Neurosurgery concepts: Key perspectives on dendritic cell vaccines, metastatic tumor treatment, and radiosurgery

Li, Gordon; Sherman, Jonathan H.; Cho, Jin Mo; Lim, Michael; Khalessi, Alexander A.; Colen, Chaim B.; Kim, Chae Yong; Wang, Viincent Yat; Zada, Gabriel; Smith, Zachary A.; Yang, Isaac

doi:10.4103/2152-7806.149389

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…The availability of the two stents has proven to be very useful to the surgeon. The proximal stent on the PICA allowed safe manipulation[ 16 ] of the vessel and positioning of the fenestrated clip. The distal stent, completely occluding the patency, allowed the surgeon to open and manipulate the aneurysm without the necessity of controlling the most distal and difficult part of the VA; finally, the combination of the intraoperative temporary occlusion with a balloon of the VA proximal part enabled the surgeon to safely manipulate and exclude the aneurysm with decompression of the stem.…”

Section: Discussionmentioning

confidence: 99%

Giant vertebral aneurysm: A case report detailing successful treatment with combined stenting and surgery

Capo¹,

Vescovi²,

Toniato³

et al. 2018

Surg Neurol Int

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Background:Giant aneurysms (>25 mm) arising from the vertebral artery (VA) often present with slow progression of symptoms and signs because of gradual brainstem and cranial nerve compression. The underlying pathophysiology is not well understood, and treatment, wherever possible, is tailored to each singular case. Endovascular management does not usually solve the problem of mass compression, whereas surgical treatment involves several complications.Case Description:A 58-year-old woman presented with a continuously growing giant right VA aneurysm, partially thrombosed, even after endovascular treatment (placement of two diversion flow stents). Operative partial aneurysmectomy and intraoperative placement of an endovascular balloon allowed removal from circulation without significant bleeding with a good neurological outcome.Conclusions:The variability of VA thrombosed giant aneurysms implies a customized therapeutic strategy. Combined endovascular techniques and surgical clipping allow safe and successful trapping and aneurysmectomy. This case highlights the benefits of treating similar pathologies with a combination of both techniques.

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Section: Discussionmentioning

confidence: 99%

Giant vertebral aneurysm: A case report detailing successful treatment with combined stenting and surgery

Capo¹,

Vescovi²,

Toniato³

et al. 2018

Surg Neurol Int

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Microsurgical Resection of Lung Carcinoma Spinal Cord Metastasis: 2-Dimensional Operative Video

Pojskić

Arnautović

2019

ONSURG

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This video demonstrates microsurgical resection of intramedullary spinal cord metastasis of lung adenocarcinoma. Lung cancer is the predominant cause of rare metastatic intramedullary involvement of the spinal cord.1-4 Because of severe disabilities, these tumors should be considered for treatment with the goal of complete removal to preserve neurological functioning.5-9 Surgical resection improves symptoms, preserves ambulatory status, and increases survival time twice that of nonsurgical treatments.3,8,10 Surgery can be effective in arresting neurological decline.11,12 To our knowledge, this is the first video report of an intramedullary spinal cord metastasis resection. A 69-yr-old male with history of lung cancer presented with acute onset left arm abduction, forearm flexion, and hand weakness (3/5) and gait disturbance. Cervical spine MRI revealed C4/C5 nonhomogenously enhancing intramedullary tumor measuring 22 × 10 × 7 mm. Sagittal T2-weighted image demonstrated extensive cord edema. The C4 and C5 laminectomies were performed. Microsurgical techniques were employed.13-15 Metastasis involved the left lateral aspect of the cord with invasion of 2 left dorsal sensory nerve roots, which were resected. Further transection of the dentate ligament relaxed the spinal cord, enabling safer tumor resection. Pial dissection using bipolar forceps, microscissors, and microdissector enabled tumor delivery. Following resection, dural closure was reinforced with previously harvested fat tissue graft to prevent CSF leak.16 Postoperative MRI revealed complete macroscopic resection with improvement of spinal cord swelling. Patient improved his gate and his left arm motor strength was stable. Subsequently, patient received focal adjuvant radiotherapy. Written consent was obtained directly from the patient.

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Neurosurgery concepts: Key perspectives on dendritic cell vaccines, metastatic tumor treatment, and radiosurgery

Cited by 2 publications

References 6 publications

Giant vertebral aneurysm: A case report detailing successful treatment with combined stenting and surgery

Giant vertebral aneurysm: A case report detailing successful treatment with combined stenting and surgery

Microsurgical Resection of Lung Carcinoma Spinal Cord Metastasis: 2-Dimensional Operative Video

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