.
{"title":"A Review Of Anterior Interhemispheric Subfrontal Approach In Management Of Suprasellar Meningiomas With Endoscopic Assistance","authors":"Ashish Kumar, C. Deopujari, V. Karmarkar","doi":"10.5580/ea1","DOIUrl":"https://doi.org/10.5580/ea1","url":null,"abstract":"Objective: The aim of this paper is to review the anterior interhemispheric subfrontal approach for resection of suprasellar meningiomas and to study the use of endoscope in achieving near complete resection. Methods: All cases of suprasellar meningiomas operated trans-cranially during last 13 years were analyzed retrospectively. Majority presented with visual complaints. The outcome was assessed after surgery and at follow up (ranging from 1-12 yrs) in terms of visual outcome, extent of resection and mortality & morbidity of the procedure. There were a total of 36 cases of which 15 were planum sphenoidale, 7 were tuberculum sellae, 4 were anterior clinoidal, 1 was a diaphragma sellae meningioma. In 9 cases there was a wider attachment to more than one place.25 patients underwent anterior interhemispheric subfrontal approach, 9 were operated from pterional approach and 2 were operated from unilateral sub-frontal approach. Endoscopy was used whenever required.Results: The meningiomas were excised completely in 33 cases (Simpson grade I and II) while subtotal excision was done in 3 cases. The visual recovery was observed in 60% of the patients while it was preserved in 40% cases. One patient died after 1 month of an uneventful discharge due to a seizure episode while bilateral anosmia was seen in 2 patients.Conclusions: Anterior interhemispheric subfrontal approach for suprasellar meningiomas is one of the key surgical approaches for management of larger midline lesions. The use of endoscope can further help in achieving near total resection. Although this approach has not been amongst the preferred ones off late, meticulous technique and adequate precautions can help in achieving optimal results with little morbidity.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130338299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-12-31DOI: 10.1038/NPRE.2009.3267.4
A. Filler
{"title":"The History, Development and Impact of Computed Imaging in Neurological Diagnosis and Neurosurgery: CT, MRI, and DTI","authors":"A. Filler","doi":"10.1038/NPRE.2009.3267.4","DOIUrl":"https://doi.org/10.1038/NPRE.2009.3267.4","url":null,"abstract":"","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124923700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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