World Neurosurg
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The purpose of this study is to investigate trends in the incidence of subarachnoid hemorrhage (SAH) in South Korea from 2006-2009. ⋯ The age-adjusted incidence rates of SAH were slightly decreased in South Korea. Further research should be conducted to identify the clinical risk factors to reduce SAH incidence rates even more, especially in younger people.
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The use of dural grafts is very useful when primary dural closure cannot be achieved. Our primary objective was to study the incidence of postoperative cerebrospinal fluid leak, including fistula and pseudomeningocele, and postoperative infection by comparing autologous material and a new collagen graft. ⋯ The new collagen-based product derived from porcine cells (Peridry), compared with an autologous tissue, is safe, effective, easy to use, as well as time saving in cranial neurosurgery.
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To report a single case of malignant transformation of a vestibular schwannoma after radiosurgery and review the growing body of literature describing patients with malignant transformation of primary benign tumors after radiosurgery, including vestibular schwannoma. ⋯ Malignant vestibular nerve tumors are extremely rare; only 18 cases have been reported in the literature. Our patient is the sixth pathologically confirmed case of malignant transformation after radiosurgery, supporting the contention that radiosurgery itself may play a causative role in transformation. In a histologically benign lesion, the presence of an elevated MIB-1 labeling index may predispose toward malignant transformation in the setting of adjuvant radiosurgery.
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This study sought to describe a patient with a slowly progressive cauda equina syndrome (CES) who had imaging findings of the CES that occurs as a rare complication of ankylosing spondylitis (AS), but whose spinal fusion was due to thoracolumbosacral instrumentation, not spondyloarthropathy. ⋯ This case strongly suggests that extensive surgical thoracolumbosacral fusion can, rarely and after many years, be associated with lumbosacral nerve root damage and a slowly progressive CES that is similar to that seen in patients with spinal fusion due to longstanding AS.
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We introduce a technique that uses intraoperative flat-panel detector computed tomography (FD-CT) and three-dimensional rotational angiography (3D-RA) acquired in the hybrid operative suite to provide full neuronavigation capabilities during cerebrovascular surgery without the use of preoperative imaging studies. ⋯ Hybrid operating suites equipped with FD-CT, 3D-RA, and NNS capabilities can be used to provide intraoperative 3D image guidance during cerebrovascular surgery with excellent accuracy and without the need for preoperative angiography. Furthermore, this technique required less than 15 minutes for image acquisition and utilizes digitally subtracted angiographic images that are superior to conventional CT or MRI for the imaging of cerebrovascular pathology.