Extraneural recurrence of an intracranial nongerminomatous germ cell tumor to cervical lymph nodes in a pediatric patient: Case report.

Background: Intracranial germ cell tumors (GCTs) comprise 3%-5% of pediatric primary central nervous system (CNS) tumors in Western countries. Though they are related in embryonic origin to gonadal GCTs, which are considered highly treatable with cisplatin-based chemotherapy regimens, intracranial GCTs vary in malignant potential and sensitivity to radiation and chemotherapy, generally carrying a worse prognosis. Metastases of intracranial GCTs outside of the CNS are rare, indicate a poor prognosis, and their salvage treatment is not well established.

Gigli saw facilitates safe minimal access sagittal suturectomy in infants.

The authors describe the use of the Gigli saw for craniectomy in minimal access surgery to address sagittal craniosynostosis. This modification allows for supine positioning and avoidance of potential brain compression with endoscopic instruments, and provides visually clear, safe, and facile removal of the fused suture and surrounding calvaria. The video can be found here: https://vimeo.

Infected subgaleal hematoma in a 4-month-old girl.

Subgaleal hematoma is an uncommon, but potential sequela of birth trauma and instrument-assisted delivery of neonates, as well as head trauma in young children. A rare complication is an infection of the subgaleal hematoma, which typically happens due to concomitant scalp lacerations. Escherichia coli is the most common causative pathogen in peripartum cases, and Staphylococcus aureus predominates in trauma cases.

Intraneural nodular fasciitis of the radial nerve with rapidly progressive motor symptoms.

Background: Nodular fasciitis is a benign mesenchymal tumor arising from fascia that typically presents as a rapidly growing, subcutaneous mass. Intraneural cases are very rare and can present with neurological symptoms, requiring surgical resection.

Case Description: A 31-year-old woman presented to us with painful paresthesias in her elbow and progressive motor deficits, for which she underwent surgery.

Establishing a surgical skills laboratory and dissection curriculum for neurosurgical residency training.

Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory.

Lumbar disc herniations 'to operate or not' patient selection and timing of surgery.

At times lumbar disc herniations present a quandary to the spine surgeon in regards to the most appropriate intervention and a need to optimize medical and surgical therapies. We discuss a case of ours and our experience in treating this common spinal pathology, along with a commentary on the article published by Kim et al. entitled 'Spontaneous regression of extruded lumbar disc herniation: three cases report in Korean J Spine.

Compressive Cervicothoracic Adhesive Arachnoiditis following Aneurysmal Subarachnoid Hemorrhage: A Case Report and Literature Review.

We present the case of a 55-year-old woman with diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine following posterior inferior cerebellar artery aneurysmal subarachnoid hemorrhage (SAH). She underwent aneurysm clipping with subsequent gradual neurologic decline associated with sensory disturbances, gait ataxia, and spastic paraparesis. Magnetic resonance imaging revealed diffuse adhesive arachnoiditis in the posterior fossa and cervicothoracic spine, syringobulbia, and multiple arachnoid cysts in the cervicothoracic spine along with syringohydromyelia.

MRI-guided laser interstitial thermal therapy in neuro-oncology: a review of its current clinical applications.

Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) is a minimally invasive treatment modality with recent increasing use to ablate brain tumors. When originally introduced in the late 1980s, the inability to precisely monitor and control the thermal ablation limited the adoption of LITT in neuro-oncology. Popularized as a means of destroying malignant hepatic and renal metastatic lesions percutaneously, its selective thermal tumor destruction and preservation of adjacent normal tissues have since been optimized for use in neuro-oncology.

Hurthle cell carcinoma presenting as a single choroid plexus metastasis.

Choroid plexus masses represent approximately 0.3-0.8% of intracranial tumors.

Use of high-field intraoperative magnetic resonance imaging to enhance the extent of resection of enhancing and nonenhancing gliomas.

Background: Intraoperative magnetic resonance imaging (IoMRI) is used to improve the extent of resection of brain tumors. Most previous studies evaluating the utility of IoMRI have focused on enhancing tumors.

Objective: To report our experience with the use of high-field IoMRI (1.