Supraclinoid Internal Carotid Artery Dolichoectasia Causing Compression of the Prechiasmatic Optic Nerve.

Background And Importance: Intracranial arterial dolichoectasia (or dilatative arteriopathy) is characterized by abnormal elongation, tortuosity, or increase in diameter of at least one of the main cerebral vessels. Dolichoectasia can be found incidentally or can present with cranial neuropathies (including vision loss) or stroke. Here, we describe the presentation and open surgical treatment of a patient with dolichoectasia of the intracranial internal carotid artery (ICA) causing monocular vision loss.

Natural history of pituitary carcinoma with metastasis to the cervical spine: illustrative case.

Background: Pituitary carcinoma is a rare tumor of the adenohypophysis with noncontiguous craniospinal dissemination and/or systemic metastases. Given the rarity of this malignancy, there is limited knowledge and consensus regarding its natural history, prognosis, and optimal treatment.

Observations: The authors present the case of a 46-year-old woman initially treated with invasive prolactin-secreting pituitary macroadenoma who developed metastatic disease of the cervical spine 6 years later.

High-grade glioma imaging volumes and survival: a single-institution analysis of 101 patients after resection using intraoperative MRI.

Purpose: Intraoperative magnetic resonance imaging (iMRI) has been efficacious in maximizing resection of high-grade gliomas (HGGs). In this single-institution study of patients with HGGs who underwent resection using iMRI, the authors present a volumetric-based survival analysis to evaluate progression-free survival (PFS) and overall survival (OS), as well as the impact of additional resection on survival.

Methods: This retrospective analysis included patients with HGGs who underwent resection using iMRI from 2011 to 2021.

Case Series and Systematic Review of Electronic Scooter Crashes and Severe Traumatic Brain Injury.

Objective: Electric scooters (e-scooters) are an increasingly popular form of transportation, but their use has also resulted in increased incidence of traumatic brain injury (TBI). Previous reports have predominantly described mild TBI with limited attention to other injury patterns. Our objective was to evaluate the impact of e-scooter use on rates of severe TBI.

Pediatric Traumatic Brain Injury in a Geographically Dispersed Population: A Relationship Between Distance to Definitive Neurosurgical Treatment and Outcome.

Background: There are limited data on the association between transport distance and outcomes in pediatric patients with severe traumatic brain injuries (sTBIs), despite children having to travel further to pediatric trauma centers (PTCs).

Objective: To assess whether distance from a PTC is associated with outcomes in children who undergo cranial surgery after sTBI.

Methods: Children with sTBI who underwent craniectomy/craniotomy at our PTC between 2010 and 2019 were identified retrospectively.

Carotid Stump Syndrome With Stent-Assisted Coil Embolization.

Carotid stump syndrome (CSS) is a rare cause of recurrent ipsilateral cerebrovascular events that typically manifests as transient ischemic attacks or amaurosis fugax. The cause of these recurrent symptoms is thought to be microembolization from an occluded internal carotid artery that reaches intracranial circulation through anastomoses. We undertook a systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the PubMed, Web of Science, and Embase databases of the endovascular treatment options for CSS.

Solitary manifestations of primary B-lymphoblastic lymphoma of the spine: Systematic literature review with case illustration.

Background: Given the locally destructive osteolytic nature of primary B-cell lymphoblastic lymphoma (B-LBL) of the spine, careful attention is needed to identify clinical signs and symptoms as well as radiological findings of spinal instability because these lesions may warrant resection, decompression, and instrumentation with posterolateral fusion. Our objective was to summarize the presenting symptoms, clinical features, potential treatment modalities, and clinical outcome of cases described in the literature.

Methods: We undertook a systematic literature review to identify all relevant cases and case series describing primary manifestations B-LBL of the spine using Pubmed/Medline.

Impact of modified Frailty Index-11 (mFI-11) on postoperative complications in patients undergoing transsphenoidal resection of pituitary tumors: Analysis of 2006-2014 ACS-NSQIP database.

Introduction: Frailty is a measure of physiologic reserve that is frequently cited as a predictor of postoperative complications. However, the effect of frailty on patients undergoing a relatively common procedure such as transsphenoidal resection of pituitary tumors (TSRPT) is unknown. Therefore, we sought to explore this relationship using a large, national database.

Preoperative MRI characteristics predict chronic subdural haematoma postoperative recurrence: a meta-analysis.

Purpose: Prior studies have reported that preoperative T1 magnetic resonance imaging (MRI) signal iso- or hypointensity may indicate higher risk of postoperative chronic subdural haematoma recurrence (cSDH). The authors undertook a meta-analysis to determine whether preoperative MRI characteristics may predict recurrence and/or reoperation after initial surgical evacuation of cSDH.

Materials And Methods: Embase, PubMed and Cochrane Library were queried to find articles published after 1990 that included data on preoperative brain MRIs obtained prior to burr hole or craniotomy haematoma evacuation of unilateral or bilateral cSDH and data on postoperative recurrence and/or repeat evacuation.

Stereotactic laser interstitial thermal therapy for brainstem cavernous malformations: two preliminary cases.

Brainstem cavernous malformations (CMs) often have high hemorrhage rates and significant posthemorrhage morbidity. The authors present two cases in which magnetic resonance thermography-guided laser interstitial therapy was used for treatment of pontine CMs after recurrent hemorrhage. Both patients showed significant symptomatic improvement and were hemorrhage-free at 12- and 6-month follow-up, respectively.

Effect of patient age on glioblastoma perioperative treatment costs: a value driven outcome database analysis.

Introduction: Identification of groups of patients or interventions with higher associated treatment costs may be beneficial in efforts to decrease the overall financial burden of glioblastoma (GBM) treatment. The authors' objective was to evaluate perioperative surgical treatment cost differences between elderly and nonelderly patients with GBM using the Value Driven Outcome (VDO) database.

Methods: The authors obtained data from a retrospective cohort of GBM patients treated surgically (resection or biopsy) at their institution from August 2011 to February 2018.

Preoperative and intraoperative perfusion magnetic resonance imaging in a RELA fusion-positive anaplastic ependymoma: A case report.

Background: Ependymomas are rare neuroepithelial tumors thought to arise from radial glial precursor cells lining the walls of the ventricles and central canal of the brain and spinal cord, respectively. Histopathological classification, according to World Health Organization criteria, has only recently defined the RELA-fusion positive ependymoma. These tumors may account for 70% of supratentorial ependymomas in children and represent an aggressive entity distinct from other ependymomas.

Giant Cell Tumor of the Lateral Skull Base: Diagnostic and Management Options.

Giant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base.

Clinical presentation and treatment paradigms of brain arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) is characterized by recurrent spontaneous epistaxis, mucocutaneous telangiectases, and multisystem arteriovenous malformations (AVMs). Brain AVMs typically present at birth and are identified in approximately 10-20% of patients with HHT. A retrospective review was undertaken of all HHT patients with known single or multiple brain AVMs treated at our institution.

Acute Compartment Syndrome as a Complication of the Use of Intraoperative Neuromonitoring Needle Electrodes.

Background: The use of intraoperative neurophysiologic monitoring (IOM) has become commonplace in many neurosurgical procedures as a tool to reduce the risk of complications through the early identification of reversible neurologic compromise. Although complications related to IOM itself are exceedingly rare, recognizing their clinical presentation in the postoperative neurosurgical patient is essential for the early identification and implementation of appropriate treatment.

Case Description: The authors present a case report of a patient who developed postoperative acute compartment syndrome in the right arm after placement of neuromonitoring needles for routine IOM during endovascular treatment of a left internal carotid artery aneurysm.

Clinical presentation and treatment paradigms in patients with hereditary hemorrhagic telangiectasia and spinal vascular malformations.

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that causes angiodysplasia and results in mucocutaneous telangiectasias and arteriovenous malformations of organs. Although central nervous system vascular malformations can occur anywhere along the neuraxis, spinal vascular malformations are rare. We present our experience with the presentation and management of spinal vascular malformations in patients with HHT.

Neurovascular patterning cues and implications for central and peripheral neurological disease.

The highly branched nervous and vascular systems run along parallel trajectories throughout the human body. This stereotyped pattern of branching shared by the nervous and vascular systems stems from a common reliance on specific cues critical to both neurogenesis and angiogenesis. Continually emerging evidence supports the notion of later-evolving vascular networks co-opting neural molecular mechanisms to ensure close proximity and adequate delivery of oxygen and nutrients to nervous tissue.