World Neurosurg
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Case Reports
Intraoperative visualization of subependymal arteries at the atrium supplying the descending motor pathway.
We previously disclosed that damage to the subependymal arteries (SEAs) caused by coagulation of the choroid plexus at the atrium can result in infarction within the lateral posterior choroidal artery territory, followed by hemiparesis. The present study describes the intraoperative anatomical findings of the SEAs and choroid plexus at the atrium, which were verified only by a few cadaveric studies. ⋯ Manipulations to the inner side of the choroid plexus at the transition from the atrium to the body of lateral ventricle can damage the SEAs. Not only coagulation of the SEAs themselves, but also coagulation of choroid plexus itself may reduce the blood flow in the SEAs, resulting in ischemic complications at descending motor pathway.
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Os odontoideum is an uncommon abnormality of the craniovertebral junction where the tip of the odontoid process lacks continuity with the body of C2. The clinical presentation is variable, but severe neurologic impairment can result. ⋯ To our knowledge, there are no cadaveric reports in the literature regarding an os odontoideum. Such a case allows a rare window into the anatomy and relationships of this pathologic structure.
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Atlantoaxial rotatory subluxation (AARS) is a rare type of traumatic cervical spine injury in adults, commonly manifesting with painful torticollis and suboccipital headache. Early diagnosis is mandatory to avoid catastrophic consequences. We report a rare case of a patient with AARS who presented with nystagmus due to rotational vertebral artery occlusion. ⋯ Careful neurologic examination is of paramount importance in diagnosis and management of cervical spine injuries. Nystagmus, as a well-known manifestation of rotational vertebral artery syndrome, can be the presenting symptom of AARS.
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Case Reports
Recrudescence of symptoms of remote ischemic stroke after a cerebral angiogram: Report of a case.
Ischemic stroke recrudescence, or reappearance of previously resolved symptoms of ischemic stroke, may occur after physiologic stress. Although generally thought to be uncommon, this syndrome may account for a significant proportion of stroke mimics. ⋯ Recrudescence of symptoms of a previous stroke may be initiated by subarachnoid hemorrhage and/or a cerebral angiogram. The possibility of ischemic stroke recrudescence should be kept in mind as a possible stroke mimic.