World Neurosurg
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Cavernous carotid aneurysms are typically small, asymptomatic, and often do not require treatment. We present the case of a 59-year-old woman, a 3-pack-a-day smoker, who presented with the primary complaint of left retro-orbital pain, left complete ophthalmoplegia, left-sided blindness, and right abducens palsy. Imaging revealed a giant right cavernous carotid aneurysm, which had expanded to the contralateral cavernous sinus wall and superiorly through the diaphragm sellae. ⋯ Postoperative computerized tomography angiography confirmed placement of the clips and patency of the vessel. At short-term follow-up, the patient's trigeminal pain had successfully resolved and she had retained vision in the right eye. This case demonstrates the feasibility of expanded endonasal approaches in managing this challenging pathology (Video 1).
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Lumbar spinal stenosis often necessitates surgical intervention, with preoperative musculoskeletal health significantly influencing postoperative outcomes. This prospective cohort study investigates the sex-specific impact of preoperative musculoskeletal characteristics on postoperative leg pain in elderly patients undergoing lumbar surgery. ⋯ These findings highlight the need for sex-specific preoperative assessments to improve surgical outcomes, suggesting that targeted preoperative interventions to enhance musculoskeletal health could benefit female patients undergoing lumbar surgery.
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Aneurysmal subarachnoid hemorrhage (aSAH) has a high complications burden, with in-hospital mortality as the most devastating outcome. We aimed to develop and validate a risk score for early prediction of in-hospital mortality after aSAH. ⋯ Risk of in-hospital mortality after aSAH can be predicted with high accuracy using baseline characteristics. The novel risk score showed best diagnostic performance in the construction and validation cohorts and can aid in early prognostication and treatment decisions.
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The aim of this study was to use computed tomography-based 3-dimensional morphometric imaging to precisely quantify the anatomic parameters of the lumbar laminae and increase the precision of laminar fenestration during percutaneous endoscopic spinal surgery. ⋯ This study has revealed significant anatomical diversity within the laminae of lumbar vertebral segments. These findings provide important anatomical information for surgeons performing precise laminar fenestration during endoscopic spinal surgery.
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To determine the incidence of subdural hygroma (SDH) on routine early postoperative imaging following foramen magnum decompression (FMD) with dural opening in patients with Chiari 1 malformation (CM1). ⋯ SDH is a common finding in the early postoperative scans of patients undergoing FMD and dural opening for CM1. While nearly two-thirds of these patients are asymptomatic, SDH with ventriculomegaly can be associated with mortality and significant morbidity and may require emergency treatment.