World Neurosurg
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Case Reports
IgG4-Related Disease: A New Etiology Underlying Diffuse Intracranial Dilating Vasculopathy.
Diffuse intracranial aneurysmal vasculopathy is a rare condition, previously described in patients with human immunodeficiency virus infection. IgG4-related disease (IgG4-RD) is a recognized inflammatory disease of systemic organs, leading to fibrosis of connective tissues. It also has been linked to inflammatory dilating aortic aneurysms, coronary vascular disease, hypophysitis, orbital pseudotumor, and pachymeningitis. It has not yet been described as a cause of diffuse intracranial dilating vasculopathy. Histologically, this disease is characterized by IgG4-plasma cell infiltration, fibrosis, and phlebitis. ⋯ This is the first reported case of a diffuse intracranial dilating vasculopathy secondary to IgG4-RD. Recognition of similar pathologic findings in clinical presentation and radiologic workup should prompt further rheumatologic workup and possible immunosuppressive therapies.
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Case Reports
Is there a place for the posterior approach in cases of acute myelopathy on thoracic disc hernia?
Acute myelopathy in cases of thoracic disc herniation (TDH) is an exceptional condition for which the treatment is not codified. Here we present the results of a standardized procedure in 10 patients who underwent surgery for acute myelopathy on TDH between December 2009 and December 2016. ⋯ Laminectomy appears to allow stabilization of the neurologic situation in rare cases of acute myelopathy on TDH. The need for complementary resection of the hernia by an anterior approach should always be discussed secondarily.
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Case Reports
Endovascular Treatment of Complex Distal Posterior Cerebral Artery Aneurysms with the Pipeline Embolization Device.
To assess the safety and efficacy of the Pipeline Embolization Device (PED) for endovascular treatment of complex, distal posterior cerebral artery (PCA) aneurysms. ⋯ PED use provides a practical and viable treatment option for complex, distal PCA aneurysms. Based on our limited institutional experience, PED use for treatment of complex, distal PCA aneurysms in select patients appears safe and effective.
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To investigate the biomechanical properties of a novel stabilization method for posterior cervical motion preservation using bioderived freeze-dried tendon. ⋯ Bilateral facet joint stabilization can significantly limit excessive flexion motion and maintain adequate stability. Furthermore, the preservation of extension motions without limiting lateral bending and rotation ideally simulates the features of the posterior ligamentous complex. This preserves the dynamic stability of the lower cervical spine.
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In the context of bronchial cancers, the brain is one of the most frequent sites for metastases. Local treatments of these metastases have evolved and are often combined to obtain greater efficiency, while the main objective remains to reduce the symptoms. Radiosurgery is currently used as a primary option for patients harboring few numbers of small to middle-sized brain metastases. In nonsquamous non-small cell lung cancer (NSCLC), chemotherapy is often associated with bevacizumab. Our goal was to assess the safety of this early combination. ⋯ Radiosurgery may be safely combined with bevacizumab quite early on for patients with nonsquamous NSCLC with brain metastases.