Neurosurgery
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Iatrogenic vertebral artery (VA) injury is a rare but potentially devastating complication associated with cervical and craniocervical surgery. ⋯ VA injury is an uncommon complication of cervical and/or skull base surgery. Standardized management recommendations may help reduce complications associated with these rare but potentially devastating injuries.
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Comparative Study
Biomechanical comparison of transforaminal lumbar interbody fusion with 1 or 2 cages by finite-element analysis.
Anterior lumbar interbody fusion and posterior lumbar interbody fusion with 1 cage have been shown to have similar biomechanics compared with the use of 2 cages. However, there have been no reports on the biomechanical differences between using 1 or 2 cages in transforaminal lumbar interbody fusion (TLIF) surgery. ⋯ Single-cage TLIF approximates biomechanical stability and increases the stress of the bone graft. The use of a single cage may simplify the standard TLIF procedure, shorten operative times, decrease cost, and provide satisfactory clinical outcomes. Thus, single-cage TLIF is a useful alternative to traditional 2-cage TLIF.
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Randomized Controlled Trial Multicenter Study
Predictors of subsequent overdrainage and clinical outcomes after ventriculoperitoneal shunting for idiopathic normal pressure hydrocephalus.
Little is known about variables associated with overdrainage complications and neurofunctional and health-related quality of life outcomes in idiopathic normal-pressure hydrocephalus (iNPH) patients after shunt surgery. ⋯ Few, if any, baseline and treatment characteristics may be helpful in estimating the individual risk of complications and clinical outcomes after shunt surgery for iNPH. Patients should be informed that longer surgery for any reason may increase the risk of later overdrainage. Also, women should be counseled about a sex-associated increased risk of the development of clinical symptoms of overdrainage, although the latter cannot be distinguished from a generally higher prevalence of headaches in the female population.
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Hemodynamic insults--high wall shear stress (WSS) combined with high positive WSS gradient (WSSG)--have been proposed to link to cerebral aneurysm initiation. We report 4 cases of aneurysms with proximal stenosis, including 1 de novo aneurysm, that might be associated with hemodynamic insults caused by the proximal stenosis. ⋯ BT, basilar terminusCFD, computational fluid dynamicsICA, internal carotid arteryWSS, wall shear stressWSS, wall shear stress gradient.
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There has been growing interest in clinical single-neuron recording to better understand epileptogenicity and brain function. It is crucial to compare this new information, single-neuronal activity, with that obtained from conventional intracranial electroencephalography during simultaneous recording. However, it is difficult to implant microwires and subdural electrodes during a single surgical operation because the stereotactic frame hampers flexible craniotomy. ⋯ We achieved simultaneous implantation of microwires, depth electrodes, and broad-area subdural electrodes. Our method enabled simultaneous and stable recording of hippocampal single-neuron activities and multichannel intracranial electroencephalography.