Resolution of Large Cervico-Thoracic Syringomyelia Following Treatment of Thyrotoxicosis: A Case Report.

Treatment for a large symptomatic syrinx associated with a Chiari 1 is predominately surgical, via a foramen magnum decompression (FMD), with the aim to normalise cerebrospinal fluid (CSF) movement. Whilst theories of underlying hyperdynamic states in Chiari 1 and Syringomyelia exist, to date there is no effective medical treatment to reverse Syringomyelia. A 17-year-old female was referred with a seven-month history of gradually progressive impaired temperature sensation in her left upper limb.

Neuronavigation-assisted bedside placement of bolt external ventricular drains in the intensive care setting: a technical note.

Background: The insertion of bolt external ventricular drains (EVD) on the intensive care unit (ICU) has enabled rapid cranial cerebrospinal fluid (CSF) diversion. However, bolt EVDs tend to be perceived as a more challenging technique, particularly when dealing with small ventricles or when there is midline shift distorting the ventricular morphology. Furthermore, if neuronavigation guidance is felt to be necessary, this usually assumes a transfer to an operating theatre.

A Novel Neurosurgery Referral Course: Feasibility, Validation, and Inferences for Patient Care.

Objective: The speciality of neurosurgery is under-represented in the majority of medical school curriculums, and those rotating within this specialty tend to be those with career aspirations within this field. Consequently, few emergency medicine trainees are exposed to this specialty. The aim of this educational project was to develop and validate a neurosurgery referral course for the target audience of emergency medics.

Ventriculoatrial Shunt Catheter Tip Migration Causing Tricuspid Regurgitation: Case Report and Review of the Literature.

Background: Given recent positive safety evidence, ventriculoatrial (VA) shunt placement may increase in popularity once more. We describe a rare case of Tricuspid regurgitation due to VA shunt catheter tip traversing the valve.

Case Description: A woman aged 42 years with a preexisting VA shunt was referred to this center with 3 months of orthostatic headache, nausea, and palpitations that occurred while sleeping on her right side.

Approach to Slitlike Ventricles: Parietal-Occipital versus Frontal Burr Catheter Entry Sites.

Background: Slit ventricles can be a challenging target during shunt catheter insertion. Traditionally, the frontal approach has been considered optimal for small ventricles. At this center, routine use of electromagnetic (EM) stereotactic guidance (Stealth, Medtronic, Dublin, Ireland) has enabled a parietooccipital (P-O) burr hole approach to the frontal horns.

Extradural Compressive Spinal Cerebrospinal Fluid Leak in Ehlers-Danlos Syndrome.

Ehlers-Danlos syndrome can be associated with cerebrospinal fluid (CSF) disturbances including recurrent CSF leak and Chiari I malformations. Persistent pseudomeningoceles are known to be associated with raised intracranial pressure. We present an unusual case of a compressive epidural CSF collection occurring after a computed tomography-guided L5 nerve root block and describe an effective management strategy.

Clinical Outcome of Radiating Multiple Subpial Transections Alone for Drug Resistant Epilepsy After More Than 5 Years Follow-Up.

Objective: Multiple subpial transection (MST) is a possible surgical treatment for patients with epileptogenic foci located in eloquent cortical areas. Commonly, it is performed in addition to other surgical techniques. In some cases, however, it is performed alone.