World Neurosurg
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Giant aneurysms are very high-risk lesions both in terms of natural history and treatment. Bypass with distal occlusion is thought to be a safe treatment option for these aneurysms. Here, we report 2 cases of aneurysm rupture after bypass and distal occlusion, review the literature, and discuss the possible underlying mechanisms, in the hopes of influencing treatment planning and averting such complications in the future. ⋯ Aneurysm rupture can occur after bypass and distal occlusion, despite initial appearances of intraoperative stability. We suggest that the mechanisms are not a simple pressure within the dome and may be due to rapid thrombosis with subsequent aneurysm wall destabilization or stretching and capacitance causing persistent filling. When possible, it seems that complete trapping or proximal occlusion may be preferable to distal occlusion for these giant aneurysms. The optimal management of these highly morbid lesions remains to be determined.
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Case Reports
Long-standing isolated autoimmune hypothalamitis diagnosed with endoscopic transventricular biopsy: a case report.
Autoimmune hypothalamitis, which is among the causes of acquired central diabetes insipidus, has seldom been described in the literature. This condition is probably provoked by the production of anti-vasopressin-secreting cell antibodies and antihypothalamus antibodies and is often associated with pituitary or polyendocrine autoimmunity. Correct diagnosis and immediate treatment are essential to avoid the progression of the pathologic process. ⋯ The endoscopic transventricular approach has proved to be an effective and safe way to obtain tissue samples for histopathologic examination from a region that is usually difficult to reach; it also gives direct visualization of the lesion, which makes sampling easier. The lesion size decreased after treatment but no clinical improvement was detected, either on the cognitive or on the endocrinologic side.
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Neuronavigation has become a common means of placing pedicle screws in vertebral arthrodesis, because it reduces the incidence of complications related to poor screw positioning. ⋯ When coupled with fpCT, the ROSA Spine robot is a reliable, accurate means of performing lumbar pedicle screwing.
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Case Reports
Image-Guidance to Aid Pedicle Screw Fixation of a Lumbar Fracture-Dislocation Injury in a Toddler.
Pedicle screw fixation of the lumbar spine in children age <2 years is particularly challenging, as successful cannulation of the small pedicle dimensions requires a high level of precision and there are no implants specifically designed for the infant spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for the placement of spinal screws in areas where the bony anatomy is small and/or anatomically complex, as in the upper cervical area. ⋯ Image-guided placement of pedicle screws may be a useful aid in achieving accurate and safe fixation in the small dimensions of the infant spine.
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The importance of videos in social media communications in the context of health care and neurosurgery is becoming increasingly recognized. However, there has not yet been a systematic analysis of these neurosurgery-related communications. Accordingly, this study was aimed at characterizing the online video content pertaining to neurosurgery. ⋯ The findings from this study highlight the increasing use of video communications related to neurosurgery and show that institutions, neurosurgeons, and patients are using YouTube as an educational and promotional platform. As online communications continue to evolve, it will be important to harness this tool to advance patient-oriented communication and knowledge dissemination in neurosurgery.