World Neurosurg
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Case Reports
Treatment of symptomatic dolichoectatic vertebrobasilar aneurysms: a single-centre experience in 12 patients.
To report our single-center experience in the treatment of dolichoectatic vertebrobasilar aneurysms. ⋯ If the condition of the patients is stable and benign, they can be treated with medication or stent reconstruction. Given the serious complications that can be caused by open surgery, care must be taken when selecting the patients to be treated using open surgery, but more studies are needed to support this conclusion. The key points are to avoid aneurysm thrombosis and maintain patency of the perforators.
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Applicability of Carotid Artery Stenting for Patients 80 Years or Older: A Single-Center Experience.
A meta-analysis found that for internal carotid artery stenosis procedures in elderly patients, the risk of perioperative stroke is significantly greater for carotid artery stenting (CAS) than for carotid endarterectomy. We retrospectively examined characteristics and perioperative results of CAS for patients 80 years and older at a single medical center. ⋯ The plaque of carotid stenosis in octogenarians is often vulnerable, but using a dual protection and blood aspiration method, we safely performed CAS in octogenarian patients.
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Cervical spinal cord stimulation is a safe and effective treatment for chronic axial neck pain and upper limb neuropathic pain. We report our novel institutional experience with performing cervical spinal cord stimulation trials with patients placed in an upright sitting position. This allows easy access to the cervical epidural space and has the added benefit of unobstructed access to the airway. ⋯ Cervical spinal cord stimulation trials performed in an upright, sitting position allow for easy epidural access and an unobstructed airway with reasonable setup time.
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Case Reports
Stent-Assisted Coil Embolization for Ruptured Intracranial Dissecting Aneurysms Involving Essential Vessels.
The optimal treatment strategy for ruptured intracranial dissecting aneurysms involving essential vessels remains controversial. The aim of this study was to review the safety and efficacy of endovascular treatment at our center. ⋯ Careful follow-up is necessary after endovascular coiling for ruptured dissecting aneurysm involving essential vessels. Although additional treatment might be required, stent-assisted coiling could be a less invasive and feasible method for handling these difficult lesions.
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Sellar arachnoid cysts are a rare occurrence but may impinge on vital parasellar anatomy and thus are often symptomatic. The etiology of sellar arachnoid cysts is contentious, fueled by heterogeneity in cyst wall structure and contents between cases. The "ball-valve" mechanism is 1 of 2 predominant theories describing their formation, which contends that an aperture in the diaphragm allows cerebrospinal fluid to enter the cyst, propelled by pulsatile flow, but its egress is obscured by the pituitary during the ebb of the pressure wave. ⋯ Intraoperative video evidence during arachnoid cyst fenestration supports the "ball-valve" theory of sellar arachnoid cyst development.