World Neurosurg
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Neurosarcoidosis tends to occur in younger patients and shows poorer prognosis. Central nervous system involvement is found in approximately 10% of the sarcoidosis patients. ⋯ Neurosarcoidosis is known to be a master of disguises since it has variable imaging presentation and frequently mimicks meningioma. Neurosarcoidosis presenting as multiple discrete dural based mass lesions without any other systemic involvement is rarer.
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Flow diverters (FDs) were introduced for management of large or giant cavernous carotid aneurysms (CCAs) in addition to conventional modalities, dramatically changing treatment strategies. This study examined the management of unruptured large/giant CCAs in Japan when FDs were being introduced using a nationwide survey. ⋯ The nationwide survey reported here determined the status of treatment for unruptured large/giant CCAs in Japan when FDs were being introduced. Because PAO has disadvantages including the long-term hemodynamic effects of ICA occlusion, reconstructive treatment using FDs is optimal for this type of aneurysm; however, PAO can be an option in selected cases given the higher rates of complete occlusion and symptom improvement.
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Previous studies have found that percutaneous vertebroplasty (PVP) can effectively improve the local pain (LP) of the affected vertebra caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) regardless of unilateral or bilateral puncture, but there are few reports on whether it is equally effective for the accompanying distant lumbosacral pain. The objective of this study was to analyze the clinical efficacy of unilateral or bilateral PVP in the treatment of thoracolumbar OVCF with distant lumbosacral pain. ⋯ PVP can not only improve the LP and ODI index of the responsible vertebra of OVCF in the thoracolumbar region, but also improve the accompanying distant lumbosacral pain symptoms, and the puncture approach does not affect the improvement of postoperative pain and function.
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Cervical stenosis (CS) is the pathologic narrowing of the central canal of the cervical spine. It is often incidentally discovered. It is unclear whether pre-existing CS can lead to worse outcomes and higher incidences of post-traumatic spinal cord injury (SCI). ⋯ Though patients with pre-existing CS do not have higher odds of SCI in studies with internal controls, we find that patients with CS do have higher incidences of SCI and are over-represented in the population of SCI patients. In select CS patients with active lifestyles, close follow-up and consideration of various treatment options may be indicated.