World Neurosurg
-
Case Reports
Deep brain stimulation for the treatment of dopa-responsive dystonia: A case report and literature review.
The aim of this study was to observe the improvement in patients with dopa-responsive dystonia (DRD) after deep brain stimulation (DBS) of the globus pallidus internus (GPi). ⋯ After 6 months of GPi DBS treatment, the total BFMDRS score of the patient was 5, a 94.28% improvement over the preoperative baseline score. In addition, the MMSE, MOCA, HAMA, and HAMD scores of the patient were 30, 30, 1, and 2, respectively. Intelligence and cognitive levels of the patient did not change significantly compared with the preoperative baseline level, whereas anxiety and depression status of the patient improved compared with the preoperative status. GPi DBS treatment can significantly improve the symptoms of systemic dystonia in patients with DRD, and to a certain extent improve the anxiety and depression status of these patients. Therefore, we conclude that GPi DBS is an alternative safe and effective treatment for patients with DRD.
-
Case Reports
Giant Iliac Artery Pseudoaneurysm Mimicking Postoperative Fluid Collection and Discitis.
In this report, we describe an extremely rare case of a giant pseudoaneurysm of the internal iliac artery causing marked destructive changes at a disk space and mimicking diskitis-osteomyelitis. Only 2 other cases of pseudoaneurysms extending into the disk space have been reported, and those arose from the aorta and were relatively straightforward to diagnose. ⋯ Complex paraspinal fluid collections causing osseous erosions should raise the possibility of an aneurysm/pseudoaneurysm. Computed tomography or conventional angiography should be considered if the question of a vascular mass/collection cannot be answered on conventional cross-sectional imaging, as inadvertent biopsy of a pseudoaneurysm can cause catastrophic bleeding.
-
With this case report, we aim to add to the clinical literature on the use of three-dimensional printed patient-specific implants in spinal surgery, show the current state of the art in patient-specific implant device design, present thorough clinical and radiographic outcomes, and discuss the suitability of titanium alloy as an implant material for patients with cancer. ⋯ Computer-aided preoperative planning with three-dimensional printed biomodels and custom implant resulted in relatively quick and simple reconstruction after tumor resection, with good clinical and radiographic outcomes at 17 and 14 months, respectively. For patients with primary tumors who may require follow-up radiotherapy or postoperative magnetic resonance imaging, metals used in the devices cause significant imaging artifact.