Turk Neurosurg
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Tension pneumocephalus is a rare and life threatening complication of intracranial surgical procedures, and requires immediate recognition and surgical intervention. Tension pneumocephalus following ventriculoperitoneal shunt surgery is extremely rare and commonly seen as a delayed complication. ⋯ We present a case of acute tension pneumocephalus following ventriculoperitoneal shunt surgery for normal pressure hydrocephalus, which was managed well with close neurological follow-up and rapid surgical intervention. The use of the portable CT scanner in this case saved significant time, without the transport of the patient to the radiology unit, made early surgical intervention possible, and prevented morbidity and mortality.
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Variations in the anatomy of the lateral femoral cutaneous nerve (LFCN) have been reported in the literature. LFCN is vulnerable to injury during several surgical operations, therefore any surgeon intervening in the area should be familiar to its topographic variability. Lesion of the nerve leads to a condition known as "meralgia paresthetica". ⋯ In specific the anterior LFCN branch originated from the femoral nerve, whereas at the level of the inguinal ligament, four nerve branches were present. The existence of multiple LFCN branches could lead to diagnostic confusion in case of "meralgia paresthetica", while if the neurosurgeon is not aware of the potential variability during surgical decompression of the nerve, postoperative complications may occur. The supernumerary LFCN branches could be identified by ultrasound imaging and be used as optimum vascularized grafts for sensory nerve repair.
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Case Reports
Compound elevated skull fracture: a clinical series of three patients with a review of the literature.
Compound elevated fracture of the skull is an unusual variety of fracture of the cranial vault that has been rarely described in the currently available literature. The authors describe three such patients with post-traumatic compound elevated skull fracture. The pertinent literature is reviewed, the injury mechanism is highlighted and the management issues are discussed in detail. ⋯ Elevated skull fractures are usually compound injuries. High velocity tangential impact to the skull vault is the most likely causative mechanism in such type of injury. Delay in surgery could lead to intracranial sepsis including meningitis and brain abscess. Thus, these fractures should be aggressively treated.
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To describe a reconstructive technique using single stent for wide-necked aneurysms. ⋯ The stent-jail technique represents an efficacious adjuvant technique to assist coiling of selected wide-necked cerebral aneurysms. This technique is particularly helpful for wide-necked aneurysms.
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Case Reports
Dural carotico-cavernous fistula: pre and postembolization appearances of bone-subtracted CT angiography.
Digital subtraction angiography (DSA) is the best method of evaluating carotid cavernous fistulas (CCF). DSA, however, has the disadvantage of being an invasive procedure. ⋯ In this case report, we report a case of a dural carotico-cavernous fistula (CCF), appearances of pre and postembolization BSCTA images, confirmed by on DSA. As far as we know, CCF demonstrated by BSCTA has not been reported yet.