World Neurosurg
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Gamma Knife radiosurgery (GKRS) represents a well-accepted treatment for small-medium vestibular schwannomas (VS); however, its application in larger VS is still controversial. ⋯ Surgical resection remains the primary approach for large VS with symptomatic brainstem compression. GKRS can be considered a safe and effective option in particular in patients who are not good candidates for surgery.
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Patients with subarachnoid hemorrhage (SAH) by hemorrhagic arteriovenous fistulas (AVFs) usually presents with meningeal signs, including headache and nausea, and focal neurologic deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. ⋯ Spinal SAH alone rarely causes focal neurologic deficit. However, this case suggests spinal SAH can cause acute compressive myelopathy when complicated with preexisting spinal canal stenosis.
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Multiple sclerosis (MS) is a common autoimmune and neurodegenerative disease of the central nervous system characterized by inflammatory demyelination, axonal degeneration, and neuronal loss. The exact pathogenesis of MS remains uncertain; however, studies have shown that the development of MS is influenced by genetic and environmental factors. Cerebral aneurysms (CAs) are life-threatening lesions of cerebral vessels characterized by a bulge in the intracranial arterial wall that spontaneously ruptures. It has been hypothesized that patients with MS are at increased risk of developing cerebral aneurysms. This hypothesis can be supported by analyzing the pathogenesis and genetics of the development of MS and CA. To our knowledge, no previous studies have shown an association between MS and CA. ⋯ This report suggests a possible genetic association between MS and CAs. The strongest evidence of association was found for the TNFRSF1A gene, a proinflammatory gene that is involved in mitogen-activated protein kinase (MAPK) and NF-Kappa B signaling pathways, and has been identified as a candidate gene in the development of MS. MAPKs were also found to be elevated in CAs.
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The C1-C2 joint has multiple degrees of freedom of movement and C1-C2 dislocation (AAD) is often multiplanar. The existing methodology to assess the dislocation is limited to few planes. The object of this study is to redefine and objectively assess congenital AAD in each possible plane, before and after the operation. ⋯ The objective assessment of C1-C2 dislocation and joints in each plane was to determine its management and help in achieving multiplanar correction.
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The DERIVO embolization device (DED) is a new nitinol flow diverter stent manufactured for the treatment of intracranial aneurysms. In this study, we evaluated the safety and efficacy of the DED in the treatment of intracranial aneurysms and present the short- and midterm results. ⋯ The DED seems effective and safe in the treatment of different kinds of intracranial aneurysms.