Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jan 2011
Case ReportsRuptured intracranial aneurysms associated with moyamoya disease: three case reports.
Three cases of ruptured intracranial aneurysm associated with moyamoya disease are presented. Endovascular treatments were performed successfully in two patients with major artery aneurysms. One patient with a collateral aneurysm was managed conservatively and follow-up angiography 1 year later demonstrated spontaneous disappearance of the aneurysm. Our experience suggests that although aneurysms associated with moyamoya disease show differences in evolution and location, endovascular treatment of major artery aneurysms is safe and effective, and peripheral aneurysms which cannot be directly accessed for surgery or endovascular embolization may be treated conservatively.
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A 69-year-old male presented with a rare dural cyst manifesting as numbness and pain in the limbs. Magnetic resonance imaging revealed a mass anterior to the medulla oblongata appearing as low intensity on T(1)-weighted and high intensity on T(2)-weighted imaging, with no enhancement. A cystic lesion ventral to the medulla oblongata was removed via the lateral suboccipital transcondylar approach. ⋯ The lesion was diagnosed as dural cyst. Dural cysts can be defined as cyst with the wall consisting of dura mater-like fibrous tissue, and attached to the dura mater. The origin of the present dural cyst was considered to be congenital.
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Neurol. Med. Chir. (Tokyo) · Jan 2011
Case ReportsSpontaneous intracranial hypotension presenting without orthostatic headache complicated by acute subdural hematoma after drainage for chronic subdural hematoma--case report.
A 28-year-old man presented with a case of spontaneous intracranial hypotension (SIH) manifesting as a bilateral chronic subdural hematoma (CSDH) without orthostatic headache. He developed life-threatening acute SDH as a complication of CSDH drainage. Neurosurgeons should be aware that SIH patients do not always present with orthostatic headache. Brain magnetic resonance imaging with gadolinium may be recommended for young adults with non-traumatic CSDH before drainage to exclude SIH, even if they do not present with orthostatic headache.
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Neurol. Med. Chir. (Tokyo) · Jan 2011
Case ReportsSpontaneous superficial temporal artery pseudoaneurysm in elderly women--three case reports.
Three women older than 75 years presented with spontaneous superficial temporal artery (STA) pseudoaneurysms manifesting as a pulsatile mass in the preauricular region. None of the patients had a history of trauma. ⋯ Spontaneous STA pseudoaneurysms are extremely rare. We suggest that all 3 aneurysms were associated with latent dissection and external force exerted by the frames of glasses.
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Neurol. Med. Chir. (Tokyo) · Jan 2011
Case ReportsPerimedullary arteriovenous fistula at the craniocervical junction - case report - .
Perimedullary arteriovenous fistulas (AVFs) at the craniocervical junction are uncommon, and are often fed by the anterior spinal artery, with only a few cases fed by the intradural vertebral artery (VA). A 55-year-old man presented with a case of perimedullary AVF fed by the VA at the craniocervical junction manifesting as subarachnoid hemorrhage. Left vertebral angiography demonstrated an AVF supplied by branches from the VA. ⋯ Two feeding arteries were coagulated and dissected, followed by coagulation of a small feeder. The draining veins became discolored and shrank. 3D-CTA performed 2 months after the operation revealed disappearance of the AVF. Open surgery was successfully performed for the almost perimedullary AVF at the craniocervical junction, and is considered to be preferable for the treatment of this disease.