World Neurosurg
-
The prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) depends on their condition on arrival at the hospital. However, a small number of patients recover from an initially poor condition. We investigated the correlation between quantitative measures of computed tomography (CT) perfusion (CTP) on arrival and the outcomes of patients with World Federation of Neurosurgical Society (WFNS) grade V aSAH. ⋯ We cannot expect a favorable outcome for patients with WFNS grade V aSAH with aMTT >6.385 seconds or more than 2 of 8 areas with MTT >7.0 seconds.
-
Hemifacial spasm occurs when a blood vessel compresses against an area near the root exit zone of the facial nerve. Developments in diagnostic neuroimaging have allowed three-dimensional (3D) observation of artery and nerve locations, an effective aid for treatment selection. However, an accurate interpretation of the 3D data remains challenging because imaging representations of complex small vessels are drowned out by noise. We used a noise elimination method to analyze artery and nerve locations and to determine their 3D relationship. ⋯ An accurate identification of the offending arteries and compression sites was possible, and this method is anticipated to offer effective means of preoperative simulation.
-
Autonomous innervations of the lungs are maintained by cervical sympathetic and vagal nerves. Sympathetic overactivity-induced neurogenic pulmonary edema (NPE) is known as a serious complication of subarachnoid hemorrhage, but the rational neuronal mechanism of that overactivity has not yet been clarified fully. The aim of this study was to examine whether there is a relationship between vagal nerve ischemia related sympathetic overactivity and neurogenic pulmonary edema in subarachnoid hemorrhage. ⋯ High neuron density of stellate ganglion may have important roots in sympathetic overactivity-related NPE development in subarachnoid hemorrhage.
-
Intracranial germinoma is a rare primary brain cancer, usually located within the midline and mainly affecting Asian pediatric patients. Interestingly, we report here the peculiar case of a young North-African adult patient suffering from a basal ganglia germinoma without the classical ipsilateral cerebral hemiatrophy associated with this location.
-
The pathophysiology of dural arteriovenous fistulas (dAVF) is not fully understood. Retrograde venous flow can lead to venous congestion and disruption of the blood-brain barrier, resulting in diffuse contrast enhancement. ⋯ This case report highlights how venous congestion is an important differential diagnosis in contrast-enhancing lesions associated with dAVF and how it should be taken in consideration to avoid radiologic misdiagnoses and unnecessary treatment.