Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jun 2007
Clinical characteristics and surgical management for juxtafacet cysts of the lumbar spine.
Retrospective analysis of 10 cases of resection of symptomatic lumbar juxtafacet cysts in nine patients (mean age 65.4 years) investigated the relationship between surgical method and progression of spinal spondylolisthesis or cyst recurrence. Patient characteristics, surgical methods, and postoperative course were reviewed. The most common preoperative symptom, painful radiculopathy, occurred in all cases, followed by motor weakness in five, sensory loss in four, and intermittent claudication in four. ⋯ However, new juxtafacet cysts were later detected on the contralateral side to the initial lesion in two patients. Surgical removal of juxtafacet cysts is recommended for immediate symptomatic relief. Concomitant spinal fixation to prevent progression of spinal spondylolisthesis or cyst recurrence depends on cyst size, involvement of surrounding structures, degree of preoperative spondylolisthesis, and facet joint destruction.
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Neurol. Med. Chir. (Tokyo) · Jun 2007
Case ReportsComplete neck clipping of internal carotid-posterior communicating artery aneurysms using bayonet-shaped aneurysm clips: technical note.
Neck clipping for internal carotid-posterior communicating artery (IC-PC) aneurysms using standard straight, angled, or curved clip may result in remnant aneurysm neck. We describe complete neck clipping of IC-PC aneurysms using a bayonet-shaped clip. The bayonet-shaped clip is applied perpendicular to the long axis of the internal carotid artery (ICA), and the blades of the clip are inserted between the aneurysm neck and the ICA. ⋯ This technique was used in four patients with ruptured ICA aneurysms and five patients with unruptured ICA aneurysms. Postoperative cerebral angiography demonstrated no residual aneurysm neck and preservation of the Pcom in all patients. This technique is useful for cases of IC-PC aneurysm involving the origin of the Pcom.
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Neurol. Med. Chir. (Tokyo) · Jun 2007
Case ReportsPerimesencephalic non-aneurysmal subarachnoid hemorrhage caused by cavernous sinus thrombosis: case report.
A 37-year-old man presented with perimesencephalic non-aneurysmal subarachnoid hemorrhage associated with cavernous sinus thrombosis. Anticoagulant therapy was administered to treat the cavernous sinus thrombosis, but provoked severe intracranial hemorrhage, severely disabling the patient. Perimesencephalic non-aneurysmal subarachnoid hemorrhage is a benign clinical entity with generally good prognosis, but the association with cavernous sinus thrombosis requires careful investigation prior to treatment.