Turk Neurosurg
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Piriformis syndrome is a rare neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve. The treatment of piriformis syndrome includes injections into the piriformis muscle around the sciatic nerve. These invasive approaches have been used with various techniques to increase the safety of the procedure. Computed tomography (CT)-guided injection of the piriformis muscle and the clinical outcome of the patients are discussed. ⋯ CT-guided piriformis injection is a safe and effective method in the treatment of piriformis syndrome.
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One of the clinical presentations of intracranial aneurysm is unilateral oculomotor nerve palsy (ONP). The most common location is the posterior communicating artery. Surgical clipping and/or endovascular coiling of the aneurysm are the treatments. The aim of this study was to identify the factors that influence the postoperative recovery of patients who have posterior communicating aneurysm with ONP. ⋯ Early decompression of the posterior communicating aneurysm yielded satisfactory recovery and ONP can be reversible. In our patients, the first component of oculomotor function to recover was the parasympathetic fibers.
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Gunshot wounds to the head (GSWH) account for the majority of penetrating brain injuries, and are the most lethal. Since they are rare in Europe, the number of neurosurgeons who have experienced this type of traumatic injury is decreasing, and fewer cases are reported in the literature. ⋯ GSWH are often devastating. The in-hospital mortality for civilians with penetrating craniocerebral injury is very high. Survivors often have high rate of complications. When facial paralysis is present, masseteric-facial direct neurorraphy represent a good treatment.
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Case Reports
Complete spontaneous thrombosis and recanalization of a ruptured posterior cerebral artery aneurysm.
Complete spontaneous thrombosis followed by recanalization of non-giant aneurysms is a rare event that can be discovered incidentally on advanced neural images. In this case report, the authors described a woman who presented with subarachnoid hemorrhage (SAH) and left posterior cerebral artery (PCA) territory ischemic stroke. Cerebral angiography revealed a left PCA aneurysm at the P1-P2 junction. ⋯ Ventriculo-peritoneal shunt surgery for hydrocephalus was performed and the patient noted a great improvement of the neurological deficit. Follow-up contrast-enhanced CT after 10 weeks revealed recurrence of the aneurysm. This case provides insight into the natural dynamic process of intracranial aneurysm, and a complete thrombosed aneurysm has the potential for recanalization.
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Case Reports
Intramedullary spinal cord metastasis of renal cell carcinoma 6 years following the nephrectomy.
Intramedullary spinal cord metastasis is an uncommon manifestation of systemic tumor. We present a case of metastatic mass inside the thoracic spinal cord 6 years after nephrectomy because of renal cell carcinoma. ⋯ The case shows that renal cell carcinoma has the possibility of metastasis into spinal cord even several years after nephrectomy. Any symptom of neurological deficit should alert to a possible intramedullary spinal cord metastasis.