38-year delayed spinal leptomeningeal dissemination of a paediatric pilocytic astrocytoma: a case report

Introduction: Pilocytic astrocytoma (PA) is among the commonest primary intracranial tumours in children but has a low incidence among the adult population, and spinal occurrences are particularly infrequent. We report a spinal intradural extramedullary (IDEM) recurrence of this tumour a significant duration after initial treatment. Such a case is previously unreported in the literature. Case Summary: A 46-year-old female presented with a 3-month history of worsening back pain. Reduced sensation on the right side in L1, L2, and per rectum was found on examination. MRI displayed a L3 IDEM mass. Background was significant for childhood PA, debulked at age 8 and 13. Right L3 hemilaminectomy and subtotal resection was performed. The mass was found to be composed of pleomorphic astroglial cells and was glial fibrillary acidic protein-positive with a fusion between exon 16 of KIAA1549 and exon 9 of BRAF. A recurrence of pilocytic astrocytoma in the lumbar spine was diagnosed, over 38 years after previous treatment. Conclusion: This novel case of long-term leptomeningeal dissemination of cerebellar PA to the lumbar spine is unprecedented. The delayed dissemination of this tumour may warrant further molecular investigation of pilocytic astrocytoma to assess underlying predispositions for such a presentation

Shaping perceptions and inspiring future neurosurgeons: the value of a hands-on simulated aneurysm clipping workshops at a student-organized neurosurgical conference

Objective: Early exposure to niche specialities, like neurosurgery, is essential to inform decisions about future training in these specialities. This study assesses the impact of a hands-on simulated aneurysm clipping workshop on medical students' and junior doctors' perceptions of neurosurgery at a student-organized neurosurgical conference. Methods: Ninety-six delegates were sampled from a hands-on workshop involving hydrogel three-dimensional printed aneurysms clipping using surgical microscopes. Consultant neurosurgeons facilitated the workshop. Changes in delegates' perceptions of neurosurgery were collected using Likert scale and free-text responses postconference. Results: Postworkshop, 82% of participants reported a positive impact on their perception of neurosurgery. Thematic analysis revealed that delegates valued the hands-on experience, exposure to microsurgery, and interactions with consultant neurosurgeons. Thirty-six of the 96 delegates (37.5%) expressed that the workshop dispelled preconceived fears surrounding neurosurgery and improved understanding of a neurosurgeon's day-to-day tasks. Several delegates initially apprehensive about neurosurgery were now considering it as a career. Conclusion: Hands-on simulated workshops can effectively influence medical students' and junior doctors' perceptions of neurosurgery, providing valuable exposure to the specialty. By providing a valuable and immersive introduction to the specialty, these workshops can help to dispel misconceptions, fears, and apprehensions associated with neurosurgery, allowing them to consider the specialty to a greater degree than before. This study of a one-time workshop cannot effectively establish its long-term impact on said perceptions, however

Editorial: Glasgow Neuro Society 2021 Conference Proceedings

No abstract available

Tenth-anniversary Glasgow Neuro Society 2022 conference proceedings

No abstract available

Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

Carotico-cavernous fistula: An educational case

AbstractINTRODUCTIONWe present a case of direct carotico-cavernous fistula (CCF) and its successful treatment.PRESENTATION OF CASEA 55-year-old male presented with left eye discomfort, diplopia and pulsatile tinnitus. He had a recent history of head injury. Examination showed proptosis, chemosis, orbital bruit, and abducens nerve palsy. Digital subtraction angiography confirmed CCF, which was managed endovascularly. The patient recovered fully after treatment.DISCUSSIONCCF has a variety of presenting clinical signs, imaging manifestations, and treatment options available.CONCLUSIONCCF is a rare and dangerous neurological disorder that should be promptly diagnosed and treated

Transjugular extension of meningioma into the mediastinum—a case report

A case of a tentorial meningioma with atypical histological features invading the transverse sinus and extending along the internal jugular vein up to the superior mediastinum is described. This report illustrates one of the many ways meningiomas spread beyond the cranial cavity and the difficulty in managing such a problem