World Neurosurg
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Review Case Reports
Subacute Posttraumatic Ascending Myelopathy after an Incomplete Spinal Cord injury from Gunshot Wound to the Spine - Case Report and Review of the Literature.
Subacute posttraumatic ascending myelopathy (SPAM) is a rare event that occurs after spinal cord trauma or ischemia. SPAM is defined as progressive loss of spinal cord or nerve root function days to weeks after the initial trauma that cannot be attributed to mechanical instability. Because of the rarity of this condition, there is no clear understanding of its cause, natural history, or treatment guidelines for patient management. ⋯ This case demonstrates that spinal cord injury is a dynamic lesion, both in the immediate postinjury stage and in the subacute time interval as well. This is the first reported case of SPAM that occurred after the resolution of incomplete SCI and only the second that occurred after a gunshot wound.
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Review Meta Analysis
Direct microsurgical embolectomy for acute occlusion of the internal carotid artery and middle cerebral artery.
Surgical embolectomy is the most promising therapy for physically removing emboli from major cerebral arteries. However, it requires an experienced surgical team, time-consuming steps, and is not incorporated into acute stroke therapy. ⋯ Our results suggest that microsurgical embolectomy can rapidly, safely, and effectively retrieve clots and deserves reappraisal, although the choice largely depends on local institutional expertise.
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Review Meta Analysis
Fronto-basal midline meningiomas: is it right to shed doubt on the transcranial approaches? Updates and review of the literature.
Traditionally, the surgical removal of tuberculum sellae meningioma (TSM) and olfactory groove meningioma (OGM) requires transcranial approaches and microsurgical techniques, but in the last decade endoscopic expanded endonasal approaches have been introduced: transcribriform for OGMs and transtuberculum-transplanum for TSM. A comparative analysis of the literature concerning the two types of surgical treatment of OGMs and TSM is, however, difficult. ⋯ At present, the microsurgical technique is still the gold standard for the removal of the anterior cranial fossa meningiomas of all sizes, and the endoscopic technique remains a second option in certain cases.
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Review Meta Analysis
A Systematic Review of Chiari I Malformation: Techniques and Outcomes.
To elucidate the most efficacious treatments of Chiari I malformation (CIM). ⋯ Only bony decompression cannot achieve satisfactory outcomes. Bony decompression plus duroplasty showed the most favorable outcomes. Resection of tonsils was not recommended because of the high rate of side effects. Shunt may aggregate clinical signs and symptoms and increase the size of cavities.
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Randomized Controlled Trial
Parametric digital subtraction angiography imaging for the objective grading of collateral flow in acute middle cerebral artery occlusion.
To report the feasibility of parametric color-coded digital subtraction angiography (DSA) in complementing the traditional, subjective way of leptomeningeal collateral assessment in acute middle cerebral artery (MCA) occlusions. ⋯ The relative maximum contrast density of MCA territory on 2-dimensional DSA measured by parametric imaging technique appears to be a simple and reliable metric for the assessment of leptomeningeal collaterals in cases of acute MCA occlusion.