Histopathological Correlation (World Health Organization Classification) of Meningiomas and Their Anatomical Localization: A Multicenter Epidemiological Study in Mexico.

OBJECTIVE: To determine the epidemiology of the localization and histological type of meningiomas in the Mexican population and the distribution of the different histological patterns and their relationship to tumor localization and patient demographics. METHODS: A retrospective analysis was performed in 5 hospitals in Mexico from 2009 to 2019. For qualitative variables, mean values were compared using Pearson χ2 test for the correlation between location and histological pattern as well as the clinical presentation and the patient's sex. Student t test was performed for age and its correlation with location and histology. RESULTS: Analysis of 179 patients revealed significant differences in histopathological pattern, patient sex, and tumor location. No significant differences were found for age or clinical presentation in association with any specific histological pattern. CONCLUSIONS: There was a correlation between the histology of the 15 histopathological varieties of meningiomas and the predilection site of appearance as well as certain demographic aspects, such as sex. This study lays the foundation for future studies in Mexico on the differentiation and typing of meningiomas regardless of the histological grade to which they belong, as the exact behavior of these tumors, including grade I tumors, remains unknown to date.

Minimally invasive management for a giant lumbar intervertebral disc herniation: A case report, and literature review.

INTRODUCTION AND IMPORTANCE: Low back pain and lower limb radiculopathy are some of the most common diagnoses in our neurosurgery department. Giant lumbar intervertebral disc herniation, are not a common find in our daily practice. Management for this kind of pathology is controversial. The quest for the best surgical approach is still a matter of debate. This case report intends to demonstrate the advantages of minimally invasive procedures. CASE PRESENTATION: 40-year-old female, diagnosed with giant lumbar L5-S1 disc herniation with localized lower back electric-type pain, 5/10 intensity in the visual analog scale (VAS) and an Oswestry Disability Index (ODI) score of 76 points, underwent minimally invasive surgery (MIS) with tubular retractor system. 6-month post-op, the patient referred no pain, and an ODI score of 4 points was obtained. CLINICAL DISCUSSION: There is no clear classification, regarding the lumbar intervertebral disc herniated content. We didn't find any clear indications or contraindications regarding the relationship of the size of herniated disc content and surgical approach (MIS vs Open). We perform on average 175 spine cases per year and educational commitment with spine pathology is demonstrated with our spine fellowship since 3 years ago. CONCLUSION: We believe giant extruded regardless of migration, single-level intervertebral disc herniation, could be effectively and safely treated by MIS.

Intracranial hypertension syndrome secondary to internal jugular vein thrombosis due to miliary cervical tuberculosis: A case report.

BACKGROUND: Thrombosis of the internal jugular vein (IJV) is extremely rare, being central catheterization the most common cause. We present a case of a patient with an unusual appearance of neurological symptoms as a consequence of thrombosis of the IJV secondary to miliary tuberculosis. CASE DESCRIPTION: A 30-year-old woman with disseminated tuberculosis, with multiple lymphadenopathy, axillary, cervical, mesenteric, retroperitoneal, and inguinal, presented with clinical evidence of intracranial hypertension. A diagnostic cerebral angiography was performed, which revealed an occluded left internal jugular and venous stasis in the entire cerebral venous system. The patient was treated with low-molecular-weight heparin, with which she had an adequate evolution. CONCLUSION: Tuberculosis is capable of generating a state of hypercoagulability, in addition to a mechanical compression effect due to cervical lymphadenopathy. We report an unusual clinical presentation, with intracranial involvement due to IJV thrombosis secondary to miliary tuberculosis. So far, there are no cases with a similar presentation described above.

360-surgery for a giant cervical chordoma with involvement of the right vertebral artery.

BACKGROUND: Chordomas are malignant tumors that arise from the remnants of the notochord. Complete en bloc radical resection with postoperative radiation therapy is currently considered the gold standard. Here, we performed a 360-staged approach to manage a C3-C4 chordoma that involved the right vertebral artery. CASE DESCRIPTION: A 40-year-old woman presented with a C3-C4 chordoma that invaded the right vertebral artery. She responded well to a circumferential approach including resection and stabilization. CONCLUSION: A 40-year-old woman with a C3-C4 spinal chordoma was optimally managed with a combined anterior/posterior surgical approach including decompression/fusion.