Surg Neurol
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Diaphragm pacing with electrical stimulation of the phrenic nerve is an established treatment for central hypoventilation syndrome. The device, however, is not readily available, at least in Japan. We used the spinal cord stimulator for pain control for phrenic nerve stimulation. The purpose of this study is to evaluate the efficacy and feasibility of phrenic pacing with the compromise method. ⋯ Though longer follow-up is necessary, diaphragm pacing by stimulation of the phrenic nerve with the spinal cord stimulator is feasible for a treatment of central hypoventilation syndrome.
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The widespread use of magnetic resonance imaging (MRI), now the first line investigation for back and leg pain, reveals cystic sacral lesions more often than myelography did in the past. There is agreement that symptomatic perineurial sacral cysts should be treated surgically. However, it is still debated whether the preference should be given to the curative option, consisting of excision of the cyst with duraplasty, or to drainage of the cyst to relieve symptoms. In this retrospective study the efficacy of microsurgical cyst resection with duraplasty is evaluated. ⋯ Microsurgical excision of the cyst combined with duraplasty or plication of the cyst wall is an effective and safe treatment of symptomatic sacral cysts and, in the view of the authors, the method of choice.
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Review Case Reports
Interhemispheric arachnoid cyst in the elderly: case report and review of the literature.
Preoperative differential diagnosis of interhemispheric cysts is sometimes difficult. ⋯ It is highly possible that an interhemispheric cyst without agenesis of the corpus callosum in an adult is an arachnoid cyst.
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Intracranial dissecting aneurysms have been associated with subarachnoid hemorrhage (SAH) or cerebral ischemia. We encountered a patient presenting with simultaneous subarachnoid hemorrhage and brainstem infarction caused by a dissecting aneurysm of the vertebrobasilar artery, which was diagnosed by magnetic resonance imaging (MRI) but did not show abnormal findings on cerebral angiography. ⋯ This is a rare case of a vertebrobasilar dissecting aneurysm that simultaneously caused both SAH and brain stem infarction. MRI should be performed in the acute phase of SAH of unknown origin to determine the possible coexistence of a dissecting aneurysm, as occurred in this case.
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The purpose of this study was to establish standards for the pressure monitoring system and to define the pressure pattern during percutaneous trigeminal ganglion compression for treatment of trigeminal neuralgia. ⋯ The pressure monitoring system has proven to be accurate, reliable, and extremely useful for monitoring the percutaneous trigeminal ganglion balloon compression procedure.