World Neurosurg
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Even in the era of advanced medical treatment, brain abscess still has a high mortality rate. At our institution, brain abscess has been treated mainly using stereotactic or echo-guided aspiration followed by relatively long-term antibiotic treatment, achieving favorable outcomes. To evaluate the efficacy of our strategy involving less-invasive aspiration surgery and long-term selective antibiotic administration for brain abscess, a single-institution series of cases was investigated. ⋯ Most patients underwent aspiration surgery and achieved favorable outcomes. Along with antibiotic treatment for a sufficiently long period to cover anaerobes, this approach can be expected to yield good results.
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The purpose of this preliminary cadaveric study was to quantify the dimensional changes of the neuroforamen and area available for the cord (AAC) after implantation of various interbody devices with and without posterior longitudinal ligament (PLL) removal. ⋯ Similar to the lumbar spine, segmental distraction via placement of an interbody device produces indirect decompression of the cervical neuroforamen. Results indicate that a 34% increase in neuroforaminal area and a 51% increase in AAC are achievable with appropriately sized interbody devices and adequate distraction at the posterior aspect of the vertebral body.
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Spinal cystic echinococcosis (CE) is a rare but devastating form of a neglected parasitic disease caused by the larval stage of the cestode Echinococcus granulosus. CE or hydatid disease most commonly affects the liver and lungs. Spinal CE occurs in less than 1% of all cases. ⋯ She was treated with surgical removal of the cystic lesions by laminectomy and instrumentation. Long-term oral albendazole was recommended postoperatively. Her status was medically stable at 5-year follow-up, but lower limbs paralysis, urinary retention, and bowel dysfunction persisted.
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Left ventricular assist devices (LVADs) are an epoch-making treatment option for patients with severe heart failure; however, the patients occasionally experience severe acute ischemic strokes (AISs). Although mechanical thrombectomy is considered as an effective treatment for severe AIS in patients with LVADs, there remains a paucity of data on the long-term outcomes. This study aimed to investigate the acute-phase efficacy and long-term outcomes of mechanical thrombectomy for AIS patients with LVADs. ⋯ This study revealed the long-term benefit of mechanical thrombectomy for AIS in patients with LVADs, eventually achieving 50% of independence from LVADs.
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Middle meningeal artery embolization (MMAE) is a novel approach for treatment of chronic subdural hematoma (cSDH). Studies comparing different procedural techniques for MMAE are lacking. It is unclear whether isolated use of coils results in suboptimal outcomes compared to when particle embolization is also performed. The objectives of this study are to describe the outcomes of coil-only MMAE and compare them with those of combined use of coils and particles. ⋯ Isolated use of coils for endovascular treatment of cSDHs can be as effective as adjunct use of particle embolization. This method eliminates the risks of cranial nerve and visual complications associated with MMAE, can prevent procedural abortion due to presence of dangerous anastomoses, and reduces the technical complexity of the procedure.