World Neurosurg
-
An 82-year-old man with dementia, gait disturbance, and a small cerebral infarction owing to severe bilateral carotid artery stenosis was successfully treated with carotid artery stenting (CAS). Preoperative cerebral vascular reactivity was reduced in the bilateral cerebral hemispheres. We performed CAS to treat right internal carotid artery stenosis. Following CAS, cerebral vascular reactivity showed an increase in the bilateral cerebral hemispheres. Memory, fluency, and attention also showed improvement. ⋯ This case illustrates the potential benefit of single-stage CAS for cognitive function in severe bilateral carotid artery stenosis without hyperperfusion syndrome.
-
Comparative Study
Comparison of conventional microscopic and exoscopic experimental bypass anastomosis - A technical analysis.
Recently, the use of digital exoscopes has been increasingly promoted as an alternative to microscopes. The aim of this study is to compare experimental bypass quality in both visualization methods. ⋯ Both methods produced equally satisfactory results in experimental bypass procedures. The exoscope has the potential for better 3-dimensional visualization and sharing the surgeon's view with others for teaching purposes.
-
Meningiomas are the most common benign intracranial tumor. Although meningiomas are slow growing and potentially highly vascularized, hemorrhage of these tumors is rare. We propose 2 novel modifiable risk factors that may provoke intratumoral hemorrhage of a World Health Organization grade I meningioma. ⋯ Spontaneous hemorrhage of meningiomas is a rare event. Known risk factors are age older than 70 or younger than 30; intraventricular or convexity location; malignant, fibrous, or angioblastic histopathology; and presence of hypertension, anticoagulation therapy, and traumatic brain injury. We propose 2 new risk factors to be considered that may predispose to hemorrhage of a meningioma: serotonin-modulating therapy and high-dose estrogen-replacement.
-
Dermoid cysts are benign, congenital rare lesions, frequently occurring in or near the midline. Rare localizations and variable radiologic findings have been described but remain exceptional. ⋯ Rare localizations previously published in the literature are discussed for dermoid cysts. To our best knowledge, this is the first giant dermoid cyst presenting with this localization.
-
Endovascular embolization is being increasingly used to treat cerebral arteriovenous malformations. Common complications associated with embolization include intracranial hemorrhage and ischemic stroke; intracranial infections seldomly occur and are even less frequently reported. Although abscess formation after embolization is exceedingly rare, it is a serious condition that warrants immediate attention. ⋯ Although rare, formation of an intracranial abscess after endovascular embolization is a potential complication in the treatment of arteriovenous malformations.