World Neurosurg
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Review Case Reports
Surgical treatment of spontaneous internal carotid artery dissection with abducent nerve palsy: A case report and review of literature.
Sixth-nerve palsy often develops as a result of trauma, neoplasm, or vascular disease affecting the pons. Less commonly, this palsy can be caused by pathology of the internal carotid artery in the cavernous sinus region. Here, we describe a rare case of spontaneous dissection of the internal carotid artery in the cavernous sinus accompanied by acute sixth nerve palsy that was successfully treated with surgery. ⋯ Intracavernous ICA dissection is a possible cause of sixth nerve palsy. While most cases likely result from compromised arterial blood supply to the affected nerve, compression of the cranial nerves by the expanded artery can occur in some cases. Surgical treatment is a safe and effective option for relieving nerve compression after intracavernous ICA dissection.
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This meta-analysis was conducted to evaluate the therapeutic effects in clinical and radiologic outcomes of a self-locking stand-alone cage (SSC) and cage-with-plate (CP) for multilevel anterior cervical discectomy and fusion (ACDF). ⋯ ACDF with SSC and CP in multilevel cervical spondylosis achieved similar clinical relief. Although CP maintained better cervical lordosis, SSC contributed to less surgical pain and fewer complications. ACDF with SSC is safe and efficient in treating multilevel cervical spondylosis.
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To evaluate long-term outcome and reoperation rate for microsurgical bilateral decompression via unilateral approach of lumbar spinal stenosis, a common degenerative spinal disease of the lumbar spine. ⋯ Bilateral decompression via unilateral approach for lumbar spinal stenosis allowed a sufficient and safe decompression of the neural structures, resulting in a highly significant reduction of symptoms and disability, acceptable reoperation rate, and improved health-related quality of life.
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Brainstem arteriovenous malformations (AVMs) represent ∼5% of all intracranial AVMs and carry a higher risk of hemorrhage than their supratentorial counterparts. There is a high and near-uniform mortality with initial and recurrent episodes of hemorrhage. Brainstem AVMs may also present symptomatically with focal neurologic deficits or hydrocephalus. ⋯ Embolization may also be used effectively as stand-alone monotherapy for small lesions with 1 or 2 arterial feeders not supplying eloquent parenchyma. Although an extensive evidence base exists for clinical usefulness of stereotactic radiosurgery as monotherapy or in combination with other therapeutic modalities, only a few studies have reported specifically on obliteration and complication rates with monotherapeutic embolization in the treatment of brainstem AVMs. The potential role of embolization as monotherapy for brainstem AVMs is reviewed and discussed.
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Review Case Reports
Severe kyphoscoliosis associated with multiple giant intraspinal epidural cysts: a case report and literature review.
Severe kyphoscoliosis associated with multiple giant spinal epidural arachnoid cysts (SEACs) is an extremely rare condition and remains a challenge in clinical practice. This study aimed to present a case of severe spinal deformity associated with multiple giant SEACs and to discuss strategies for the preoperative diagnosis and treatment. ⋯ Cyst-peritoneal shunting surgery followed by PVCR, as in our case, could be an alternative surgical strategy for multiple giant SEACs associated with severe rigid kyphoscoliosis.