Ali Al-Shalchy, Rania H. Al-Taie, Hagar A. Algburi, Mustafa Ismail
Transorbital approaches represent a paradigm shift in skull base surgery, focusing on minimally invasive techniques that prioritize patient outcomes and surgical precision. The scientific community, recognizing the significance of these advances, necessitates a possible review and meta-analysis to encapsulate the collective efficacy, safety, and developmental trajectory of these approaches. This was a literature review targeting literature in the past 10 years to present evidence for studies on surgical approaches transorbital. The included articles were analyzed. In addition, the references list of the included papers was searched for further articles. Studies based on the endoscopic endonasal and transorbital approach have emphasized that it is minimally invasive; on the other hand, it offers an advantage to maximal resection success in the case of skull base tumors with advanced endoscopic skills. Transorbital neuroendoscopic surgery was criticized for being highly technical and narrow in its scope, with reduced morbidity. Superior Eyelid Approach involves a direct access with hidden incisions, potential for eyelid complications. Lateral orbitotomy entailed some inherent risks, such as muscle and nerve injury, but it gave excellent exposure to lesions that are lateral in the orbit. The transorbital endoscopic intraconal approach and the transconjunctival approach give direct advantages but are, however, limited to the type of lesion and location. The main technique focused on in this overview is the approaches through orbits, which greatly contribute to further innovation brought into the surgical panorama of skull base interventions. All such techniques do have their characteristics and applications, keeping them moving toward less invasiveness.
{"title":"Neuroanatomical perspectives on transorbital approaches: A meta-analysis","authors":"Ali Al-Shalchy, Rania H. Al-Taie, Hagar A. Algburi, Mustafa Ismail","doi":"10.25259/sni_351_2024","DOIUrl":"https://doi.org/10.25259/sni_351_2024","url":null,"abstract":"\u0000\u0000Transorbital approaches represent a paradigm shift in skull base surgery, focusing on minimally invasive techniques that prioritize patient outcomes and surgical precision. The scientific community, recognizing the significance of these advances, necessitates a possible review and meta-analysis to encapsulate the collective efficacy, safety, and developmental trajectory of these approaches.\u0000\u0000\u0000\u0000This was a literature review targeting literature in the past 10 years to present evidence for studies on surgical approaches transorbital. The included articles were analyzed. In addition, the references list of the included papers was searched for further articles.\u0000\u0000\u0000\u0000Studies based on the endoscopic endonasal and transorbital approach have emphasized that it is minimally invasive; on the other hand, it offers an advantage to maximal resection success in the case of skull base tumors with advanced endoscopic skills. Transorbital neuroendoscopic surgery was criticized for being highly technical and narrow in its scope, with reduced morbidity. Superior Eyelid Approach involves a direct access with hidden incisions, potential for eyelid complications. Lateral orbitotomy entailed some inherent risks, such as muscle and nerve injury, but it gave excellent exposure to lesions that are lateral in the orbit. The transorbital endoscopic intraconal approach and the transconjunctival approach give direct advantages but are, however, limited to the type of lesion and location.\u0000\u0000\u0000\u0000The main technique focused on in this overview is the approaches through orbits, which greatly contribute to further innovation brought into the surgical panorama of skull base interventions. All such techniques do have their characteristics and applications, keeping them moving toward less invasiveness.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344896","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}
Tamaki Kobayashi, Yosinori Maki, Hiroyuki Ikeda, Masaomi Koyanagi, M. Oda, Masaaki Saiki
Nervous system involvement in immunoglobulin G4-related disease (IgG4-RD) has been rarely reported. We describe an unusual case of IgG4-RD manifested as paresthesia in the right lower extremity. A 51-year-old male presented with paresthesia in the right S1–S3 regions. A neurological examination revealed peripheral neuropathy. Blood examination results were normal, barring slightly elevated IgG levels. Initial magnetic resonance imaging of the swollen right S1 and S2 nerve roots revealed lymphoma, schwannoma, and sarcoidosis. However, following the biopsy, the pathological findings were not typical of these diseases. Abdominal computed tomography revealed perirenal lesions, and IgG4-RD was suspected. The patient had a serum IgG4 level of 724 mg/dL. Additional pathological evaluations of the swollen S1 nerve revealed findings that corresponded to the diagnostic criteria for IgG4-RD. Oral steroid therapy was initiated, which improved paresthesia, and the swollen S1 nerve root gradually shrank. This report highlights a rare case of IgG4-RD involving nerve roots that neurosurgeons should consider.
{"title":"Immunoglobulin G4-related disease manifesting as peripheral neuropathy: A rare clinical symptom due to rare autoimmune disease","authors":"Tamaki Kobayashi, Yosinori Maki, Hiroyuki Ikeda, Masaomi Koyanagi, M. Oda, Masaaki Saiki","doi":"10.25259/sni_157_2024","DOIUrl":"https://doi.org/10.25259/sni_157_2024","url":null,"abstract":"\u0000\u0000Nervous system involvement in immunoglobulin G4-related disease (IgG4-RD) has been rarely reported.\u0000\u0000\u0000\u0000We describe an unusual case of IgG4-RD manifested as paresthesia in the right lower extremity. A 51-year-old male presented with paresthesia in the right S1–S3 regions. A neurological examination revealed peripheral neuropathy. Blood examination results were normal, barring slightly elevated IgG levels. Initial magnetic resonance imaging of the swollen right S1 and S2 nerve roots revealed lymphoma, schwannoma, and sarcoidosis. However, following the biopsy, the pathological findings were not typical of these diseases. Abdominal computed tomography revealed perirenal lesions, and IgG4-RD was suspected. The patient had a serum IgG4 level of 724 mg/dL. Additional pathological evaluations of the swollen S1 nerve revealed findings that corresponded to the diagnostic criteria for IgG4-RD. Oral steroid therapy was initiated, which improved paresthesia, and the swollen S1 nerve root gradually shrank.\u0000\u0000\u0000\u0000This report highlights a rare case of IgG4-RD involving nerve roots that neurosurgeons should consider.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"32 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338904","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}
M. J. Mustapha, Ahmed Muthana, Ahmad O. Sulaiman, Samer S. Hoz
{"title":"Enhancing medical education experience through community-based experience and services","authors":"M. J. Mustapha, Ahmed Muthana, Ahmad O. Sulaiman, Samer S. Hoz","doi":"10.25259/sni_343_2024","DOIUrl":"https://doi.org/10.25259/sni_343_2024","url":null,"abstract":"","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"46 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141343870","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}
M. W. Baqai, Zara C. Shah, Muhammad Jawad Amin Malik, Noreen Zia, Shameel Shafqat, Nida Zahid, M. S. Shamim
Craniopharyngiomas (CPs) are rare, low-grade tumors characterized by a range of debilitating symptoms. Most of the existing literature reports postoperative outcomes of the different treatment modalities of childhood CP. However, few studies have reported the impact of these different treatment methods on the quality of life (QoL) of survivors of childhood CP. Therefore, we aim to assess the correlation between different surgical modalities on the QoL of patients with childhood CP from a lower-middle-income country. Twenty-nine survivors who underwent treatment for CP were included in the study. The selected patients had either been managed with complete resection, debulking, or placement of an Ommaya reservoir. QoL was assessed by the pediatric quality of life (PedsQL) questionnaire. The effect of the different treatment modalities on the QoL was assessed. Mean follow-up was 4.4 ± 2.19 years. The type of surgery was significantly related to the mean PedsQL scores for the total score as well as each of the individual domain scores (P < 0.001). Complete resection of the tumor resulted in the lowest mean (standard deviation) PedsQL total score of 56.6 ± 7.12 compared to the Ommaya reservoir with biopsy (83.3 ± 5.69) and debulking (93.8 ± 3.37) (P < 0.001). There was a significant effect of the type of surgical treatment on the QoL of the survivors of childhood CP. It is important to consider the long-term outcomes in addition to immediate postoperative outcomes when deciding on a treatment strategy while managing children with CP.
{"title":"Quality of life of pediatric patients with craniopharyngioma: A retrospective series from a low-middle-income country with more than 4 years follow-up","authors":"M. W. Baqai, Zara C. Shah, Muhammad Jawad Amin Malik, Noreen Zia, Shameel Shafqat, Nida Zahid, M. S. Shamim","doi":"10.25259/sni_186_2024","DOIUrl":"https://doi.org/10.25259/sni_186_2024","url":null,"abstract":"\u0000\u0000Craniopharyngiomas (CPs) are rare, low-grade tumors characterized by a range of debilitating symptoms. Most of the existing literature reports postoperative outcomes of the different treatment modalities of childhood CP. However, few studies have reported the impact of these different treatment methods on the quality of life (QoL) of survivors of childhood CP. Therefore, we aim to assess the correlation between different surgical modalities on the QoL of patients with childhood CP from a lower-middle-income country.\u0000\u0000\u0000\u0000Twenty-nine survivors who underwent treatment for CP were included in the study. The selected patients had either been managed with complete resection, debulking, or placement of an Ommaya reservoir. QoL was assessed by the pediatric quality of life (PedsQL) questionnaire. The effect of the different treatment modalities on the QoL was assessed.\u0000\u0000\u0000\u0000Mean follow-up was 4.4 ± 2.19 years. The type of surgery was significantly related to the mean PedsQL scores for the total score as well as each of the individual domain scores (P < 0.001). Complete resection of the tumor resulted in the lowest mean (standard deviation) PedsQL total score of 56.6 ± 7.12 compared to the Ommaya reservoir with biopsy (83.3 ± 5.69) and debulking (93.8 ± 3.37) (P < 0.001).\u0000\u0000\u0000\u0000There was a significant effect of the type of surgical treatment on the QoL of the survivors of childhood CP. It is important to consider the long-term outcomes in addition to immediate postoperative outcomes when deciding on a treatment strategy while managing children with CP.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"42 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344050","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}
G. Prasad, Gopal Krishna, Ameya Kale, M. Rajeshwari, Shashank Sharad Kale
Spinal eosinophilic granulomas (EG) are rare tumors, mostly reported in the pediatric age group. They constitute <1% of primary bone neoplasms, and cervical spine involvement is uncommon. A 20-year-old male presented with neck pain for a 4-month duration. Six years previously, he had received six cycles of vinblastine for biopsy-proven histiocytosis of an axillary lymph node; this resulted in incomplete remission. Present magnetic resonance/computed tomography (CT) imaging revealed a lytic C2 body lesion with atlantoaxial instability. When the CT-guided biopsy was suggestive of EG, he was managed with definitive surgery and adjuvant radiotherapy. Cervical spine EG is rare in adults. CT-guided biopsy should confirm the diagnosis and should be followed by definitive surgery and adjuvant radiotherapy.
{"title":"Eosinophilic granuloma of the cervical spine in a young adult: A rare case report","authors":"G. Prasad, Gopal Krishna, Ameya Kale, M. Rajeshwari, Shashank Sharad Kale","doi":"10.25259/sni_262_2024","DOIUrl":"https://doi.org/10.25259/sni_262_2024","url":null,"abstract":"\u0000\u0000Spinal eosinophilic granulomas (EG) are rare tumors, mostly reported in the pediatric age group. They constitute <1% of primary bone neoplasms, and cervical spine involvement is uncommon.\u0000\u0000\u0000\u0000A 20-year-old male presented with neck pain for a 4-month duration. Six years previously, he had received six cycles of vinblastine for biopsy-proven histiocytosis of an axillary lymph node; this resulted in incomplete remission. Present magnetic resonance/computed tomography (CT) imaging revealed a lytic C2 body lesion with atlantoaxial instability. When the CT-guided biopsy was suggestive of EG, he was managed with definitive surgery and adjuvant radiotherapy.\u0000\u0000\u0000\u0000Cervical spine EG is rare in adults. CT-guided biopsy should confirm the diagnosis and should be followed by definitive surgery and adjuvant radiotherapy.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"56 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344838","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}
Cerebral vasospasm is a rare postoperative complication of transsphenoidal pituitary adenoma surgery with potentially severe consequences. These vasospasms generally have a delayed presentation at a mean of 8 postoperative days. We report an unusual case of hyperacute onset of cerebral vasospasm that occurred immediately after surgery. A 38-year-old man underwent endoscopic transsphenoidal surgery for a nonfunctioning pituitary adenoma. The patient experienced mild subarachnoid hematoma during surgery. Three hours after surgery, he developed rightward conjugate eye deviation and complete paralysis of the left upper and lower extremities. Diagnostic imaging revealed cerebral vasospasm in both middle cerebral arteries, and symptoms improved after intra-arterial administration of fasudil hydrochloride. There is a need for prompt diagnosis and therapeutic intervention when typical symptoms of cerebral vasospasm, such as paralysis, occur at any time during the postoperative course.
{"title":"Cerebral vasospasm occurring immediately after endoscopic transsphenoidal resection of a pituitary adenoma: A case report","authors":"Satoshi Aihara, Takeshi Umegaki, Takehiro Soeda, Haruka Iwamura, Junichi Takeda, Masahiro Nonaka, Takahiko Kamibayashi","doi":"10.25259/sni_342_2024","DOIUrl":"https://doi.org/10.25259/sni_342_2024","url":null,"abstract":"\u0000\u0000Cerebral vasospasm is a rare postoperative complication of transsphenoidal pituitary adenoma surgery with potentially severe consequences. These vasospasms generally have a delayed presentation at a mean of 8 postoperative days. We report an unusual case of hyperacute onset of cerebral vasospasm that occurred immediately after surgery.\u0000\u0000\u0000\u0000A 38-year-old man underwent endoscopic transsphenoidal surgery for a nonfunctioning pituitary adenoma. The patient experienced mild subarachnoid hematoma during surgery. Three hours after surgery, he developed rightward conjugate eye deviation and complete paralysis of the left upper and lower extremities. Diagnostic imaging revealed cerebral vasospasm in both middle cerebral arteries, and symptoms improved after intra-arterial administration of fasudil hydrochloride.\u0000\u0000\u0000\u0000There is a need for prompt diagnosis and therapeutic intervention when typical symptoms of cerebral vasospasm, such as paralysis, occur at any time during the postoperative course.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"21 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141342962","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}
Perianeurysmal cyst formation after endovascular treatment of cerebral aneurysms is a rare complication; however, the number of reports has gradually increased in recent years due to the development of several endovascular treatments. We present a case of delayed perianeurysmal cyst enlargement 8 years after endovascular treatment for multiple recurrences of a large cerebral aneurysm in the anterior communicating artery. The patient presented with obstructive hydrocephalus caused by an enlarged perianeurysmal cyst. The patient underwent cyst fenestration using neuroendoscopy and ventriculoperitoneal shunting, recovered from the clinical symptoms, and had a good prognosis. Histopathological findings showed that the cyst wall contained a fibrotic layer under the monoependymal layer with hemosiderosis without evidence of neovascularization or inflammatory cell infiltration. These findings suggest that the origin of the perianeurysmal cyst wall is not the aneurysm itself but the adjacent brain tissue. Perianeurysmal cysts can develop during long-term follow-up, and clinicians should consider surgical treatment, including cyst fenestration, using neuro-endoscopy if the cyst presents with clinical symptoms.
{"title":"Neuroendoscopic cyst fenestration for delayed enlargement of perianeurysmal cyst formation through long-term follow-up after endovascular treatment: A case report and review of literature","authors":"Koichiro Sato, Kohei Suzuki, Yoshiteru Nakano, Yu Murakami, Takeshi Saito, J. Yamamoto","doi":"10.25259/sni_308_2024","DOIUrl":"https://doi.org/10.25259/sni_308_2024","url":null,"abstract":"\u0000\u0000Perianeurysmal cyst formation after endovascular treatment of cerebral aneurysms is a rare complication; however, the number of reports has gradually increased in recent years due to the development of several endovascular treatments.\u0000\u0000\u0000\u0000We present a case of delayed perianeurysmal cyst enlargement 8 years after endovascular treatment for multiple recurrences of a large cerebral aneurysm in the anterior communicating artery. The patient presented with obstructive hydrocephalus caused by an enlarged perianeurysmal cyst. The patient underwent cyst fenestration using neuroendoscopy and ventriculoperitoneal shunting, recovered from the clinical symptoms, and had a good prognosis. Histopathological findings showed that the cyst wall contained a fibrotic layer under the monoependymal layer with hemosiderosis without evidence of neovascularization or inflammatory cell infiltration. These findings suggest that the origin of the perianeurysmal cyst wall is not the aneurysm itself but the adjacent brain tissue.\u0000\u0000\u0000\u0000Perianeurysmal cysts can develop during long-term follow-up, and clinicians should consider surgical treatment, including cyst fenestration, using neuro-endoscopy if the cyst presents with clinical symptoms.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141371560","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}
Patients affected by Von Hippel-Lindau (VHL) are prone to develop central nervous system neoplasms such as hemangioblastomas (HBs). Myxopapillary ependymoma (MPE) is not commonly associated with VHL disease. We present the first case of a VHL patient affected by simultaneous silent cauda equina MPE and a symptomatic conus medullaris HB. The patient was first operated for systemic tumors and followed for asymptomatic HBs. Simple surveillance was maintained until neurological symptoms appeared. Regular follow-up demonstrated objective growth of the cystic conus medullaris tumor while the cauda equina lesion remained stable. Surgery was performed to avoid further neurological worsening. Histopathological examination showed conus medullaris HB and a nearby cauda equina MPE. Simultaneous spinal HBs and isolated MPE may exceptionally occur in VHL patients.
Von Hippel-Lindau（VHL）患者易患血管母细胞瘤（HBs）等中枢神经系统肿瘤。我们报告了第一例同时患有无症状马尾MPE和无症状圆锥髓质HB的VHL患者。患者首先接受了系统性肿瘤手术，并对无症状的 HB 进行了随访。在出现神经系统症状之前，患者一直接受简单的监测。定期随访显示，囊性延髓肿瘤有客观生长，而马尾病变保持稳定。为避免神经功能进一步恶化，患者接受了手术治疗。组织病理学检查显示，锥髓HB和附近的马尾MPE同时存在。
{"title":"Cauda equina myxopapillary ependymoma in von Hippel-Lindau disease: A case report","authors":"Lucas Ribeiro, Valérie Rigau, Luc Bauchet","doi":"10.25259/sni_104_2024","DOIUrl":"https://doi.org/10.25259/sni_104_2024","url":null,"abstract":"\u0000\u0000Patients affected by Von Hippel-Lindau (VHL) are prone to develop central nervous system neoplasms such as hemangioblastomas (HBs). Myxopapillary ependymoma (MPE) is not commonly associated with VHL disease.\u0000\u0000\u0000\u0000We present the first case of a VHL patient affected by simultaneous silent cauda equina MPE and a symptomatic conus medullaris HB. The patient was first operated for systemic tumors and followed for asymptomatic HBs. Simple surveillance was maintained until neurological symptoms appeared. Regular follow-up demonstrated objective growth of the cystic conus medullaris tumor while the cauda equina lesion remained stable. Surgery was performed to avoid further neurological worsening. Histopathological examination showed conus medullaris HB and a nearby cauda equina MPE.\u0000\u0000\u0000\u0000Simultaneous spinal HBs and isolated MPE may exceptionally occur in VHL patients.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373242","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}
David Shin, Brandon Shin, Zachary Brandt, Kai Nguyen, Adel Battikha, Davis Carter, M. Carter, J. Razzouk, Nathaniel Wycliffe, Wayne Cheng, Olumide A. Danisa
This study utilized computed tomography (CT) to establish normative radiographic morphometric measurements of cervical disc space height (DSH) and interpedicular distance (IPD) and document the influence of patient sex, race, ethnicity, and anthropometric characteristics. Cervical CTs of 1000 patients between 18 and 35 years of age without known spinal pathology were reviewed. Statistical analyses included the assessment of associations between patient height, weight, sex, race, and ethnicity regarding DSH and IPD. Irrespective of disc level, average DSH measurements were as follows: anterior height of 2.6 ± 1.0 mm, middle height of 4.1 ± 1.2 mm, and posterior height of 1.8 ± 1.0 mm. IPD was only measured between C3 and C7 vertebrae, and irrespective of disc level, the mean IPD measurement was 21.1 ± 1.5 mm. Significant differences for anterior, middle, posterior DSH, and IPD were observed in all disc levels. Significant differences in DSH and IPD were observed for all anthropometric factors of sex, race, and ethnicity relative to vertebral level. Males had significantly larger DSH and IPD measurements across all vertebral levels compared to females. Caucasians had larger DSH and IPD at select vertebral levels compared to African Americans and Hispanics. This study describes measurements of DSH and IPD between C2 and T1 levels in 1000 healthy 18–35-year-old subjects without known pathology. DSH and IPD measurements varied based on patient sex, race, ethnicity, and disc level.
{"title":"Morphometric analysis of cervical disc space height and interpedicular distance using computed tomography","authors":"David Shin, Brandon Shin, Zachary Brandt, Kai Nguyen, Adel Battikha, Davis Carter, M. Carter, J. Razzouk, Nathaniel Wycliffe, Wayne Cheng, Olumide A. Danisa","doi":"10.25259/sni_279_2024","DOIUrl":"https://doi.org/10.25259/sni_279_2024","url":null,"abstract":"\u0000\u0000This study utilized computed tomography (CT) to establish normative radiographic morphometric measurements of cervical disc space height (DSH) and interpedicular distance (IPD) and document the influence of patient sex, race, ethnicity, and anthropometric characteristics.\u0000\u0000\u0000\u0000Cervical CTs of 1000 patients between 18 and 35 years of age without known spinal pathology were reviewed. Statistical analyses included the assessment of associations between patient height, weight, sex, race, and ethnicity regarding DSH and IPD.\u0000\u0000\u0000\u0000Irrespective of disc level, average DSH measurements were as follows: anterior height of 2.6 ± 1.0 mm, middle height of 4.1 ± 1.2 mm, and posterior height of 1.8 ± 1.0 mm. IPD was only measured between C3 and C7 vertebrae, and irrespective of disc level, the mean IPD measurement was 21.1 ± 1.5 mm. Significant differences for anterior, middle, posterior DSH, and IPD were observed in all disc levels. Significant differences in DSH and IPD were observed for all anthropometric factors of sex, race, and ethnicity relative to vertebral level. Males had significantly larger DSH and IPD measurements across all vertebral levels compared to females. Caucasians had larger DSH and IPD at select vertebral levels compared to African Americans and Hispanics.\u0000\u0000\u0000\u0000This study describes measurements of DSH and IPD between C2 and T1 levels in 1000 healthy 18–35-year-old subjects without known pathology. DSH and IPD measurements varied based on patient sex, race, ethnicity, and disc level.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373904","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}
Abrar Nasser Maqsud, Fatimah AlKhunaizi, H. Al-Jehani
Klüver-Bucy syndrome (KBS) is a rare neuropsychiatric disorder, and it can be associated with a variety of neurological disorders. It is characterized by visual agnosia, placidity, hyperorality, hypersexuality, dietary changes, amnesia, and hypermetamorphosis. KBS is mainly a clinical diagnosis, with at least three symptoms sufficient to diagnose the condition. The case describes a 49-year-old Filipino woman with a history of hypertension who presented with symptoms strongly suggesting KBS following subarachnoid hemorrhage, including behaviors such as hyperorality, hypermobility, placidity, hypermetamorphosis, and hypersexuality along with memory disturbance. She was managed as a case of brief psychotic disorder initially with olanzapine, then on the second presentation as a case of delirium with risperidone. Among many symptoms of KBS, only three symptoms are required for the diagnosis clinically. Numerous neurological conditions can cause KBS. Symptomatic treatment is the mainstream treatment currently for KBS.[3] While different differential diagnoses are present, neurologists, psychiatrists, neurosurgeons, and radiologists should collaborate and be vigilant for the diagnosis of KBS, especially with the presence of one of its etiologies.
克吕弗-布西综合征（Klüver-Bucy Syndrome，KBS）是一种罕见的神经精神疾病，可伴有多种神经系统疾病。它的特征是视觉缺失、平和、亢进、性欲亢进、饮食改变、健忘和畸形。本病例描述的是一名 49 岁的菲律宾妇女，她有高血压病史，在蛛网膜下腔出血后出现了强烈提示 KBS 的症状，包括性欲亢进、多动、多愁善感、多形、性欲亢进和记忆障碍等行为。在 KBS 的众多症状中，临床诊断只需要三个症状。许多神经系统疾病都可能导致 KBS。对症治疗是目前 KBS 的主流治疗方法。[3] 虽然存在不同的鉴别诊断，但神经科医生、精神科医生、神经外科医生和放射科医生应通力合作，对 KBS 的诊断保持警惕，尤其是在存在其中一种病因的情况下。
{"title":"Rare presentation of Klüver-Bucy syndrome following subarachnoid hemorrhage","authors":"Abrar Nasser Maqsud, Fatimah AlKhunaizi, H. Al-Jehani","doi":"10.25259/sni_358_2024","DOIUrl":"https://doi.org/10.25259/sni_358_2024","url":null,"abstract":"\u0000\u0000Klüver-Bucy syndrome (KBS) is a rare neuropsychiatric disorder, and it can be associated with a variety of neurological disorders. It is characterized by visual agnosia, placidity, hyperorality, hypersexuality, dietary changes, amnesia, and hypermetamorphosis. KBS is mainly a clinical diagnosis, with at least three symptoms sufficient to diagnose the condition.\u0000\u0000\u0000\u0000The case describes a 49-year-old Filipino woman with a history of hypertension who presented with symptoms strongly suggesting KBS following subarachnoid hemorrhage, including behaviors such as hyperorality, hypermobility, placidity, hypermetamorphosis, and hypersexuality along with memory disturbance. She was managed as a case of brief psychotic disorder initially with olanzapine, then on the second presentation as a case of delirium with risperidone.\u0000\u0000\u0000\u0000Among many symptoms of KBS, only three symptoms are required for the diagnosis clinically. Numerous neurological conditions can cause KBS. Symptomatic treatment is the mainstream treatment currently for KBS.[3] While different differential diagnoses are present, neurologists, psychiatrists, neurosurgeons, and radiologists should collaborate and be vigilant for the diagnosis of KBS, especially with the presence of one of its etiologies.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374411","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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