World Neurosurg
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Bow hunter's syndrome is a rare cause of vertebrobasilar insufficiency arising from mechanical compression of the vertebral artery (VA) during rotation of the head. Surgical treatment usually involves direct decompression of the VA at the site of compression. We describe what is to our knowledge the first reported case of a posterior inferior cerebellar artery (PICA)-to-PICA in situ bypass for treatment of Bow hunter's-type ischemia in a patient with a VA dissection. ⋯ The PICA-to-PICA in situ bypass is a useful option in the treatment of Bow hunter's-type ischemia in the absence of focal structural compression of the VA or VA stenosis.
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To evaluate the effects of reoperation with deep brain stimulation (DBS) in the caudal zona incerta (cZi) in patients with failed DBS in the ventral intermediate (Vim) nucleus of the thalamus for essential tremor. ⋯ The effect on tremor was, in this small sample population, improved by implanting an electrode in the cZi. The effect was modest in those patients suffering a deterioration years after the initial operation.
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To determine whether perfusion computed tomography (CT) is useful for identifying patients with poor-grade subarachnoid hemorrhage (SAH) with reversible etiologies and whether early obliteration in patients with poor-grade aneurysmal SAH leads to favorable outcomes. ⋯ Early bilateral prolonged MTT at the thalami and old age are associated with a poor outcome. Early obliteration benefits a significant portion of SAH patients.
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The computerized freezing milling technique is derived from the virtual human project. It has been widely used in three-dimensional (3D) reconstruction of the human body and organs. With this technique, the study was undertaken to explore the 3D features and adjacent anatomic relationships of the sellar region for skull base surgery. ⋯ The combination of coronary sectional anatomy and 3D reconstruction can display the anatomic characteristics of the sellar region. The 3D models are video films that continuously and dynamically display anatomic structures in 3D space at different velocities.
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Case Reports
Incidence and clinical features of symptomatic cerebral hyperperfusion syndrome after vascular reconstruction.
Vascular reconstructions are the established treatment for ischemic cerebrovascular disease. Cerebral hyperperfusion syndrome (CHS) is occasionally seen after vascular reconstruction and manifest clinical symptoms. The purpose of this study is to investigate the incidence and clinical features of CHS after vascular reconstruction. ⋯ The incidence of CHS is significantly higher in patients with MMD and results in vasogenic edema visible on magnetic resonance imaging.