World Neurosurg
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Cervical pial arteriovenous malformation (AVM) is an extremely rare condition that can present with progressive myelopathy or acute hemorrhage (subarachnoid or intramedullary). The classification process is still a topic of discussion, given the limited number of cases described, as well as correct therapeutic management. Here, we present a case of a young female with anterior cervical pial AVM associated with spinal aneurysm. ⋯ Surgical procedure with perioperative neuromonitoring is an effective way to treat anterior cervical pial AVM associated with spinal aneurysm. A multidisciplinary approach is always suggested.
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Meta Analysis Comparative Study
Biportal Endoscopic Spinal Surgery Versus Microscopic Decompression for Lumbar Spinal Stenosis - A Systematic Review and Meta-analysis.
Recent studies have shown that the clinical outcome in patients treated with the unilateral biportal endoscopic technique, also known as biportal endoscopic spinal surgery (BESS) unilateral laminotomy bilateral decompression (ULBD) in the context of this study, is more favorable compared with those treated with microscopic ULBD. In this systematic review and meta-analysis, we assess the latest evidence on the use of BESS ULBD compared with microscopic ULBD in patients with lumbar spinal stenosis. ⋯ Current evidence shows a lack of significant differences in terms of efficacy and safety between BESS and microsurgery. Further studies are required before drawing a definite conclusion.
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Minimally invasive endoscopic spine surgery is useful for the treatment of various spinal conditions. Although surgery-related complications such as dural injury, exiting nerve root injury, incomplete decompression, and hematoma have been reported, there are few reports of late complications after endoscopic surgery. ⋯ The surgeon should carefully review risk factors such as isthmic type spondylolisthesis before planning spine surgery and minimize facet joint damage during endoscopic decompression.
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Review Case Reports
Recurrent spinal intramedullary arachnoid cyst: A case report and literature review.
Symptomatic intramedullary arachnoid cysts are rarely observed lesions, particularly in the pediatric age group. Treatment includes cyst fenestration or resection of the cyst wall, and recurrence after surgery has never been reported. We report a rare case of a spinal intramedullary arachnoid cyst, which recurred after cyst fenestration and required reoperation after a certain period. ⋯ To the best of our knowledge, this is the first report of recurrence of an intramedullary arachnoid cyst. This case indicates the importance of considering the resection of cyst wall as possible because of the probability of cyst recurrence after fenestration, while careful observation is the option in the short term, especially for children or high-risk cases.
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Middle cerebral artery (MCA) fenestration is a rare vascular variant of the MCA. When this occlusion occurs, it presents challenges to identification and recanalization. We describe a patient with a partially occluded MCA fenestration in whom recanalization was successfully achieved via mechanical thrombectomy using a stent retriever with an intermediate catheter. ⋯ Mechanical thrombectomy may be feasible and safe in MCA fenestration occlusion.