Neurosurgery
-
Case Reports
Bilateral ethmoidal dural arteriovenous fistulae: a previously unreported entity: case report.
Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. Reported hemorrhage rates have ranged from 62 to 91%, and an aggressive clinical course is more likely than a benign clinical course. We describe the first case of a patient with bilateral ethmoidal dural AVFs. ⋯ Anterior ethmoidal dural AVFs may occur bilaterally. Given their complex angiographic appearance, their presence bilaterally may not be readily apparent on preoperative angiography. Intraoperative angiography is crucial to identify a contralateral fistula and to verify that ligation has been curative.
-
Biography Historical Article
Neurosurgery 100 years ago: the Queen Square letters of Foster Kennedy.
The prominent New York City neurologist Foster Kennedy (1884-1952) trained at London's Queen Square from 1906 to 1910. He was exposed to a number of eminent neurologists including, Sir Victor Horsley and other surgeons. ⋯ Descriptions of the personalities involved give rare insight to this era. The Foster Kennedy syndrome--homolateral optic atrophy and contralateral papilledema with an inferior frontal tumor--was characterized under the stimulating support of Gowers and Horsley.
-
Review Case Reports
Spinal arachnoid cyst related to a nonaneurysmal perimesencephalic subarachnoid hemorrhage: case report.
We report the first case of a delayed symptomatic spinal arachnoid cyst related to a nonaneurysmal perimesencephalic hemorrhage. We review the literature concerning posthemorrhagic spinal arachnoid cysts. ⋯ This extremely rare complication should be kept in mind when delayed lower-limb neurological deficits appear after subarachnoid hemorrhage, even in a perimesencephalic form.
-
Comparative Study
Effects of 23.4% sodium chloride solution in reducing intracranial pressure in patients with traumatic brain injury: a preliminary study.
Mannitol is the standard of care for patients with increased intracranial pressure (ICP), but multiple administrations of mannitol risk renal toxicity and fluid accumulation in the brain parenchyma with consequent worsening of cerebral edema. This preliminary study assessed the safety and efficacy of small-volume injections of 23.4% sodium chloride solution for the treatment of intracranial hypertension in patients with traumatic brain injury who became tolerant to mannitol. ⋯ This study suggests that 23.4% hypertonic saline is a safe and effective treatment for elevated ICP in patients after traumatic brain injury. These results warrant a rigorous evaluation of its efficacy as compared to mannitol in a prospective randomized controlled trial.
-
Comparative Study
Visual field preservation after curative multi-modality treatment of occipital lobe arteriovenous malformations.
Occipital lobe arteriovenous malformations (AVMs) provide challenging management decisions because of their proximity to the visual cortex and optic radiations. Preservation of visual function throughout treatment is the mainstay of therapeutic planning. We reviewed visual field (VF) outcomes of all patients who received curative treatment for occipital AVMs at Stanford University to evaluate the efficacy of different treatment strategies. ⋯ Occipital AVMs can be safely cured using multimodality strategies with minimal risk to visual function despite the proximity of these lesions to the visual cortex and associated pathways.