World Neurosurg
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Various modifications have been tested to prevent kyphosis after Bryan cervical disc arthroplasty (CDA). However, the migration of Bryan prostheses has not been systematically studied. This study investigated the cause of anterior migration (AM) and assessed the effect of AM on clinical and radiographic outcomes. ⋯ The intermediate clinical outcomes for patients treated with modified Bryan CDA were satisfactory; however, overcorrection of segmental lordosis may lead to AM of the prosthesis, which could restrict patient range of motion and cause postoperative neck pain.
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Surgery for meningioma is associated with significant blood loss. Preoperative embolization has been associated with reduction of blood loss and has been noted to decrease intensity on T1 + contrast sequences. We investigate potential relationships between blood loss and the extent of T1 + contrast intensity. ⋯ Along with gender and tumor volume, extent of T1+C intensity is also an independent predictor of EBL. This finding may be helpful for surgical management of meningioma.
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Subependymomas are rare, slow-growing, benign tumors. Because they are scarce, knowledge relating to survival remains lacking. Consequently, we explore the SEER database to evaluate prognostic and treatment factors associated with intracranial subependymoma. ⋯ Clinical factors such as younger age, female sex, and location within ventricles or near brain stem demonstrated positive relationship with overall survival. For treatment options, surgery remains a mainstay option. No support for radiation therapy was identified.
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Penetrating neck injury occurs in 5%-10% of all trauma cases and carries a significant burden of morbidity and mortality (15%). We describe the evaluation and management of a 25-year-old man shot in the neck with occlusion of the left vertebral artery from its origin to C6. This is a case report in which medical data were analyzed retrospectively with institutional review board approval. ⋯ The patient presented with silent cerebellar infarction due to a vertebral artery injury and impending vertebrobasilar insufficiency. This case demonstrates clinical evaluation of the posterior circulation and treatment with a bypass technique through mobilization of the vertebral artery from the boney vertebral foramen with anastomosis to the common carotid.
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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.