World Neurosurg
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The present study evaluated the relationships among perioperative hyperchloremic metabolic acidosis (HCA), hyperchloremia, and postoperative acute kidney injury (AKI) in patients who had undergone craniotomy for intracranial hemorrhage (ICH). ⋯ Perioperative HCA was independently related to an increased incidence of AKI after craniotomy for ICH. An increase in Cl- levels and perioperative hyperchloremia were associated with increased development of HCA but were not significantly related to the development of postoperative AKI.
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This study aimed to analyze the risk factors for secondary new vertebral compression fractures (SNVCFs) after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures. ⋯ Low BMD, high preoperative compression ratio, and high preoperative SI may be predictive factors for SNVCFs. In particular, to prevent AVCF, the injected bone cement should be distributed both evenly and symmetrically along the inferior-to-superior axis and the relative bone cement volume should not be excessive. Bone cement should be injected carefully to avoid upper adjacent intradiscal leakage. Prompt BMD correction is important to prevent SNVCF.
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Meningiomas extended to the scalp without any bony changes are rare. A 79-year-old man presented with a large subcutaneous mass in the midline parieto-occipital region and progressive right hemiparesis. ⋯ Histopathologic examination of both intracranial and extracranial tumors demonstrated the same atypical meningioma (World Health Organization grade II). The possible route of extracranial extension of the tumor may be the sizable parietal foramen.
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Case Reports
Acupuncture induced cranial epidural abscess: Case report and review of the literature.
Acupuncture is a common form of alternative medicine that is used for pain control among other modalities of treatment. It is a relatively safe procedure, but complications, including those of infectious etiology, may still occur. ⋯ To our knowledge, this is the first report of intracranial abscess after acupuncture. Given the worldwide application of this alternative treatment, physicians, acupuncturists, and the general public should be aware of the possibility of this rare but serious complication.
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The purpose of this study was to investigate neck movement and various conditions of the aortic arch that may hinder access to the carotid artery during neurointerventional procedures. ⋯ Factors such as older age, acute arch angle, higher elongation type, arch calcification, and carotid artery angulation were verified as factors affecting access by a simple catheter; however, neck extension was shown to facilitate access in about 10%-30% of patents.