An Unusual Presentation of Spontaneous Rupture of Dermoid Cyst
Intracranial dermoid cysts are exceptionally rare tumors. Interestingly, this condition has a low mortality rate but a high morbidity rate due to its numerous complications. We report a case of a 62-year-old man who presented with a headache and was found to have a ruptured dermoid cyst, complicated with the dissemination of lipid droplets within the subarachnoid space.
Isaac Alsallamin
Ryan Choudhury
Francisco J Somoza-Cano
Austin Makadia
Mythri Mudrieddy
Anastasiia Weiland
Ameed Bawwab
Afnan Alsallamin
Faris Hammad
Kanchi Patell
Abdul Rahman Al Armashi
Cureus
. 2022 Feb 7;14(2):e21976. doi: 10.7759/cureus.21976. eCollection 2022 Feb.
2022
English
Retrospective analysis of small intracranial hemorrhage in trauma: Is acute care surgery team management alone safe?
Acute care surgery; Brain Injury Guidelines; Intracranial hemorrhages; Neurosurgery; Traumatic brain injury
Background: The Brain Injury Guidelines (BIG) provide a validated framework for categorizing patients with small intracranial haemorrhages (ICH) who could be managed by acute care surgery without neurosurgical consultation or repeat head computed tomography in the absence of neurological deterioration. This replication study retrospectively applied BIG criteria to ICH subjects and only included BIG1 and BIG2 subjects.Methods: The trauma registry was queried from 2014 to 2019 for subjects with a traumatic ICH <1 cm, Glasgow Coma Scale score of 14/15 and not on anticoagulation therapy. Patients were then categorized under BIG 1 or BIG2 and outcomes were evaluated.Results: Two hundred fourteen subjects were reviewed (88 BIG1 and 126 BIG2). Twenty-three subjects had worse repeat imaging, but only one had worsening exam that resolved spontaneously. None required neurosurgical intervention. One died of non-neurological causes.Conclusions: Retrospective analysis supported our hypothesis that patients categorized as BIG1 or BIG2 could have been safely managed by acute care surgeons without neurosurgical consultation or repeat head imaging. A review of minor worsening on repeat imaging without changes in neurological exams and no need for neurosurgical interventions supports this evidence-based approach to the management of small intracranial haemorrhages.
Murali S; Alam F; Kroeker J; Ginsberg J; Oberg E; Woodruff P; Moore AN; Raimonde AJ; Novakovic R; Buderer NM; Stausmire JM; Leskovan JJ; Afaneh A
Brain Injury
2021
2021-06-16
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1080/02699052.2021.1920052" target="_blank" rel="noreferrer noopener">10.1080/02699052.2021.1920052</a>
The Inferolateral Surgical Triangle of the Cavernous Sinus: A Cadaveric and MRI Study width Neurosurgical Significance.
Anatomy; skull base; cadaver dissection; inferolateral triangle; neurosurgery
The inferolateral triangle is a surgical skull base triangle used as a neurosurgical landmark. There are few reports of its measurements with little attention paid to anatomical variations. The inferolateral triangle was measured in ten adult human cadaveric heads via dissection then direct measurement and five participants undergoing neuroimaging using tracing features. In the cadavers, mean lengths (mm) of the superior, anterior, and posterior borders were 17.0 (± 5.5), 12.9 (± 1.7), and 17.8 (± 3.3), respectively, with mean area of 97.85 (± 28.17) mm(2). In the participants, mean lengths (mm) of the superior, anterior, and posterior borders were 17.35 (±4.01), 14.36 (±1.36), and 18.01 (±2.43), respectively, with mean area of 113.6 (±25.46) mm(2). No statistical difference in triangle areas between groups was found. Intimate understanding of the inferolateral triangle is essential to skull-based surgery; Knowing its anatomy and variations aids in surgical planning and understanding of regional pathology.
Kimball H; Kimball D; Blihar D; Zurada A; Tubbs RS; Loukas M
World Neurosurgery
2021
2021-02-19
journalArticle
<a href="http://doi.org/10.1016/j.wneu.2021.02.058" target="_blank" rel="noreferrer noopener">10.1016/j.wneu.2021.02.058</a>
Frameless deep brain stimulation surgery: A community hospital experience
accuracy; Community hospital; Deep brain stimulation; disease; Essential tremor; Frameless; metaanalysis; Neurosciences & Neurology; Neurosurgery; outcomes; Parkinson's; parkinsons-disease; stereotaxy; subthalamic nucleus; Surgery; tremor
Objective: Frame-based stereotaxy has regularly been utilized for deep brain stimulation (DBS) surgery. More recently, frameless neuronavigation has revealed similar outcomes for functional neurosurgical operations. Such comparable outcomes have been described by tertiary referral centers, but whether such excellent surgical outcomes are attainable in a community setting has yet to be reported. Methods: Eighteen patients received frameless DBS surgery, 11 with subthalmic nucleus (STN) implantation for Parkinson's disease (PD) and 7 with ventral intermediate nucleus (Vim) implantation for essential tremor (ET). Their data was collected and analyzed, including the Unified Parkinson's Disease Rating Scale (UPDRS) and tremor scores. Results: There was a 58% reduction in UPDRS III and a 47% reduction in overall levodopa dose in those with STN DBS (p<0.0001 and p<0.0005, respectively) and those with Vim DBS had a 76% improvement in their overall tremor rating score (p<0.002) at mean follow-up (8.2 and 10.1 months, respectively). No intraoperative complications occurred. Two subjects developed wound dehiscence post-operatively and another had fall-induced lead fracture, all treated with uncomplicated hardware replacement. Conclusions: Frameless DBS for PD and ET can be safely performed in a community setting with similar excellent outcomes as those of larger academic centers as well as clinical results comparable to framebased surgery. Patients living in community or rural areas may not need to travel across city or even state lines to receive this surgical option, especially if they have the opportunity to receive it closer to home. (C) 2012 Elsevier B.V. All rights reserved.
Zahos P A; Shweikeh F
Clinical Neurology and Neurosurgery
2013
2013-07
Journal Article
<a href="http://doi.org/10.1016/j.clineuro.2012.11.006" target="_blank" rel="noreferrer noopener">10.1016/j.clineuro.2012.11.006</a>