Turk Neurosurg
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Ventriculostomy or external ventricular drain (EVD) placement by free-hand technique has a high malplacement rate. It is a blind procedure that often requires multiple attempts and revisions. To date, no neurological complication due to EVD malplacement has been reported in the literature. ⋯ Our discussion focused on various techniques that can improve the accuracy of EVD insertion. EVD insertion under image guidance provides better accuracy with limited disadvantages. We hypothesized that the patient's coma was due to the mass effect and irritation of the malplaced EVD exerted onto the ventral periaqueductal grey matter and the ascending neurons from upper brainstem.
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The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. ⋯ Craniocerebral firearm injury is characterized by rapid traumatic condition development as well as serious trauma and contamination. Accurately judging the traumatic condition and the ballistic tract, performing complete debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury.
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We encountered no study conducted on the evaluation of prevertebral soft tissue (PVST) thickness by magnetic resonance imaging (MRI) during our literature search. Measuring PVST thickness by MRI in the cervical region of adult cases was aimed in the present retrospective study. ⋯ Progressively widespread use of MRI for the traumas inflicting the cervical region makes it obligatory to specify normal values for the thickness of PVST measured by MRI.
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The current study aims to explore the diagnosis and treatment of traumatic internal carotid artery pseudoaneurysm (TICAP) primarily manifested by repeated epistaxis. ⋯ DSA is the gold standard for TICAP diagnosis. Endovascular interventional therapy is the treatment of choice for TICAP. Compared with internal carotid artery occlusion with balloons, covered stent implantation is a more valuable endovascular intervention method.
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Deep brain stimulation for Parkinson's disease is a well-established therapeutic intervention for refractory disease. The main nuclear targets are the subthalamic nucleus and the globus pallidus internus. Periodic limb movements are often an associated condition in patients with Parkinson's disease. ⋯ The case of a 57-year-old man with severe Parkinson's disease and periodic limb movement who underwent bilateral globus pallidus deep brain stimulation surgery for his Parkinson's disease is presented and discussed. Intraoperatively the patient's periodic limb movements responded to voltage stimulation higher than those required for improvement of his parkinsonian symptoms. The immediate and reversible improvement in these symptoms contralateral to the stimulation site suggests pallidal stimulation may directly ameliorate periodic limb movement symptoms.