No shinkei geka. Neurological surgery
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Review Case Reports
[Hemifacial spasm caused by a dissecting aneurysm of the vertebral artery, and resulting in acute exacerbation].
The authors report a rare case of a symptomatic hemifacial spasm caused by a dissecting vertebral artery aneurysm and by an anterior inferior cerebellar artery(AICA). A 54-year-old man presented with left hemifacial spasm persisting for 5 years, and the spasm had undergone acute aggravation. ⋯ Microvascular decompression of the facial nerve with proximal clipping of the vertebral artery dissecting aneurysm was successfully performed. The hemifacial spasm disappeared immediately after the surgery.
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Case Reports
[A case with Stanford type A acute aortic dissection that presented with consciousness disturbance and hemiparesis].
The patient was a 63-year-old female who had a past history of hypertension. She suddenly complained of agonizing pain and became comatose soon thereafter. Upon admission, she was in a state of shock, with upper airway obstruction and a coma. ⋯ The pathological examination showed that the arterial dissection occurred in the layer of elastic fiber, and the minimum arterial thickness of the medial layer was 0.2mm. The patient improved after the operation and her neurological deficits disappeared completely 13 days after operation. Brain and spinal MRI 15 days after the operation showed no abnormality.
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To evaluate the usefulness of transcranial motor evoked potential(MEP)monitoring for aneurysm surgery. ⋯ Intraoperative transcranial MEP monitoring is useful for predicting motor function after aneurysm surgery.