Turk Neurosurg
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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.
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We describe a patient presented with sequential events of hemifacial spasm, cerebral infarction and fatal subarachnoid hemorrhage. All of them are seemingly separate entities. Radiological examination revealed that the cause was vertebrobasilar dolichoectasia (VBD) coexisting with a giant saccular aneurysm of basilar artery. ⋯ The condition is very rare and its progression may result in compression of brainstem and cranial nerves, ischemic and/or hemorrhagic stroke. The treatment of such condition is difficult and further research on the risk stratification of VBD for predicting stroke. Close monitoring and aggressive surgical interventions might be needed for high-risk patients.
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Lung cancer is the leading cause of cancer-related mortality worldwide. Pain is a common problem in these patients, yet inadequate or dissatisfactory management is prevalent. ⋯ CT-guided percutaneous cordotomy is an effective procedure that should be used in the treatment of cancer-related pain problems. We suggest that cordotomy should be preferred as soon as possible in patients who fail to respond to the classic analgesic therapy.
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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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To raise the awareness of the appropriate management of unusual clinical presentation of cervical disc herniation. ⋯ Brown-Sequard syndrome is a rare presentation of cervical disc herniation but accurate diagnosis, and early anterior spinal cord decompression lead to complete recovery of these cases.