World Neurosurg
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To investigate a novel intermuscular surgical approach for posterior upper cervical spine fixation. ⋯ The posterior bilateral intermuscular approach for upper cervical spine injuries is a valid alternative for Hangmans' fractures type I, type II, and type Ia according to Levine and Edwards classification as well as atlantoaxial subluxation caused by upper cervical spine trauma.
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Endoscopic third ventriculostomy (ETV) is a safe and effective treatment for hydrocephalus. An entry point located 4 cm anterior to the coronal suture, 3 cm anterior to Kocher point, and approximately 9 cm from the pupil at the midpupillary line has been used successfully for the last 20 years in our center. We aimed to evaluate this alternative anterior entry point routinely used for ETV, with or without concurrent endoscopic biopsy. ⋯ The anterior entry point is a safe and effective method for ETV, especially when considering concurrent ventricular tumor biopsy. This entry point may be considered as a more minimally invasive procedure when using rigid endoscopy and may also eliminate the need for a flexible scope.
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This study aims to establish a new classification system for proximal anterior cerebral artery (A1) aneurysms and to offer treatment strategies, based on the lessons learned by studying the case reports of 41 patients with A1 aneurysms. ⋯ A1 artery aneurysms are a rare type of aneurysm with unique characteristics. The classification system proposed here accurately summarizes these characteristics to better guide treatment strategies.
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Chronic back pain is a common problem, and imaging is crucial for effective diagnosis and treatment. In low-resource settings conventional myelography is a cheap alternative to magnetic resonance imaging and computed tomography. This study was conducted to reexamine the diagnostic reliability, effectiveness for surgical decision making, and safety of conventional myelography. ⋯ Conventional myelography is a reliable and safe diagnostic test. Appropriate and sound surgical decisions can be made following conventional myelography tests.
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Deep brain stimulation (DBS) may cause various complications including intracerebral hemorrhage (ICH). Because ICH causes devastating neurologic outcomes, various surgical techniques are attempting to reduce the chances of ICH. More importantly, early detection and proper management of postoperative ICH are indispensable. ICH may occur immediately or delayed following DBS; in this study, we analyzed the clinical features of delayed ICH after DBS. ⋯ Our study demonstrates that delayed ICH can occur after DBS even with normal brain CT immediately after DBS. Because ICH can cause serious neurological sequelae, the possibility of delayed ICH after DBS should be considered for the optimal management of patients.