World Neurosurg
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Case Reports
Spontaneous spinal epidural hematoma with lumbar facet joint destruction mimicking pigmented villonodular synovitis.
Spontaneous spinal epidural hematoma (SSEH) is a spinal emergency that requires early diagnosis and decompression surgery. Here, we report a case of SSEH that was difficult to differentiate from pigmented villonodular synovitis (PVS) because of combined facet joint destruction and that required gross total resection, a procedure not typically indicated for SSEH. ⋯ SSEH could be combined with facet joint destruction composed of bone necrosis. Awareness of SSEH with facet joint destruction can facilitate early diagnosis and appropriate surgical treatment.
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In this study we aim to evaluate the feasibility of creating volumetric models of highly intricate skull-base anatomy-previously not amenable to volumetric reconstruction-using endoscopic endonasal approaches. ⋯ Endoscopic volumetric models represent a new way to depict the anatomy of the skull base; their use with 3-dimensional technologies could potentially improve the visuospatial understanding of narrow surgical corridors for education and surgical-planning purposes.
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To evaluate the safety and efficacy of stent-only technique with Low-profile Visualized Intraluminal Support (LVIS) for uncoilable intracranial aneurysms. ⋯ LVIS stent-only technique is safe and efficacious for uncoilable aneurysms, even for ruptured ones.
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Foraminal cervical nerve root compression can be caused by lateral disk herniation or osteophyte formation of the vertebrae. Improved diagnosis and evaluation can be achieved using different imaging techniques: radiographs, computed tomography (CT), and magnetic resonance imaging. We retrospectively evaluated the potential influence of a virtual reality (VR) visualization technique on surgery planning and evaluation of postoperative results in patients with monosegmental, unilateral osseous cervical neuroforaminal stenosis. ⋯ Reconstruction of pre- and postoperative 2D-CT images of the cervical spine into 3D images, and the spatial and anatomical reconstructions in VR models, can be helpful in planning surgical approaches and treatment strategies for patients with cervical foraminal stenoses, and for evaluation of their postoperative results.
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Treatment of unruptured intracranial aneurysms (IAs) in elderly patients is associated with a high risk of morbidity and mortality, necessitating a thorough understanding of the potential rupture risk. The aim of this study was to identify morphologic parameters and anatomic locations that could discriminate ruptured IAs in patients ≥70 years old. ⋯ Aneurysm size, size ratio, and aspect ratio may not be reliable discriminants of rupture in elderly patients. Unruptured IAs in elderly patients should be evaluated on the basis of shape irregularity and anatomic location.