World Neurosurg
-
The presence of hemiparesis on arrival in patients with subarachnoid hemorrhage (SAH) is presumed to affect prognosis; intracranial hematomas with mass effect responsible for hemiparesis are frequently observed in these patients. The aim of this study was to clarify characteristics and outcomes of patients who presented with hemiparesis on arrival with no responsible hematomas (hemiparesis without hematoma) having mass effect demonstrated on computed tomography. ⋯ Hemiparesis can be expected to improve in patients with SAH with hemiparesis without hematoma, and such patients appear to have a better prognosis than patients with SAH with hemiparesis and responsible hematomas. A possible major mechanism of hemiparesis without hematoma based on the characteristics identified is a combination of transient ipsilateral hemispheric functional failure caused by the impact of aneurysmal rupture and transient ischemia of the perforators originating from the internal carotid artery.
-
Visual field deterioration caused by secondary empty sella after cabergoline therapy for prolactinoma is a rare event. Chiasmapexy is performed to treat empty sella syndrome. Although various materials have been used for the elevation of the optic chasm, the most appropriate material remains to be established. Here, we describe the efficiency of chiasmapexy for empty sella syndrome following dopamine agonist treatment and the utility of septal cartilage and sphenoidal sinus bone as materials for chiasmapexy. ⋯ Chiasmapexy is an effective surgical method for treating visual deterioration caused by empty sella after cabergoline treatment. Endoscopic endonasal chiasmapexy with septal cartilage and sphenoidal sinus bone is a considerable option because it is minimally invasive and involves decreased risk of infection.
-
The implications of diagnosis and treatment of central or axial atlantoaxial dislocation (CAAD) as a cause of symptoms of cervical myelopathy are evaluated. ⋯ Identification and treatment of CAAD can have a significant management impact on patients where the cause of spastic quadriparesis is otherwise undiagnosed.
-
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.
-
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.