World Neurosurg
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Postoperative intracerebral hemorrhage (ICH) after direct bypass surgery for Moyamoya disease could contribute to neurologic deterioration. The aim of this study was to evaluate the effectiveness of 5-day bed rest in reducing the occurrence of postoperative ICH. ⋯ Five-day bed rest after direct bypass surgery dramatically can reduce the incidence of postoperative ICH and neurologic deterioration after direct bypass surgery.
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Cauda equina syndrome (CES) can have devastating neurological sequelae if surgical treatment is delayed. However, out-of-hours surgery (weekdays from 6:00 pm to 8:00 am and all weekend operations) can potentially result in higher rates of intraoperative complications, resulting in worse outcomes. In the present study, we have described our outcomes for patients with CES during an 8-year period (December 2011 to October 2019) with the aim of assessing the risk of out-of-hours surgery. ⋯ Our analysis has suggested that emergency decompressive surgery for patients with CES does not result in worsening of outcomes with out-of-hours surgery compared with in-hours. However, our findings also showed that no clear benefit exists to expediting surgery for those with severe presentations. Thus, decompressive surgery should be undertaken at the earliest possible time to safely do so.
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The primary objective of the present study was to investigate the correlations among cervical paraspinal muscle morphology changes (fatty infiltration [FI] and muscle atrophy), cervical degeneration, and clinical features in patients with chronic nonspecific neck pain (CNSNP). ⋯ Correlations among the muscle morphology changes, cervical degeneration, and clinical features were established for patients with CNSNP. Muscle volume changes and FI might affect CNSNP diversely through different paraspinal muscle groups. These results imply a complex contribution of muscle morphological changes to cervical degeneration and the clinical course of CNSNP.
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Posterior cerebral artery (PCA) aneurysms are rare, and most are giant, dissecting, or fusiform in morphology. Proximal occlusion of the PCA without revascularization causes high risk of ischemic complications. This study aimed to evaluate the safety and validity of using superficial temporal artery (STA)-PCA bypass through zygomatic anterior temporal approach in complex PCA aneurysms. ⋯ STA-PCA bypass appears to be safe and effective for the treatment of complex PCA aneurysms requiring supplementation of blood flow in the area of the PCA. We established a surgical route, allowing the procedure to be done through the zygomatic anterior temporal approach. This approach provides adequate operative field exposure and reduces retraction of temporal lobe.
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To investigate the efficacy of a lateral mass fusion device combined with a three-dimensional-printed model in treatment of craniovertebral junction abnormalities. ⋯ During 1-year follow-up, neurological function improvement and atlantoaxial joint reduction were satisfactory. The lateral mass fusion device combined with a three-dimensional printed model may be a clinically useful technique.