World Neurosurg
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Cord signal change (CSC) on magnetic resonance (MR) imaging is an important radiologic feature of degenerative cervical myelopathy (DCM). Occasionally, DCMs correlate with clinical symptoms with no CSC. The aim of this study was to evaluate clinical and radiologic features, depending on the presence of CSC in DCM. ⋯ DCM with negative CSC can be caused by a well-preserved cervical ROM, even with less deteriorated canal stenosis and kyphosis. C27ROM may be a helpful radiologic parameter in diagnosing DCM before CSC appears.
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The authors present a case of a 66-year-old male who was diagnosed with human immunodeficiency virus, and his medical course of highly active antiretroviral therapy was complicated with the development of immune reconstitution inflammatory syndrome, which led to development of movement disorder consisting of right-sided resting tremor, neck dystonia, and jaw clenching. ⋯ This is the first reported case in the literature of a human immunodeficiency virus-positive patient's treatment course complicated with immune reconstitution inflammatory syndrome with neurologic manifestation, which was refractory to medical therapy and thus treated with deep brain stimulation.
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Case Reports
Learning from mistakes: Pancreatic laceration - Devastating complication during spine surgery.
Posterior decompression and fusion surgery is one of the most commonly performed surgeries for thoracolumbar tuberculosis with destruction of vertebral bodies. Tuberculosis causes gross destruction of the vertebral bodies and surrounding tissue, making them friable. ⋯ This case illustrates the possibility of pancreatic injury should always be kept in mind if the patient develops acute abdominal discomfort in the postoperative period. Also, a multidisciplinary approach along with intensive care backup and vigilant postoperative monitoring is of utmost importance, especially when an unusual event has occurred during the surgery.
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Case Reports
Carotid free-floating thrombus in a stent six months after carotid artery stenting: A case report.
Carotid free-floating thrombus (CFFT) is defined as a blood clot attached to the arterial wall with surrounding blood flow at its distal component. Although rare, it is a clinically significant cause of embolic stroke. CFFT within a stent has not been previously reported. ⋯ Carotid plaque formation and plaque rupture can occur within a carotid stent and present as a CFFT.
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In adult patients undergoing multidetector computed tomography (CT) of the brain, we observed linear calcification along the deep venous system on thin (<3 mm) sagittal reconstructions. We found no reports of this finding in the velum interpositum (VI) in the imaging literature. We performed a focused examination of the VI on 2 autopsy cases and retrospectively reviewed sagittal, thin-section reconstructions of CT scans of 273 consecutive adult patients. ⋯ Evidence supports that linear midline calcification along the internal cerebral veins represents age-related, physiologic calcification of extraventricular choroid plexus within the VI. Awareness of this previously unreported finding on CT will prevent mistaking these physiologic calcifications on CT for evidence of underlying venous pathology. This finding provides additional support that the midline choroid plexus lies within the VI rather than in the third ventricle and expands our understanding of the detailed anatomy of the VI.