Modified Inside-outside Occipito-Cervical Plate System: Preliminary Results.

CONTEXT: Internal rigid fixation provides immediate stability of the occipito-cervical (OC) junction for treatment of instability; however, in current practice, the optimal OC junction stabilization method is debatable. AIMS: The aim of this study to test the safety and efficacy of a newly designed modified inside-outside occipito-cervical (MIOOC) plate system for the treatment of instability. SETTINGS AND DESIGN: This was a feasibility study of MIOCC plate system. SUBJECTS AND METHODS: Five male and four female patients with OC instability were treated using MIOOC plate system. Stabilization rate, safety, and efficacy were evaluated radiologically and clinically. RESULTS: Mean age of the patients was 35 ± 11 (range: 22-58) years. Etiology of OC instability included trauma, neoplasm, congenital abnormalities, and iatrogenic. The fusion levels ranged from occiput-C3 to occiput-C6. Mean follow-up duration was 22 ± 10 (range: 6-46) months. There were neither complication nor was there any need for plate revision or screw pullout. Mortality occurred in one patient due to primary malignancy at 6 months; otherwise, no morbidity was observed. During the follow-up, no recurrent subluxation or newly developed instability at adjacent levels occurred. All patients showed a satisfactory union at the most recent follow-up examination. CONCLUSIONS: These preliminary results suggest that the MIOCC plate system is a useful and safe method for providing immediate internal stability of the OC junction. Using a multi-piece plate design in this plate system provided easy implantation and a better interface between plate and OC bones. Further, clinical studies and long-term results are needed to determine the reliability of the MIOOC plate system.

Mesial temporal extraventricular neurocytoma (mtEVN): A case report and literature review.

AIM: We describe a case of mesial temporal extraventricular neurocytoma (mtEVN) in a 23-year-old male presenting with drug-resistant seizures and review the literature on this rare tumor. METHODS: A PubMed search was queried using the MeSH term "neurocytoma" and key search terms "extraventricular", "temporal", and "epilepsy". Titles and abstracts were screened for temporal neurocytomas. References were reviewed to identify further studies. RESULTS: Twenty case reports were selected comparing the presentation, radiological, histopathological, and surgical outcomes of neocortex temporal EVNs (ntEVN) and mtEVNs. CONCLUSION: Gross total resection of mtEVNs under intraoperative electrocorticography monitoring typically affords an excellent prognosis and successful seizure control.

Primary intradural extramedullary hydatid cyst.

Spinal hydatid cysts account for 1% of all cases of hydatid disease; primary intradural hydatid cysts are uncommon. We present a case of pathologically confirmed intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease. The patient presented with back pain, paraparesis, and weakness. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after surgical removal. To our knowledge, this is the 25th case of hydatid cyst at an intradural extramedullary location reported in the literature.

Convexity dural chondroma: a case report and review of the literature.

The majority of intracranial chondromas arise from cartilage rests in the synchondrosis at the base of the skull. Chondromas are most commonly found in the sellar and parasellar regions, usually located extradurally. In rare instances, these tumours originate from the dura mater of the convexity. We report a rare case of a chondroma arising from the convexity dura mater. The origin of this tumour is analysed and the literature reviewed.