World Neurosurg
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Case Reports
Complete transection of optic nerve after endovascular coiling of a large ophthalmic artery aneurysm: Case report.
We describe a patient who developed delayed blindness of the left eye at 5 weeks after endovascular coiling of a large ophthalmic aneurysm. ⋯ This report describes a rare complication of a sudden increase in size of a large ophthalmic aneurysm despite successful endovascular occlusion.
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Magnetic resonance imaging plays an important role in identification of any underlying structural cause in spontaneous cerebrospinal fluid (CSF) leaks-either rhinorrhea or otorrhea. Sphenoid bone defects have been reported in those presenting as idiopathic intracranial hypertension with or without CSF rhinorrhea. Sphenoid lateral recess defect with intrasphenoidal encephalocele is one of the uncommon causes of spontaneous CSF leakage. Many classifications of basal encephaloceles have been used along with associated predisposing anatomic factors for the CSF leak. ⋯ We discuss the various classification systems of sphenoidal encephaloceles and review the terminology and comprehensive imaging details to be included in reporting such cases for appropriate treatment planning.
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This study aimed to clarify the risk factors of treatment for unruptured cerebral aneurysms (UCAs) in elderly patients by comparing the morbidity at discharge between surgical clipping and endovascular coiling in nonelderly (<65 years) and elderly (≥65 years) patients based on a national database in Japan. ⋯ Endovascular coiling after control of diabetes mellitus was recommended for the treatment of UCA in elderly patients. The ICA location of aneurysm in the elderly should be paid attention as the treatment risk.
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Preoperative tumor-related edema of the optic tract (EOT) is often found along the white matter tract of the visual system. However, the relationship of EOT with visual function and outcome remains unclear. Therefore we aimed to elucidate whether the presence of EOT is associated with visual outcome in patients with sellar and suprasellar tumors. ⋯ This study reveals that EOT caused by sellar and suprasellar tumors is associated with worse visual function and poor improvement postoperatively.
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The reported incidence of postoperative ileus (POI) after spine surgery depends on the surgical approach and definition used. It is therefore possible that the overall incidence is substantially higher than previously thought. POI has consequences for both the patient and hospital resources, and can significantly increase health care costs. ⋯ Despite use of early interventions, the median LOS remains significantly longer in patients who develop POI after complex spine surgery. Knowledge of the associated predictive risk factors could potentially assist with the development of rigorous, evidence-based preventative strategies.