White cord syndrome (WCS) is a rare case of severe neurological deterioration after surgical decompression for cervical myelopathy. It was proposed to be secondary to an ischemia/reperfusion injury. An association of WCS with a hypoxic brain injury (HBI) has not been documented. A 63-year-old man presented to us with progressive symptoms of cervical myelopathy. Computed tomography scan and magnetic resonance imaging (MRI) scan findings were suggestive of an ossified posterior longitudinal ligament with cord atrophy and myelomalacia changes. He was managed surgically by decompression and fusion through a posterior approach. During the surgery, there was a sudden loss of neuromonitoring signals after laminectomy, and wake-up assessment revealed neurological deterioration. Immediate postoperative imaging revealed adequately placed screws and adequate cord decompression. A high dose of intravenous steroids was given. Repeat MRI scan on the 3rd postoperative day suggested cord edema over a large area on T2-weighted images. He was diagnosed as WCS and managed conservatively. He had persistent abdominal distension postoperatively, and a diagnostic endoscopy was advised. At the start of the procedure, the patient had a sudden-onset loss of consciousness. Electrocardiogram suggested bradyarrhythmias with hypotension. The patient was resuscitated, intubated, and shifted to intensive care unit. He was diagnosed to have a HBI. He was managed with multidisciplinary rehabilitation and discharged at 4 months' postoperatively with stable vitals. There was no improvement in the neurology or his consciousness. Spine surgeons have to be aware of this potentially disastrous complication of WCS. One should take adequate postoperative care to avoid preventable complications like HBI associated with it.Navigating a large-caliber catheter into the intracranial artery may generate a "ledge effect," which disturbs successful neurointervention. Particularly, navigation of a large-lumen aspiration catheter is often required to achieve fast recanalization in acute ischemic stroke cases. Occasionally, the aspirator cannot be passed through the ophthalmic artery origin because of the ledge effect. Here, we report a new technique for mitigation of the ledge effect that involves the use of double micro-guidewires (MGWs). We refer to this technique as the "beanstalk method." We evaluated the efficacy of our idea using a silicon vascular model. Two 0.014" MGWs are used for navigation of a 0.068" aspirator. After one guidewire is navigated to the distal portion, another MGW is advanced along with the former guidewire, in a spiral fashion, similar to the growth of a beanstalk. The aspirator can then pass with the coaxial double-guidewire, although there is a severe gap in the vessel. We performed an in vitro study to demonstrate the effectiveness of the beanstalk method. The beanstalk method was very useful, even under challenging conditions that did not allow for passage of a conventional coaxial catheter or buddy-wire. The beanstalk method effectively decreases the ledge effect because of the shape of the two wires just ahead of the catheter, which contrasts with the hardness of the spiral wires. In cases involving challenging vasculature, the beanstalk method achieves smoother catheter navigation than the conventional coaxial method or buddy-wire technique.Orbital cavernous venous malformations (CVMs) are usually slow progressing. Multiple CVMs, bilateral orbital CVMs, and acute presentations are rare. We present a rare, bilateral, orbital CVM with acute painful visual loss in the left eye. The initial clinical presentation mimicked an idiopathic orbital inflammation. Orbital magnetic resonance imaging revealed its rare location at the left orbital apex. Finally, pathology confirmed the presence of an intralesional hemorrhage of a CVM.Trigeminal neuralgia (TN) secondary to cerebellar arteriovenous malformation (cAVM) is a rare condition with only few reports existing in the literatures. Given to its rarity, the treatment armamentarium is still controversial. We reported our experiences treated two cases of TN secondary to cAVM using different strategies. The first case was successfully treated by a combination of gamma knife radiosurgery and microvascular decompression (MVD) of the trigeminal nerve. https://www.selleckchem.com/products/mln-4924.html The second case was successfully treated by one-step microsurgical AVM resection and MVD of the trigeminal nerve. Postoperative immediate pain relief was achieved in both patients. Microsurgical procedure is still playing an important role in treating TN secondary to cAVM.The presence of collision tumors without any evidence of phacomatoses, genetic syndromes, or any history of previous radiation to the brain is extremely rare. We report a case with two diverse primaries, a tentorial meningioma and a colloid cyst found in the same patient occurring in the absence of these conditions. To the best of our knowledge, a single case of a colloid cyst and meningioma found together in the same patient has been reported till date. In such cases, the surgical dilemma as to which tumor to operate first has been addressed in our case report.Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. We present an unusual case of a giant frontal sinus osteoma leading to subdural empyema formation. Determine the origin and the optimal surgical approach of these unusual lesions by analyzing giant osteomas of the frontal and ethmoidal sinuses in the literature. We report a rare case of giant frontoethmoidal osteoma with intracranial extension in a 34-year-old man, revealed by seizures. Neuroradiological studies revealed frontoparietal subdural empyema associated to a large osteoma in the right frontal sinus. The patient underwent surgical evacuation of the empyema and resection of the osteoma in one stage operation of decompressive craniotomy. The patient recovered very well after surgery and postoperative antibiotic therapy. This case represents in the literature only the third-reported case of subdural empyema complicating frontoethmoidal osteoma. The surgical treatment options, including open surgery techniques and endoscopic approaches, as well as pathogenesis are discussed according to the relevant literature.