World Neurosurg
-
Review Case Reports
Embolization of Ruptured Distal Lenticulostriate Artery Aneurysms.
To describe the critical role of endovascular treatment and safety for the patients who presented with intraventricular hemorrhage owing to rupture of the distal lenticulostriate artery aneurysms. ⋯ Endovascular therapy is available and safe as a treatment option for distal lateral lenticulostriate artery aneurysms.
-
Review Case Reports
C2-3 Anterior cervical arthrodesis in the treatment of Bow Hunter's Syndrome: Case report and review of the literature.
Bow hunter's syndrome (BHS) or rotational vertebral artery occlusion is a rare syndrome of vertebrobasilar insufficiency due to compression or occlusion of the contralateral vertebral artery with cervical axial rotation. Compression at the C2-C3 level, the junction between the axial and subaxial spine, has not been described. Management can include medical treatment with antiplatelet medications, surgical fusion, or vertebral artery decompression. ⋯ This case report demonstrates that even high cervical etiology for BHS can be successfully managed from an anterior approach. At present, no consensus has been reached for the treatment of BHS. A review of the current data demonstrated that anterior approaches without decompression are slightly safer than posterior approaches, with a smaller risk of vertebral artery injury. Depending on the anatomic variant and the pathophysiology of vertebral compression, an anterior approach without decompression provides a feasible alternative for the treatment of symptomatic BHS.
-
Multicenter Study Comparative Study
Prospective Comparative Study in Spine Surgery Between O-Arm and Airo Systems: Efficacy and Radiation Exposure.
Pedicle screw placement remains challenging. The present study focuses on the comparison between 2 intraoperative-based neuronavigation systems (O-Arm and AIRO) during thoracolumbar screw instrumentation. ⋯ Intraoperative computed tomography-based navigation is a major innovation that improves the accuracy of pedicle screw positioning with acceptable patient radiation exposure and reduced surgical team exposure.
-
Review Case Reports
Early Recognition and Initiation of Temozolomide Chemotherapy for Refractory, Invasive Pituitary Macroprolactinoma with Long-Term Sustained Remission.
Invasive, medically refractory, and multiply recurrent pituitary adenomas pose a rare, but nevertheless significant, challenge for conventional management modalities. Temozolomide (TMZ) has been reported to be useful as an adjunctive treatment for some patients. We describe the efficacy of TMZ when used early in the management of invasive prolactinoma. ⋯ We conclude that TMZ can be efficacious in the management of medically and surgically refractory, invasive atypical prolactinomas, resulting in normalization of the prolactin levels and control of the tumor size. We encourage the inclusion of TMZ in the management of refractory, recurrent, and invasive prolactinomas, as a fourth-line treatment strategy, after dopamine agonist treatment, transsphenoidal resection, and radiation therapy. We especially advocate the early use of TMZ for aggressive and otherwise refractory prolactinomas.
-
Review Case Reports
Radiologic Characteristics and High Risk of Seizures in Infants with Ruptured Intracranial Aneurysms: Case Report and Review of the Literature.
To evaluate the parameters related to the high risk of preoperative seizures in infants (1 year or younger) with ruptured intracranial aneurysms. ⋯ Infant patients with ruptured intracranial aneurysms have a high risk of preoperative seizures. The typical radiologic finding of distal arterial aneurysm with lobe hemorrhage was frequently observed in the MCA, and it might be related to the high risk of preoperative seizures in this population. Microsurgical techniques effectively control postoperative seizures in infants with ruptured intracranial aneurysms.