Neurosurgery
-
The present case report is the first one to report a bilateral anastomotic artery between the internal carotid artery and the anterior communicating artery in the presence of a bilateral A1 segment, fenestrated anterior communicating artery (AComA), and associated aneurysm of the AComA, which was discovered by magnetic resonance angiography and treated surgically. ⋯ The postoperative course was uneventful, with complete recovery. Follow-up angiograms documented the successful exclusion of the aneurysm. Defining this particular internal carotid-anterior cerebral artery anastomosis as an infraoptic anterior cerebral artery is not appropriate because there is already an A1 segment in its habitual localization. Therefore, it is also thought that, embryologically, this anomaly is not a misplaced A1 segment but the persistence of an embryological vessel such as the variation of the primitive prechiasmatic arterial anastomosis. The favorable outcome for our patient suggests that surgical treatment may be appropriate for many patients with this anomaly because it provides a complete and definitive occlusion of the aneurysm.
-
Comparative Study
National trends in surgical procedures for degenerative cervical spine disease: 1990-2000.
Degenerative cervical spine disease is one of the most common indications for spinal surgical intervention. The impact of the unprecedented changes in healthcare technology and delivery over the past decade is unknown. We examined this issue using the Nationwide Inpatient Sample database, a representative sample of all United States inpatient hospitalizations. ⋯ Compared with one decade ago, the surgical treatment of degenerative cervical spine disease has evolved to include a higher percentage of anterior and fusion procedures performed on a more diverse, older, and comorbid patient population, with shortened hospital stay and improved morbidity and mortality, although at substantially increased cost.
-
This study examined the relationship of the optic radiation to the landmarks important in temporal lobe surgery. ⋯ The optic radiation reached the anterior tip of the temporal horn. Resections that extend through the roof of the temporal horn more than 3 cm behind the temporal pole cross the anterior loop of the optic radiation.
-
Biography Historical Article
Neurosurgery 100 years ago: the Queen Square letters of Foster Kennedy.
The prominent New York City neurologist Foster Kennedy (1884-1952) trained at London's Queen Square from 1906 to 1910. He was exposed to a number of eminent neurologists including, Sir Victor Horsley and other surgeons. ⋯ Descriptions of the personalities involved give rare insight to this era. The Foster Kennedy syndrome--homolateral optic atrophy and contralateral papilledema with an inferior frontal tumor--was characterized under the stimulating support of Gowers and Horsley.
-
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.