Neurochirurgie
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Comparative Study
Vertebral artery-posterior inferior cerebellar artery convergence aneurysms treated by endovascular or surgical treatment: Mid- and long-term outcome.
Management of vertebral artery-posterior inferior cerebellar artery convergence (VA-PICA) saccular aneurysms requires a specialized neurovascular team. The objective is to preserve the functional outcome while performing a complete and reliable long-term exclusion of the aneurysm. ⋯ VA-PICA aneurysms are rare and require multidisciplinary management. Microsurgical treatment should be discussed when the PICA originates from the aneurysmal neck, particularly in patients with a ruptured small aneurysm, in order to obtain a reliable and long-term exclusion of the aneurysm.
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Anterior approach indications in unstable thoracolumbar fractures (UTLF) are debated. The aim of this study was to evaluate the results of anterior fixation and expandable prosthetic vertebral body cage (EPVBC) implantation alone or combined with a posterior approach in the management of UTLF. ⋯ Anterior approach and EPVBC implantation, in UTLF, is a safe and effective procedure, providing long-term vertebral body height and kyphosis correction. Adverse effects of anterior approach remain acceptable. Single anterior fixation is a reliable surgical alternative in thoracic fractures without posterior spine segment injury or spinal cord compression. These results prompted us to extend anterior approach indications in oncology and infectious diseases.
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"Entrapped temporal horn" is an unusual form of obstructive hydrocephalus which is due to an obstacle at the trigone of the lateral ventricle that seals off the temporal horn that may act as a space occupying process. In this study, our aim was to assess the clinical presentation, imaging, pathophysiology and the management of this entity. ⋯ Trapped temporal horn syndrome can act as a space occupying process and requires surgical management. Internal shunting provides good results. However, the long term outcome depends on the etiology.