Spontaneous cerebrospinal fluid leaks of the temporal bone - clinical features and management outcomes.

Objective: METHODS: A retrospective cohort study over seven-years from 2013 to 2020 was conducted at five tertiary referral centres. Patients identified with biochemically confirmed spontaneous cerebrospinal fluid leaks of the temporal bone manifesting as middle ear fluid with no other obvious cause were included. Demographics (age, gender, body-mass-index), symptomatology, past medical history, examination, investigation (biochemical and radiological), management and outcomes were recorded.

Endonasal endoscopic resection of suprasellar craniopharyngioma: A retrospective single-center case series.

Introduction: Endoscopic endonasal approach (EEA) has recently been proposed as an option for resection of primary and recurrent suprasellar craniopharyngioma. However, surgical outcome has not yet been fully evaluated, especially in regards to recurrent cases.

Methods: We analysed our institution (Sir Charles Gairdner University Hospital, Perth, Australia) case-series retrospectively.

Modulation of saccades in humans by electrical stimulation of the posterior subthalamic area.

Objective: Posterior subthalamic area (PSA) deep brain stimulation (DBS) targeting the zona incerta (ZI) is an emerging treatment for tremor syndromes, including Parkinson's disease (PD) and essential tremor (ET). Evidence from animal studies has indicated that the ZI may play a role in saccadic eye movements via pathways between the ZI and superior colliculus (incerto-collicular pathways). PSA DBS permitted testing this hypothesis in humans.

Single-Piece Titanium Plate Cranioplasty Reconstruction of Complex Defects.

Background: Different methods have been described for the reconstruction of cranial defects and orbital defects. The complex contouring between the orbital roof and frontal bone creates significant design challenges for prefabricated cranio-orbital reconstructions. In describing the first reported patient of combined skull and orbital roof reconstruction with a single-piece titanium plate cranioplasty, the authors present a new method of combined complex cranio-orbital reconstruction.

Spinal subarachnoid hemorrhage secondary to rupture of an isolated radicular artery aneurysm.

Aneurysmal subarachnoid hemorrhage (aSAH) of spinal origin is an uncommon entity and comprises less than 1% of all aSAH. The paucity of clinical cases creates challenges to its diagnosis and management. We present the case of a 58-year-old male, who presented with a spinal subarachnoid hemorrhage secondary to a de novo spinal radicular artery aneurysm.

Retinal vein pulsation is in phase with intracranial pressure and not intraocular pressure.

Purpose: As efforts to noninvasively measure intracranial pressure (ICP) increase, we thought it important to investigate the timing of retinal venous pulsation in relation to the intraocular and intracranial pressure pulses.

Methods: Neurosurgical patients undergoing continuous direct ICP monitoring had video recordings of ICP, IOP, and retinal venous pulsation waveforms taken with constant timing relative to the cardiac cycle using pulse oximetry. Video frames of the maxima and minima of these parameters, including retinal vein diameter, were identified.

Accuracy of magnetic resonance imaging-directed frame-based stereotaxis.

Background: Accurate placement of a probe to the deep regions of the brain is an important part of neurosurgery. In the modern era, magnetic resonance image (MRI)-based target planning with frame-based stereotaxis is the most common technique.

Objective: To quantify the inaccuracy in MRI-guided frame-based stereotaxis and to assess the relative contributions of frame movements and MRI distortion.

Accuracy of postoperative computed tomography and magnetic resonance image fusion for assessing deep brain stimulation electrodes.

Background: Knowledge of the anatomic location of the deep brain stimulation (DBS) electrode in the brain is essential in quality control and judicious selection of stimulation parameters. Postoperative computed tomography (CT) imaging coregistered with preoperative magnetic resonance imaging (MRI) is commonly used to document the electrode location safely. The accuracy of this method, however, depends on many factors, including the quality of the source images, the area of signal artifact created by the DBS lead, and the fusion algorithm.

High-frequency pallidal stimulation for camptocormia in Parkinson disease: case report.

Background And Importance: Camptocormia is characterized by abnormal flexion of the thoracolumbar spine that increases during upright posture and abates in the recumbent position and has been reported to occur in patients with Parkinson disease. Camptocormia causes significant spinal and abdominal pain, impairment of balance, and social stigma.

Clinical Presentation: A 57-year-old woman with Parkinson disease developed severe camptocormia, which did not improve with trials of antiparkinsonian and muscle relaxant medications.

Does remote ischemic preconditioning prevent delayed hippocampal neuronal death following transient global cerebral ischemia in rats?

Objective: To determine if remote ischemic preconditioning (RIPC) induced by transient limb ischemia is protective against delayed hippocampal neuronal death in rats undergoing transient global cerebral ischemia (GCI).

Method: Animals were randomized into 3 groups: Group I (Control, n = 5) underwent sham procedure, namely, general anesthesia x 2, without cerebral ischemia; Group II (RIPC + GCI, n = 5) was subjected to RIPC, induced by transient left hind limb ischemia under general anesthesia prior to GCI; Group III (GCI only, n = 5) underwent sham procedure under general anesthesia prior to GCI. Twenty-four hours after the RIPC or sham procedure, a transient GCI was induced for 8 minutes in Groups II and III by means of bilateral common carotid artery occlusion and hypotension.

Spinal chondromyxoid fibroma of C2.

Chondromyxoid fibroma of bone (CMF) is a rare benign primary bone neoplasm accounting for less than 0.5% of all primary bone neoplasms. The spine is an uncommon site for this tumour, with forty-two cases reported in the modern English literature.