Although resection is the gold standard treatment for spinal ependymoma, permanent neurological deterioration has been reported postoperatively in 20%-27% of patients. Despite thorough dissection of the tumor from its surroundings, conventional longitudinally directed midline myelotomy can lead to injury to the dorsal column, possibly due to deformation of the posterior median septum as the tumor grows. To address this issue, the authors have been performing precise midline myelotomy through the anatomical posterior median septum by directly dissecting the dorsal column. This video presents the principles and application of this technique.
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http://dx.doi.org/10.3171/2023.7.FOCVID2317 | DOI Listing |
Childs Nerv Syst
December 2024
Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Purpose: This report aims to present a case of a child with holocord pilocytic astrocytoma and review the existing literature to provide insights into current management strategies.
Case Presentation: An 11-month-old patient presented with progressive quadriplegia and was initially diagnosed with a spinal abscess. MRI revealed a heterogeneously enhancing cystic intramedullary lesion extending from the cervicomedullary region to the conus medullaris.
World Neurosurg
April 2024
Division of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tübingen, Tübingen, Germany.
A 14-year-old boy presented with a 2-year history of slowly increasing weakness and atrophy in the right forearm and leg. Magnetic resonance imaging (MRI) revealed an intramedullary diffusely infiltrating lateralized tumor at C3-7. An extended biopsy was planned.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2024
Bukovinian State Medical University, Chernivtsi, Ukraine. Electronic address:
Introduction And Importance: D-wave (Direct waves) are Motor Evoked Potentials (MEPs) generated by a single transcranial stimulation and captured by attaching an epidural recording electrode caudal to the vulnerable area. Intraoperative neurophysiologic monitoring (IONM) is widely used in neurosurgery to recognize important neurological structures but can be challenging in the pediatric population due to incomplete neural development.
Case Presentation: Case 1: A 48-year-old female presented to the outpatient department with complaints of difficulty walking for the past six months, numbness and weakness in bilateral lower limbs with recurrent falls for the past 1 month.
Oper Neurosurg (Hagerstown)
April 2024
School of Medicine, Tulane University, New Orleans , Louisiana , USA.
Background And Importance: Intramedullary spinal cord lesions are eloquent lesions that are surgically resected via posterior midline myelotomy (PMM). This treatment method carries the risk of postoperative neurological deficits. Various intraoperative neuromonitoring techniques have been used to address this concern.
View Article and Find Full Text PDFWorld Neurosurg
February 2024
Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.
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