World Neurosurg
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Case Reports
Trigeminal Neuralgia Completely Relieved after Stent Assisted Coiling of a Superior Cerebellar Artery Aneurysm.
Although secondary trigeminal neuralgia is usually due to tumors or multiple sclerosis, other major neurologic diseases, such as aneurysms, should be taken into account when the history or the symptoms suggest a secondary origin. ⋯ The complete relief from the neuralgic paroxysms immediately after endovascular stent-assisted occlusion of a superior cerebellar artery aneurysm demonstrates the crucial role of a pulsating stimulus on the demyelinated nerve fibers in evoking the ectopically generated discharges.
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The apical ligament has long been reported to contain notochord remnants and thus might serve as a site of origin of chordoma formation at the skull base. However, to our knowledge, the histologic study of the apical ligament using histologic staining specific for notochordal tissue has not been previously performed. Therefore the current study was undertaken. ⋯ On the basis of our cadaveric study, the apical ligament does not contain notochord tissue and in adults should not be considered a remnant of this structure. Moreover, it is unlikely that the apical ligament gives rise to chordomas at the craniocervical junction under normal circumstances.
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To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. ⋯ Intraoperative CSF leaks have a propensity to occur in cases with fibrous or large tumors. Once an intraoperative leak is identified, our graded cranial base repair method is safe and reliable.
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Altered mental status (AMS) has been associated with inferior surgical outcomes. The factors leading to AMS after spine surgery are unknown. The aim of this study is to determine the risk factors and independent predictors of 30-day readmission for AMS in patients with spine deformity after undergoing elective spine surgery. ⋯ Our study suggests that increasing age and intensice care unit transfer are independent predictors of 30-day readmission for AMS after spine surgery in patients with spine deformity.
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The present study is focused on correlation of parent vessels and neck diameters with anterior communicating artery (AComA) aneurysmal depth and growth direction. The study principally aims to suggest a new classification of AComA-located aneurysms based on the physical characteristics of parent vessels. ⋯ The dominant A1 bifurcation type is the most common type of AComA-located aneurysm. The present classification provides clinical value in understanding how AComA aneurysms grow and behave. It helps to understand the geometry of multilobulated aneurysms such as ruptured blebs locations during treatment procedures respecting the direction of the dominant A1 axis in group II. Multiple anatomic variations of this complex AComA area can clarify future subtypes of these 2 groups. Thus, further investigation of more patients is needed.