World Neurosurg
-
A vertebral artery arteriovenous fistula is rare and usually due to trauma. Atraumatic cases are quite rare. We reported 2 cases and a review of other reported studies. ⋯ Vascular changes are known in patients with neurofibromatosis. A proposed pathogenesis of fistula is that the fragility and defective nature of the arterial wall could be a predisposing factor or it might be congenital. Understanding the clinical symptoms, diagnosis, and effective management strategies are important for physicians treating patients with a vertebral artery arteriovenous fistula.
-
This study is aimed to comprehensively assess the prevalence and distribution of thoracic disc herniation (TDH) or thoracic hypertrophied ligamentum flavum causing stenosis (HLFS) by magnetic resonance image (MRI) in patients with back or leg pain. ⋯ The prevalence of TDH had a significant association with the presence of lumbar surgical lesions and no association with age. The prevalence of thoracic HLFS had a strong association with age and no association with lumbar surgical lesions.
-
Combined revascularization is the preferred surgical management of adult Moyamoya disease. However, postoperative flap necrosis of the scalp is not an uncommon complication. We investigated the role of scalp incision design on the basis of the course of the superficial temporal artery (STA) to prevent postoperative scalp necrosis. The utility of tissue expander in wide scalp defect repair is explored. ⋯ Miserable scalp flap design results in a large scalp defect during combined bypass surgery. However, tissue expanders aided the reconstruction of a large scalp defect. Reconstruction using tissue expanders and advancement of local rotation flap is recommended in case of large scalp necrosis. The procedure yields cosmetically superior outcomes due to scalp hair conservation and concealment of postoperative scar behind the hair line.
-
In the neurosurgery residency, inherent personality traits can play a significant role in the adaptability and success of the resident physician. ⋯ Personality typing can be used to gain valuable insight into the composition of neurosurgery residency cohorts and resolve conflicts arising from personality differences within these groups as well as within the larger hospital setting.