The Efficacy of the Echelon 10 Pre-Shaped Microcatheter for Delivering a Stent in Difficult Conditions
Ryuzaburo Kanazawa, Takanori Uchida, Tetsuhiro Higashida, Yuichi Takahashi, Naoyuki Arai, Hidenori Ohbuchi and Tomoyuki Yoshihara
Article Type: Technical Note | First Published: December 31, 2020
In some endovascular procedures, the insertion of stent delivery catheters (SDCs) is difficult. We demonstrated the efficacy of the Echelon 10 MicroCatheter (90-degree angle; Medtronic, Dublin, Ireland) during such procedures. We used the Echelon 10 MicroCatheter during difficult procedures to navigate SDCs to the distal artery from the aneurysm. The purpose of this was to reduce mechanical stress on the aneurysmal wall. The SDC was inserted by means of an exchange technique with an intermediate...
Use of Acetazolamide in the Postoperative Care of Endoscopic Cerebrospinal Fluid Leak Closure
J Nuyts, J Demeestere, M Jorissen and L Van Gerven
Article Type: Case Report and Literature Review | First Published: December 31, 2020
Spontaneous cerebrospinal fluid (CSF) leaks are defined as leaks without identifiable etiology, often presenting as spontaneous rhinorrhea. This is thought to be a variant of idiopathic intracranial hypertension (IIH). Spontaneous CSF leak closure often requires surgery, which has proven to be less successful than their non-spontaneous counterparts. There is growing evidence that active intracranial pressure (ICP) management in the postoperative care can improve success rates. We aim to give an ...
Segmental Spinal Dysgenesis: Case Report and Literature Review
Alejandro Vargas-Moreno, María Fajardo-Montes, Diego Miguel Rivera-Mariño and Juan Carlos Acevedo-González
Article Type: Case Report and Literature Review | First Published: December 26, 2020
Full-term female-neonate, delivered by cesarean section without complications, with prenatal ultrasound documentation of bilateral congenital talipes equinovarus and suggestive imaginological signs of a non-specific thoracolumbar spine malformation. At the time of birth, the physical examination reflected the presence of a dorsal complex cutaneal appendix covered by skin, associated with lower limbs hypertonia and bilateral talipes equinovarus. There were no respiratory alterations. MRI images o...
Spontaneous Resolution of Sub-Acute Subdural Haematoma
Krishan Kumar Sharma and Asgar Ali
Article Type: Case Report | First Published: December 26, 2020
As per Guidelines for surgical management of Traumatic Brain Injury by Brain Trauma Foundation & The Congress of Neurological surgeons, surgery is indicated in Acute subdural haematoma if CT scan shows midline shift > 5 mm, or haematoma thickness > 10 mm regardless of patient’s Glasgow coma scale score. However, nothing specified separately for sub-acute subdural haematoma. Mostly same criteria are being followed for selecting patients for surgery in sub-acute and chronic subdural haematoma. S...
De Novo Cavernoma in the Sensory Cortex Causing Cervicobrachialgia
Dhruv Jain, MS, Michael Broduhn, MD, Sophie Rosahl and Steffen K Rosahl, MD, PhD
Article Type: Case Study and Review of Literature | First Published: December 17, 2020
A 32-year-old female presented with neck pain radiating to the ulnar forearm along with occasion-al tingling sensations. Three years earlier, she had suffered from left-sided cerebellar infarction caused by dissection of the left vertebral artery. The dissection was provoked by manual therapy administered by a certified physiotherapist. Antiplatelet treatment with Aspirin 100 mg/day was established. One year later, she experienced tingling in the left side of her face. At the time, intracerebral...
Orbital Apex Syndrome and Carotid Artery Injury Associated with Transorbital Stab Injury
Dimitri Laurent, MD, Brian Corlis, MD and Gregory JA Murad, MD
Article Type: Case Report | First Published: December 09, 2020
Transorbital penetrating injuries are particularly rare in the adult population. We present a case of TOPI sustained in an assault using a ballpoint pen-with concomitant transmaxillary injury due to a pencil stab wound-and a review of the literature. Transorbital penetrating injuries (TOPI) are particularly rare in the adult population, accounting for 0.096% of all head injuries. In the setting of TOPI, there should be a high index of suspicion for damage to the intracranial vascular and neural ...
Management of Cavernous Sinus Chondroma in the Pediatric Population: Case Report and Comprehensive Literature Review
Carlos Roberto Massella, MD, Yasmeen Elsawaf, BS, Sabino Luzzi, MD, Paulo Mácio Porto de Melo, MD and Samer K Elbabaa, MD, FAANS, FAAP, FACS
Article Type: Case Report and Comprehensive Literature Review | First Published: December 06, 2020
Resection of a cavernous sinus tumor may be performed utilizing three primary approaches: The middle cranial fossa epidural approach, the combined transsylvian- subtemporal approach, and the medial transsphenoidal approach. Herein, we describe an exceedingly rare cavernous sinus chondroma in an 18-year-old male who presented with a history of binocular diplopia and trochlear nerve palsy. Brain CT scan detected a left sided cavernous sinus calcified mass and the MRI confirmed an enhancing lesion ...
Virtual Reality Image Processing for Effective Deep Brain Stimulation of the Anterior Thalamic Nucleus in Epilepsy Patients
Crystal N Adams, MD, Mohamad Z Koubeissi, MD, Aalap Herur-Raman and Donald C Shields, MD, PhD
Article Type: Case Report | First Published: November 28, 2020
Deep brain stimulation of the anterior thalamic nucleus for treatment of pharmacoresistant epilepsy is a surgical option for patients who are not candidates for resective surgery. One of the challenges of this technique relates to the small size of the anterior thalamic nucleus (approximately 10 mm × 5 mm × 5 mm). Stimulation several millimeters outside the intended target provides suboptimal seizure control. One option for achieving accurate stimulation includes the use of virtual reality sof...
Case Report: A Rare Case of Penetrating Trauma of Frontal Sinus with Anterior Table Fracture
Himanshu Raval, Mona Bhatt and Nihar Gaur
Article Type: Case Report | First Published: November 25, 2020
Head injury is common component of any road traffic accident injury. Injury involving only frontal sinus is uncommon and unique as its management algorithm is changing over time with development of radiological modalities as well as endoscopic intervention. Frontal sinus injuries may range from isolated anterior table fractures causing a simple aesthetic deformity to complex fractures involving the frontal recess, orbits, skull base, and intracranial contents. Only anterior table injury of front...
Chordoid Meningioma: Case Report and Review of the Literature
Marek Prokopienko, Teresa Wierzba-Bobrowicz, Wiesława Grajkowska, Tomasz Stępień and Michał Sobstyl
Article Type: Case report and Review of the Literature | First Published: November 16, 2020
Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman’s syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of choroid meningioma in adult patient without Castleman’s syndrome manifestation. As its chordoid features is related with a rapid recurrence after incomplete remo...
A Case of Subarachnoid Hemorrhage from the Posterior Pial Artery of the Medulla Oblongata
Takahiro Ogishima, MD, PhD, Takashi Sugawara, MD, PhD, Shoko Hara, MD, Tadashi Nariai, MD, PhD, and Taketoshi Maehara, MD, PhD
Article Type: Case report and Case Series | First Published: October 29, 2020
We present a case with localized subarachnoid hemorrhage in cisterna magna. The patient exhibited re-bleeding after admission. Repeated angiography couldn’t find the bleeding cite. Surgical exploration revealed that the responsible artery was a tiny pial artery on the posterior surface of medulla oblongata. Even though the artery was too small to be delineated in angiogram, subarachnoid hemorrhage and re-bleeding did occur. In this report we discuss the cause of the small artery rupture and po...
Chondromyxoid Fibroma of Lumbar Vertebrae: Case Report and Literature Review
İsmail KAYA, MD
Article Type: Case Report and Literature Review | First Published: October 01, 2020
Chondromyxoid fibroma is a benign tumor of long bone metaphysis. In this article, we reported L4 laminar attachment of chondromyxoid fibroma case and made extensive literature revive. A 56-year-old Caucasian female unable to walk without pain at her right leg diagnosed with chondromyxoid fibroma at right l4 lamina. Complete excision of the lesion via routine lumbar disc surgery with 6 months follow up without pain. Her Hypoesthesia cured also muscle weakness totally recovered. Chondromyxoid fibr...
Neuronavigation in Reconstructive Surgery of a Large Skull Defect after Decompressive Craniectomy: Case Report
Zhanna Semenova, MD, PhD and Andrei Marshintsev
Article Type: Case Report | First Published: September 21, 2020
In the absence of autogenous bone due to various reasons, the choice of an implant becomes an important problem of reconstructive surgery. With introduction of computer modelling and development of prototyping technologies the issues of cosmetic reconstructive operations are becoming less relevant. In late cranioplasty implant production and installation is complicated by the presence of significant bone growth along the perimeter of cranial defect. The ability to adjust implant to a bone window...
Multiple Spinal Metastases from a Malignant Paraganglioma
Chrystal Calderon, MBBS, MRCS, Alberto Perez Villafuerte, Arianne Lalla, MBBS and Sandeep Maharajh, MBBS
Article Type: Case Report | First Published: September 16, 2020
A malignant paraganglioma is a rare form of cancer that depicts varying symptomatology on presentation. This case serves to highlight an aggressive form of the disease, with considerable metastasis to the cervical, thoracic, and lumbar spine. This case was reliant on histopathological analysis to confirm the diagnosis. A 34-year-old male of Afro-Caribbean descent presented with a 1-month history of shortness of breath, body pains and lower limb weakness. On investigation for a pulmonary embolus,...
Reconstruction of Cranial Defect With Individualized PEEK Implant: Case Report
Cristopher Mayer O, Tomás Donoso H, Roberto García B, Claudio Huentequeo M and Francisco Pampin L
Article Type: Case Report | First Published: August 12, 2020
Cranioplasty has numerous indications, and its main objective is to support the underlying noble structures, along with restoring shape and aesthetics. The treatment of choice is controversial, and is mainly related to the type of material to be used. There were no complications in the perioperative period, nor were there rejection reactions, infection or exposure of the implant in the postoperative period, with satisfactory aesthetic (improvement of the cranial contour) and functional results d...
Pleomorphic Xanthoastrocytoma Presenting as Long-Term Complex Focal Epilepsy of the Frontal Lobe: Case Report
Velázquez Domínguez Héctor Eduardo, Guerrero Jazo Francisco Javier, Velázquez Santana Héctor, Pozos Ochoa Luis Iván, López Rodríguez Christopher Josué, Salcedo Hernández Missael de Jesús and Fraga González Rodrigo
Article Type: Case Report | First Published: July 27, 2020
Pleomorphic xanthoastrocytoma (PXA) is a rare tumor with favorable prognosis, classified as grade II in the World Health Organization (WHO) and accounts for less than 1% of all astrocytic neoplasm. It is commonly found in childhood and young adults. This tumor has been described as part of the spectrum of Long-Term Epilepsy Associated Tumors (LEAT). The most common location is supratentorial, involving predominantly the temporal lobe. Here we present the case of a 6-year-old female with long-ter...