World Neurosurg
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Bow hunter's syndrome is due to vertebrobasilar insufficiency caused by rotational compression of the vertebral artery. We report a case in which an osteophyte compressed the left vertebral artery causing cerebellar stroke. The patient underwent successful resection of the osteophyte via anterior surgical approach, and his symptoms of headache and dizziness dissipated postoperatively. This unique syndrome has been treated with multiple modalities and must remain in the clinician's differential as a treatable cause of stroke.
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The ideal treatment method for cranial arachnoid cysts stills controversial, each of endoscopic and microscopic techniques has its pros and cons. ⋯ The fenestration through the lateral pontomesencephalic membrane created a shortcut of cerebrospinal fluid flow to the basal cisterns especially cerebellopontine cistern and represents a reliable option with an acceptable success rate. It creates a good drainage to the large cysts.
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The acute-stage intraoperative findings of the spinal dural laceration in patients with traumatic cerebrospinal fluid (CSF) leakage have not been clearly revealed so far. Herein, we report an interesting case of traumatic CSF leakage in a patient who underwent acute-stage direct closure for a dural laceration similar to a stab at the C1/2 level. Because a 41-year-old man strongly twisted his neck, he had a typical orthostatic headache. ⋯ Direct surgical closure was performed 13 days after the onset of symptoms, and dural laceration with sharp edges was detected on the right side at the C1/2 level. The laceration was sutured and coated with dural sealant. Finally, the patient's orthostatic headache was relieved completely after the operation.
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Due to increasing longevity, the incidence of degenerative lumbar disc diseases has increased, and surgical treatment is often necessary. In this context, the anterior approach becomes an important technique. However, one of the main limitations of this method is the need for dedicated retractors, which requires larger incisions for its positioning and increases the cost of the procedure. The objective of the present study was to describe a technique for retracting abdominal structures by anterior approaches to the lumbar spine using Steinmann wires. ⋯ The technique described is safe, inexpensive, and reproducible. Simple and easily accessible instruments are required in most hospital complexes.