World Neurosurg
-
Review Case Reports
Atlantoaxial synovial cyst: Case report and literature review.
Degenerative cystic lesions of atlantoaxial joints are rare and generally believed to be due to mechanical instability. There is currently no consensus on the management of such lesions in symptomatic and asymptomatic patients. Both conservative and surgical strategies have been described. Surgery may involve anterior or posterior approaches with and without decompression and instrumentation. ⋯ Atlantoaxial synovial cysts are rare and the optimal surgical approach has not been determined. We further conducted a literature review and found a total of 70 other cases of atlantoaxial synovial cysts reported to date in the literature. We attempt to analyze available data and evaluate anterior versus posterior approaches and the need for decompression, amount of cyst resection, and instrumentation.
-
The security of medical devices is critical to good patient care, especially when the devices are implanted. In light of recent developments in information security, there is reason to be concerned that medical implants are vulnerable to attack. The ability of attackers to exert malicious control over brain implants ("brainjacking") has unique challenges that we address in this review, with particular focus on deep brain stimulation implants. ⋯ Targeted attacks include impairment of motor function, alteration of impulse control, modification of emotions or affect, induction of pain, and modulation of the reward system. We also discuss the limitations inherent in designing implants and the trade-offs that must be made to balance device security with battery life and practicality. We conclude that researchers, clinicians, manufacturers, and regulatory bodies should cooperate to minimize the risk posed by brainjacking.
-
Review Case Reports
Delayed Presentation of an Extracranial Internal Carotid Artery Pseudoaneurysm and Massive Epistaxis Secondary to a Nasal Foreign Body. Case Report and Review of the Literature.
Epistaxis is a very common medical condition and can often be controlled with conservative measures. Rarely, uncontrolled and life-threatening epistaxis can occur. ⋯ Massive epistaxis is a potentially lethal condition. Although the source uncommonly originates from the internal carotid artery, pseudoaneurysm rupture needs to be considered on the differential diagnosis in selected patients. This case illustrates the need for vigilance for the presence of foreign objects and/or vessel injuries in the setting of acute, massive epistaxis. Additionally, we describe treatment options and review the literature.
-
Review Historical Article
From Mystics to Modern Times: A History of Craniotomy & Religion.
Neurosurgical treatment of diseases dates back to prehistoric times and the trephination of skulls for various maladies. Throughout the evolution of trephination, surgery and religion have been intertwined to varying degrees, a relationship that has caused both stagnation and progress. From its mystical origins in prehistoric times to its scientific progress in ancient Egypt and its resurgence as a well-validated surgical technique in modern times, trephination has been a reflection of the cultural and religious times. Herein we present a brief history of trephination as it relates religion, culture, and the evolution of neurosurgery.
-
China is a densely populated country faced with more than 1 million cases of traumatic brain injury annually. Since the late 1930s, there has been a great improvement in the field of neurosurgery in the treatment of neurotrauma. ⋯ We present a historical vignette of the development of neurotrauma in China over almost 80 years. It is valuable to have this documentation of the growth of neurosurgery in China by authors who are familiar with the subject matter.