World Neurosurg
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Case Reports
Sudden aggravated radicular pain caused by hemorrhagic spinal angiolipomas after a back massage. A case report.
Spinal angiolipomas (SALs) are benign tumors that usually present a slow progressive spinal cord or radicular compression. Acute myelopathy or acute aggravated radicular syndrome are exceedingly rare. ⋯ SALs are unusual benign tumors that are composed of mature fatty tissue and abnormal blood vessels; sudden aggravated spinal cord or radicular compression syndrome is rare. MRI is the best choice in the diagnosis of SALs. Surgery may be performed in different ways depending on the type of SALs, and the prognosis is generally good.
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To assess the effectiveness of a clinical decision support tool consisting of an electronic medical record best practice alert (BPA) on the frequency of lumbar imaging in patients with acute low back pain in the ambulatory care setting, and to explore why providers order imaging outside of clinical guidelines. ⋯ The present study demonstrates the effectiveness of a simple, low-cost clinical decision support tool in reducing imaging rates for patients with acute low back pain. We also identify reasons why providers order imaging outside of clinical guidelines.
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The transradial approach has slowly been gaining momentum in neuroendovascular procedures. We sought to assess its feasibility and safety and present a case series of transradial intraoperative angiography (IOA) during microsurgical clip ligation of intracranial aneurysms. ⋯ Our initial experience shows the transradial approach for IOA in clip ligation of aneurysms to be feasible and safe, with potential advantages over transfemoral IOA.
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We explored the risk factors for the occurrence of delayed facial paralysis (DFP) after microvascular decompression (MVD) for hemifacial spasm (HFS). ⋯ Although DFP frequently occurred after MVD, it can recover spontaneously. The longer the course of HFS, the more frequently DFP will occur after MVD. The earlier that DFP develops, the shorter will be the time to recovery.
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Case Reports
Fulminant reversible cerebral vasoconstriction syndrome after carotid endarterectomy for asymptomatic stenosis.
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare complication after carotid endarterectomy (CEA). Only a limited number of prior cases of RCVS have been reported after CEA for asymptomatic carotid stenosis. ⋯ A high index of suspicion should be maintained in post-CEA patients presenting with headaches or focal neurologic deficits, and vigilance with serial vascular imaging may help minimize long-term complications.