World Neurosurg
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Case Reports
Hybrid surgical rescue of failed stent retrieval with acute middle cerebral artery occlusion.
Failure of stent retrieval and periprocedural embolization of plaque are rare complications of carotid artery stenting, which need emergency surgical treatment. In Video 1, we demonstrate failed stent retrieval with acute middle cerebral artery occlusion that was treated with carotid endarterectomy and stent-assisted thrombectomy in a hybrid operating room. A 65-year-old man underwent carotid artery stenting for symptomatic left internal carotid artery stenosis with severe calcification. ⋯ After carotid endarterectomy, the stent-assisted thrombectomy was performed. Postoperative digital subtraction angiography confirmed the recanalization of the middle cerebral artery. The patient's neurologic function dramatically improved after hybrid treatment.
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Case Reports
Facial nerve schwannoma complicated by acute hemorrhage post treatment with stereotactic radiosurgery.
Facial nerve schwannomas (FNSs) are rare benign tumors that arise from Schwann cells of the facial nerve. FNSs are similar to vestibular schwannomas in many aspects, yet their infiltrative nature into the facial nerve fascicles warrants a more conservative management approach. In the last decade, stereotactic radiosurgery (SRS) has shown promise in stabilizing or shrinking FNSs. ⋯ SRS has led to better facial nerve function and outcomes and is currently considered a reasonable alternative to microsurgical resection in patients with FNSs. This is the first report to our knowledge of an acute, life-threatening hemorrhage after SRS in a patient with FNS.
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This study aimed to compare morphologic changes of deep paraspinal muscles at C4-7 in patients with C5-6 single-level cervical spondylotic myelopathy (CSM), and to evaluate the relationship between morphologic changes and the level of spinal cord compression. ⋯ In patients with C5-6 single-level CSM, fat infiltration and atrophy of deep paraspinal muscles, especially the Lcap, LC, and MF, mainly occurred in the level of spinal cord compression and caudal adjacent level. In the cranial adjacent segment, the degree of MF and SSC fat infiltration in patients with CSM was also aggravated. This may suggest that multiple mechanisms are involved in paraspinal muscles degeneration in CSM.
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To investigate the swallowing improvement in patients who underwent a transcervical prevascular retrovisceral approach for symptomatic cervical diffuse idiopathic skeletal hyperostosis (DISH), by means of the 10-item Eating Assessment Tool (EAT-10) questionnaire. ⋯ Surgical management seems to be effective in resolving swallowing disorders related to this disease in a consistent percentage of patients. This evidence is supported by the statistically significant improvement in EAT-10 scores after treatment. Moreover, it might be postulated that early intervention can guarantee a higher success rate because patients with severe and very severe dysphagia had significantly smaller improvement.
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Comparative Study
Quantitative Anatomical Comparison of Anterior, Antero-Lateral and Lateral, Microsurgical and Endoscopic Approaches to the Middle Cranial Fossa.
To quantitatively compare different microsurgical and endoscopic approaches to the middle cranial fossa in a preclinical setting with a novel, computer-based research method. ⋯ This study implemented a novel neuronavigation-based research method to quantitatively compare different approaches to the middle cranial fossa; its results might guide, after consideration of clinical implications, the choice of the neurosurgical approach to different areas of this complex skull base region.