World Neurosurg
-
Severe kyphosis is infrequently seen in neonates with myelomeningoceles. Spinal skeletal dysmorphology complicates repair, as local tissue may be insufficient to cover the dural repair. Although neonatal kyphectomy has been proposed as a potential solution to this problem, it carries significant potential risks that may not be acceptable to families. ⋯ Acellular dermal matrix is a potentially useful adjunct for definitive reconstruction of complex neonatal soft tissue defects where local tissue is not available.
-
Neurogenic stunned myocardium (NSM) is a devastating complication of subarachnoid hemorrhage (SAH). The most widely accepted mechanism in the pathogenesis of NSM and takotsubo cardiomyopathy is catecholamine-mediated direct myocardial injury. The aim of this study is to examine if there is any effect of sympathetic overactivity of the stellate ganglions on myocardial tissues, secondary to vagal complex degeneration in SAH-induced NSM. ⋯ NSM and takotsubo cardiomyopathy may be induced by vagal complex degeneration and sympathetic overactivity, which originated from more neurons, including stellate ganglia and more degenerated neuron densities of nodose ganglia.
-
The underlying mechanisms of headache in adult moyamoya disease (MMD) are not clear. The aim of this study is to clarify the factors that are associated with headache in adult patients with MMD after superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis. ⋯ The results of our analyses revealed that aside from ischemia, the postoperative increase rate of the STA may be a candidate reason for headache, especially in adult patients with MMD.
-
Case Reports
Spontaneous spinal epidural hematoma with lumbar facet joint destruction mimicking pigmented villonodular synovitis.
Spontaneous spinal epidural hematoma (SSEH) is a spinal emergency that requires early diagnosis and decompression surgery. Here, we report a case of SSEH that was difficult to differentiate from pigmented villonodular synovitis (PVS) because of combined facet joint destruction and that required gross total resection, a procedure not typically indicated for SSEH. ⋯ SSEH could be combined with facet joint destruction composed of bone necrosis. Awareness of SSEH with facet joint destruction can facilitate early diagnosis and appropriate surgical treatment.
-
Case Reports
Three-level lumbar en bloc spondylectomy with 3D-printed vertebrae reconstruction for recurrent giant cell tumor.
Primary malignancies involving the mobile spine often require total en bloc spondylectomy with complex mechanical reconstruction, which can be augmented with novel application of the 3-dimensional (3D)-printing technique. ⋯ To our knowledge, this is the first reported case of multilevel lumbar TES for GCT reconstructed using a 3D-printed vertebrae. Although TES-specifically in the lumbosacral spine-remains challenging due to its unique anatomy and increased risk of neurologic insult, it is an effective option for curative management of GCTs.