Thoracoabdominal approach to large adrenal tumors - when laparoscopic adrenalectomy is not enough: a retrospective four-year study.

Laparoscopic adrenalectomy is considered to be the gold standard approach in the field of adrenal surgery. This technique offers advantages of great importance compared to variant laparotomy techniques. Notwithstanding, a technique that needs to be mentioned is the thoracoabdominal approach which facilitates the anatomic exposure of the retroperitoneum, adrenal gland, and great vessels and is strongly recommended for the surgery of large, malignant adrenal tumors.

Is Carmustine Wafer Implantation in Progressive High-Grade Gliomas a Relevant Therapeutic Option? Complication Rate, Predictors of Complications and Onco-Functional Outcomes in a Series of 53 Cases.

: The aim was to determine the complication rate and the predictors of complications and survival in high-grade glioma surgically managed at progression with implantation of Carmustine wafers. : A retrospective series of 53 consecutive patients operated on between 2017 and 2022 was built. : The median age was 55 ± 10.

BRAF and MEK inhibitor targeted therapy in papillary craniopharyngiomas: a cohort study.

Objective: Targeted therapy (TT) with BRAF/MEK inhibitors has emerged as a potential treatment in papillary craniopharyngiomas (PCPs). However, standardized data on large cohorts are lacking. Our study aimed to assess real-life efficacy and safety of BRAF/MEK inhibition in patients with PCPs.

Spontaneous Intraventricular Tension Pneumocephalus.

Here, we report a very rare case of spontaneous intraventricular tension pneumocephalus. This case concerns a 40-year-old patient with medical history of a tumor of the pineal region and a secondary hydrocephalus treated by multiple ventriculoperitoneal shunts. He presented in the emergency room because of unusual headaches, nausea, and visual loss.

The Mini-Spheno-Supraorbital Craniotomy for Treatment of Ruptured Anterior Circulation Aneurysms.

Yasargil introduced the pterional approach mainly for clipping of anterior circulation (AC) aneurysms. We implemented the mini-spheno-supraorbital (MSS) craniotomy, changing the shape and reducing the size of the classical pterional craniotomy. The literature on clipping ruptured AC aneurysms through reduced-in-size craniotomies is sparse.

Purely cystic meningioma: Case report and systematic review of the literature.

Meningiomas are the most common benign intracranial tumors. They are generally asymptomatic, and discovered incidentally during cerebral imaging. The vast majority of meningiomas are solid, highly cellular and well-vascularized neoplasms.

The evaluation of the usefulness of CO laser in microsurgical resection of brain tumors.

Background: Since its introduction to surgery, the CO laser has been used in the treatment of various neurosurgical pathologies as it combines cutting, vaporizing, and coagulating properties in one tool and has a safe penetration depth. In this case series of 29 patients, we present the evaluation of the usefulness of the closed system type - sealed tube surgical CO laser in the surgical removal of brain tumors.

Methods: The Sharplan 40C model SurgiTouch, sealed tube type CO laser, was used in the resection of 29 brain tumors; 13 meningiomas, six metastases, nine gliomas, and one acoustic neuroma.

Vertigo: Could this Symptom Indicate the Existence of an Unruptured Intracranial Aneurysm?

Unruptured intracranial aneurysms (UIAs) can be presented with various symptoms, including atypical headaches and cranial nerve deficits. Vertigo is often referred in the literature as a coexisting symptom. Our aim was to investigate the importance of vertigo in the UIA symptomatology and present a possible explanation for its existence.

The Use of Real-Time 3D Intraoperative Ultrasound "Angiography" in Localization and Occlusion Control of a Ruptured Mycotic Aneurysm: A Case Report.

Background:  Infectious (mycotic) aneurysms are rare with high mortality and are most commonly found at the distal branches of the middle cerebral artery (MCA). Because aneurysms of the distal MCA are located deep in the Sylvian fissure and are small in size, intraoperative identification and safe clip occlusion of these aneurysms are challenging. Thus, the use of intraoperative imaging and navigation can be beneficial.

Clipping of a basilar tip aneurysm using hypothermia and circulatory arrest: a case report.

Treatment of complex and giant aneurysms remains challenging despite modern endovascular and microsurgical techniques. We report the first case of microsurgical clipping of a complex basilar tip aneurysm under circulatory arrest and hypothermia performed in Greece. A 52-year-old patient presented with a Hunt and Hess Grade 4 subarachnoid hemorrhage.

Treatment of adjacent segment disease with percutaneous transforaminal endoscopic discectomy: Early experience and results.

Purpose: Adjacent segment disease (ASD) constitutes a long-term complication of instrumented spinal fusion. Aim of this study is to analyze the utilization of percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of symptomatic ASD, emphasizing basically in the postoperative course.

Methods: A prospective study with 35 patients was designed.

Severe kyphoscoliosis in a 17-year-old patient with T11-T12 hemivertebra: X-ray imaging of the abnormal anatomy of the thoracolumbar spine.

Young patient exhibiting lumbar pain accompanied by severe kyphoscoliosis-hemivertebra of the thoracolumbar spine; a rare etiology with difficult surgical treatment.

Healing of colonic anastomosis in rats under obstructive ileus conditions.

Background: The anastomosis leak in colon resections is a crucial post-operative complication with significant morbidity and mortality.  Methods: Forty (40) Wistar rats were allocated in two groups. In SHAM group only anastomosis was performed.

Spontaneous Epidural Hematoma of the Cervical Spine Following Thrombolysis in a Patient with STEMI-Two Medical Specialties Facing a Rare Dilemma.

Spontaneous spinal epidural hematoma (SSEH) is a rare, albeit well-documented complication following thrombolysis treatment in ST elevation myocardial infarction (STEMI). A SSEH usually manifests with cervical pain and neurologic deficits and may require surgical intervention. In this case report, we present the first reported SSEH to occur following thrombolysis with reteplase.

Salter-Harris type II fracture of the distal femur in a newborn: Acute anatomic imaging alterations after labor dystocia.

A rare clinical presence of Salter-Harris type II fracture of the distal femur in a newborn. The crucial role of imaging in depicting urgent anatomical alterations.

An incidental intracranial lesion in a young woman with head trauma: The key role of CT bone reconstruction in the diagnosis of an osteoma of the anterior cranial fossa.

A young female was subjected to brain CT due to head trauma after a car accident. A lesion was found in the area of the right frontal lobe raising concern. After reconstruction of the CT slices, the radiologic features indicated a skull base osteoma, without the need for further intervention.

Comparison of Quality of Life Between Men and Women Who Underwent Transforaminal Percutaneous Endoscopic Discectomy for Lumbar Disc Herniation.

Background: Studies describing the efficacy of transforaminal percutaneous endoscopic discectomy (TPED) on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender, something that has never been reported before in the literature. The purpose of this study is to evaluate, in accordance with the sex of the patients, possible differences in the health-related quality of life of those who underwent TPED for lumbar disc herniation (LDH).

Methods: A total of 76 patients diagnosed and treated with TPED for LDH with 1-year follow-up were selected and divided into 2 groups of equal number depending on sex.

Mechanoreceptors of the Achilles tendon: a histomorphological study in pigs with clinical significance for humans.

Introduction: Tendons contain neurosensory elements called mechanoreceptors which contribute to the neuromuscular system as sources of reflex signals. The literature is lacking in histological assessment of mechanoreceptors of the Achilles tendon in piglets and our aim was to indicate their types, location and quantity.

Methods: The study was performed using histological tissue samples from the Achilles tendon of ten healthy pigs, five left, five right, six males, four females.

A rare case of spinal cord compression due to cervical spine metastases from paraganglioma of the jugular foramen-how should it be treated?

Paragangliomas are benign neoplasms that arise from the autonomic nervous system and the associated paraganglia. Although benign, they have been shown to possess metastatic potential. Involvement of the spine is rare.

Comparison of quality of life between men and women who underwent Transforaminal Percutaneous Endoscopic Discectomy for lumbar disc herniation.

Background: Studies describing the efficacy of TPED on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender something that has never been reported before in the literature. The purpose of this study is to evaluate possible differences of the health-related quality of life in patients who underwent TPED for LDH in accordance with sex.

Methods: Seventy-six patients diagnosed and treated with TPED for LDH with 1 year follow-up were selected and divided into two groups of equal number depending on sex.

Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid.

Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions.