World Neurosurg
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Review Case Reports
Repositioning Technique for the Decompression of Symptomatic Dolichoectatic Vertebrobasilar Pathology: A Comprehensive Review of Sling Characteristics and Surgical Experiences.
The repositioning of a dolichoectatic vertebrobasilar artery (VBA) for arterial decompression has been extensively used in the clinical setting. We aimed to describe and summarize the technical characteristics and clinical results of the sling technique. ⋯ The excellent surgical outcomes and durable long-term results suggest that the repositioning technique is highly effective in resolving symptoms related to the compression of DVB pathology. The wrap-sling technique might be the preferred option owing to the simultaneous symptom relief and lower rate of temporary complications. However, cranial nerve manipulation should be meticulously implemented to avoid permanent negative effects.
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Meta Analysis Comparative Study
Radiographic and Clinical Outcomes of Oblique Lateral Interbody Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Disease.
The effects of oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) have not been compared by a meta-analysis. The present study aimed to summarize the radiographic and clinical outcomes of OLIF and MI-TLIF for degenerative lumbar disease. ⋯ The radiographic and functional outcomes and length of hospital stay were similar between the 2 groups. The OLIF group showed advantages in operative blood loss and operative time; however, the incidence of complications in this technique was greater than that in the MI-TLIF group.
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Review Case Reports
Retromedullary Hemangioblastoma Mimicking a PICA Aneurysm: Case Report & Literature Review.
Hemangioblastomas (HBMs) are benign vascular neoplasms that most commonly arise within the cerebellum. Although other vascular lesions should be considered in the differential diagnosis, HBMs rarely resemble aneurysms on neuroimaging and only 1 case of a cerebellar HBM mimicking a posterior fossa aneurysm has been reported. Here we describe a retromedullary HBM that masqueraded as a distal posterior inferior cerebellar artery (PICA) medullary branch aneurysm. ⋯ To our knowledge, this is the second case of HBM mimicking a PICA aneurysm. Given the rarity of PICA medullary branch aneurysms and their highly symptomatic nature, other etiologies, especially HBM, should be strongly considered when an apparent distal PICA aneurysm is diagnosed in an asymptomatic patient. If the lesion is unamenable to endovascular treatment, there should be high suspicion for HBM and subsequent craniotomy should be pursued.
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Review Case Reports
Pneumoventricle of Unknown Origin: A Personal Experience and Literature Review of a Clinical Enigma.
Pneumocephalus is an uncommon and life-threatening neurologic condition. Air within the ventricular system of the brain is also known as pneumoventricle (PV). It requires emergency treatments to prevent catastrophic neurologic outcomes. Head injury is the most common cause of PV, but there are other well-recognized etiologies in case there is no clear radiological evidence of skull discontinuity. ⋯ The aim of the present paper is to report a case of post-traumatic PV without radiological signs of skull base or convexity fracture in a 72-year-old man, underlining the diagnostic and clinical features, and review the relevant literature.
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The pial (leptomenigeal) collateral circulation is a key determinant of functional outcome after mechanical thrombectomy after large-vessel ischemic stroke. Patients with good collateral blood flow benefit up to 24 hours after stroke onset, whereas those with poor collateral flow evidence less or no benefit. ⋯ The comprehension of collagerogenesis in humans and the evaluation of collateral status could aid in identifying patients who will benefit not only from mechanical thrombectomy in the extended time window but also from any reperfusion strategy. We performed a literature review focused on radiographic, clinical, and genetic aspects of the collateral circulation.