Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
-
An awake craniotomy for epilepsy surgery is presented where a bilingual patient post-operatively reported temporary aphasia of his first language (Spanish). This case report discusses the potential causes for this clinical presentation and methods to prevent the occurrence of this in future patients undergoing this form of surgery.
-
Sickle cell disease can present with neurological manifestations. One such presentation is with posterior reversible leukoencephalopathy also known as reversible posterior leukoencephalopathy. ⋯ Only a few patients with the association between sickle cell disease and posterior reversible leukoencephalopathy have been described in the adult literature. We present two patients from our institutions to emphasise the association between the two conditions and summarise the published cases in the literature.
-
The conventional technique of intracranial aneurysm embolization using Onyx HD-500 (ev3 Neurovascular, Irvine, CA, USA) involves repetitive balloon inflation-deflation cycles under general anesthesia. By limiting parent artery occlusion to 5 minutes, this cyclic technique is thought to minimize cerebral ischemia. However, intermittent balloon deflation may lengthen procedure time and allow balloon migration, resulting in intimal injury or Onyx leakage. ⋯ Permanent non-disabling neurological morbidity occurred in one patient (4.2%). Minor, transient, and/or angiographic complications were seen in three patients (12.5%), none related to the technique itself. Onyx embolization of unruptured intracranial aneurysms can be safely and effectively performed using continuous balloon inflation under conscious sedation.
-
Intra-arterial (IA) therapy for stroke is an increasingly utilised management approach for acute ischaemic stroke. We aimed to correlate radiological characteristics and recanalisation success with radiological and functional outcomes at 90 days in patients treated with IA therapy. This was a single centre, retrospective study investigating the correlation between pre-procedural Computed Tomography-Angiogram Source Image (CTA-SI) Alberta Stroke Program Early Computed Tomography Score (ASPECTS), recanalisation success, and functional outcome at 90 days in patients with an acute ischaemic stroke from 2007-2012. ⋯ Patients with high pre-procedural CTA-SI ASPECTS are significantly more likely to have high post-procedural NCCT score (OR 23.36, 95% CI: 3.26-166.92, p=0.002). Recanalisation success was strongly associated with good clinical outcome, unaffected by known predictive factors, which included age and stroke severity. This association was unattenuated by CTA-SI ASPECTS.