World Neurosurg
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Intracranial nail gun injury is a rare traumatic event and can result from a suicide attempt. Cerebral angiography is essential in the evaluation of damage to the intracranial vessels, and surgical removal of nails is generally the optimal treatment. Intraventricular hemorrhage can happen after removal of intracranial nails. Endovascular surgery or intraoperative computed tomography has been reported to be useful for detection and treatment of intraventricular hemorrhage. After the surgical removal of nails, attention should be paid for complications such as pseudoaneurysm and infection. ⋯ As for treatment of a case of intracranial nail gun injury, our case shows that preoperative cerebral angiography is not always needed in intracranial nail gun injury when there is no apparent damage to the intracranial vessels and emergent removal of nails is required. External ventricular drainage preceding the removal of a puncture object can be an effective management strategy for secondary intraventricular hemorrhage.
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The purpose of this study was to assess the feasibility of minimally invasive transforaminal lumbar interbody fusion (TLIF) and bilateral decompression via a unilateral approach that was performed with a novel working retractor with an endoscopic system for degenerative lumbar spondylolisthesis associated with spinal stenosis, to minimize surgical trauma without compromising the quality of the treatment outcome. ⋯ The use of navigation-assisted endoscopic TLIF with bilateral decompression via a unilateral approach appears safe and feasible. The endoscopic surgical procedure may be an alternative surgical option for degenerative lumbar disease.
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To investigate the relationships between upstream venous sinus stenosis and pulsatile tinnitus (PT), and to assess the correlation with diverticulum growth and the effectiveness of stent implantation. ⋯ Our findings strongly support a major role of diverticulum stenosis before in PT development and suggest that such stenosis is a causative factor of diverticulum growth. They also confirm the effectiveness of stent implantation for the treatment of PT.
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Primary spinal cord (PSC) glioblastoma multiforme (GBM) is extremely rare and accounts for only 1.5% of all spinal cord tumors. Therefore, its treatment is still ill defined. To elucidate prognostic factors, we performed a single-institutional retrospective review of the largest series to date of patients with PSC GBM who underwent surgical resection in West China Hospital between 2008 and 2014. A total of 14 patients with PSC GBM were reviewed. ⋯ According to our study, the combination of postoperative radiotherapy and temozolomide chemotherapy can improve prognosis and may serve as a feasible postoperative adjuvant treatment of PSC GBM.
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This study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiologic and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm. ⋯ A1 segment hypoplasia is a significant independent risk factor for unfavorable clinical outcomes of surgical clipping ACoA aneurysm and ACA infarction after surgery.