World Neurosurg
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The aim of this study is to provide credible and comparable evidence on the efficacy and safety of pure microvascular decompression (MVD) for primary trigeminal neuralgia (TN), and also to find out the possible prognostic factors of excellent long-term outcome after the surgery. ⋯ This is a perspective cohort study of pure MVD, which confirms the long-term effectiveness and safety of the surgery for primary TN. Patients with typical symptoms, positive magnetic resonance findings, or obvious vessel compressions might have better long-term prognosis.
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Comparative Study Controlled Clinical Trial
Acute normovolemic hemodilution is safe in neurosurgery.
To determine the safety of acute normovolemic hemodilution (ANH) for patients undergoing neurosurgical procedures. ⋯ ANH is a safe procedure for patients undergoing neurosurgical procedures. Further studies are necessary to confirm the improvement in brain oxygen extraction and the clinical impact. Nonetheless, patients undergoing aneurysm clipping with good clinical grades seem to profit from ANH.
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Case Reports
Traumatic (type II) odontoid fracture with transverse atlantal ligament injury: a controversial event.
Traumatic (Type II) odontoid fractures are very common injuries. Nevertheless, their connection with transverse atlantal ligament injury is controversial and poorly defined. The aim of this study is to report a single case of traumatic (type II) odontoid fracture with transverse atlantal ligament injury and to critically analyze the role of ligaments and membranes together with neuroradiological tools in the management of craniovertebral junction-traumatized patients. ⋯ Traumatic (type II) odontoid fracture with transverse atlantal ligament avulsion can be considered an unusual event. It is our opinion that the routine use of MRI for all patients with type II odontoid fracture could be unjustified in clinical practice. Strict clinical surveillance of all patients managed conservatively and the use of MRI in selected cases could be a reasonable management option.
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Mycotic aneurysm rupture has been described as a rare, universally fatal complication of central nervous system Coccidioides immitis meningitis. Recently, however, we reported the successful surgical management of a midbasilar dissecting mycotic aneurysm related to C. immitis meningitis in a 24-year-old pregnant woman with acquired immune deficiency syndrome. ⋯ Our patient represents the only survivor of a C. immitis mycotic aneurysm rupture. In her case, long-term clinical and radiographic stability were achieved through a vigilant multidisciplinary approach.
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In 2009, during the World Congress of Neurological Surgery in Boston, Massachusetts, the World Federation of Neurosurgical Societies (WFNS) Executive Committee decided to establish a Military Neurosurgeons Committee. A separate scientific session on military neurosurgery was held at the next WFNS Interim Meeting in September 2011 in Brazil. A further separate session on military neurosurgery will take place at the next WFNS Meeting in Seoul, South Korea.