World Neurosurg
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Review Biography Historical Article
Ulf Fernstrom (1915-1985) and his Contributions to the Development of Artificial Disc Replacements: A Historical Vignette.
Artificial disc replacements, which serve the function of separating vertebrae to allow for proper spinal alignment, can help treat debilitating low back pain in patients who have failed other conservative methods of treatment. A Swedish surgeon, Ulf Fernström, was the pioneer of artificial disc replacement, and his contribution in the form of Fernström balls dramatically altered spinal surgery and technique by showing the proper technique and implant that should be used for areas requiring motion in many planes. ⋯ Of the wide range of implants on the market for the intervertebral disc space, all designs and applications of products stem from the initial discovery made by Fernström, thus making him a pioneer in disc replacement.
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Review Case Reports
Asystole during Onyx embolization of a Pediatric Arteriovenous Malformation: a severe case of the Trigeminocardiac reflex.
Trigeminal-cardiac reflex (TCR) from the stimulation of sensory branches of trigeminal nerve can lead to hemodynamic instability. This phenomenon has been described during ophthalmologic, craniofacial, and skull base surgeries. TCR has been reported rarely with endovascular onyx embolization of dural arteriovenous fistulas. ⋯ TCR can lead to significant hemodynamic changes during endovascular Onyx embolization of vascular malformations (both pial AVM and dural arteriovenous fistulas) involving receptive field of trigeminal nerve. Therefore, the anesthesiologist should be made aware of treatment approach before intervention and appropriate precautions taken.
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Review Case Reports
Septic Arthritis of an Atlantoaxial Facet Joint with Normal Inflammatory Markers: Case Report and Literature Review.
Septic arthritis of the atlantoaxial facet joint is extremely rare. Contiguous spread to the median atlantoaxial joints with subsequent dens erosion can lead to atlantoaxial instability. Misleading normal inflammatory markers can result in delayed diagnosis and catastrophic consequences. ⋯ Infection must be considered in the differential diagnosis for neck pain when imaging findings are suggestive of an infectious process, even in an afebrile patient with normal C-reactive protein and erythrocyte sedimentation rate levels. Magnetic resonance imaging and computed tomography can play a critical role in such cases, potentially leading to a more timely diagnosis.
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Review Case Reports
Primary germinoma originating from the insular lobe: a case report and review of the literature.
Primary intracranial germinomas occurring in the cerebral hemisphere are extremely rare, with only a few reported cases in the literature. We describe an unusual case of a primary germinoma that developed in the insular lobe, with little involvement in the basal frontal lobe. ⋯ The causes of ectopic germinomas of the midline structures of the brain are still unclear, but the theory of misplacement may partially clarify this phenomenon. Reflecting a lack of definitive management guidelines for atypical germinoma, the present patient was treated with focal radiotherapy around the lesion after surgery and achieved remission by 34 months postoperatively.
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Review Case Reports
Basilar artery herniation into the sphenoid sinus secondary to traumatic skull base fractures: case report and review of the literature.
Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture. ⋯ Basilar artery incarceration and herniation through the sphenoid sinus is rare. Such an injury portends a poor prognosis. We discuss the relevant clinical imaging and review the literature.