Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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This retrospective study evaluated the recovery of ankle dorsiflexion (ADF) weakness following decompressive surgery in order to identify factors indicative of a better outcome. Fifty-six consecutive patients with ADF weakness secondary to nerve root compression underwent lumbar decompressive surgery. The demographic features, duration and severity of preoperative ADF weakness, associated radicular pain, as well as the radiological and intraoperative findings were recorded. ⋯ Only small improvements take place beyond 6 weeks following surgery. The degree of deficit at presentation is predictive of the extent of recovery. Recovery in ADF strength is more evident in younger patients.
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Case Reports
Acute thrombosis and recanalization of a ruptured anterior communicating artery aneurysm.
A 35-year-old man sustained a subarachnoid hemorrhage due to the rupture of an anterior communicating artery aneurysm. A second angiogram taken 8 hours later demonstrated that the ruptured aneurysm had thrombosed spontaneously with a small residual aneurysm stump at the neck. ⋯ This case differs from previous reports of spontaneously thrombosed ruptured aneurysms because the aneurysm recanalized within 2 days. Thus a thrombosed ruptured aneurysm has the potential for recanalization, and should be considered at risk of further hemorrhage.
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Motor complications induced by levodopa (L-dopa) treatment in Parkinson's disease (PD) are not well documented in patients of Chinese ethnicity. We performed a cross-sectional study to investigate the prevalence of dyskinesias and motor fluctuations, and the factors determining their development, in a population of Chinese patients with PD. Among 137 patients with PD, 98 (71.5%) had received a L-dopa preparation. ⋯ Patients with dyskinesias and motor fluctuations had significantly longer duration of PD and L-dopa treatment, higher daily doses of L-dopa, and higher scores in the 39-item Parkinson's Disease Questionnaire (PDQ-39), when compared to patients without motor complications. Among these factors, motor fluctuations were best predicted by duration of L-dopa treatment and dyskinesias by disease duration. We conclude that motor complications are closely related to disease and treatment parameters, especially the treatment and disease duration.
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The human sacrum is the target of lumbosacral instrumentation and decompression procedures. Such surgical interventions require detailed knowledge of the anatomy of the human sacrum. The aim of this study was to measure surgically relevant parameters. ⋯ Thus, this study describes anatomical specifications of the sacrum. These defined morphometric details should be taken into consideration during surgical procedures. This study also describes anatomical landmarks which will allow injury of the sacrum during surgery to be avoided.
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Titanium mesh is a commonly used material for cranioplasty. While it is a safe and highly biocompatable material, it can modify the presentation of post-operative complications. This case report details 3 patients (2 recurrent meningiomas and an extradural haematoma) in whom post-operative complications, although not caused by the titanium mesh, were modified in their presentation by the permeability of the material. The permeable nature of the mesh allows intracranial pathological processes to extend extracranially and vice versa.