World Neurosurg
-
Case Reports
Vertebral Artery Stump Syndrome Due To Chronic Complicated Aortic Dissection: A Case Report.
Vertebral artery (VA) stump syndrome arises when thrombi of an occluded proximal VA propagate to the brain and cause posterior circulation strokes. This phenomenon has been described in limited reports to date. ⋯ We describe a unique mechanism of VA stump syndrome due to VA occlusion and pressure waves from an aortic dissection and present the first report of VA stump syndrome treatment by surgical exclusion of the VA.
-
Blast-induced traumatic brain injuries (bTBIs) are increasingly frequent in civilian settings. We present the first study of individuals with bTBI in Iraq. The study focuses on one of the deadliest suicide car bomb attacks in Iraq and uses it to show the devastating nature of bTBIs. ⋯ This study sheds light on the devastating nature of bTBIs. Neurosurgeons worldwide need to be mindful of the unique triaging, diagnostic, and management requirements of these injuries.
-
Limited studies exist to support the safety of performing neuromodulation surgeries in patients whose anticlotting medication has been held. Here, we assess the safety of performing deep brain stimulation (DBS) in this patient population. ⋯ We found no increased risk of complications in patients routinely on anticlotting medication undergoing DBS lead placement. We show that our protocol was successful in balancing increased risks of bleeding and of thromboembolic events in this patient group.
-
Open microsurgical thrombectomy for acute intracranial large vessel occlusion (LVO) has been the subject of dozens of case reports and series. However, no clear indications exist to define its role in the management of acute ischemic stroke. Our aim was to review all the available data on open microsurgical thrombectomy, for both spontaneous as well as iatrogenic intracranial vessel occlusion, in terms of indication and results. ⋯ In the era of endovascular thrombectomy, open microsurgical techniques might still play a role in highly selected patients. The reported patients show that microsurgical thrombectomy seems efficient and effective in improving patient outcome. Ideally, a multidisciplinary approach with vascular neurosurgeons trained and skilled in microvascular techniques is recommended.
-
Among chondrosarcomas arising from bones and soft tissues, mesenchymal chondrosarcoma (MCS), especially primary spinal intradural extramedullary MCS, is extremely rare, and only 18 cases have been reported to date. We report an adult case of this rare condition mimicking meningioma. ⋯ Primary spinal intradural extramedullary MCS has been reported to have a better prognosis than MCS occurring in other regions. In a case with early complete surgical resection, adjuvant therapy should be considered at the time of recurrence.