Neurosurgery
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Basilar artery occlusion is a clinical event with an exceedingly high mortality rate. Improved survival is closely associated with successful recanalization of the occluded basilar artery. Bilateral vertebral artery occlusion (BVAO) is a unique disease entity that effectively denies any direct access to the basilar artery for endovascular rescue therapy. We report a case of successful intra-arterial basilar artery thrombolysis in a patient with BVAO. ⋯ Knowledge of potential collateral pathways is important when direct access to the main intracranial vessels is not available. Basilar artery thrombolysis through collateral vessels is clinically effective when a direct approach to the artery is not feasible.
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We examined the surgical anatomy of the ophthalmic artery (OA) by dissection of cadaver heads, evaluating the anatomic relationships between the origin of the OA and both its proximal course and surrounding structures. In addition, we demonstrated the surgical application of these anatomic features for safe surgical exploration of this region. ⋯ Our anatomic findings demonstrate anatomic variation of the OA in terms of its region of origin. Several anatomic points that were noteworthy during surgical exploration of this region are discussed.
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Case Reports Comparative Study
Artificial pedicle screw reconstruction of the cervical spine after lateral paramedian transpedicular approach for lesions of the ventral cervical spinal canal.
We describe in detail the anatomic and surgical principles of a lateral cervical paramedian transpedicular approach, a novel technique that provides access to the ventral cervical spinal canal. We also describe single-stage posterior column reconstruction of the cervical spine in which traditional cervical lateral mass screws are used simultaneously to reconstruct the cervical pedicle and to allow for three-column stabilization in a continuous posterior screw-rod construct after this approach. ⋯ Cervical spinal stability is enhanced, because all cervical levels are incorporated into the final screw-rod construct.
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Case Reports
Thalamic stimulation as a treatment for primary erythromelalgia: technical case report.
We report the use of bilateral thalamic stimulation in a case of primary erythromelalgia with immediate and important pain relief for 3 years. ⋯ We conclude that thalamic stimulation was successful in this case of primary erythromelalgia.
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Hemangioblastomas are not uncommon intramedullary spinal cord neoplasms. They are highly vascular, benign tumors that occur either sporadically or in the presence of von Hippel-Lindau disease. Despite their exceptionally vascular nature, these lesions can consistently be resected completely and safely with minimal blood loss. We describe a microsurgical method for removal of these tumors from the spinal cord.