World Neurosurg
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Case Reports
Suturing treatment for blood blister-like aneurysm in the supraclinoid segment of the internal carotid artery.
Blood blister-like aneurysms (BBAs) are rare but dangerous and challenging to treat. Recurrence and rebleeding are often reported, and many neurosurgeons and interventional radiologists are discouraged by such poor outcomes. Currently, there is no standard method to treat this type of aneurysm. ⋯ We conclude that this suturing technique is an optional safe and reliable method to treat BBAs.
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Novel audiovisual feedback methods were developed to improve image guidance during skull base surgery by providing audiovisual warnings when the drill tip enters a protective perimeter set at a distance around anatomic structures ("distance control") and visualizing bone drilling ("virtual drilling"). ⋯ Distance control reduced the risks of drill damage proportional to the protective perimeter distance. Errors in virtual drilling reflect spatial errors of the image guidance system. These feedback methods are clinically feasible.
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Varicella zoster virus remains dormant in the dorsal root ganglia after childhood exposure to chickenpox. Its reactivation results in herpes zoster, otherwise known as shingles, which is a painful vesicular rash in a dermatomal distribution. We present a case of foraminal disk extrusion that resulted in radicular pain in a dermatomal distribution. The resultant inflammatory response around the dorsal root ganglion triggered an episode of shingles, which elegantly highlights the pathophysiology of this condition at a gross anatomic level.
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Here we report a 72-year-old man who presented with complaint of sudden-onset weakness and impaired sensation in the left lower extremity. Radiographic evaluation revealed a congenital malformation with multiple formation defects including a giant thoracic prevertebral myelomeningocele. Following microsurgical detethering of the spinal cord, the patient recovered ambulation with assist. While thoracic myelomeningoceles are themselves rare, in this case the patient presented at a late age and responded well to conservative management.
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The Simpson grading system has played an important role in surgical resections of meningiomas. The aim of this study was to determine if this grading system predicts meningioma recurrence in a modern cohort of patients with tumors of all World Health Organization grades. ⋯ Identification and consideration of factors associated with recurrence after gross total or subtotal resections may help guide treatment strategies for patients with meningiomas.