World Neurosurg
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The disadvantages of a contralateral approach (CA) include deep and narrow surgical corridors and inconsistent ability to achieve proximal control of the supraclinoid internal carotid artery (ICA). However, a CA remains as a microsurgical option for selected ICA-ophthalmic (opht) segment aneurysms. ⋯ In selected patients, transient cardiac arrest induced by adenosine during a contralateral approach allows a brief flow arrest and softening of the aneurysm for safer exposure and clipping.
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Case Reports
Aneurysm of the A1 segment of the anterior cerebral artery associated with the persistent primitive olfactory artery.
The persistent primitive artery constitutes the anterior cerebral artery proper. When the persistent primitive artery keeps its embryologic course along the olfactory bulb, it is called the persistent primitive olfactory artery (PPOA). ⋯ There is a high incidence of aneurysms associated with a PPOA. Follow-up studies are necessary in the present case to monitor for the development of another aneurysm at the hairpin bend.
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This report describes the technique for implanting a vagus nerve stimulator via a single low anterior cervical incision and discusses the advantages of this technique over that of the more commonly used 2-incision technique. ⋯ The single-incision technique described here for implantation of vagus nerve stimulators is technically straightforward and safe, and has significant advantages over the 2-incision technique.
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Magnesium (Mg) is an essential element for the body's normal physiological functioning. It has a major role in modulating vascular smooth muscle tone and peripheral arterial resistance. A low serum Mg level on admission (HMg0) has been associated with more severe presentation in patients with subarachnoid hemorrhage. However, data on HMg0 specifically in relation to intracerebral hemorrhage (ICH) are scarce. We sought to determine the incidence and clinical significance of HMg0 in patients with ICH. ⋯ HMg0 occurs in one third of patients with ICH and is associated with more severe presentation and intraventricular hemorrhage. Mg levels on admission correlate inversely with systolic BP and directly with GCS scores at presentation. HMg0 does not influence outcomes at discharge.
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Comparative Study
Different Surgical Approaches for the Spinal Schwannoma: A Single Surgeon's Experience with 49 Consecutive Cases.
Comparing different surgical approaches for spinal schwannoma, the safety and efficacy of the minimally invasive surgery (MIS) approach were demonstrated, and a suitable indication for each surgical approach was analyzed. ⋯ Safe and complete resection of intradural extramedullary schwannoma was obtained through the MIS approach. Regardless of sagittal extension of the tumor, a schwannoma with an axial diameter of 16 mm located in the lumbar spine can be effectively treated with the MIS approach, including foraminal extension.