World Neurosurg
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Case Reports
Ultrasonography monitoring with Superb Microvascular Imaging technique in brain tumor surgery.
Neuronavigation based on preoperative magnetic resonance imaging has been developed as a useful tool to improve visibility of the surgical site in the operative field. Ultrasonography (US) monitoring has also been used as a reliable imaging technique, providing real-time information during neurosurgical operations. We combined the latest innovative imaging technique for detecting very low-flow components, Superb Microvascular Imaging (SMI), with US monitoring during brain tumor surgery. ⋯ We combined SMI technique with US monitoring during brain tumor surgery and observed healthy and tumor vessels. Further research is important for the development of a more precise and reliable neurosurgery.
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Carotid atherosclerosis is a known risk factor for acute ischemic stroke. Although severe luminal narrowing is a well-established risk factor for future ischemic events, 10% of patients with acute ischemic stroke or transient ischemic attacks are thought to have ischemic events secondary to vulnerable carotid plaques in the setting of mild to moderate carotid artery stenosis. ⋯ We postulate that the likely mechanical "squeeze" of the vulnerable plaque involving the retropharyngeal proximal internal carotid artery was responsible for the multiple recurrent transient ischemic attacks, which characteristically occurred only while eating. Resolution of the episodes after carotid endarterectomy supports this hypothesis.
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We compared and evaluated percutaneous retrogasserian balloon compression (PBC) and Gamma Knife radiosurgery (GKRS) for treatment of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS). ⋯ PBC and GKRS are effective techniques for treatment of TN in patients with MS. Fewer complications and superior long-term relief were associated with GKRS. We consider GKRS as the first option for the treatment of TN in patients with MS, reserving PBC for patients with acute, intractable pain.
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Case Reports
Evolution of a stump aneurysm that transformed from a fusiform aneurysm in the middle cerebral artery: A case report.
A spontaneous fusiform aneurysm in the middle cerebral artery (MCA) can present with both ischemic and hemorrhagic symptoms, but this aneurysm's clinical course and prognosis are unclear because of its rarity. ⋯ This is the first case report in which serial images demonstrate the stepwise occlusion of an artery with fusiform change and the evolution of a stump aneurysm in the MCA over an extended period.
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Retrospective cohort study. ⋯ The results of this study confirm that APCD aids surgical outcomes of ALIF in patients with suspected lumbar discogenic pain. We recommend performing APCD before ALIF to confirm lumbar discogenic pain.