Preoperative and Postoperative Midline Index Ratio and Pre- and Postoperative Variation of the Hematoma Thickness Accurately Predict Surgical Recurrence of Chronic Subdural Hematomas.

Background:  Chronic subdural hematoma (cSDH) is a common pathology in daily practice of neurosurgery. Surgical management usually offers a significant clinical recovery. However, the recurrence rate is still high.

Leukoencephalopathy with Cerebral Calcifications and Cysts: The Neurosurgical Perspective. Literature Review.

Backgrounds: Labrune syndrome is a rare white matter disease characterized by angiomatous leukoencephalopathy, diffuse intracranial calcifications and supratentorial and infratentorial parenchymal cysts. The clinical worsening is often related to cyst expansion, and surgery may be advocated for symptomatic management in about one third of cases. However, no consensus exists on the surgical timing, the most effective procedure, and the long-term results.

Holocordic Spinal Sbdural Hematoma: A Challenging Management In Emergency: Literature Review.

Objective: Spinal subdural hematoma (SSH) is a rare entity and the etiology has yet to be elucidated. Holocordic spinal hematomas represent an exception. The management of these patients remains controversial, due to their rarity and their extremely poor prognosis.

Abrupt foramen magnum syndrome due to shunt malfunction in a previously asymptomatic chiari I malformation: the hidden predictable risk in long-lasting shunted patients.

Cerebrospinal fluid overdrainage in long-lasting shunted hydrocephalus is a well recognized complication. It may lead to different clinical syndromes which may occur over time, namely cranioencephalic disproportion and hindbrain herniation. Among the latter, Chiari malformation type 1 classically refers to one of the mildest form.

Current management of central nervous system metastasis from cholangiocarcinoma: the neurosurgical perspective. Literature review.

Central nervous system (CNS) metastasis from cholangiocarcinoma (CCA) are extremely rare and associated prognosis is poor. The involvement of the CNS by metastatic CCA may discourage any further treatment; however, data from the literature are discordant, due to recent reports of exceptionally long follow-up after surgical resection of a brain metastasis. Electronic databases, such as PubMed/MEDLINE and Google Scholar, were analyzed for studies published up to October 2018 using the search term "cholangiocarcinoma and central nervous system metastasis or brain metastasis".

Clinical diagnosis-part II: what is attributed to Chiari I.

Purpose: Chiari malformation type I is identified as radiological appearance of cerebellar tonsil herniation below the foramen magnum. The wide spectrum of clinical manifestations variably associated sometimes encompasses signs and symptoms whose correlation with the malformation remains debatable. However, a correct clinical framework is relevant in tailoring the strategy of management, and in particular, establishing the appropriate surgical intervention.

Chylous fistula: management of a rare complication following right anterior cervical spine approach.

Purpose: Chylorrhea resulting from injury of the lymphatic system during neck dissection is a well-known complication. It is an uncommon occurrence in spinal surgery, and only one case after right anterior cervical spine surgery has been described so far. Despite its rarity, chylous leakage deserves a particular attention since it may become a serious and occasionally fatal complication if not detected early and managed appropriately.

Repeat Bleeding 18 Years After Hemorrhagic Pilocytic Astrocytoma: Prognostic Implications of Conservative Management-Case Report and Literature Review.

Background: Acute hemorrhagic occurrence of pilocytic astrocytomas is extremely rare but has become increasingly recognized and often presents in clinically emergent situations. The precise significance of hemorrhage in these tumors and its pathogenetic mechanisms have not yet been defined. Nothing is known about the natural history of bleeding pilocytic astrocytomas.

Hypertrophic Pachymeningitis and Hydrocephalus-The Role of Neuroendoscopy: Case Report and Review of the Literature.

Background: Hypertrophic pachymeningitis (HP) is a rare primary or secondary inflammatory disorder that manifests with thickening of dura mater involving predominantly the tentorium and falx in the focal form. Hydrocephalus has not been reported in association with secondary HP.

Case Description: A 61-year-old woman presented with intracranial HP of the posterior fossa secondary to Wegener granulomatosis not responsive to corticosteroid therapy.

Brain Granuloma: Rare Complication of a Retained Catheter.

Background: Ventriculoperitoneal (VP) shunt is the most frequent treatment for hydrocephalus. VP shunt malfunction is a very common problem in neurosurgical practice, often requiring shunt revision procedures. In some cases, complete removal of a VP shunt may present difficulties, leading the surgeon to leave the ventricular catheter in situ.

Supratentorial Embryonal Tumors in the Elderly: Diagnostic Pitfalls and Clinical Prognosis.

Supratentorial embryonal tumors are very rare malignant tumors of neuroectodermal origin, characterized by an aggressive clinical behavior. They occur prevalently in children. They have been sporadically described in adults and represent an even rarer occurrence in elderly patients, raising many issues on the diagnostic pitfalls and their appropriate management.

Paraganglioma of the cauda equina region.

Background Context: Cauda equina paragangliomas (CEPs) are rare neuroendocrine tumors. The difficulty in differential diagnosis with other tumors of this region may be misleading for surgical planning and prognostic expectations.

Purpose: To report on a rare case of CEP and review the most current information regarding the diagnosis, treatment options, and outcomes.

Spinal intramedullary arachnoid cyst: case report and literature review.

Background Context: Intramedullary arachnoid cysts are extremely rare; only 14 cases have been reported in the literature so far.

Purpose: We report on the case of a 31-year-old woman who presented with back pain and progressive paraparesis secondary to a dorsal intramedullary arachnoid cyst detected on magnetic resonance imaging (MRI): the surgical planning and clinico-radiological outcome are discussed along with a review of the relevant literature.

Study Design: Case report and literature review.

Epilepsy in Tuberous Sclerosis Complex.

Tuberous Sclerosis Complex (TSC) is an autosomal dominant multisystem disorder, characterized by the presence of hamartomatous lesions involving different organ systems, including the brain. Epilepsy is the most common presenting symptom, representing a major source of morbidity and mortality. Despite multiple antiepileptic drug combinations, in about two thirds of cases the patients present high-frequency drug-resistant epilepsy, and nonpharmacologic options may be considered.

Lim mineralization protein is involved in the premature calvarial ossification in sporadic craniosynostoses.

Sporadic mono-sutural craniosynostosis represents a highly prevalent regional bone disorder, where a single cranial suture undergoes premature ossification due to a generally unclear etiopathogenesis. The LIM mineralization protein (LMP) was recently described as an efficient osteogenic molecule involved in osteoblast differentiation, expressed in calvarial tissues upon corticosteroid-osteogenic induction and used as a potent inducer of bone formation in several animal models. In this study, calvarial cells isolated from both prematurely fused and physiologically patent sutures of children with sporadic craniosynostosis, were used as an in vitro paradigmatic model for the study of the molecular events involved in calvarial osteogenesis, focusing on the possible role of the LMP-related osteogenic signaling.

Effects of nerve growth factor in experimental model of focal microgyria.

Aim: The effects on neural repair of intraparenchymal nerve growth factor (NGF) administration were evaluated in neonate Wistar rats with experimentally induced focal microgyria.

Methods: A freezing focal polymicrogyric lesion was induced on the frontal cortex in 35 newborn Wistar rats on postnatal day 1. NGF was administered in 15 cases, with 20 pups as controls.

Percutaneous decompression of lumbar spinal stenosis with a new interspinous device.

Objective: This study was designed to evaluate the feasibility of the implantation of a new interspinous device (Falena) in patients with lumbar spinal stenosis. The clinical outcomes and imaging results were assessed by orthostatic MR during an up to 6-month follow-up period.

Methods: Between October 2008 and February 2010, the Falena was implanted at a single level in 26 patients (17 men; mean age, 69 (range, 54-82) years) who were affected by degenerative lumbar spinal stenosis.

Endoscopic third ventriculostomy for the management of Chiari I and related hydrocephalus: outcome and pathogenetic implications.

Background: Hydrocephalus affects 7% to 10% of patients with Chiari I malformation (CIM). It can be successfully treated by endoscopic third ventriculostomy (ETV), possibly improving related CIM and syringomyelia.

Objective: To confirm the effectiveness of ETV in the management of Chiari-related hydrocephalus and symptoms and to estimate the posterior cranial fossa volume (PCFV) to find the possible reasons for the success or failure of ETV.

Multidisciplinary treatment of giant invasive prolactinomas in paediatric age: long-term follow-up in two children.

Background: Invasive giant prolactinomas are rare tumours, still representing a therapeutic challenge due to their characteristics of invasiveness and variable clinical course. Giant prolactinomas in childhood are extremely rare. Only single case reports have been described in the literature.

Giant subcortical heterotopia involving the temporo-parieto-occipital region: a challenging cause of drug-resistant epilepsy.

The clinical, radiological, neurophysiological and neuropsychological findings of three patients with giant subcortical heterotopia are reported. All patients experienced psychomotor and behaviour improvement after surgery. Two subjects are seizure-free after complete excision of the heterotopia; the third patient significantly improved following subtotal removal (Engel's class II).

Vertex scalp mass as presenting sign of a complex intracranial vascular malformation.

Scalp masses are not infrequently encountered in daily clinical practice. They are represented by a wide spectrum of different clinical entities and are usually managed by an excision or by simple observation. Although it happens rarely, head lumps may hide an underlying cranioencephalic malformation that has to be preoperatively diagnosed to perform an appropriate treatment.

A late complication of CSF shunting: acquired Chiari I malformation.

Purpose: Acquired Chiari I malformation developing after cerebrospinal fluid (CSF) shunting is an intriguing late complication of CSF shunt surgery and not only raises questions as to its pathogenesis but also poses many queries about the possible adverse effects on the subsequent child development as well as on the indications and possibilities of surgical correction.

Materials And Methods: We report a series of 17 patients with the neuroradiological evidence of an "acquired" Chiari type I malformation. These patients, 3 to 24 years (mean 11.