World Neurosurg
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Case Reports
Giant Iliac Artery Pseudoaneurysm Mimicking Postoperative Fluid Collection and Discitis.
In this report, we describe an extremely rare case of a giant pseudoaneurysm of the internal iliac artery causing marked destructive changes at a disk space and mimicking diskitis-osteomyelitis. Only 2 other cases of pseudoaneurysms extending into the disk space have been reported, and those arose from the aorta and were relatively straightforward to diagnose. ⋯ Complex paraspinal fluid collections causing osseous erosions should raise the possibility of an aneurysm/pseudoaneurysm. Computed tomography or conventional angiography should be considered if the question of a vascular mass/collection cannot be answered on conventional cross-sectional imaging, as inadvertent biopsy of a pseudoaneurysm can cause catastrophic bleeding.
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Spinal myoclonus (SM) is a rare hyperkinetic movement disorder that is either idiopathic or secondary to spinal cord lesions. The treatment is either symptomatic only or addresses the underlying etiology. We describe 2 patients with SM with compression myelopathy who were treated with spinal cord stimulation (SCS). ⋯ SCS might offer a more selective medicament-free therapy option for SM. The activation of intraspinal networks and replacement of supraspinal descending influences are mechanisms of SCS in this disorder.
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Carotid endarterectomy (CEA) for high cervical internal carotid artery stenosis is considered to be technically demanding because of the difficulty in dissecting the distal end. We report the surgical technique and outcome analysis of CEA for high cervical lesions. ⋯ The surgical outcomes for high cervical lesions are equivalent to that of non-high cervical lesions. Excessive blood pressure management from the early postoperative days is a risk of PRCI.