Internal hematoma architecture predicts subdural hematoma responsiveness to standalone middle meningeal artery embolization.

Purpose: Subdural hematoma (SDH) is quickly becoming the most common neurosurgical pathology due to the aging population. Middle meningeal artery embolization (MMAE) has recently emerged as an effective adjunct to surgical SDH evacuation by decreasing recurrence risk. MMAE has also shown promise as a standalone SDH intervention, but clinical and radiographic predictors of successful MMAE remain ill-defined.

Treatment of tumor-induced cerebral venous sinus stenosis: Technical note and review of the literature.

Introduction: Tumors that invade or compress the venous sinuses have the potential to impair venous drainage. Rarely, this may be so severe as to induce intracranial hypertension. Other studies have previously described venous sinus stenting (VSS) for the treatment of these symptomatic lesions.

Posterior fossa Hodgkin's lymphoma radiographically mimicking an arteriovenous malformation: illustrative case.

Background: Intracranial Hodgkin's lymphoma (HL) is an exceedingly rare condition that is at an increased risk of misdiagnosis and mismanagement, especially when initial radiographic evidence points to an alternative pathology.

Observations: The authors describe the case of a 75-year-old female who presented with a posterior fossa lesion initially concerning for a vascular malformation on computed tomography imaging due to perilesional hypervascularity. Subsequent angiography revealed a developmental venous anomaly (DVA) but no arteriovenous shunting.

Occipital venous sinus stenting for idiopathic intracranial hypertension and pulsatile tinnitus: A case series.

Venous sinus stenting for dural venous sinus outflow obstruction due to an intrinsic filling obstruction or extrinsic stenosis is an increasingly popular treatment strategy for idiopathic intracranial hypertension (IIH) and isolated pulsatile tinnitus (PT). The most common site of stenosis is the lateral venous sinus at the transverse-sigmoid junction. Approximately 10% of the population has a persistent occipital venous sinus (OVS), a variant that may be the dominant venous drainage pathway in the setting of a hypoplastic or aplastic transverse sinus.

Anatomical determinants of occipitocervical fusion in skull base chordoma resection: a systematic review of the literature with illustrative cases.

Objective: Skull base chordomas are rare, locally osseo-destructive lesions that present unique surgical challenges due to their involvement of critical neurovascular and bony structures at the craniovertebral junction (CVJ). Radical cytoreductive surgery improves survival but also carries significant morbidity, including the potential for occipitocervical (OC) destabilization requiring instrumented fusion. The published experience on OC fusion after CVJ chordoma resection is limited, and the anatomical predictors of OC instability in this context remain unclear.

The role of surgical disconnection for posterior fossa pial arteriovenous fistulas and dural fistulas with pial supply: an illustrative case series.

Background: Pial arteriovenous fistulas (pAVFs) are rare vascular malformations characterized by high-flow arteriovenous shunting involving a cortical arterial supply directly connecting to venous drainage without an intermediate nidus. Dural arteriovenous fistulas (dAVFs) can infrequently involve additional pial feeders which can introduce higher flow shunting and increase the associated treatment risk. In the posterior fossa, arteriovenous fistula (AVF) angioarchitecture tends to be particularly complex, involving either multiple arterial feeders-sometimes from both dural and pial origins-or small caliber vessels that are difficult to catheterize and tend to be intimately involved with functionally critical brainstem or upper cervical cord structures.

Eclipse balloon-assisted straight sinus thrombectomy: A novel technique.

Cerebral venous sinus thrombosis comprises 0.5% of all strokes and usually affects young adults. Straight sinus involvement is relatively rare, and it is associated with poor prognosis.

[Spinal injury related to alpine winter sports].

Winter sports are the cause of a significant number of spinal injuries in Switzerland. However, the number of patients, the mechanism, the presentation, the diagnosis and the treatment of vertebral fractures have considerably evolved over the last decades. As the hospital of Sion, in Valais, is particularly exposed to these diagnoses, we analyzed two series of prospective cases 30 years apart (1989-1990 and 2019-2020) and propose a review of the main types and mechanisms of fractures, diagnosis, and management for the primary care physician.

The interdural hematoma: A subtype of convexity subdural/dural hematoma with specific radioanatomical characteristics.

Background: Rare cases of biconvex hematomas splitting the convexity dura mater were reported and denominated interdural hematoma (IDH). Due to their rarity, little is known about their radiological characteristics, and in most cases, their invasive management with craniotomy and dural membrane excision is unnecessary.

Case Description: We report here a case of single burr-hole endoscopic evacuation of an IDH and its complete resolution after the 6-month follow-up imaging.

Traumatic Brain Injury in Alpine Winter Sports: Comparison of Two Case Series from a Swiss Trauma Center 30 Years Apart.

Background:  Between 3 and 15% of winter sports-related injuries are related to head injuries, which are the primary cause of mortality and disability among skiers. Despite the widespread adoption of helmets in winter sports, which has reduced the incidence of direct head injury, there is a paradoxical trend of an increasing number of individuals wearing helmets sustaining diffuse axonal injuries (DAI), which can result in severe neurologic sequelae.

Methods:  We retrospectively reviewed 100 cases collected by the senior author of this work from 13 full winter seasons during the period from 1981 to 1993 and compared them with 17 patients admitted during the more shortened 2019 to 2020 ski season due to COVID-19.

Impact of Subjective Evaluations in Predicting Response to Ventriculoperitoneal Shunt for Idiopathic Normal Pressure Hydrocephalus.

Background: Cerebrospinal fluid tap test is a common procedure to predict the efficacy of ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus. Objective tests after cerebrospinal fluid tap test are used to establish the surgical indication, but subjective improvements may also be important in selection of surgical candidates. The aim of this study was to evaluate surgical outcomes of patients with ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus, comparing patients showing objective improvement with patients improving only on subjective assessments.

Endoscope-Assisted Extreme Lateral Supracerebellar Infratentorial Approach for Resection of Superior Cerebellar Peduncle Pilocytic Astrocytoma: Technical Note.

(1) Background: Superior cerebellar peduncle (SCP) lesions are sparsely reported in the literature. The surgical approaches to the cerebello-mesencephalic region remain challenging. In this article, we present the extreme lateral supracerebellar infratentorial (ELSI) approach to treat a large hemorrhagic pilocytic astrocytoma of the SCP.

Occipito-transtentorial approach for falcotentorial meningiomas: how I do it.

Background: Falcotentorial meningiomas are rare tumors that arise at the junction of the dural folds of the tentorium and falx cerebri, at the junction of the vein of Galen with the straight sinus with possible extensions along the course of the straight sinus. Surgery of falcotentorial meningiomas remains challenging due to the intimate neurovascular relationships in the posterior incisural space.

Methods: We describe the key steps of the occipito-transtentorial approach for falcotentorial meningiomas with a video illustration.

Late metachronous cerebral metastasis of pancreatic adenocarcinoma of the tail of the pancreas: a case report.

Background: Pancreatic cancer is one of the leading causes of cancer mortality and one of the most lethal malignant neoplasms worldwide. It is known for its local tumor extension to the liver; other common sites include the lung, distant lymph nodes, and bone. Brain metastases are extremely rare and represent less than 0.

Radiosurgery for Benign Vertebral Body Hemangiomas of the Spine: A Systematic Review and Meta-Analysis.

Objective: Spinal vertebral hemangiomas (SVHs) are the most common benign tumors of the spine. We performed a systematic review and meta-analysis of radiosurgery (RS) for SVHs.

Methods: We reviewed articles published between January 1990 and December 2020 on PubMed.

Feeding artery aneurysms associated with large meningiomas: case report and review of the literature.

Though brain tumors and intracranial aneurysms co-exist, the occurrence of feeding artery aneurysms with meningiomas are unusual. We describe here a large falcine meningioma that was associated with three feeding artery aneurysms of the anterior circulation. These aneurysms can be treated either by pre-operative endovascular therapy or during the meningioma surgery.

Banking Brain Tumor Specimens Using a University Core Facility.

Within the past three decades, the significance of banking human cancer tissue for the advancement of cancer research has grown exponentially. The purpose of this article is to detail our experience in collecting brain tumor specimens in collaboration with the University of Miami/Sylvester Tissue Bank Core Facility (UM-TBCF), to ensure the availability of high-quality samples of central nervous system tumor tissue for research. Successful tissue collection begins with obtaining informed consent from patients following institutional IRB and federal HIPAA guidelines, and it needs a well-trained professional staff and continued maintenance of high ethical standards and record keeping.

Surgical anatomy of the diaphragm in the anterolateral approach to the spine: a cadaveric study.

Study Design: Laboratory cadaveric study.

Objective: To delineate the pertinent surgical anatomy of the diaphragm during access to the anterolateral thoracolumbar junction.

Summary Of Background Data: The general anatomy of the thoracic diaphragm is well described.

The minipterional craniotomy for anterior circulation aneurysms: initial experience with 72 patients.

Background: The pterional craniotomy is well established for microsurgical clipping of most anterior circulation aneurysms. The incision and temporalis muscle dissection impacts postoperative recovery and cosmetic outcomes. The minipterional (MPT) craniotomy offers similar microsurgical corridors, with a substantially shorter incision, less muscle dissection, and a smaller craniotomy flap.

Extracranial glioblastoma in transplant recipients.

Purpose: Traditionally, gliomas are considered to be confined to the central nervous system. The shortage of solid donor organs resulted in consideration of organs from patients with primary malignancy such as glioblastoma multiforme (GBM) for transplantation into patients suffering from end-stage organ disease.

Methods: We performed a PubMed search including all studies that documented patient demographics, pre- and post-transplantation conditions as well as time to metastasis and overall survival in recipients of organ transplants from donors suffering from GBM.

The rib head as a landmark in the anterolateral approach to the thoracic spine: a computed tomography-based morphometric study.

Object: The rib head is an important landmark in the anterolateral approach to the thoracic spine. Resection of the rib head is typically the first step in gaining access to the underlying pedicle and ultimately the spinal canal. The goal of this work is to quantify the relationship of the rib head to the spinal canal and adjacent aorta at each thoracic level using CT-based morphometric measurements.

Thromboembolic events and spinal surgery.

Management of patients undergoing neurosurgical spinal procedures requires balancing the competing risks of hemorrhage and thrombosis. Deep venous thrombosis (DVT) and pulmonary embolism (PE) may be significant complications following spinal surgery. The authors reviewed 30 studies regarding thromboembolic events following spinal surgery for various etiologies and analysed all the methods used to prevent thromboembolic events.