Surg Neurol
-
The neuroprotective effects of statins possibly depend on their pleiotropic effect such as antioxidative and anti-inflammatory properties. In this study, we have evaluated the efficiency of atorvastatin on brain edema, lipid peroxidation, and ultrastructural changes in TBI animal model. ⋯ In this descriptive study, the remarkable improvements of atorvastatin on brain edema, lipid peroxidation, and ultrastructural investigations encouraged us for a further dose optimization study.
-
Cervical spondylotic myelopathy represents a debilitating disorder, often resulting in significant neurological impairment over time. Cervical laminectomy has enjoyed a successful track record in the surgical management of these patients. Little is understood regarding the significance of postdecompressive migration of the spinal cord in relation to patient outcome. ⋯ Preoperative cervical alignment does not statistically correlate with postoperative spinal cord drift in patients undergoing multisegmental decompressive laminectomy and fusion for CSM. The observation of significant posterior shifting of the spinal cord in the context of straight or kyphotic preoperative alignment suggests that posterior decompression and arthrodesis represent a viable option in the surgical management of patients with CSM with nonlordotic preoperative alignment.
-
Association of leukoencephalopathy with calcifications and cysts is extremely rare. It should be differentiated from FD or bilateral striopallidodentate calcinosis and astrocytoma. Yet, there are many other clinical syndromes featuring bilateral symmetric cerebral calcifications. Neuroradiologic and histopathologic findings are more helpful than clinical picture in differentiating these 3 entities from each other. ⋯ Patients with findings of cystic cerebral calcifications on CT scans should be followed cautiously for acute deterioration because surgery is indicated in cases having signs of increased intracranial pressure.
-
In patients harboring bilateral supratentorial aneurysms, the operation has traditionally been accomplished via sequential craniotomies, starting with the side of the ruptured aneurysm. Ideally, if the contralateral aneurysms can be exposed adequately and safely, surgical clipping of all aneurysms via a single, unilateral craniotomy would simplify treatment because the patient could avoid a second craniotomy and anesthesia. We present our technique of the unilateral approach to bilateral multiple intracranial aneurysms. ⋯ The advantage of the technique is obvious-the ability to spare the patient the risk and inconvenience associated with a separate craniotomy at the same or different stage. The disadvantage of the technique is that the space of manipulation is deep and narrow. Therefore, it is an alternative approach only for experienced neurosurgeons.