World Neurosurg
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Case Reports
Intracranial Venous Reflux Caused by Occlusion of the Brachiocephalic Vein Mimicking Dural Arteriovenous Fistula.
High signal intensity of cerebral venous sinuses on magnetic resonance angiography (MRA) indicates high flow of shunt from arterial blood, suggesting dural arteriovenous fistula (dAVF). Herein, we describe the cases of 2 patients with intracranial venous reflux caused by brachiocephalic vein occlusion (BVO) mimicking dAVF on MRA. ⋯ Central venous occlusion may occur in patients with end-stage renal disease who are receiving AVG for hemodialysis. Intracranial venous reflux resulting from BVO can induce various neurologic disorders including intracranial venous hypertension or hemorrhage. Prompt recognition and implementation of endovascular treatment can be beneficial in cases of symptomatic central venous occlusion.
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Case Reports
Muslin granuloma mimicking parenchymal hematoma in a patient with seizures 30 years after aneurysm wrapping.
Muslin foreign body granulomas are a known complication of muslin aneurysm wrapping and have been associated with vision loss from optochiasmatic arachnoiditis. Muslin granulomas have also been confused with abscesses due to surrounding inflammatory changes. In this clinical image, we present a unique case of a muslin granuloma mimicking an intraparenchymal hematoma.
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The connection between the ventrolateral frontal and temporoparietal cortices has an important role in language function on the language-dominant side and spatial awareness on the nondominant side. However, the laterality of these pathways remains controversial. We investigated the laterality of this connection using corticocortical-evoked potentials (CCEPs). ⋯ The CCEP amplitudes were significantly larger in the dominant hemisphere. These findings can lead to better hypotheses regarding the relationship between language functions and the development of the network connecting the frontal and temporoparietal cortices.
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This study is aimed to comprehensively assess the prevalence and distribution of thoracic disc herniation (TDH) or thoracic hypertrophied ligamentum flavum causing stenosis (HLFS) by magnetic resonance image (MRI) in patients with back or leg pain. ⋯ The prevalence of TDH had a significant association with the presence of lumbar surgical lesions and no association with age. The prevalence of thoracic HLFS had a strong association with age and no association with lumbar surgical lesions.
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Hypotension, a risk factor for increased mortality following traumatic brain injury (TBI), is traditionally defined as systolic blood pressure (SBP) <90 mm Hg. We aimed to redefine hypotension and determine its optimal threshold in patients with TBI. ⋯ The threshold for hypotension in patients with severe TBI should be redefined and modified by age, and patients ≤60 years old should be considered hypotensive at SBP <100 mm Hg, whereas in older patients, SBP <120 mm Hg should be diagnosed as hypotension.