Intraventricular cavernomas are so uncommon that only 42 well-documented cases have been previously reported in the literature. It seems that their radiological diagnosis may be difficult because of their uncommon location in the ventricular system and their voluminous size. A wrong preoperative diagnosis has sometimes been the cause of inefficient therapy, such as radiotherapy, for these surgically curable benign lesions.
In vitro computer-aided pedicle screw insertion is more accurate than lateral-view fluoroscopy in the thoracic spine. The main disadvantage is the time consumption compared with that required by lateral-view fluoroscopy. The total time of the surgical operation should be decreased with the future development of these techniques.
To the best of our knowledge, the clinical course of our patient, consistent with a thick leptomeningeal spread of hemangioblastoma from the posterior fossa to the sacrum, is unique. Nevertheless, the short life expectancy of our patient is usual in von Hippel-Lindau disease. This case report illustrates the crucial challenge to develop a specific drug therapy related to angiogenesis in von Hippel-Lindau disease.
Management of patients with sphenoidal cerebrospinal fluid rhinorrhea remains controversial. With consideration of the etiology of cerebrospinal fluid leaks, size of the sinus, location of the fistula, and previous surgery, one may choose either an extracranial or transcranial approach. In two patients in whom conventional procedures failed or seemed to be inapplicable, the cerebrospinal fluid leak was successfully treated through an original transfacial approach with palpebral incisions. A transzygomatic osteoplastic flap provided access to close the fistula and to exclude the sinus with a bone graft.
To the best of our knowledge, the clinical course of our patient, consistent with a thick leptomeningeal spread of hemangioblastoma from the posterior fossa to the sacrum, is unique. Nevertheless, the short life expectancy of our patient is usual in von Hippel-Lindau disease. This case report illustrates the crucial challenge to develop a specific drug therapy related to angiogenesis in von Hippel-Lindau disease.
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