No shinkei geka. Neurological surgery
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Microvascular decompression(MVD)surgery has been established as a standard treatment for hemifacial spasm. However, because decompression surgery results in unfavorable outcomes in some cases, a more critical monitoring strategy is required. To improve surgical outcome for hemifacial spasms, abnormal muscle response(AMR)has been proposed as a tool for intraoperative electrophysiological monitoring during MVD surgery. Here, we report a single case of surgical MVD monitoring using artery wall stimulating electromyography(AWS-EMG). AWS-EMG was developed as a new monitoring method in addition to AMR. ⋯ In addition to AMR, AWS-EMG might be a promising candidate for intraoperative monitoring for patients with hemifacial spasm.
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Case Reports
[Ruptured Aneurysm of Bihemispheric Anterior Cerebral Artery A1-A2 junction:A Case Report].
We report a rare case with a ruptured aneurysm of the bihemispheric anterior cerebral artery(ACA), a rare anomaly of the ACA. A 50-year-old female experienced a sudden onset of severe posterior cervical pain. CT revealed diffuse subarachnoid hemorrhage(SAH)and intra cerebral hemorrhage of the left rectal gyrus. ⋯ A neck clipping was performed completely through the right transsylvian approach. There are several reports of an aneurysm with bihemispheric ACA, but all cases are distal ACA aneurysms. In this case, the aneurysm was proximal to the bihemispheric ACA and such aneurysms have not been reported.