Turk Neurosurg
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Case Reports
Dural carotico-cavernous fistula: pre and postembolization appearances of bone-subtracted CT angiography.
Digital subtraction angiography (DSA) is the best method of evaluating carotid cavernous fistulas (CCF). DSA, however, has the disadvantage of being an invasive procedure. ⋯ In this case report, we report a case of a dural carotico-cavernous fistula (CCF), appearances of pre and postembolization BSCTA images, confirmed by on DSA. As far as we know, CCF demonstrated by BSCTA has not been reported yet.
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Case Reports
Clinical characteristics and outcomes of patients with cerebral herniation during continuous lumbar drainage.
The aim of this study was to investigate the clinical characteristics and outcomes of patients who developed cerebral herniation after continuous lumbar cerebrospinal fluid (CSF) drainage. ⋯ Cerebral herniation induced by continuous lumbar drainage is mostly reversible if early identification and prompt management are realized. Faster drainage speed may be associated with earlier occurrence of brain herniation during lumbar drainage.
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In demyelinating disease spectrum, tumor-like (tumefactive) demyelinating lesions (TDL) are rarely seen. Atypical imaging and clinical features of these lesions may cause misdiagnosis of tumor or abscess. ⋯ Although MRI, CSF and pathologic examination help in differential diagnosis of the mass lesions, close follow-up is still crucial for the definite diagnosis. A higher MS conversion rate was found in patients with a younger TDL onset age.
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Intradural disc herniation is a rare entity that occurs most commonly in the lumbar spine particularly at L4-L5 region. Most often it is diagnosed intraoperatively in a case of simple intervertebral disc herniation. Contrast enhanced MRI is mandatory for pre operative diagnosis. ⋯ The fragment was removed and the rent was sutured. The patient recovered well from the surgery. Intradural disc herniations must be considered in the differential diagnosis of prolapsed intervertebral disc disease especially with recent worsening of symptoms and mismatch of unenhanced MRI findings with intraoperative findings.
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This study aims to evaluate how analgesia-sedation causes alterations of HLA-DR and cytokines (IL-10 and IL-6) in patients undergoing cerebral angiography for several cerebral vascular diseases. ⋯ We suggest that the effects of fentanyl and midazolam on the immune response are the reflection of the effects by the monocyte, mHLA-DR expression. In the future, depending on the immunological status of the patients, different anesthetic applications including the new anesthetic agents that will be able to decrease immune system suppression will be required.