World Neurosurg
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The location of the origin of the posterior inferior cerebellar artery (PICA) is highly variable. An extracranial origin PICA from the vertebral artery (VA) is not rare. But the PICA originated extradurally where the VA ascends between the transverse foramina of C-2 and C-1, a rare anatomic variant. Double-origin PICA is another rare anatomic variant observed in 1%-4% of patients in whom 2 PICA branches converge distally. ⋯ To our knowledge, this is the first report of a cadaveric anatomy case of bilateral PICA that originated extradurally between the vertebrae C-1 and C-2, and simultaneously there existed a right double-origin PICA. Such a case is rare, but understanding of the anatomic variation is important. To avoid complications during surgery at the craniovertebral junction, these potential variations should be correctly identified preoperatively.
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Depression is a prevalent and disabling condition associated with spinal cord injury (SCI). Such associated negative factor warrants the use of valid and reliable psychological assessment tools among this group. One of the available assessment means is the Patient Health Questionnaire-9 (PHQ-9), a short screening measure that evaluates depression status. Our aim is to test the psychometric properties of the Arabic version of the PHQ-9 including validity and reliability among Lebanese individuals with SCI. ⋯ Our findings suggest that the PHQ-9 has good psychometric properties and is a valid and reliable measure of depression among the Lebanese individuals with SCI.
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To evaluate the safety and effectiveness of microsurgical clipping and endovascular embolization for the treatment of middle cerebral artery aneurysm (MCAA). ⋯ Both microsurgical clipping and endovascular embolization were safe and effective methods for the treatment of MCAA, but patients with ruptured MCAAs treated with endovascular embolization were more likely to experience recurrence.
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Vascular injury complications during lumbar discectomy are rare but potentially life-threatening. Therefore, an early diagnosis and effective treatment management is required for these complications. ⋯ Although lumbar discectomy is one of the most commonly performed neurosurgical procedures, the routine rules of discectomy should not be neglected. Early detection and a multidisciplinary approach can help prevent mortality in the event of vascular injury.
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Hemimasticatory spasm (HMS) is a rare masticatory muscle disorder. Drug therapy, microvascular decompression, and botulinum toxin have had varying efficacy and adverse effects. We have reported the cases of 2 patients who had undergone a novel therapy for HMS, based on endoscope-assisted nerve avulsion of the masseter nerve attached to the temporomandibular joint (TMJ) disc. ⋯ Endoscope-assisted avulsion of the masseter nerve attached to the TMJ disc showed a good curative effect, little trauma, few complications, and a quick postoperative recovery. It could be used as an alternative treatment of HMS for selected patients.