World Neurosurg
-
and importance: Epistaxis is a rare presentation of the ruptured cavernous carotid aneurysm (CCA) especially nontraumatic type. Both endovascular therapies and open surgeries have a role in the treatment with various outcomes, but the standard procedure is not well established. We report a successful high-flow bypass with cervical internal carotid artery ligation for aneurysm repair and review the related literature. ⋯ In cases of massive or recurrent epistaxis without coagulopathy or nasal pathology, a CCA should be considered. Immediate cessation of bleeding is necessary. Flow-preservation bypass with proximal ligation of the parent artery is one of the effective procedures for the treatment of this condition with low morbidity.
-
Despite the fact that technologic advances and surgical experience expand the use of endoscope in spinal surgery, there are few reports on its application in the management of spinal tumors. We present a case report of intradural extramedullary tumor excision with the percutaneous full endoscopic translaminar approach. ⋯ This report supports that full endoscopic spinal intradural extramedullary mass excision may give good results in selected cases and in experienced hands.
-
Traumatic brain injury (TBI) results in both focal and diffuse brain pathological features that become severely exacerbated after the initial injury. Owing to this disease complexity, no effective therapeutic measure has yet been devised aimed directly at these pathological processes. We developed a clinically relevant model of TBI and tested the bidirectional neuroprotective role of adenosine 2A receptors (A2ARs) at different times. ⋯ The A2AR agonist showed a beneficial neuroprotective effect at the early stages after TBI, and the A2AR antagonist showed a benefit at the later stages after TBI. These findings suggest that A2AR agonists and antagonists should be used in accordance with the point at which the TBI occurred.
-
The relationship between superior cervical ganglia (SCG) ischemia due to bilateral common carotid artery ligation (BCCAL) and basilar artery (BA) reconfiguration was investigated. ⋯ A meaningful and paradoxic correlation was detected between the BA VDI values and degenerated neuron density of SCG after BCCAL. Although a low degenerated neuron density within SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation with steno-occlusive carotid artery diseases, a high degenerated neuron density may cause dangerous vasodilatation of BA.