World Neurosurg
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Review Case Reports
Non-traumatic multiple vertebral compression fractures induced by primary hyperparathyroidism: A case report and literature review.
Primary hyperparathyroidism (PHPT) is one of the causes of osteoporosis and is known to increase the fracture risk of bone. However, multiple vertebral compression fracture because of PHPT is extremely rare. ⋯ When a patient has multiple compression fractures without any trauma history and a very low T score, the presence of other underlying diseases should be investigated.
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Review Case Reports
Treatment of large or giant cavernous aneurysm associated with a persistent trigeminal artery: a case report and review of literature.
Primitive trigeminal artery (PTA) is the most common anomaly of primitive carotid-basilar anastomosis and is associated with cerebrovascular anomalies, such as aneurysm. Large or giant cavernous aneurysm associated with PTA is rare, and the treatment strategies differ in comparison with large or giant aneurysm without PTA. In this article, we report an unusual case of a giant cavernous aneurysm associated with PTA and review treatment strategies for large or giant cavernous aneurysm associated with PTA. ⋯ The treatment strategy for large or giant cavernous aneurysm associated with PTA is different from strategies used for large or giant cavernous aneurysm without PTA. Simple ligation of internal carotid artery is inadequate because the aneurysm is supplied through the PTA, from the vertebrobasilar system. Furthermore, the treatment strategy has to be revised according to whether the PTA can be occluded. Keeping in mind PTA preservation, an appropriate strategy should be selected.
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PHACE syndrome (Posterior fossa malformations, large cervicofacial infantile Hemangiomas, Arterial anomalies, aortic coarctation and Cardiac abnormalities, and Eye abnormalities) is a neurocutaneous disorder including posterior fossa malformations, hemangiomas, arterial lesions, cardiac defects, and eye abnormalities. PHACE arteriopathies may be progressive and recently have been categorized based on the risk of acute ischemic stroke, increasing attention to the potentially devastating consequences of cerebrovascular complications in this syndrome. In contrast, the natural history of arteriopathy in PHACE syndrome remains poorly understood. At the moment, there are no established surgical guidelines for high-risk vasculopathies, including quasi-moyamoya, in this syndrome. ⋯ Although the natural history of arteriopathy in PHACE syndrome is poorly understood, patients with high-risk vasculopathies, such as quasi-moyamoya disease, may benefit of revascularization by using encephaloduroarteriosynangiosis and encephalomyosynangiosis.
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It remains unclear whether stereotactic radiosurgery (SRS) offers the same benefit for patients with type 2 trigeminal neuralgia (TN2) as for those with type 1 trigeminal neuralgia (TN1). The objective of this study is to compare the outcomes of patients with TN1 and TN2 after SRS. ⋯ SRS offers similar rates of initial pain relief, pain score distribution, pain recurrence, and time to pain recurrence between patients with TN1 and TN2. The time to initial pain relief was longer for patients with TN2.
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Transvenous (TV) embolization is ideal for endovascular treatment of intracranial dural arteriovenous fistulas (DAVF). However, it is not always feasible because of various factors, and transarterial (TA) embolization could then be tried. We aimed to determine the incidence of distally enlarged feeding artery phenomenon and the major feeding artery in DAVF. If the TV approach is difficult and this phenomenon is observed, we could use this vessel for transarterial intravenous (TAIV) embolization as an endovascular treatment modality for DAVF. ⋯ Distally enlarged feeding artery phenomenon was observed in 32% of patients with intracranial DAVF. This group was predominantly the restrictive type. We conclude that this phenomenon might help determine a patient's eligibility for TAIV embolization when TV embolization is difficult or impossible.