J Neurosurg Case Lessons
November 2024
Background: Cerebral radiation necrosis (RN) is an uncommon sequela that occurs in up to 25% of irradiated patients. This can occur 6 months to several years after therapy and create symptoms of headaches, focal neurological deficits, seizures, or behavioral changes. Management can involve corticosteroids, antiplatelet drugs, surgery, and hyperbaric oxygen therapy (HBOT).
View Article and Find Full Text PDFA time-honored medical ritual that combines emotion and cognition into a seamless consolidation of lucid memories is a feared teaching method in medical education. The resulting neurophysiology is explained from a neurosurgeon's perspective - equal parts guilt and dread as a prescription for an improved and sustained trainee fund of knowledge. Much of the available literature published with regard to pimping explores its pedagogy and use in medical practice.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
August 2023
Background: Intradural spinal arachnoid cysts (SACs) are a rare cause of spinal cord compression. Treatment is centered on decompression of the spinal cord via laminectomy or laminoplasty followed by resection or fenestration of the cyst. Although laminectomy or laminoplasty access may be needed to achieve the desired result, either procedure can be associated with more extensive surgical dissections and long-term spinal stability concerns, including postsurgical kyphosis.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2023
Background: Multiple bilateral brain abscesses occur rarely in immunocompetent patients. Hematogenous spread to the central nervous system (CNS) allows suppuration and abscess formation in the privileged immune environment of the CNS; hematogenous spread to the spinal cord is extremely rare and the combination of multifocal brain abscesses and intramedullary abscesses has not been reported. This report presents a rare presentation and diagrams a treatment algorithm involving iterative minimal access surgeries and prolonged medical management.
View Article and Find Full Text PDFMR-guided laser interstitial therapy (MRgLITT) is becoming more commonly used for minimal access approaches to intracranial lesions of all etiologies. The short-term safety profile of MRgLITT is favorable compared with sweeping incisions and open craniotomies, especially for lesions located in deep, periventricular, and highly eloquent areas. The Visualase software (Medtronic Inc.
View Article and Find Full Text PDFHomologous recombination in the genetic transformation model organism Streptococcus pneumoniae is thought to be important in the adaptation and evolution of this pathogen. While competent pneumococci are able to scavenge DNA added to laboratory cultures, large-scale transfers of multiple kb are rare under these conditions. We used whole genome sequencing (WGS) to map transfers in recombinants arising from contact of competent cells with non-competent 'target' cells, using strains with known genomes, distinguished by a total of ~16,000 SNPs.
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