World Neurosurg
-
Case Reports
Rescue Strategy for Troublesome Situations Related to Recipient and Donor Arteries during Low-Flow Bypass Surgery.
Although technically demanding, bypass surgery is a vital part of the neurosurgical armamentarium. The aim of this article was to present representative troublesome cases related to the manipulation of donor arteries (DAs) and recipient arteries during low-flow extracranial-intracranial bypass. ⋯ The intraoperative accidents reported here were frustrating; however, all patients were safely rescued without significant sequelae. It is hoped that our experiences will help young neurosurgeons handle troublesome situations.
-
Parasympathetic network damage results in facial nerve damage, sublingual ganglion degeneration, sublingual gland dysfunction, and dry mouth. In this study, subarachnoid hemorrhage (SAH) was considered to be the cause of dry mouth. ⋯ Clinical findings in infection and diseases such as Sjögren syndrome, aseptic meningitis, and SAH are similar. However, until now, SAH has not been demonstrated experimentally to cause dry mouth. Discovering that SAH might cause dry mouth might prevent unnecessary use of antibiotics and decrease morbidity due to the wrong or late diagnosis.
-
Owing to prolonged hospitalization and the complexity of care required for patients with aneurysmal subarachnoid hemorrhage (aSAH), these patients have a high risk of complications. The risk for wound infection after microsurgical treatment for aSAH was analyzed. ⋯ Microsurgical treatment for aSAH is associated with a relatively low risk of wound infection. However, patients undergoing DC may be at an increased risk for infection. Additional attention and comprehensive wound care are warranted for these patients.
-
To compare clinical and imaging outcomes after cervical disc replacement (CDR) in patients with different Hounsfield units (HU). ⋯ The HU value has a large variation range among the patients with T-score ≥ -2.5. We found significantly increased rates of implant subsidence, loss of ISH, and adjacent segment degeneration in patients with lower HU value undergoing CDR. However, these radiographic complications did not predispose patients with lower HU value to worse clinical outcomes. Routine application of HU combined with dual-energy X-ray absorptiometry measurement to evaluate bone quality may help to screen the optimal candidates for CDR and reduce the implant-related complications.
-
We report a middle-aged man with a history of traumatic cervical spinal cord injury with extensive edema. Decompressive surgery of posterior laminectomy and fixation was performed. An irreparable dural rupture on dorsal-lateral side of the cord was found during operation. ⋯ Half a year later, however, the patient presented with C5 nerve palsy. Magnetic resonance imaging revealed cervical spinal cord herniation with pseudomeningocele. Late postoperative cervical spinal cord herniation with pseudomeningocele may occur in any cervical spine trauma cases with dural rupture and/or defect, and close follow-up and observation are needed in the postoperative period.