World Neurosurg
-
Case Reports
Tibial artery autografts: alternative conduits for high flow cerebral revascularizations.
Extracranial-to-intracranial (EC-IC) bypass is a valuable tool in treating intracranial diseases requiring flow replacement or parent vessel sacrifice. Radial artery grafts (RAGs) and saphenous vein grafts (SVGs) have been used as conduits to provide adequate high flow revascularizations. It is a therapeutic challenge when these grafts are unavailable. ⋯ Tibial arteries are safe, contingent alternatives to conventional conduits for performing high flow cerebral revascularizations and conduit reconstructions.
-
Case Reports
Onyx embolization of a ruptured lenticulostriate artery aneurysm in a patient with moyamoya disease.
Lenticulostriate artery (LSA) aneurysms are uncommon. Most reported cases have been surgically treated. There are only three reports of LSA aneurysms treated with endovascular techniques. ⋯ Treatment of these lesions with either surgery or endovascular therapy is challenging and requires specialized expertise. Given the risks of surgery, we believe that LSA aneurysms are best treated by endovascular means, especially in the setting of moyamoya disease.
-
Certain clinical situations, such as a surgical embolectomy for an acute embolic occlusion of the internal carotid artery (ICA) or the surgical repair of a blood blister-like aneurysm (BBA), can require the superior wall of the ICA to be repaired using a microsuture technique. This can be complicated and challenging, as it not only involves delicate work in a deep surgical field but is also a time-limited procedure performed during temporary occlusion of the ICA. Thus, to facilitate a less complicated repair of the ICA and maintenance of the cerebral blood flow during the procedure, a microsuture technique using compartmentalizing clips is proposed. ⋯ The proposed microsuture technique using compartmentalizing clips facilitates the repair of the ICA in cases of a surgical embolectomy or BBA without temporary occlusion of the ICA.
-
The aim of this study was to noninvasively visualize whether cerebrospinal fluid (CSF) compartments are in communication. ⋯ With this case report, we show the usefulness of a newly described magnetic resonance imaging time-spatial labeling inversion pulse technique to establish that an enlarging CSP was the cause of progressive hydrocephalus and that the hydrocephalus was successfully endoscopically treated when the CSP was fenestrated into the ventricular system, establishing communication between the two CSF compartments.
-
Imaging after blunt cervical trauma is being used increasingly to screen patients for injury of the vertebral artery (VA). There are no guidelines for imaging of the VA for nonpenetrating cervical trauma. The purpose of this study was to determine the effect of VA injury on clinical outcome after blunt cervical trauma. ⋯ The clinical outcome of patients with blunt cervical trauma was not associated with the presence of VA abnormalities. Given the rare but potentially devastating consequences of a VA injury, however, screening may still be worthwhile.