World Neurosurg
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Case Reports
Synchronous Diagnosis of Intradiploic Epidermoid Cyst and Anatomically Close Associated Chronic Epidural Hematoma.
Intradiploic epidermoid cyst (IEC) concurrent with chronic epidural hematoma (CEDH) has never been reported in the literature. We report a unique case of IEC concurrent with anatomically close associated CEDH. ⋯ Intradiploic epidermoid cyst concurrent with chronic epidural hematoma is extremely rare. We present the first case of intradiploic epidermoid cyst concurrent with anatomically close associated chronic epidural hematoma.
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Case Reports
Positioning-Related Neuromonitoring Change During Anterior Cervical Discectomy and Fusion.
Intraoperative neuromonitoring (ION) signal changes during spine surgery may portend a potentially catastrophic neurologic injury that, if identified and addressed expediently, may allow the surgeon to take correction actively and prevent permanent neurologic injury. ⋯ The use of multimodality ION is recommended for ACDF with shoulder traction to prevent postoperative neurologic deficit associated with a position-related injury. Baseline ION should be established before positioning.
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Prior studies have shown that most patients with mild traumatic brain injury or negative computed tomography (CT) scans of the head rarely decline or require neurosurgical interventions. One common reason for a delayed decline is an intracranial hemorrhage that presents within 24-48 hours. This is typically seen in elderly patients and/or patients on antiplatelet or anticoagulation agents. We describe a case of a delayed subdural hemorrhage presenting in a young adult not on any antiplatelet or anticoagulation therapy. ⋯ In rare cases, patients with negative initial head CT scans neurologically deteriorate as a result of a delayed acute subdural hematoma. We present an unusual case of a young patient on no medications with no CT findings of an intracranial injury who neurologically declined due to a delayed acute subdural hematoma.
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Observational Study
Cognitive Impairments After Clipping of Ruptured Anterior Circulation Aneurysms.
The cognitive impairments after treatment of ruptured aneurysms have often been underestimated. This study sought to assess their prevalence and analyze various associated factors. ⋯ Cognitive impairments are frequent after treatment of ruptured anterior circulation aneurysms. Impairments in recent memory, remote memory, and phonemic fluency are significantly greater after treatment of ACA-related aneurysms, compared with others, independent of other factors.
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Despite its growing popularity, no comparative studies have explored the minimum clinically important difference (MCID) of health-related quality of life scores following lumbar interbody fusion (LIF) performed on a single-level adult low-grade isthmic spondylolisthesis (LGIS). ⋯ We postulate that excessive SL does not affect lumbar lordosis; rather, it can result in lowering posterior disk height. The decrease in posterior DH may lead to a decreased foraminal height that, in turn, can lead to nerve root compression. Proper restoration of disk height and bone fusion is more important than restoration of more segmental lordosis or slip reduction for isthmic spondylolisthesis.