World Neurosurg
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A few reported studies have documented psychotic syndromes secondary to a middle fossa arachnoid cyst (AC). However, the association between middle fossa ACs and psychopathological symptoms remains to be determined. The present study investigated the psychopathological effects of middle fossa ACs in young men. ⋯ The presence of ACs and cyst size were associated with psychopathology in this select group of young men. The size-dependent psychopathological effects of ACs appear to result from a local mass effect on the brain.
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Few studies have evaluated surgical options in the treatment of cervical metastatic disease. The aim of this study is to report the surgical outcomes of patients treated with the posterior-only approach for metastatic cervical disease. ⋯ In our series, posterior-only fixation provided postoperative pain relief and achieve spinal stability, ultimately improving the quality of life. In conclusion, posterior-approach decompression and stabilization is a safe and feasible procedure in patients with neurologic or mechanical instability for cervical spine metastasis.
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Cerebral aneurysm growth often precedes rupture. Definite contributors to aneurysm growth have not been determined even by means of recently developed commercially available computational fluid dynamics (CFD) software. We developed an original CFD tool that can analyze data from time-of-flight magnetic resonance angiography (TOF-MRA) before growth in the growing aneurysms and investigate possible factors for aneurysm growth in the near future. ⋯ A focal increase in WSS in the peak systolic phase may be a risk factor for aneurysm enlargement in the near future.
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Lumbar spondylolisthesis can be related to facet arthropathy and disc degeneration or to a fracture of the pars interarticularis, but the mechanistic underpinnings of spondylolisthesis remain unclear. We posit that high sacral slope and body weight increase sacral inclination vector forces, which leads to pars fractures and exacerbates risk for spondylolisthesis. ⋯ These data suggest that high sacral endplate inclination vector force is a risk factor for developing pars fracture-mediated spondylolisthesis.
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Internal carotid artery (ICA) injury is 1 of the most feared complications in endoscopic pituitary surgery. Different endovascular techniques are available for the management of early and delayed ICA injuries. ⋯ Despite the presence of acute hemorrhage and the need for antiplatelet therapy, a flow diverter stent can be used as emergency treatment of ICA injury in selected circumstances.