World Neurosurg
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Although posterior lumbar interbody fusion (PLIF) has provided satisfactory clinical outcomes, adjacent segment disease (ASD) is one of the most important complications affecting long-term results. However, according to ASD studies, few have described repeat surgery. The purpose of this study was to elucidate incidence, time period, and clinical features of multiple-repeated ASD after PLIF. ⋯ Multiple-repeated ASD was observed in 0.4% of the patients. All patients developed iatrogenic flatback as a result of repeated ASD, and corrective surgeries were required for these patients.
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Case Reports
Pallidothalamic tractotomy for Parkinson's disease with 1-year follow-up: a case report.
The pallidothalamic tract connects the globus pallidus internus and the ventrolateral portion of the thalamus, and ablation of the pallidothalamic tract (pallidothalamic tractotomy [PTT]) reportedly exerts antiparkinsonian effects. However, the detailed clinical course has not yet been elucidated. Here, we present the first single case report of PTT performed in a patient with Parkinson disease, with 1-year follow-up. ⋯ We present a rare case of PTT performed in a patient with Parkinson disease. PTT might be useful in patients who do not desire device implantation.
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Among several novel predictors on noncontrast computed tomography (CT) for hematoma expansion in spontaneous intracerebral hemorrhage (sICH), shape irregularity grade, satellite sign, and island sign are all related to irregular shape of hematoma. This study is aimed to compare the accuracy of these imaging markers for predicting hematoma expansion in the same cohort of sICH patients. ⋯ Island sign seems to be the optimal shape-related predictor for hematoma expansion in sICH patients and could be included in the future predictive model for hematoma expansion.
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Review Case Reports
Multiple Intracranial Aneurysms from Coccidioidal Meningitis: A Case Report Featuring Aneurysm Formation and Spontaneous Thrombosis with Literature Review.
Coccidioidal meningitis can progress to vasculitis with aneurysm formation. Although aneurysmogenesis is rare, it carries exceptionally high mortality. Except in one instance, prior case reports have documented universally fatal consequences. ⋯ Coccidioidal aneurysms carry a high mortality. The mainstay of therapy remains lifelong triazole antifungal therapy with the addition of liposomal amphotericin in cases of treatment failure. Steroid use is controversial but should be considered whenever there is vascular involvement. Although watchful waiting is reasonable in light of the possibility of spontaneous thrombosis with medical management, dynamic changes in aneurysm size or configuration should prompt timely endovascular or operative interventions.
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Review Case Reports
Meckel's Cave Epidermoid Cyst Presenting as Multiple Cranial Nerve Deficits Due to Indirect Tumoral Compression of the Cavernous Sinus: A Case Report and Literature Review.
Epidermoid cysts in Meckel cave are exceedingly rare. Since 1971, only 17 cases have been reported in the literature, with most patients presenting with trigeminal hypesthesia. However, outgrowth of these lesions from Meckel cave can rarely lead to compression of the proximate cavernous sinus and the neurovascular structures contained within. To date, 2 cases have reported a Meckel cave epidermoid cyst presenting clinically as an intracavernous cranial nerve palsy, presumably a clinical manifestation of cavernous sinus compression from the lesion. ⋯ This is a unique report depicting an epidermoid cyst in the Meckel cave causing numerous cranial nerve deficits because of indirect tumoral compression of cranial nerves within the cavernous sinus.