World Neurosurg
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Tuberculosis (TB) of the posterior spinal element is an uncommon condition. In a developed country its diagnosis is becoming difficult due to low incidence. ⋯ TB of the posterior elements of the spine is a diagnostic challenge in developed parts of the world. We describe the first likely case of tubercular ligamentum flavum cyst, which was managed by a full endoscopic uniportal approach.
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Superior cerebellar artery (SCA) aneurysm arising from the SCA itself is rare, and treatment of this aneurysm is challenging because of the important anatomic structures, such as the perforating arteries to the brainstem and cranial nerves. We describe a successful coil embolization with a Low-profile Visualized Intraluminal Support Junior (LVIS Jr.) stent for the proximal SCA dissecting aneurysm. ⋯ Endovascular treatment assisted with LVIS Jr. stent for proximal SCA dissecting aneurysm arising from small parent artery was safely and effectively feasible.
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To evaluate the efficacy and safety of tranexamic acid (TXA), we conducted a systematic review and meta-analysis of studies on intravenous TXA in posterior lumbar interbody fusion (PLIF) in adults. ⋯ This meta-analysis showed that intravenous TXA can significantly reduce surgical blood loss and patients treated with TXA did not have a significant decrease in transfusion rates. Furthermore, it is safe and does not increase the risk of thrombotic events. We recommend intravenous TXA and the use of high-dose TXA during PLIF in adults. However, more high-quality and large-sample studies will be needed to confirm this result.
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Dural arteriovenous fistulas (DAVFs) occurring in the superior sagittal sinus (SSS) region are difficult to cure. Endovascular treatment (EVT) is an effective method for the treatment of SSS region DAVFs. Currently, no systematic review of EVT for SSS region DAVFs is available. A systematic review of the literature is necessary. ⋯ In treating SSS region DAVFs, EVT can completely obliterate the fistula point and correct venous shunting. Thus, currently EVT is an effective treatment for SSS region DAVFs. Although many complications can occur, this approach achieves good outcomes in most cases.
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Spontaneous spinal epidural hematoma (SSEH) is a rare and morbid entity, with the prognosis affected by delayed diagnosis and surgical intervention. The correlation between the timing of the intervention and neurological recovery has not been clearly reported. We present a retrospective study of SSEH to determine the correlation between the timing of surgical intervention and changes in the spinal cord signal on magnetic resonance imaging (MRI) with the neurological outcome. ⋯ Significant neurological recovery after surgical decompression of SSEHs can be achieved, despite the significant preoperative neurological deficits, spinal cord changes on MRI, and delayed timing of intervention.