Neurenteric cysts at foramen magnum in children: presentation, imaging characteristics, and surgical management—case series and literature review

Objective: To examine the clinical presentation, diagnostic evaluation, and management of Killian–Jamieson diverticula (KJD) through literature review. Methods: A comprehensive literature review was conducted through December 2018 using keywords Killian–Jamieson diverticula/diverticulum. Data extracted included clinical presentation, imaging characteristics, surgical management, and postoperative care. Sources: PubMed and Google Scholar. Results: Sixty-eight cases of KJD in 59 reports (29M:39F; median 58 years old) were identified for review. The most common presentation was dysphagia (n = 39), suspected thyroid nodule (n = 24) and globus (n = 14). The majority of KJD (n = 51) occur on the left, with rare reports of right side (n = 11) and bilateral (n = 5) presentation. Thirty-two cases describe surgical management: 22 utilizing a transcervical approach, with (n = 13) or without (n = 9) cricopharyngeal myotomy; and 10 reported endoscopic surgery. Diverticula managed transcervically averaged 3.8 cm in size in comparison to average 2.8 cm in the endoscopic group. Time to diet initiation after transcervical surgery averaged 4 days versus 2 days after endoscopic surgery. Complications were reported in 2/68 cases; both were diverticula recurrence after endoscopic surgery. Conclusion: Killian–Jamieson diverticula is a rare diagnosis that should be considered in the evaluation of dysphagia, globus, and also suspected thyroid nodule. When patient symptoms warrant intervention, a transcervical approach, with or without cricopharyngeal myotomy, is most commonly utilized. In recent years, an endoscopic approach has been presented as an alternative for smaller diverticula. Further understanding of the optimal treatment and postoperative management for KJD requires larger cohorts. Level of Evidence: 4

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Surgical management and outcome of adult posterior cranial fossa and spinal hemangioblastoma: a 6-case series and literature review

Neurological Research ◽

10.1080/01616412.2020.1796382 ◽

2020 ◽

Vol 42 (12) ◽

pp. 1010-1017

Author(s):

Bruno Splavski ◽

Blazej Zbytek ◽

Kenan I. Arnautovic

Keyword(s):

Literature Review ◽

Surgical Management ◽

Case Series ◽

Posterior Cranial Fossa ◽

Cranial Fossa ◽

Spinal Hemangioblastoma

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Surgical management of ventral and ventrolateral foramen magnum meningiomas: report on a 64-case series and review of the literature

Neurosurgical Review ◽

10.1007/s10143-012-0381-6 ◽

2012 ◽

Vol 35 (3) ◽

pp. 359-368 ◽

Cited By ~ 29

Author(s):

Andrea Talacchi ◽

Antonio Biroli ◽

Christian Soda ◽

Barbara Masotto ◽

Albino Bricolo

Keyword(s):

Surgical Management ◽

Case Series ◽

Foramen Magnum ◽

Review Of The Literature

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Surgical Management for Refractory Bleb Dysesthesia

Journal of Ophthalmology ◽

10.1155/2020/7570454 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Agnieszka Dyrda ◽

Alfonso Anton ◽

Juan Pablo Figueroa-Vercellino ◽

Marta Pazos

Keyword(s):

Surgical Treatment ◽

Literature Review ◽

Surgical Management ◽

Rare Complication ◽

Fibrous Tissue ◽

Case Series ◽

Long Term Results ◽

Radial Incision ◽

First Choice ◽

Ocular Discomfort

Purpose. To present long-term results of modified bleb-limiting conjunctivoplasty as a successful treatment for intractable bleb dysesthesia and to review the literature on the surgical management of dysesthetic bleb. Methods. Consecutive case series and literature review. We present four cases of surgically reduced painful blebs. Our technique consisted of the following steps: (1) conjunctival, radial incision to the bare sclera in the desired limit of the bleb; (2) suturing with buried, interrupted sutures at the nearest edge of the filtering bleb; (3) lower limbal peritomy including unwanted area of the extended bleb; (4) dissection and removal of the underlying fibrous tissue when present; (5) conjunctival and resorbable sutures. In addition, a systematic literature review was performed. Only reports presenting outcomes of surgical treatment of bleb dysesthesia after filtering procedure were included in review. Results. Four eyes were included consecutively in the study in a period of 4 years. On average, they developed circumferential bleb dysesthesia 9.3 ± 4.7 months after uneventful combined phacotrabeculectomy with Mitomycin C as primary procedure. Surgical reduction was decided after failure of lubricants in controlling ocular discomfort. Two cases showed a dense fibrous tissue beneath the conjunctiva that was excised to ensure filtration. In all cases, a rapid disappearance of symptoms with very good aesthetic and functional outcome was observed. After 12-month follow-up, patients remained asymptomatic and maintained intraocular pressure of 10.7 ± 1.2 mmHg without treatment. A systematic review of the literature obtained 15 eligible case series (n = 123) with rates of success within 46–100%, favoring less aggressive approaches to reduce bleb size. Conclusion. Bleb dysesthesia is a rare complication of filtering glaucoma surgery. This modified bleb-limiting conjunctivoplasty technique (with removal of subjacent fibrous tissue if present) is able to target the underlying etiology providing ocular discomfort relief while maintaining bleb function and may be considered as first-choice surgical treatment.

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Surgical Management of Delayed Presentation of Osteochondral Knee Injuries in Adolescents - Case Series and Literature Review

10.19080/oroaj.2016.03.555607 ◽

2016 ◽

Vol 3 (2) ◽

Author(s):

Samuel Mc Mahon

Keyword(s):

Literature Review ◽

Surgical Management ◽

Knee Injuries ◽

Case Series ◽

Delayed Presentation

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Preoperative Diagnosis of Suprasellar Hemangioblastoma with Four-Dimensional Computed Tomography Angiography: Case Report and Literature Review

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734335 ◽

2021 ◽

Vol 31 (02) ◽

pp. 499-509

Author(s):

Yi Tong ◽

Denis Sirhan ◽

Maria Cortes

Keyword(s):

Computed Tomography ◽

Case Report ◽

Literature Review ◽

Surgical Management ◽

Computed Tomography Angiography ◽

Diabetes Mellitus Type Ii ◽

Von Hippel Lindau ◽

First Case ◽

Imaging Characteristics ◽

Vhl Disease

Purpose Our case report presents the first case of suprasellar hemangioblastoma diagnosed preoperatively with dynamic computed tomography angiography (four-dimensional [4D] CTA) in a patient without Von Hippel-Lindau (VHL) disease. We illustrate the imaging characteristics of these exceedingly rare tumors and discuss the role of 4D CTA in confirming this diagnosis and guiding surgical management. Finally, we present a literature review of imaging findings, differential diagnosis, management, and prognosis. Case A 39-year-old woman known for diabetes mellitus type II and dyslipidemia presented with headache, bitemporal hemianopsia, and mild hyperprolactinemia. Initial diagnosis of suprasellar meningioma separate from pituitary gland was revised to definitive diagnosis of suprasellar hemangioblastoma after 4D CTA. Conclusion Suprasellar hemangioblastomas are extremely rare, often associated to VHL disease. They present as enhancing as suprasellar mass with prominent intra- and peritumoral vascular flow-voids on magnetic resonance imaging. 4D CTA confirms their vascular nature, demonstrates characteristic rapid shunting with feeding arteries, and enlarged draining veins, and is important in guiding surgical management.

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Preoperative evaluation and surgical management of infants and toddlers with drug-resistant epilepsy

Neurosurgical FOCUS ◽

10.3171/2018.7.focus18220 ◽

2018 ◽

Vol 45 (3) ◽

pp. E3 ◽

Cited By ~ 6

Author(s):

Jonathan Pindrik ◽

Nguyen Hoang ◽

Luke Smith ◽

Mark Halverson ◽

Mary Wojnaroski ◽

...

Keyword(s):

Literature Review ◽

Surgical Management ◽

Epilepsy Surgery ◽

Preoperative Evaluation ◽

Case Series ◽

Developmental Outcomes ◽

Drug Resistant ◽

Infants And Toddlers ◽

Study Team ◽

Drug Resistant Epilepsy

OBJECTIVEDespite perioperative risks, epilepsy surgery represents a legitimate curative or palliative treatment approach for children with drug-resistant epilepsy (DRE). Several factors characterizing infants and toddlers with DRE create unique challenges regarding optimal evaluation and management. Epilepsy surgery within children < 3 years of age has received moderate attention in the literature, including mainly case series and retrospective studies. This article presents a systematic literature review and explores multidisciplinary considerations for the preoperative evaluation and surgical management of infants and toddlers with DRE.METHODSThe study team conducted a systematic literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, targeting studies that investigated children < 3 years of age undergoing surgical treatment of DRE. Using the PubMed database, investigators selected peer-reviewed articles that reported seizure outcomes with or without developmental outcomes and/or perioperative complications. Studies were eliminated based on the following exclusion criteria: sample size < 5 patients; and inclusion of patients > 3 years of age, when demographic and outcomes data could not be separated from the cohort of patients < 3 years of age.RESULTSThe study team identified 20 studies published between January 1990 and May 2017 that satisfied eligibility criteria. All selected studies represented retrospective reviews, observational studies, and uncontrolled case series. The compiled group of studies incorporated 465 patients who underwent resective or disconnective surgery (18 studies, 444 patients) or vagus nerve stimulator insertion (2 studies, 21 patients). Patient age at surgery ranged between 28 days and 36 months, with a mean of 16.8 months (1.4 years).DISCUSSIONThe study team provided a detailed summary of the literature review, focusing on the etiologies, preoperative evaluation, surgical treatments, seizure and developmental outcomes, and potential for functional recovery of infants and toddlers with DRE. Additionally, the authors discussed special considerations in this vulnerable age group from the perspective of multiple disciplines.CONCLUSIONSWhile presenting notable challenges, pediatric epilepsy surgery within infants and toddlers (children < 3 years of age) offers significant opportunities for improved seizure frequency, neuro-cognitive development, and quality of life. Successful evaluation and treatment of young children with DRE requires special consideration of multiple aspects related to neurological and physiological immaturity and surgical morbidity.

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