World Neurosurg
-
Case Reports
Ruptured blister-like aneurysm arising from the proximal posterior cerebral artery: a case report.
Blister-like aneurysms (BLAs) arise mostly at the supraclinoid internal carotid artery. We report a rare case of ruptured BLA arising at the P1 segment of the posterior cerebral artery (PCA). ⋯ Proximal PCA is a rare but possible location for BLA. When the cause of bleeding SAH cannot be identified, repeated radiologic assessments including posterior circulation should be performed. If perforators of the unaffected site supply the thalamus and midbrain bilaterally and an ipsilateral posterior communicating artery exists, PAO of P1 seems feasible as a treatment. Elective intervention is not recommended because of the characteristics of ruptured BLAs.
-
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.
-
The anatomy of the veins in the pineal region is one of the most complex areas in the brain because all major deep cerebral veins converge there: the internal cerebral veins (ICVs), the great cerebral vein of Galen (GV), the basal veins (BVs), and the internal occipital veins (IOVs). The aim of this study was to comprehensively describe the anatomy of the veins in the pineal region using computed tomography angiography. ⋯ Because an injury to major deep cerebral veins may result in severe postoperative neurologic deficits, it is essential for neurosurgeons to be familiar with both normal and variant patterns of veins in the pineal region.
-
Giant pituitary adenomas are considered a surgical challenge. Their invasiveness, irregular growth, and extensions make this surgery critical. Because of this reason, the radical resection rate is low in such pathology. ⋯ He had no hypopituitarism and diabetes insipidus after the surgery. Cerebrospinal fluid leak was not observed. Unfortunately, oculomotor palsy did not improve after surgery (Video 1).
-
Case Reports
Two-Level Separation Surgery for Thoracic Epidural Metastatic Disease: An Operative Video Demonstration.
The spinal column is one of the most common regions of cancer metastasis. Spinal metastases typically occur in the vertebral body, and due to direct posterior extension or retropulsed pathological fractures, they often present with signs and symptoms of epidural spinal cord compression. This scenario requires surgical management to relieve compression and stabilize the spine. ⋯ In this video, we present the case of a 61-year-old woman with metastatic hepatocellular carcinoma found to have severe spinal cord compression due to pathological vertebral body fractures at T10-T12, and ventral epidural disease at T10 and T12. The patient received T8-L2 posterior instrumented fusion and T10 and T12 separation surgery, with intraoperative cement embolization. We demonstrate the operative steps required to complete this procedure (Video 1).