World Neurosurg
-
Review Meta Analysis
Congenital Cervical Fusion as a Risk Factor for Development of Degenerative Cervical Myelopathy.
Congenital fusion of cervical vertebrae, including Klippel-Feil syndrome (KFS), is a suspected risk factor for development of degenerative cervical myelopathy (DCM). We aimed to establish prevalence and degenerative patterns of congenital cervical fusion (CCF) among a global cohort of patients with DCM. ⋯ The prevalence of CCF and KFS is higher in DCM than for the general population, suggesting that these patients are predisposed to DCM development. Patients with CCF also have an altered pattern of degenerative changes, seemingly related to adjacent segment degeneration that preferentially affects midcervical levels.
-
Review Meta Analysis
Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? A review of the current evidence.
We aimed to critically analyze the current evidence regarding the role of dynamic supine magnetic resonance imaging (dsMRI) in the evaluation of cervical spondylotic myelopathy. ⋯ dsMRI represents an available modification of conventional static magnetic resonance imaging and is potentially able to demonstrate pathologies that might be previously missed. Evidence suggests that dsMRI can elucidate spinal cord compression with higher sensitivity, resulting in improved diagnostic accuracy of cervical spondylotic myelopathy, which may impact surgical planning for these patients. However, more high-quality studies are required to further establish its indications to avoid overdiagnosis with this powerful imaging technique and to justify its cost-effectiveness.
-
Review Case Reports
Transient acute hydrocephalus after spontaneous intracranial bleeding in adults.
Acute hydrocephalus (AH) is commonly encountered after spontaneous or traumatic intracranial bleeding in adults. In the setting of AH, external ventricular drainage is usually proposed as the urgent management. But in rare occasions, AH could be transient and resolve spontaneously without invasive management. Although its actual incidence might be higher, only a few case reports on transient AH (TAH) after spontaneous intracranial bleeding in adults have been reported. ⋯ The osmotic and hydrostatic state in the microvessels, lymphatic pathways for the drainage of the interstitial fluid and cerebrospinal fluid, and aquaporins on the astrocytes of the patients might have important roles in the genesis and resolution of TAH. The difficulty at present is to differentiate the patients who would experience TAH from those needing surgical interventions. If surgical intervention could not be carried out temporarily, vigilant monitoring and osmotic diuretics are proposed.
-
Review Case Reports
Traumatic anterior cerebral artery pseudoaneurysmal epistaxis.
Pseudoaneurysmal epistaxis is a rare but emergent condition. We report a case of traumatic anterior cerebral artery pseudoaneurysmal epistaxis and review the published literature. ⋯ Pseudoaneurysmal epistaxis is rare, and this is the first report of an anterior cerebral artery pseudoaneurysm that manifested with epistaxis. Endovascular intervention has become the first choice of treatment for this disease. The high recurrence rate is the main disadvantage of endovascular intervention. Aneurysm trapping with bypass surgery is another treatment option.
-
Review Case Reports
A case of evolving bilateral sphenoidal meningoencephalocoeles: case report and review of literature.
The evolution of sphenoid sinus meningoencephaloceles and cerebrospinal fluid (CSF) rhinorrhea is poorly understood. ⋯ We suggest that over a period of time, chronic elevation of intracranial pressure can result in gradual erosion of the lateral wall of the sphenoid with development of meningoencephaloceles and CSF leaks.