World Neurosurg
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Retracted Publication
The optimality principle decreases hemodynamic stresses for aneurysm initiation at anterior cerebral artery bifurcations.
To investigate hemodynamic stresses on anterior cerebral artery bifurcation apex and possible mechanism of the optimality principle in protecting bifurcation wall from supercharged hemodynamic stresses. ⋯ Normal anterior cerebral artery bifurcations obey the optimality principle whereas bifurcations with Acom aneurysms do not. Disobeying the optimality principle presents significantly enhanced hemodynamic stresses to possibly damage the bifurcation wall for aneurysm initiation.
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The presence of hemiparesis on arrival in patients with subarachnoid hemorrhage (SAH) is presumed to affect prognosis; intracranial hematomas with mass effect responsible for hemiparesis are frequently observed in these patients. The aim of this study was to clarify characteristics and outcomes of patients who presented with hemiparesis on arrival with no responsible hematomas (hemiparesis without hematoma) having mass effect demonstrated on computed tomography. ⋯ Hemiparesis can be expected to improve in patients with SAH with hemiparesis without hematoma, and such patients appear to have a better prognosis than patients with SAH with hemiparesis and responsible hematomas. A possible major mechanism of hemiparesis without hematoma based on the characteristics identified is a combination of transient ipsilateral hemispheric functional failure caused by the impact of aneurysmal rupture and transient ischemia of the perforators originating from the internal carotid artery.
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Although posterior lumbar interbody fusion (PLIF) has provided satisfactory clinical outcomes, adjacent segment disease (ASD) is one of the most important complications affecting long-term results. However, according to ASD studies, few have described repeat surgery. The purpose of this study was to elucidate incidence, time period, and clinical features of multiple-repeated ASD after PLIF. ⋯ Multiple-repeated ASD was observed in 0.4% of the patients. All patients developed iatrogenic flatback as a result of repeated ASD, and corrective surgeries were required for these patients.
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Case Reports
Pallidothalamic tractotomy for Parkinson's disease with 1-year follow-up: a case report.
The pallidothalamic tract connects the globus pallidus internus and the ventrolateral portion of the thalamus, and ablation of the pallidothalamic tract (pallidothalamic tractotomy [PTT]) reportedly exerts antiparkinsonian effects. However, the detailed clinical course has not yet been elucidated. Here, we present the first single case report of PTT performed in a patient with Parkinson disease, with 1-year follow-up. ⋯ We present a rare case of PTT performed in a patient with Parkinson disease. PTT might be useful in patients who do not desire device implantation.
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Among several novel predictors on noncontrast computed tomography (CT) for hematoma expansion in spontaneous intracerebral hemorrhage (sICH), shape irregularity grade, satellite sign, and island sign are all related to irregular shape of hematoma. This study is aimed to compare the accuracy of these imaging markers for predicting hematoma expansion in the same cohort of sICH patients. ⋯ Island sign seems to be the optimal shape-related predictor for hematoma expansion in sICH patients and could be included in the future predictive model for hematoma expansion.