World Neurosurg
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Review Case Reports
Median Supraorbital Keyhole Approach for Clipping Ruptured Distal Anterior Cerebral Artery Aneurysm: Technical Report with Review of Literature.
The minimally invasive approach to distal anterior cerebral artery (DACA) aneurysms has not gained much acceptance due to difficulties associated with the conventional frontal paramedian approach. The more proximal basal interhemispheric approach, however, necessitates extensive dissection of soft tissues. We describe a novel minimally invasive median supraorbital keyhole craniotomy with a basal interhemispheric approach for clipping a ruptured DACA aneurysm. ⋯ The median supraorbital keyhole approach is a minimally invasive technique sufficient for clipping most DACA aneurysms, with easier access, better proximal control, and good cosmesis.
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Review Case Reports
Coarctation of the Aorta Complicated with Intracranial Aneurysm: A Case Report and Literature Review.
Coarctation of the aorta (CoA) complicated with rupture and hemorrhage of intracranial aneurysms is not commonly seen in clinical practice. Here we report a middle-aged female patient who presented with acute severe headache. ⋯ The pathophysiological mechanism of CoA complicated with intracranial aneurysm remains unclear, but attention should be given to the relationship between the 2 entities in clinical practice, and effective treatment should be provided according to specific conditions.
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Laser therapy has become an appealing treatment modality in neurosurgery. In this review, we report on the history, physics, surgical steps, indications and uses, and complications that have been reported to date. ⋯ With the advent of real-time monitoring and damage estimation, LITT has gained ground in the management of intracranial tumors. Larger scale trials must be performed to develop standard protocols to define specific indications for use. Further large clinical studies for LITT in non-oncologic cases are also of interest.
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To investigate the carotid atherosclerotic plaque features in patients with acute ischemic stroke. ⋯ Higher carotid atherosclerosis plaque volume, hypoechoic plaque volume, and luminal carotid stenosis may be symptoms of ulcerated plaque. Increased MMP-9 and hs-CRP levels could be used as adjunctive therapies of carotid stenosis at the molecular level.
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Benign meningiomas constitute 80%-90% of all meningiomas and represent the most common type of central nervous system tumor in adults. The vast majority of meningiomas are minimally symptomatic or asymptomatic early in their onset and thereby can often result in delayed diagnosis. Early diagnosis of meningioma is critical, as it can maximize treatment options and improve outcomes and survival. Although seizures and focal neurologic deficits are considered to be the most prevalent symptoms, depression also may be an important and significant sign. A subtle neurologic depression may be an even early presenting sign of meningioma and may precede more traditional presenting symptoms. ⋯ For patients who exhibit nuances of depression without a history of psychiatric illness, an index of suspicion for meningioma may be warranted.