World Neurosurg
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The Scepter XC balloon catheter can be used for balloon-assisted coiling (BAC) of cerebral aneurysms but also accommodates delivery of a low-profile visible intraluminal stent (LVIS Jr.). We assessed the safety and effectiveness of BAC using the Scepter XC, with LVIS Jr. stent-assisted coiling (SAC) as a bailout option. ⋯ Use of the Scepter XC for BAC, with LVIS Jr. SAC as a bailout option, shows acceptable angiographic and clinical results.
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Case Reports
Transient Episode of Alice in Wonderland Syndrome after Ventriculoatrial Shunt Revision.
Visual misperceptions as a result of neurosurgical disorders are well documented. Alice in Wonderland syndrome (AWS) typically is reported in neurologic and psychiatric disorders. We present a patient who developed symptoms of AWS postoperatively. ⋯ Visual disturbances caused by lesions along the optic radiations are common findings for neurosurgery patients, although AWS after surgical intervention has not been reported previously.
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Hemimetameric segmental shift (HMMS) is defined as ≥2 contralateral hemivertebrae (HV) that are separated by at least 1 normal vertebra. Theoretically, the 2 HV tend to balance each other to produce minor spine deformities. However, curve progression has still been observed in HMMS. No research has yet specifically studied its surgical treatment. This study aimed to report efficacy of HV resection for HMMS. ⋯ HV resection is a safe and effective treatment for HMMS that causes progressive or severe deformity.
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Ehlers-Danlos syndrome (EDS) is a rare genetic connective tissue disorders, but the vascular type (type IV) typically poses the greatest risk to patients. We report a case of multiple cranial artery dissection, which was successfully treated with carotid artery stenting. ⋯ It is extremely rare for multiple artery dissections to occur at the same time. EDS type IV should be considered as an important differential diagnosis in similar cases, even in adult patients without a known history of connective tissue disease or vascular complications.
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Evidence is lacking concerning the myriad surgical techniques for type 1 Chiari malformation. This study evaluated the impact of arachnoid violation with tonsil thermocoagulation during surgical craniovertebral junction decompression. ⋯ For treatment of symptomatic type 1 Chiari malformation, craniovertebral junction decompression with arachnoid preservation (i.e., without tonsillar manipulation) seems more suitable than the addition of arachnoid opening and thermocoagulation of the tonsils.