Complete Resection of a Torcular Herophili Hemangiopericytoma without Sinus Reconstruction: A Case Report and Review of the Literature.

A 78-year-old woman presented to the emergency department with mild headaches and a sudden onset of blurred vision. Computerized tomography scan and magnetic resonance imaging showed what was described at first as a meningioma invading and occluding the torcular Herophili, the posterior third of the superior sagittal sinus and the proximal part of the right transverse sinus. Gross total resection of the tumor was performed without reconstructing dural sinuses.

Percutaneous Interspinous Spacer vs Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients?

Background: Standalone interspinous process devices (IPDs) to treat degenerative lumbar spinal stenosis with neurogenic intermittent claudication (NIC) have shown ambiguous results in the literature.

Objective: To show that a minimally invasive percutaneous IPD is safe and noninferior to standalone decompressive surgery (SDS) for patients with degenerative lumbar spinal stenosis with NIC.

Methods: A multicenter, international, randomized, controlled trial (RCT) was con- ducted.

Clinical evaluation of the preliminary safety and effectiveness of a minimally invasive interspinous process device APERIUS(®) in degenerative lumbar spinal stenosis with symptomatic neurogenic intermittent claudication.

Purpose: New interspinous process decompression devices (IPDs) provide an alternative to conservative treatment and decompressive surgery for patients with neurogenic intermittent claudication (NIC) due to degenerative lumbar spinal stenosis (DLSS). APERIUS(®) is a minimally invasive IPD that can be implanted percutaneously. This multicentre prospective study was designed to make a preliminary evaluation of safety and effectiveness of this IPD up to 12 months post-implantation.

Foraminal disc herniation Th9-Th10 mimicking abdominal pain.

Thoracic disc herniations (TDH) requiring surgery are rare. They usually present with pain and/or myelopathy. Only 6% are wide lateral, either intraforaminal or extraforaminal.

Altered expression of connexin subtypes in mesial temporal lobe epilepsy in humans.

Object: The causes of epileptic events remain unclear. Much in vitro and in vivo experimental evidence suggests that gap junctions formed by connexins (Cxs) between neurons and/or astrocytes contribute to the generation and maintenance of seizures; however, few experiments have been conducted in humans, and those completed have shown controversial data. The authors designed a study to compare the level of expression of Cxs in hippocampi from epileptic and nonepileptic patients to assess whether an alteration of gap junction expression in epileptic tissue plays a role in seizure origin and propagation.

Long-term outcome of epilepsy surgery among 399 patients with nonlesional seizure foci including mesial temporal lobe sclerosis.

Object: The authors reviewed the long-term outcome of focal resection in a large group of patients who had intractable partial nonlesional epilepsy, including mesial temporal lobe sclerosis (MTS), and who were treated consecutively at a single institution. The goal of this study was to evaluate the long-term efficacy of epilepsy surgery and the preoperative factors associated with seizure outcome.

Methods: This retrospective analysis included 399 consecutive patients who underwent epilepsy surgery at Mayo Clinic in Rochester, Minnesota, between 1988 and 1996.

Serum magnesium levels as related to symptomatic vasospasm and outcome following aneurysmal subarachnoid hemorrhage.

Introduction: Recent evidence suggests that magnesium may be neuroprotective in the setting of cerebral ischemia, and therapeutic magnesium infusion has been proposed for prophylaxis and treatment of delayed ischemic neurological deficit (DIND) resulting from vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH). We studied the association between serum magnesium levels, the development of DIND, and the outcomes of patients with SAH.

Methods: We studied 128 consecutive patients with aneurysmal SAH treated at our institution between 1990 and 1997 who had a serum magnesium level measured at least once during the acute phase of their hospitalization.

Operative management of metastatic and malignant primary subaxial cervical tumors.

Object: The authors describe the preoperative assessment, intraoperative strategies, and long-term outcomes in 41 consecutive patients who underwent spinal reconstruction after resection of subaxial cervical neoplasms.

Methods: Thirty-three tumors were metastatic and eight were primary. Preoperative studies included direct laryngoscopy and vertebral artery (VA) balloon occlusion tests in selected patients.

Paraclinoid and cavernous sinus regions: measurement of critical structures relevant for surgical procedure.

Determination of the safest distance the falciform ligament can be incised from its origin to the orbital apex. Measurement of the distance between the oculomotor foramen and the IV nerve in the lateral wall of the cavernous sinus. Evaluation of the optic strut as an accurate landmark between the intradural (subarachnoid) and extradural segment of the internal carotid artery (ICA).

Circumferential decompression of the foramen magnum for the treatment of syringomyelia associated with basilar invagination.

Posterior fossa decompression utilizing suboccipital craniectomy and duraplasty remains the standard surgical treatment for Chiari-associated syringomyelia. In the presence of basilar invagination, anterior decompression, typically transoral odontoidectomy, or posterior decompression may be performed. We report two cases in which anterior and posterior (circumferential) decompression of the foramen magnum was used to treat cervical syringomyelia successfully.

Hemangiopericytoma of the confluence of sinuses and the transverse sinuses. Case report.

The authors describe the case of a 38-year-old man with progressive headache and blurred vision related to a hemangiopericytoma located exclusively in the confluence of sinuses (CoS) and in the transverse sinuses bilaterally. They believe this is the first report in which a hemangiopericytoma of the dural sinuses has been described without any intradural component. Although the diagnosis was not suspected preoperatively, a gross-total resection of the tumor with restoration of sinus patency was achieved to relieve the symptoms.

Nonlesional central lobule seizures: use of awake cortical mapping and subdural grid monitoring for resection of seizure focus.

Object: Surgical treatment options for intractable seizures caused by a nonlesional epileptogenic focus located in the central sulcus region are limited. The authors describe an alternative surgical approach for treating medically refractory nonlesional perirolandic epilepsy.

Methods: Five consecutive patients who were treated between 1996 and 2000 for nonlesional partial epilepsy that had originated in the central lobule were studied.

Development of a pontine cyst after endovascular coil occlusion of a basilar artery trunk aneurysm: case report.

Objective And Importance: Cyst formation within the brain parenchyma after endovascular coil occlusion of an intracranial aneurysm is a previously undescribed occurrence. We describe a 70-year-old woman who presented with a symptomatic pontine cyst 1 year after uncomplicated stenting and Guglielmi detachable coil occlusion of an unruptured basilar artery trunk aneurysm.

Clinical Presentation: A 70-year-old woman presented with an episode of transient dysequilibrium and gait difficulty.

Acute traumatic central cord syndrome: magnetic resonance imaging and clinical observations.

Object: Acute traumatic central cord syndrome has been classically thought to be caused by a hemorrhage that primarily affects the central part of the spinal cord and that destroys the axons of the inner part of the corticospinal tract devoted to the motor control of the hands. Some authors, however, have proposed that its pathogenesis is based on the destruction of the motor neurons supplying the muscles of the hand. To test the validity of these two theories, the authors retrospectively studied the magnetic resonance (MR) images obtained in 18 cases of acute traumatic central cord syndrome (ATCCS) to assess the presence of intramedullary blood and to define the distribution of the abnormal signal intensities in the cervical spinal cord.