World Neurosurg
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We sought to assess preliminary technical and clinical outcomes of Catalyst 5 (CAT 5) as front-line aspiration treatment for M2-M3 occlusion in acute ischemic stroke. ⋯ Preliminary experience using CAT 5 in distal occlusions demonstrates that it may be safe and effective in acute stroke treatment.
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Gadolinium-based contrast agents (GBCAs) used to enhance magnetic resonance imaging (MRI) scans have been linked to tissue deposition, including in the brain. The management of indolent tumors such as meningiomas requires frequent MRI scans to monitor for interval growth. Given concern regarding GBCA deposition, we sought to determine if noncontrast MRI scans in patients with asymptomatic meningiomas were equivalent to GBCA-enhanced MRI scans in surveillance monitoring. ⋯ Our study provides evidence that noncontrasted MRI scans are equivalent to contrast-weighted MRI scans to follow change in tumor size over time in asymptomatic meningiomas.
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To investigate functional outcome from reconstructive surgery in adult traumatic brachial plexus injury (AT-BPI) with associated vascular lesions. ⋯ Concomitant vascular injury leads to worse functional outcome after reconstructive surgery of traumatic brachial plexus injury.
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Case Reports
Novel Treatment of Cerebral Vasospasm Using Solitaire Stent Retriever-assisted Angioplasty: A Case Series.
Endovascular procedures such as intraarterial (IA) vasodilator injection and balloon angioplasty are used to treat medically refractory cerebral vasospasm. The effects of IA therapy may be short lived and thus require multiple treatments. Balloon angioplasty also has limitations including transient occlusion of the spastic blood vessel, possible endothelial injury, and limited access to proximal vessels. We aim to demonstrate a novel technique using a stent retriever for the management of medically refractory vasospasm, especially in distal vessels. Compared with balloon angioplasty, stent retrievers provide a passive, self-limiting expansion of blood vessels. Other benefits over balloon angioplasty include 1) ability to simultaneously inject IA vasodilators, 2) limited contact and damage to vessel wall, 3) nonocclusive expansion, and 4) technical ease. ⋯ We demonstrate the safety and efficacy of a novel technique for the treatment of medically refractory cerebral vasospasm using stent retriever angioplasty in distal vessels. Stent angioplasty can be used as an additional tool in the management of subarachnoid hemorrhage-induced cerebral vasospasm.
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Case Reports
Giant Invasive Sacral Schwannoma with Aortic Bifurcation Compression and Hydronephrosis.
Sacral schwannomas are rare tumors arising from nerve sheath Schwann cells. They are classified into 3 types: first type schwannoma arising from the sacrum, second type schwannoma eroding the sacrum, and third type schwannoma extending extensively, involving anterior, posterior, and retroperitoneal space. Among these type 2 sacral tumors, according to Klimo's classification, an eroding sacrum extending all over posteriorly, anteriorly, and laterally is still rarer. Only 38 cases have been reported in literature reviews. Only 6 cases of giant tumors of >10 cm in any 1 dimension have been reported. ⋯ Though complete resection, which caused various severe postoperative complications in the reported cases, is the best option, a less morbid procedure would be appropriate; hence we underwent subtotal excision of the tumor, with complete recovery of our patient's symptoms without neurologic deficit.