World Neurosurg
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Spontaneous intracranial hypotension (SIH) is a rare condition for which no optimal treatment guidelines have been determined. The most common presentation is orthostatic headaches, but patients can present with a variety of symptoms. ⋯ This case demonstrates that an intrathecal saline infusion can be used as an effective temporizing measure in patients with critical symptoms of SIH and it also alerts clinicians that low-pressure subdural collections can progress to subdural collections under high pressure.
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The cause of postoperative heterotopic ossification (HO) after cervical disc replacement (CDR) is unclear. The aim of the present study was to investigate the incidence of HO, its clinical significance, and whether the degree of preoperative degeneration was associated with its occurrence. ⋯ The presence of HO after CDR was a relatively frequent finding at the final follow-up visit but did not influence patients' improvements. Segments with higher grades of preoperative degeneration had a greater incidence of HO; thus, HO is likely a reflection of the degeneration process.
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Pediatric intracranial aneurysms (IAs) are rare and differ from their adult counterparts in terms of their aneurysmal characteristics, presentation, treatment, and outcomes. Their treatment is often more difficult and complex compared with that of adults. However, studies outlining the clinical effect of pediatric IAs remain sparse. ⋯ The treatment of pediatric IAs is challenging and technically demanding owing to their discrete nature compared with adult IAs and the need for greater surgical skills. We found a male predominance, with internal carotid artery bifurcation as the most frequent location of the aneurysms. Despite the greater incidence of ruptured and complex aneurysm cases, many patients had experienced a good recovery at the 6-month follow-up examinations.
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Preoperative magnetic resonance imaging with fat suppression (FS-MRI) is useful to detect bone marrow edema in osteoporotic vertebral fractures (OVFs) and thus can improve diagnostic accuracy and influence surgical strategy for percutaneous augmentation. The role of preoperative FS-MRI in preventing subsequent fractures after balloon kyphoplasty has not been investigated in initially subclinical fractures or fractures without obvious morphologic changes. ⋯ Surgical treatment according to preoperative FS-MRI did not reduce occurrence of subsequent OVFs and did not prolong fracture-free intervals within 12 months after kyphoplasty.
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Cerebral amyloidoma is the rarest presentation of amyloid-related diseases of the central nervous system. We present the case of a patient with visual difficulty and an infiltrating lesion in the temporal lobe, shown by magnetic resonance imaging. In as much as a benign clinical course is expected, a knowledge of this entity, along with state-of-the-art imaging and close follow-up, could avoid invasive procedures such as biopsy.