Journal of neurosurgery
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Journal of neurosurgery · Jul 1988
Decompression of the vertebral artery for bow-hunter's stroke. Case report.
A case of cerebellar infarction induced by repeated neck rotation ("bow-hunter's stroke") is reported. The most likely mechanism is that repeated rotational neck movement brings about thickening of the atlanto-occipital membrane, fixing the vertebral artery in the vascular groove of the atlas. ⋯ Surgical decompression of the vertebral artery at the level of the atlas in this case relieved the symptoms, and postoperative angiography demonstrated good flow within the vertebral artery even when the neck was rotated. It was not necessary to restrict the patient's neck movement postoperatively.
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Journal of neurosurgery · Jun 1988
Aneurysms of the basilar artery treated with circulatory arrest, hypothermia, and barbiturate cerebral protection.
Complete circulatory arrest, deep hypothermia, and barbiturate cerebral protection are efficacious adjuncts in the surgical treatment of selected giant intracranial aneurysms. These techniques were utilized in seven patients, one with a large and six with giant basilar artery aneurysms; four had excellent results, one had a good result, one had a fair outcome, and one died. ⋯ The surgical and anesthetic considerations are reviewed. The perioperative morbidity and long-term results support the use of these techniques in selected patients with complex intracranial vascular lesions.