Journal of neurointerventional surgery
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Review Case Reports
Endovascular embolization of cervical hemangiopericytoma with Onyx-18: case report and review of the literature.
Cervical hemangiopericytoma (HPC) is a rare tumor involving dura and bone. Because HPC shares some imaging features with meningioma, hemangioblastoma, schwannoma and solitary fibrous tumors; histology with appropriate immunohistochemistry is essential for its diagnosis and treatment. HPC is highly vascular and has a high rate of local recurrence following resection. ⋯ Histology confirmed the presumptive diagnosis of HPC. Preoperative embolization with Onyx-18 should be considered for large HPC as it may decrease the risk of intraoperative hemorrhage. In this case, embolization with Onyx-18 did not preclude histopathologic diagnosis of HPC.
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Although the standard treatment for lumbar disc herniation is lumbar microdiscectomy, nucleoplasty offers a new technique with encouraging results in well selected cases. Nucleoplasty is a minimally invasive technique that manages intradiscal herniation through energy based removal of part of the nucleus pulposus. The purpose of this study was to assess the safety and clinical outcome of the nucleoplasty procedure in well selected cases. ⋯ Nucleoplasty does not require general anesthesia, offers less morbidity and shortens recovery time. Contained herniated disc or focal protrusion are the most important inclusion criteria. Hence this technique is a promising tool in well selected cases.
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Reversible cerebral vasoconstriction syndromes (RCVS) represent a heterogeneous group of cerebrovascular disease characterized by acute presentations and transient segmental narrowing of the distal intracranial arteries. A series of patients with RCVS were studied to better understand the clinical and imaging characteristics of this rare pathology. ⋯ RCVS classically presents with 'thunderclap' headaches and neurological symptoms but cortical SAH is not an uncommon presentation with a unique and focal distribution overlying the cerebral sulci. Although the initial clinical and angiographic appearance of RCVS may be confused for vasospasm related to aneurysmal SAH or primary angiitis of the CNS, its clinical, laboratory and imaging features assist in diagnosis.