Implausible, not impossible: delayed supradiaphragmatic thoracic migration of a ventriculoperitoneal shunt in a 17-month-old.

Background: Intrathoracic migration of a ventriculoperitoneal shunt (VPS) is a phenomenally rare complication, with the supradiaphragmatic intercostal variant even more so. Whereas it can prove debilitating or even fatal via massive hydrothorax, the causative mechanism and proper management of this occurrence are undefined.

Case Presentation: A 17-month-old girl who had undergone VPS insertion at one month of age was brought to our department for somnolence and dyspnea, which had a sudden onset.

The Nightmare of AVM Surgery: Early Rupture of the Venous Drainage-Lessons from Personal Experience and a Review of the Literature.

We describe the case of a 72-year-old man who presented with signs of increased intracranial pressure, right-sided motor deficit, and repeated episodes of epilepsy due to a left frontal arteriovenous malformation (AVM) with a large superficial draining vein. Despite great efforts to protect the vein from the start, it ruptured shortly after we removed the bone flap. This required rigorous hemorrhage control, which in turn led to profuse bleeding from the nidus throughout the process of the dissection and coagulation of the arterial feeders.

Exploring anesthesia-related complications in pediatric neurosurgery: a comparative analysis of the sitting and park-bench positions.

Background And Aims: The purpose of this study is to analyze the sitting position and the park-bench position for intra-anesthesia complications in pediatric patients undergoing neurosurgery for posterior fossa lesions. Our goal is to highlight the risks associated with each of these positions under general anesthesia to aid in clinical decision making for optimal patient outcomes with regard to postoperative complications.

Methods: We retrospectively reviewed 41 pediatric patients (1 to 18 years old) undergoing posterior fossae surgery in the sitting (32) and park-bench (9) positions between January 2015 and December 2021.

Posttraumatic hydrocephalus as a complication of decompressive craniectomy-same old story, new perspectives.

Objective: Decompressive craniectomy (DC) serves as a vital life-saving intervention, demonstrating efficacy in reducing intracranial pressure (ICP). However, its efficacy hinges on meticulous surgical execution, perioperative management, and vigilance toward potential complications. The incidence of complications associated with DC plays a pivotal role in determining its superiority over medical management for patients experiencing intracranial hypertension following traumatic brain injury (TBI).

Sofia Ionescu: Pioneering the Birth of Neurosurgery in Romania and Becoming the First Female Neurosurgeon in the World.

Background: Sofia Ionescu (1920-2008) was the first female neurosurgeon in the world, pioneering her field with skill, dedication, and humility. Born in Romania, she began her career amid the tumult of World War II, performing her first neurosurgical procedure in 1944. Despite initial skepticism, her talent and commitment earned her recognition, culminating in her acknowledgment as the first female neurosurgeon by the World Federation of Neurosurgical Societies in 2005.

Magnetic Resonance Imaging Features of the Sphenoid Sinus in Patients with Non-Functioning Pituitary Adenoma.

: A magnetic resonance imaging (MRI) scan is part of the diagnostic protocol in pituitary adenoma patients. The goal of the present study is to present and analyse the MRI appearances of the sphenoid sinus (SS) in patients with non-functioning pituitary adenoma (NFPA). : This is a retrospective case-control study conducted between January 2015 and December 2023 in a tertiary referral hospital.

The Father of Wisdom: "The Influence of Surgical Experience on Overall Survival in Patients with Malignant Gliomas".

Background: The role of surgery in the management of malignant gliomas has been feverishly deliberated after the publication of the first expansive case series, the last two decades reinvigorating the discussion regarding the value of total removal in improving survivability. Despite numerous technologies being implemented to increase the resection rates of malignant gliomas, the role of surgical experience has been largely overlooked. This article aims to discuss the importance of a single surgeon's experience in treating high-grade gliomas over a period of 20 years.

Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel.

Introduction: Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance.

Research Question: This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems.

Methods: After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method.

Anastomosis between the facial nerve - ansa cervicalis and the facial nerve - hypoglossal nerve in rabbits: technical note for a practical use in peripheral facial palsy.

Background And Aims: To emphasize the importance of laboratory dissections in perfecting surgical techniques. In this paper, we describe the technical details on rabbit dissection for practical applications.

Methods: Four New Zealand rabbits were distributed into two groups and underwent anastomosis between the Facial Nerve and Ansa Cervicalis (group 1) and between the Facial Nerve and Hypoglossal Nerve (group 2).

White matter changes in fetal brains with ventriculomegaly.

Introduction: Ventriculomegaly (VM) is a fetal brain malformation which may present independently (isolated form) or in association with different cerebral malformations, genetic syndromes or other pathologies (non-isolated form).

Methods: This paper aims to study the effect of ventriculomegaly on the internal tridimensional architecture of fetal brains by way of Klingler's dissection. Ventriculomegaly was diagnosed using fetal ultrasonography during pregnancy and subsequently confirmed by necropsy.

Identifying predictive factors for mortality in patients with TBI at a neurosurgery department.

Traumatic brain injury (TBI) can have severe consequences in most cases. Many therapeutic and neurosurgical strategies have been improved to optimize patient outcomes. However, despite adequate surgery and intensive care, death can still occur during hospitalization.

Intracranial epidermoid cysts: benign entities with malignant behavior: experience with 36 cases.

Intracranial epidermoid cysts are benign slow-growing ectodermal inclusions that account for less than 1% of all intracranial tumors. We retrospectively reviewed 36 such cases to evaluate the demographic characteristics, clinical manifestations, anatomical distribution, surgical management, and treatment outcome of these tumors. Additionally, we sought to identify the relationship between median or paramedian cistern tumor localization and clinical parameters, such as recurrence risk, hospitalization duration, and postoperative complication rates.

Intracranial arteriovenous malformation (AVM) or meningothelial meningioma (MM)? Outlining the similarities and differences on imaging studies for an accurate diagnosis, case report.

Introduction And Importance: AVM and MM represent neurosurgical challenges, not only when involving eloquent brain, but also by posing a significant intraoperative haemorrhagic risk. It is a challenge in itself to establish a proper differential diagnosis between the two lesions, especially since they require distinct interventional plan of action. We present the case of a patient initially diagnosed by specialists with an intracranial AVM, which was revealed intraoperatively to be in fact an MM.

Assessing the Efficacy of Anastomosis between Ansa Cervicalis and Facial Nerve for Patients with Concomitant Facial Palsy and Peripheral Neuropathy.

For decades, patients with facial asymmetry have experienced social interaction difficulties, leading them to seek treatment in the hope of restoring facial symmetry and quality of life. Researchers evaluated numerous surgical techniques, but achieving results remains a significant hurdle. Specifically, anastomosis between the ansa cervicalis (AC) and facial nerve (FN) can hinder the patient's physical appearance.

Ventriculorenal shunts in the treatment of pediatric and adult hydrocephalus-historical perspective and analysis of current practice.

Hydrocephalus is a complex pathology that can have a significant impact on the quality of life in all age groups. Cerebrospinal fluid (CSF) diversions from the lateral ventricle to the peritoneal cavity are regarded as the treatment of first intent, but they have a high revision rate, and there are multiple factors which can impair their proper insertion and function. One of the many alternatives to peritoneal shunting is redirecting the CSF towards the renal system.

Involvement of Microglia in the Pathophysiology of Intracranial Aneurysms and Vascular Malformations-A Short Overview.

Aneurysms and vascular malformations of the brain represent an important source of intracranial hemorrhage and subsequent mortality and morbidity. We are only beginning to discern the involvement of microglia, the resident immune cell of the central nervous system, in these pathologies and their outcomes. Recent evidence suggests that activated proinflammatory microglia are implicated in the expansion of brain injury following subarachnoid hemorrhage (SAH) in both the acute and chronic phases, being also a main actor in vasospasm, considerably the most severe complication of SAH.

Predictive factors of 30-day mortality in patients with traumatic subdural hematoma.

In the present study, we aimed to assess and analyze the predictive factors of 30-day mortality in patients with acute subdural hematoma (ASDH) who underwent surgical intervention after traumatic brain injury (TBI). We conducted a retrospective study, which included a cohort of 135 consecutive patients diagnosed with ASDH who required surgical evacuation. We assessed the demographic and clinical data, the imaging data of the hematoma described by preoperative computed tomography (CT) and the type of neurosurgical intervention for hematoma evacuation via either craniectomy or craniotomy.