World Neurosurg
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It is a common assumption that the human skull and solid skull implants are impermeable to diagnostic ultrasound. We demonstrated in 2 patients that frontoparietal polyetheretherketone cranioplasties allowed useful imaging of intracranial parenchymal and vascular structures with higher ultrasound frequencies than the 2 MHz used for the temporal bone window. This knowledge about additional imaging properties may be helpful in emergency situations and for vascular monitoring. The decision for a polyether ether ketone cranioplasty may contribute to patient safety.
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Meningioma growing into an arachnoid cyst is an extremely rare event. Only 3 cases are reported in the literature. In 2 of them, an operative procedure in or near the arachnoid cyst preceded tumor growth. ⋯ We discuss the possible pathogenesis in light of the scarce published literature, as well as the differential diagnosis of this rapidly growing tumor.
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Although recent work has focused on characterizing quantitative magnetic resonance imaging (MRI) markers that may predict outcome among patients with cervical degenerative conditions, little is known about their reliability. Measurement and reporting of these markers is time-consuming and nonstandardized, preventing routine use in clinical care. ⋯ Good and very good reliability observed in measuring T2-weighted spinal cord signal change, level of worst compression, AP cord diameter, and kyphosis support use of these markers in standardized reporting, which could be incorporated into routine clinical use.
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Intraoperative resection or occlusion control is indispensable in the surgery of vascular anomalies. This can be conducted using local vascular imaging modalities or angiographic techniques. This series was performed to assess whether cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistulae (dAVFs) can be detected in a sufficient quality by intraoperative 3-dimensional (3D) fluoroscopy with intravenous contrast application. ⋯ This technique quickly supplies intraoperative images of adequate quality to locate cerebral AVM and dAVF. However, it does not produce dynamic images. Thus, early draining veins cannot be located unless anatomically identified based on the preoperative DSA. In this case, it can be used for intraoperative obliteration control.
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To date, no information about the cortical bone microstructural properties in atlas vertebrae with arcuate foramen has been reported. As a result, we aimed to test in an experimental model if there is a cortical bone thickening in an atlas vertebra which has an arcuate foramen that may play a protective role against bone fracture. ⋯ An atlas with arcuate foramen presents cortical bone thickening. This advantage in bone microarchitecture seems to contribute to a lower fracture risk compared to subjects without arcuate foramen as no coexistence in the same vertebra of a posterior atlas arch fractures and arcuate foramen was found.