World Neurosurg
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It is important to recognize the incidence and risk factors for ischemic complications after surgical revascularization for moyamoya disease (MMD). However, most studies focus on pediatric MMD or pediatric and adult MMD. Our study identified the incidence and risk factors of newly developed cerebral infarction after surgical revascularization for adult MMD. ⋯ Our findings demonstrate that newly developed, silent cerebral infarction developed more frequently than symptomatic cerebral infarction in adult patients. Cerebral infarction as initial presentation, frequent TIA before surgery, and PCA involvement were also independent risk factors for newly developed cerebral infarction after surgical revascularization for adult MMD.
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The middle fossa approach (MFA) is not used as frequently as the traditional translabyrinthine and retrosigmoid approaches for accessing vestibular schwannomas (VSs). Here, MFA was used to remove primarily intracanalicular tumors in patients in whom hearing preservation is a goal of surgery. ⋯ Preliminary results from this single-center retrospective study of patients undergoing MFA for resection of VS showed that good hearing preservation and facial nerve outcomes could be achieved with few complications. These results suggest that resection via the MFA is a rational alternative to watchful waiting or stereotactic radiosurgery.
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Review Case Reports
Pseudoaneurysm at the distal posterior inferior cerebellar artery after blunt head trauma: A case report and literature review.
Traumatic pseudoaneurysm of the distal posterior inferior cerebellar artery (PICA) is extremely rare. We report our experience of a case of pseudoaneurysm that developed on the PICA after blunt trauma to the head. ⋯ Given that development of traumatic pseudoaneurysm usually is delayed, follow-up radiologic examination is required, especially for patients with severe blunt trauma.
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Review Case Reports
Intraparenchymal meningioma: clinical, radiological, and histological review.
Although meningiomas are usually attached to the dura matter, intraparenchymal and subcortical meningiomas do not show dural attachment. ⋯ Because of the unique features described earlier, which contrast with those of ordinary meningiomas, there is a possibility that intraparenchymal meningiomas are not precisely diagnosed. Collectively, the information collected from the study cases may facilitate the appropriate management of these rare tumors.
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The presigmoid approach can be used to treat vertebrobasilar artery aneurysms when circumstances require more operative exposure. High morbidity and mortality in these cases have been reported. In this study, we describe our modified presigmoid approach for vertebrobasilar artery aneurysms and our clinical results. ⋯ We have described our experiences of using the presigmoid approach to treat vertebrobasilar aneurysms. The clinical and radiographic results are acceptable given the complex location and configuration of the treated aneurysms. Unfavorable outcomes are related to the poor admission Hunt and Hess grade, aneurysm morphology, and aneurysm size.