Adipsic diabetes insipidus: A single-center case series

Adipsic diabetes insipidus (ADI) is a rare and challenging complication secondary to several neurosurgical procedures. It can lead to severe hyperosmolarity and is associated with high rates of morbidity and mortality. Considering the variable time of thirst sensation recovery, long-term treatment is accompanied with the risk of extreme extracellular osmolality fluctuations. Herein, we report 3 cases of this rare presentation of hypothalamic injury. © 2017, Nephro-Urology Monthly

Adipsic diabetes insipidus: A single-center case series

Adipsic diabetes insipidus (ADI) is a rare and challenging complication secondary to several neurosurgical procedures. It can lead to severe hyperosmolarity and is associated with high rates of morbidity and mortality. Considering the variable time of thirst sensation recovery, long-term treatment is accompanied with the risk of extreme extracellular osmolality fluctuations. Herein, we report 3 cases of this rare presentation of hypothalamic injury. © 2017, Nephro-Urology Monthly

Surgical clipping compared to endovascular coiling of ruptured coil able middle cerebral aneurysms: A single-center experience

Objective: The middle cerebral artery (MCA) is the third most common site for ruptured intracranial aneurysms. Aneurysms in this location are known to be challenging to treat endovascularly and are commonly treated with microsurgery. Although advances in endovascular treatment options for cerebral aneurysms have markedly reduced the need for surgery in recent years and decades, there is no compelling scientific evidence that endovascular treatments are superior to surgical treatment. The present study aimed to determine the appropriate treatment modality in ruptured MCA aneurysms. Methods: We retrospectively evaluated and compared the treatment outcomes of 80 patients with ruptured MCA aneurysms who underwent either endovascular or microsurgical treatment in our center between 2011 and 2016. Post-treatment clinical and radiological outcomes were assessed in all patients. Furthermore, we compared intraoperative complications and the need for re-treatments between the two groups. Results: According to our findings, complete aneurysm occlusion was achieved in 90.5 and 89.2 of the patients in the clipping and coil group, respectively (p = 0.850). Moreover, 14.3 of the patients in the clipping group and 15.8 of the subjects in the coil group developed intraoperative complications (p = 0.851), including 3 cases of intraoperative hemorrhage and 3 cases of ischemia in the clipping group as well as 2 cases of thromboembolism and 4 cases of vasospasm during endovascular treatment in the coil group. There was an improvement in the modified Rankin score (mRS) at six months, with no significant difference between the two groups (p = 0.916). Conclusion: The results of coiling only with coil able MCA aneurysms were comparable to the results of clipping with difficult cases. Sufficient follow-up study of recurrence and retreatment are needed to determine the indication for coiling for ruptured MCA aneurysm. © 202

Lateralization of inferior petrosal sinus sampling in Cushing's disease correlates with cavernous sinus venous drainage patterns, but not tumor lateralization

Background: Inferior petrosal sinus sampling (IPSS) is known as the gold standard to distinguish whether excessive adrenocorticotropin hormone (ACTH) production origins from the pituitary gland or an ectopic source. However, due to a number of factors, the value of IPSS for adenoma lateralization may be limited. Aim of this study was to evaluate the influence of parasellar venous drainage (VD) patterns on IPSS findings in predicting lateralization of pituitary microadenomas. Methods: We retrospectively reviewed records of confirmed cases of Cushing's disease which were evaluated by IPSS prior to endoscopic tansnasal trans-sphenoidal surgery (ETSS) to assess the ability of IPSS to predict adenoma laterality. Results: Seventeen patients with pathologically confirmed Cushing's disease were retrospectively reviewed. The median age of the included patients was 37 years. Laterality of parasellar VD perfectly associated with lateralization as measured by IPSS. Symmetrical VD was associated with symmetrical ACTH gradient on IPSS. However, lateralization measured by IPSS did not show any significant correlation with lateralization detected during ETSS. Conclusion: Our study suggests that IPSS lateralization results strongly depend on parasellar VD pattern but show no significant correlation with the adenoma lateralization found during ETSS. Thus, IPSS does not appear to be an appropriate modality to predict adenoma lateralization. © 2020 Anatomy; Neurology; Medical imaging; Endocrinology; Endocrine system; Clinical research; Inferior petrosal sinus sampling; Cushing's disease; Parasellar venous drainage; Lateralization of microadenoma © 202

Successful microvascular decompression surgery for dolichoectatic vertebral artery compression of medulla oblongata in a patient with hypersomnia disorder

Introduction: Hypersomnia is a condition in which a person has trouble staying awake during the day. There are several potential causes of it, including sleep apnea and sleep disorders. Case presentation: A 43 year old male was referred to our practice with complaints of hypersomnia, snoring, slurred speech and sleep apnea for more diagnostic and therapeutic interventions. His brain MRI was significant for a vascular loop compression on medulla oblongata. The patient underwent microvascular decompression surgery subsequently and showed improvement in all of his symptoms. Conclusion: One of the rare causes of sleep apnea is medulla oblongata compression by a vascular loop. Vertebrobasilar dolichoectasia may cause this phenomenon probably and should be reviewed in imaging examinations more precisely. Microvascular decompression by using a synthetic Teflon patch may be helpful in management of these patients. © 2019, © 2019 The Neurosurgical Foundation

Craniometrical imaging and clinical findings of adult Chiari malformation type 1 before and after posterior fossa decompression surgery with duraplasty

Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical imaging outcomes of a series of patients who underwent posterior fossa decompression with duraplasty. Materials and methods: All adult patients with symptomatic CM-1 operated at a single institution with a minimum of 6 months follow-up were enrolled prospectively. Clinical outcomes and craniometrical parameters based upon MR imaging pre- and post-surgery were analyzed. Results: A series of 33 consecutive patients who met the inclusion criteria were enrolled; mean age of 33.93 ± 10 years (range 14�56 years). The most common preoperative complaint was headache. The most common clinical sign was sensory dysfunction which was relieved or improved in 63 of patients. The mean syringomyelia size had a significant reduction after the surgery (p =.01). The mean tonsillar descent also had significant reduction (p =.00). The mean McRae line length before the surgery and after that were 33.4 and 53.1 mm respectively that this change was not statistically significant (p =.42). The odontoid process parameters had no significant changes after surgery. Conclusions: Posterior fossa decompression surgery with duraplasty can improve both clinical and imaging outcomes such as syringomyelia size and tonsillar descent for patients with symptomatic CM-1. However, no significant difference was found in craniometrical parameters before and after the surgery. © 2019, © 2019 The Neurosurgical Foundation

Endoscopic cystoventriculostomy of an arachnoid cyst using a neuroendovascular stent to maintain patency*

Introduction: Cystoventriculostomy is a surgical treatment for arachnoid cysts. We present a case using a neuroendovascular stent to maintain ostomy patency. Case report: A 6½-year-old male with symptomatic arachnoid cyst underwent endoscopic fenestration and Wingspan stent insertion. Conclusion: Neuroendovascular stent placement may be an adjunct to maintain patency in cystoventriculostomy. © 2018 The Neurosurgical Foundatio

Prevalence of human herpesvirus-8 among HIV-infected patients, intravenous drug users and the general population in Iran

Studies looking at the frequency of human herpesvirus-8 (HHV-8) among Iranian blood donors have produced conflicting results. The aim of this study was to investigate the prevalence of HHV-8 DNA by using polymerase chain reaction methods among 168 healthy individuals, 60 intravenous drug users and 100 HIV-infected patients from Iran. The prevalence of HHV-8 was significantly higher among intravenous drug users (13.3) compared with the general population (3.6; P�0.017). The HHV-8 genome was mostly detected among intravenous drug users who displayed high-risk sexual behaviours. Moreover, the HHV-8 genome was also detected in 8 of HIV-infected patients. The present study findings support the likelihood that the transmission of HHV-8 is via a sexual route in the Iranian population. Journal compilation © CSIRO 2016

Cervical Lipomyelomeningocele Presenting with Progressive Motor Deficit: A Case Report and Review of the Literature

Cervical lipomyelomeningocele is a very rare form of spina bifida occulta, which can cause some complications following tethered cord syndrome. We report a 10-year-old female with a history of progressive upper-extremity weakness, a very small soft-tissue mass at the posterior aspect of her neck, and evidence of lipomyelomeningocele in her radiological study. The patient underwent laminectomy of C6 and C7 together with resection of lipomatous tissue attaching to the cord from superficial tissue and cord untethering, which resulted in progressive improvement of her weakness. © 2019 © 2019 S. Karger AG, Basel. Copyright: All rights reserved