World Neurosurg
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Bilateral or huge disc herniations cause bilateral radiculopathy and severe lower back pain. In such cases, a bilateral discectomy may be required to resolve the radicular pain in both legs. We attempted a surgical technique involving bilateral lumbar discectomy via a unilateral approach using a percutaneous biportal endoscopic technique. The purpose of the present study was to describe our surgical technique and investigate the clinical outcomes in symptomatic bilateral lumbar disc herniation. ⋯ Endoscopic unilateral laminotomy with bilateral discectomy using the percutaneous biportal endoscopic approach could be an effective and alternative treatment of symptomatic bilateral herniated disc disease affecting L4-L5 or L5-S1 segments.
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Cerebellar ectopy is a rare finding, with few cases previously reported. Intraventricular localized cerebellar ectopy was described in only 1 case within the fourth ventricle. ⋯ We describe, for the first time to our knowledge, the case of a child with ectopic cerebellar tissue harboring the supratentorial ventricular system. Plausible etiologic mechanism consists in the herniation of the cerebellar germinal tissue into the ventricular system through the ependyma, allowing cell migration to the supratentorial compartment, followed by maturation into the normal cerebellum.
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Case Reports
Foot Drop after Ilio-Caval Vein Stenting: Radicular syndrome from stent misplacement in the spinal canal.
Endovascular procedures have become more and more prevalent in both general vascular and neurosurgical practices. Because these procedures rely on real-time bidimensional control through fluoroscopic guidance, they can be prone to spatial misplacement in the third dimension when not controlled in 2 different radiologic planes. ⋯ The complex venous anatomy of the lumbar region and lumbar epidural space is illustrated in this unique case. We believe this may serve both vascular surgeons and neurosurgeons in their daily practice.
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We present the case of a 64-year-old male with a 5-day history of headaches. Magnetic resonance angiography revealed a 15 mm × 15 mm diameter aneurysm in the left middle cerebral artery arising in the region of the first branch of the middle cerebral artery-second branch of the middle cerebral artery (M2) bifurcation. Angiography revealed the lesion arose from the M2 vessel that contained a large amount of thrombus. ⋯ Both microvascular ultrasound and intraoperative angiography were used to confirm patency and flow distal to the aneurysm. In Video 1, we narrate the case and essential details of this approach. Neither Institutional Review Board nor patient consent was required to report this case with no identifiable patient information.