World Neurosurg
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Positional compression of the vertebral artery (VA) owing to cervical spondylosis is an uncommon cause of stroke. We report two cases of cervical spondylosis causing wake-up stroke, which is extremely rare. ⋯ Magnetic resonance angiography of extracranial cervical VAs may be useful as an initial screening test for VA compression secondary to cervical spondylosis as a rare cause of wake-up stroke, especially in cases of cerebral infarction in the posterior circulation with no evidences of causative arrhythmia and intracranial lesions.
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Case Reports
Bow Hunter's Syndrome from a Tortuous V1 Segment Vertebral Artery Treated with Stent Placement.
Bow hunter's syndrome is a dynamic and reversible occlusion of the vertebral artery occurring after rotation or extension of the neck. The V3 segment is the most common site of compression, especially at the atlantoaxial joint. Surgical decompression with or without cervical fusion has been the mainstay of therapy. Endovascular intervention, such as placement of stents, is rarely performed. ⋯ Stent placement is a safe and effective option for V1 segment causes of Bow Hunter's syndrome, especially in absence of bony compression.
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Comparative Study
Surgical Resection of Insular Gliomas and the Role of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Tractography - Single Surgeon Experience.
In gliomas located in proximity to eloquent areas, near total resection and subsequent radiotherapy is often preferred to avoid postoperative neurologic complications. Preoperative functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) tractography provide new insights into surgeries of insular gliomas. In this study we report our experience of surgical management of insular gliomas and the role of fMRI and DTI tractography in planning the resection. ⋯ Surgical resection of insular gliomas remains a challenge to the neurosurgeon and demands good knowledge of anatomic landmarks. Use of fMRI and DTI tractography may help achieve a good outcome.
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Case Reports
Geographically Remote Cerebral Venous Sinus Thrombosis in Patients with Intracranial Tumors.
Cerebral venous sinus thrombosis (CVST) related to intracranial tumors has most commonly been recognized as an operative complication related to local operative factors such as retraction or direct venous injury. CVST may also be caused by tumor-related factors such as local mass effect but rarely occurs geographically remote from the site of the tumor. ⋯ In 3 cases CVST was noted at the time of resection, and 3 cases occurred in a delayed fashion. Each case is discussed in detail, and the utility of intraoperative magnetic resonance imaging in the early diagnosis of this complication is highlighted.
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In previous studies, multitrack trajectories in deep brain stimulation (DBS) have usually been approximated. Using a geometrically more accurate method, we compared the stereotactic accuracy of DBS with multitrack microelectrode recording and awake stimulation (function group) and MRI-guided DBS (MRI group). ⋯ Multitrack DBS using intraoperative functional evaluation resulted in worse stereotactic accuracy than did MRI-guided DBS. However, track shifts in function-guided DBS can approach MRI targets effectively.