Surg Neurol
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The use of an interbody bone graft during anterior cervical discectomy remains a controversial topic. This study presents the outcome of 64 consecutive patients who underwent anterior cervical discectomy without an interbody fusion. ⋯ Satisfactory results can be attained by discectomy without an interbody fusion in the surgical management of cervical disc disease.
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Review Case Reports
Traumatic false aneurysm of the middle meningeal artery causing an intracerebral hemorrhage: case report and literature review.
Traumatic false aneurysms of the meningeal arteries are rare. We report an unusual case of an intracerebral hematoma caused by the rupture of a traumatic aneurysm of the middle meningeal artery. ⋯ Although rare, traumatic meningeal aneurysms should be considered as a possible cause of cerebral hematoma. Because of their potential morbidity and mortality, they must be detected and treated rapidly.
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Comparative Study
Insertion of vagal nerve stimulator using local and regional anesthesia.
Vagal nerve stimulation (VNS) is a valuable therapy for patients with intractable epilepsy. Placement of a vagal nerve stimulator typically requires general anesthesia, which frequently interrupts anticonvulsant therapy. Insertion of the stimulator using regional/local anesthesia may offer the advantages of continuity of anticonvulsant therapy and implantation in the outpatient setting. ⋯ VNS implantation under regional/local anesthesia is proficiently performed as an outpatient procedure with minimal postoperative side effects.
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Comparative Study
Vascular tunnel creation to improve the efficacy of decompressive craniotomy in post-traumatic cerebral edema and ischemic stroke.
Decompressive craniectomy with durotomy has been well described but remains a controversial treatment for traumatic or ischemic brain swelling. Although the technique can reduce intracranial pressure it frequently results in infarction of the brain tissue which extends through the durotomy because of compression and subsequent complications associated with decompressive craniectomy. ⋯ Our results suggest that placing vascular tunnels at the margins of a durotomy when performing a decompression may reduce vascular congestion and the subsequent ischemia in brain tissue which herniates through the durotomy, leading to better clinical outcomes.
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Case Reports
Complete penetration of the optic chiasm by an unruptured aneurysm of the ophthalmic segment: case report.
It is well known that aneurysms of the ophthalmic segment sometimes elevate the optic nerve or chiasm, and in case of large or giant aneurysms, the optic apparatus can be dramatically thinned. Nonetheless, they rarely penetrate the optic pathway completely. To our knowledge, no previous reports have dealt with the complete penetration of the optic chiasm by unruptured aneurysms of the ophthalmic segment. ⋯ This rare case demonstrates the potentially aggressive behavior of unruptured aneurysms of the ophthalmic segment. Patients with unruptured aneurysms of the ophthalmic segment who present with visual symptoms should be treated with surgical clipping to decompress the optic pathway as soon as possible.