World Neurosurg
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Neurovascular compression syndromes have well characterized clinical symptoms, but precise identification of the pathologic contact between the nerves and vessels can be challenging at neuroimaging. Considering that neurovascular contacts are frequent imaging findings in asymptomatic patients, correct visualization of pathological contact is crucial for the diagnosis and surgical planning. We have used magnetic resonance imaging fusion by overlaying color-coded T1-weighted postcontrast onto high-resolution T2-weighted images to better delineate imaging findings by enhancing vascular structures.
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To evaluate the effect of pedicle angle measurement in preoperative axial computed tomography in patients with adolescent idiopathic scoliosis (AIS) on correct thoracic screw placement in free-hand technique on 3-dimensional printing AIS models. ⋯ Measurement of pedicle axial axes of preoperative thoracic vertebrae on computed tomography in patients with AIS offers more reliable screwing in free-hand technique.
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In this study, we sought to characterize contemporary trends in cost and utilization of spinal cord stimulation (SCS). ⋯ Despite a declining contemporary trend in inpatient SCS, an increase was noted in admission costs and hospital charges. A significant declining trend was noted in revision SCS implantations due to device-related complications.
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The operating microscope is a foundational tool in modern neurosurgery. Operating microscopes serve increasingly as the lynchpin for highly sophisticated visualization platforms incorporating many complementary technologies. ⋯ In this article, we document our experience using the QEVO microinspection tool in a series of complex cranial neurosurgery procedures. This report focuses on the handling, visualization, and overall utility of the QEVO tool for achieving optimal visualization in deep cranial corridors.
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Actinomycosis of the central nervous system is extremely rare. A 73-year-old woman with a history of abdominal actinomycosis presented with sudden-onset headache. Magnetic resonance imaging demonstrated a nodular lesion at the left precentral gyrus. ⋯ High-resolution vessel wall imaging revealed circumferential wall enhancement of the aneurysm and multifocal enhancement of the M3 and M4 segments of both middle cerebral arteries. The patient had received a 4-week course of antibiotics, but follow-up angiography demonstrated no shrinkage or resolution of the aneurysm. Trapping combined with revascularization was successfully performed for refractory mycotic aneurysms.