Background: Parietal atretic cephalocele (PAC) is a small, subscalp lesion with underlying extracranial meningeal, neural, and glial tissues. In this paper, we analyze the related literature on the continuum of PAC-associated venous anomalies and report an exemplary case. Methods: The PubMed Medline database was searched using the following search algorithm: (Atretic encephalocele) OR (Rudimentary meningocele,) OR (Atypical meningocele) OR (Meningocele manqué) OR (Meningeal heterotopia). Only papers detailing the venous anomalies associated with PACs have been included. Results: A total of 30 papers in our search documented PAC-associated venous abnormalities. The overall number of cases reported was 68 (including our exemplary case). The most frequently identified associated venous anomaly was the presence of a “fenestrated superior sagittal sinus” recorded in 48.5% of cases (n = 33), followed closely by “persistent falcine sinus” in 47% (n = 32) and vertical embryonic positioning of the straight sinus (SS) in 44% (n = 30). The complete absence of a SS was reported in 39.7% (n = 27) and various anomalies of the Galenic system were reported in 26.8% of cases (n = 12). Conclusion: Although benign in nature, PACs are often a marker for the presence of complex and variable cerebral venous malformations, requiring extensive preoperative imaging workup for both the superficial and deep venous systems to obtain an accurate understanding of the anatomy of the venous system and guide surgical planning.
Background: Neuroanatomy is the core basis for neurosurgical excellence. The quantity of accessible neuroanatomy resources has witnessed exponential growth in recent years. Accumulating a list of popular sources and getting them ranked by neurosurgeons was the motivation behind this investigation. Methods: A list of neuroanatomy resources was compiled using Google search wherein multiple sets of variable combinations of keywords were used. A three-section, eleven-item questionnaire was designed by two neurosurgeons and revised by a third independent reviewer. Neurosurgeons from different parts of the world were invited to participate. The participants were asked to rank the neuroanatomy textbook and non-book online source that they would recommend to neurosurgeons and the features that make a textbook appealing to them. Results: A total of 250 neurosurgeons at different levels of training responded to our questionnaire. Overall, “Rhoton’s Cranial Anatomy and Surgical Approach: Albert L. Rhoton Jr., Doctor of Medicine” was the most commonly chosen textbook that the neurosurgeons would use to revise neuroanatomy (86.0%; n = 215), recommend for residents (80.8%; n = 202) and recommend for certified surgeons (Continuing Medical Education (59.8%; n = 150), where applicable. “Illustrations” was rated as the most important neuroanatomy textbook quality by 53% (n = 134). “Rhoton collection” was the most popular online source (65.7%; n = 164.25). Chi-square tests showed no association between years of experience and the textbooks neurosurgeons recommended. Conclusion: Based on our study Rhoton’s book and his online collection are the leading neuroanatomy resources, recommended by neurosurgeons for neurosurgeons worldwide. The other selected resources can be implemented as a complementary part of a comprehensive neuroanatomy teaching curriculum. Knowing the relevance of these assets from a neurosurgeon’s perspective is valuable in directing future educational plan updates and recommendations.
Introduction: Choriocarcinoma is a rare gestational trophoblastic neoplasm with a high risk of pulmonary, hepatic, and, rarely, cerebral metastasis. We report a rare case of intracerebral haemorrhage as an initial manifestation of metastatic choriocarcinoma. Case presentation: A 33-year-old female with a history of multiple abortions, ectopic pregnancy, and complete hydatidiform mole presented with a disturbed level of consciousness. Emergency brain computed tomography (CT) scan revealed an intraventricular haemorrhage (IVH) and a left frontoparietal, non-traumatic intracerebral haemorrhage (ICH) with a significant midline shift. The patient underwent emergency evacuation of the hematoma and histological evaluation revealed choriocarcinoma. Later investigations revealed evidence of systemic metastasis. The patient underwent chemoradiotherapy and recovered well. Conclusion: Metastatic choriocarcinoma should always be in the differential of non-traumatic intracerebral haemorrhage in a female child-bearing age. Also, the pathological diagnosis should always be performed in cases of ICH of an unknown source.
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