World Neurosurg
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Review Case Reports
Delayed Presentation of an Extracranial Internal Carotid Artery Pseudoaneurysm and Massive Epistaxis Secondary to a Nasal Foreign Body. Case Report and Review of the Literature.
Epistaxis is a very common medical condition and can often be controlled with conservative measures. Rarely, uncontrolled and life-threatening epistaxis can occur. ⋯ Massive epistaxis is a potentially lethal condition. Although the source uncommonly originates from the internal carotid artery, pseudoaneurysm rupture needs to be considered on the differential diagnosis in selected patients. This case illustrates the need for vigilance for the presence of foreign objects and/or vessel injuries in the setting of acute, massive epistaxis. Additionally, we describe treatment options and review the literature.
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An overview of the development of neuroendoscopy at the neurosurgery department, Ibn Sina Hospital in Kuwait, is presented with an outline of difficulties and obstacles faced by the field until it reached its current status. The factors and solutions that helped us overcome these problems are also elaborated on. After a modest beginning few years ago, endoscopic skull base procedures, intraventricular neuroendoscopy, and spinal endoscopy are regularly performed in the department. ⋯ Importantly, a multitude of essential facilities should be available to make such a pattern of practice possible. In our experience, this was made possible through continued efforts that have finally paid off and gradually led to a complete shift of the face of neuroendoscopic practice in our department. Our future endeavors aim at further development of neuroendoscopy in the department to create a center of excellence.
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Review Case Reports
Postoperative cerebral vasospasm following transsphenoidal pituitary adenoma surgery.
Cerebral vasospasm following a transsphenoidal resection of a pituitary adenoma is a devastating occurrence that can lead to delayed cerebral ischemia and poor neurologic outcome if not diagnosed and treated in a timely manner. The etiology of this condition is not well understood but can lead to significant arterial vasospasm that causes severe ischemic insults. In this paper, we identify common presenting symptoms and essential management strategies to treat this harmful disease. ⋯ Cerebral vasospasm following transsphenoidal surgery is a dangerous disease that can lead to a high likelihood of mortality if not identified and treated. Early postoperative events, such as peritumoral subarachnoid hemorrhage and hemiparesis, may be factors associated with post-transsphenoidal surgery vasospasm. Effective treatment options used in patients that regained complete neurologic recovery were by inducing hypertension, maintaining euvolemia, and administering nimodipine.
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Review Case Reports Historical Article
Glioblastoma invoking 'killer' rabbits of the Middle Ages.
We present the unusual appearance on brain magnetic resonance imaging of a glioblastoma with an uncanny shape of a rabbit. By invoking fearsome "killer" rabbits depicted in the art and literature of the Middle Ages, this image is an eerie reminder of the current lethality of this disease. There is a pressing need for more effective treatments for glioblastoma.
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Review Case Reports
Atlantoaxial synovial cyst: Case report and literature review.
Degenerative cystic lesions of atlantoaxial joints are rare and generally believed to be due to mechanical instability. There is currently no consensus on the management of such lesions in symptomatic and asymptomatic patients. Both conservative and surgical strategies have been described. Surgery may involve anterior or posterior approaches with and without decompression and instrumentation. ⋯ Atlantoaxial synovial cysts are rare and the optimal surgical approach has not been determined. We further conducted a literature review and found a total of 70 other cases of atlantoaxial synovial cysts reported to date in the literature. We attempt to analyze available data and evaluate anterior versus posterior approaches and the need for decompression, amount of cyst resection, and instrumentation.