RESUMEN
Although the literature is rich with descriptions of the approach to the third ventricle, surgeons remain cautiously reserved. In this report, we demonstrate that the transcallosal approach can be easily performed provided that preoperative planning is adequate. Familiarity with the course of major cortical and deep draining veins grants the surgeon a wide exposure of the posterior third ventricle. We discuss the indications, surgical technique, and pitfalls to this approach while providing an accompanying video mirroring our discussion.
Asunto(s)
Neoplasias del Ventrículo Cerebral/cirugía , Derivaciones del Líquido Cefalorraquídeo/métodos , Plexo Coroideo/cirugía , Cuerpo Calloso/cirugía , Craneotomía/métodos , Tercer Ventrículo/patología , Adulto , Ventriculografía Cerebral/métodos , Femenino , HumanosRESUMEN
Iatrogenic paraplegia after thoracic surgery is a devastating complication. In this report, the authors present a case of paraplegia in a toddler after the resection of a mediastinal neuroblastoma. In this case, the paraplegia was caused by spinal cord compression after migration of oxidized cellulose into the spinal canal.
Asunto(s)
Celulosa Oxidada/efectos adversos , Paraplejía/inducido químicamente , Complicaciones Posoperatorias/inducido químicamente , Compresión de la Médula Espinal/etiología , Celulosa Oxidada/uso terapéutico , Femenino , Migración de Cuerpo Extraño , Humanos , Enfermedad Iatrogénica , Lactante , Neoplasias del Mediastino/cirugía , Neuroblastoma/cirugía , Compresión de la Médula Espinal/complicacionesRESUMEN
Parietal lobe seizure foci are difficult to localize unless there is an MRI lesion or contralateral sensory aura. Rapid network projection often makes scalp EEG and semiology misleading. However, seizure control can be achieved with reasonable success when concordant information guides the physician to a parietal ictal onset. Perhaps the most important messages that this small surgical series provides is that of neurologic outcome. The parietal lobe is a highly convergent cortical region and a major network way station. Except for primary sensory phenomena and language, one cannot temporarily ablate parietal cortical association area within a presumed epileptogenic region and predict the visuospatial, cognitive, and neurologic outcome. Therefore, data demonstrating that one can resect regions of parietal cortex and not cause serious dysfunction are helpful. The mild morbidity encountered in this group of patients would not be necessarily predicted if the same region of normal parietal lobe was resected. Therefore, one must consider cortical plasticity and functional redistribution as possible reasons for this, particularly when most of these substrates are of developmental origin.