World Neurosurg
-
To determine whether perfusion computed tomography (CT) is useful for identifying patients with poor-grade subarachnoid hemorrhage (SAH) with reversible etiologies and whether early obliteration in patients with poor-grade aneurysmal SAH leads to favorable outcomes. ⋯ Early bilateral prolonged MTT at the thalami and old age are associated with a poor outcome. Early obliteration benefits a significant portion of SAH patients.
-
Case Reports
Incidence and clinical features of symptomatic cerebral hyperperfusion syndrome after vascular reconstruction.
Vascular reconstructions are the established treatment for ischemic cerebrovascular disease. Cerebral hyperperfusion syndrome (CHS) is occasionally seen after vascular reconstruction and manifest clinical symptoms. The purpose of this study is to investigate the incidence and clinical features of CHS after vascular reconstruction. ⋯ The incidence of CHS is significantly higher in patients with MMD and results in vasogenic edema visible on magnetic resonance imaging.
-
Although neurosurgical procedures are frequently performed in its territory, the zygomaticotemporal nerve (ZTN) is rarely mentioned in this literature, even though this nerve has been implicated in postsurgical pain syndromes and may become entrapped, resulting in chronic headache. The present study was performed to further elucidate the anatomy of the ZTN. ⋯ Based on our study, the ZTN has a fairly standard course that takes it along a superficial pathway overlying the pterion. It is our hope that with a greater appreciation for its anatomy and landmarks for its localization as provided herein, that injury to the ZTN may be avoided with surgical procedures in its territory, and if entrapped, may be more easily identified by the surgeon.
-
Case Reports
Anterior thigh compartment syndrome and local myonecrosis after posterior spine surgery on a Jackson table.
Acute compartment syndrome (ACS) after posterior spinal surgery is very uncommon. Most of the reported cases have ACS in the legs related to positioning in the knee-chest position; postoperative ACS in the thighs is exceedingly rare, with only one reported case (17). ⋯ Our cases indicate the need for a high index of suspicion of ACS in patients who have persistent unresolved pain and local swelling. Tissue pressure monitoring is an option in suspected cases. Iliac crest and thigh pads should not be reversed during positioning on a Jackson table.
-
Case Reports
Hemodynamic analysis of growing intracranial aneurysms arising from a posterior inferior cerebellar artery.
The role of hemodynamics in the growth of intracranial aneurysms is not completely clear. We present a hemodynamic study with two adjacent unruptured aneurysms arising from one parent artery but growing in different ways. This study aimed to investigate whether there were differences in hemodynamic characteristics between the two growing aneurysms. ⋯ Growing aneurysms can have heterogeneous hemodynamic and morphologic characteristics and different growing patterns. Growing regions of an aneurysm could be exposed to either high WSS at the inflow zone or low WSS and high oscillatory shear in the aneurysm sac.