J Neurosurg Sci
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The authors describe a iatrogenic cerebrospinal fluid fistula into the pleural cavity, a rare and unusual complication of thoracic surgery. The importance of considering this diagnosis in patients who suffer from headache and altered mental status after thoracotomy and the early surgical repair of this potentially fatal complication are stressed.
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The case is reported of a 58 year-old man with left-sided trigeminal and glossopharyngeal neuralgia, left hemifacial spasm and arterial hypertension. Preoperative MRI angiography examination showed a massively ectatic left vertebral artery. ⋯ Microvascular decompression was performed and postoperatively the patient had complete relief from the trigeminal and glossopharyngeal neuralgia, from the hemifacial spasm, and has sustained normal arterial pressure without medication. The value of MRI in diagnosing of neurovascular compression syndromes and pathophysiology of the "so called" arterial hypertension are discussed.