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https://www.readbyqxmd.com/read/28629679/how-to-address-cerebrospinal-fluid-leakage-following-ossification-of-the-posterior-longitudinal-ligament-surgery
#1
Jung Hyeon Moon, Sungjoon Lee, Chun Kee Chung, Chi Heon Kim, Won Heo
BACKGROUND: Primary dural repair in ossification of posterior longitudinal ligament (OPLL) surgery via anterior is challenging because of limited space. Based on several years of our experiences, we present our concept for addressing cerebrospinal fluid (CSF) leakage following dural tear during anterior OPLL surgery. METHODS: We reviewed the medical records of 65 patients who underwent anterior OPLL surgery from 2003 to 2014. We included 7 patients whose operation records described dural tear followed by CSF leakage...
June 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28628542/a-rare-intramedullary-spinal-cord-metastasis-from-a-retroperitoneal-leiomyosarcoma-presenting-as-a-non-traumatic-spinal-cord-injury
#2
Andrew Lamberth Parker, Terrence Pugh, Mark A Hirsch
Leiomyosarcoma (LMS) is a rare but well-recognized malignant soft tissue sarcoma of smooth muscle origin. Metastases commonly occur in the lungs, liver, kidney, brain, and bone. Cases of metastatic osseous lesions or other extradural space-occupying masses secondary to LMS leading to neurologic compromise are relatively commonplace in the literature. Conversely, cases of intramedullary spinal cord metastasis (ISCM), an unusual entity as a sequela of any cancer, are exceedingly rare as a consequence of LMS. Only 2 cases of an ISCM from LMS are currently documented in the literature, and to the best of our knowledge, no case is described in the rehabilitation literature...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28602497/anatomical-localization-of-the-cavernous-sinus-dural-fistula-by-3d-rotational-angiography-with-emphasis-on-clinical-and-therapeutic-implications
#3
Santhosh Kumar Kannath, Jayadevan Enakshy Rajan, Sankara P Sarma
BACKGROUND AND PURPOSE: Carotid cavernous sinus dural arteriovenous fistulas (CSDAVFs) are presumed to be located within the walls of the cavernous sinus, however the exact fistulous site has not yet been studied by angiographic or anatomical methods. The present study aimed to localize CSDAVFs with the help of 3D rotational angiography (RA) and correlated the observations with clinical and angiographic findings. MATERIALS AND METHODS: The CSDAVFs were categorized as dural, extradural or osseous based on the site of convergence of feeders into the venous sac...
June 8, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28601873/disappearance-of-the-hemorrhagic-component-of-the-frontal-contusion-possibly-due-to-redistribution-of-the-hematoma-within-the-subarachnoid-space-a-case-report
#4
Mohd Faheem, Manish Jaiswal, Bal Krishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava, Noor Us Saba
Posttraumatic hemorrhagic contusions are a common sequel of traumatic brain injuries. They occur in around 8% of all traumatic brain injuries. Spontaneous resolution of acute subdural and acute extradural hematomas, although rare, is a recognized entity, but spontaneous resolution of the hemorrhagic component of a contusion within 24 h has not been reported in the literature. We present a patient in whom the hemorrhagic component of her contusion resolved spontaneously over a period of 24 h after injury. The rarity of this case prompted us to this study...
June 10, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28594302/ectopic-orbital-meningioma-fact-or-fiction
#5
Lee Teak Tan, Christopher M Stewart, Fintan Sheerin, Brendan MacDonald, Priy Silva, Jonathan H Norris
Primary intraorbital ectopic meningiomas are rare and their existence remains controversial. We present a 30-year-old female with painless, non-axial proptosis and a palpable superomedial mass. The MRI demonstrated that the mass had no optic nerve sheath or sphenoid wing involvement and was initially reported to have no intracranial extension. The patient was initially thought to have an ectopic orbital meningioma. Subsequent multidisciplinary team (MDT) consultation and further specialist review of the MRI revealed a subtle dural tail connecting to an enhancing mass in the olfactory groove...
June 2017: Orbit
https://www.readbyqxmd.com/read/28583042/cervical-cord-decompression-following-embolisation-of-a-giant-cervical-vertebro-vertebral-arteriovenous-fistula
#6
George H Tse, Umang J Patel, Stuart C Coley, Richard A Dyde
Arteriovenous fistulation between the vertebral arteries to extradural (epidural) veins, termed vertebro-vertebral arteriovenous fistulae, are uncommon diagnoses without established diagnostic algorithms or treatment options. Minimal evidence exists describing the management of this pathology. Endovascular treatment was performed under general anaesthesia by coil occlusion of the vertebral artery from the point of the fistula to the mid-vertebral artery. Repeat magnetic resonance angiographic imaging one week following the procedure confirmed an 80% reduction in the size of the epidural vein and decompression of the cervical spinal cord...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28582290/atypical-growing-pattern-of-superficial-temporal-artery-pseudoaneurysm
#7
Jeonghyun Ha, Yong Hyun Kim, Bo La Yun, Kyu Sang Lee, Chang-Sik Pak, Jae Hoon Jeong
Superficial temporal artery pseudoaneurysm is rare and usually caused by trauma. Pseudoaneurysms have been reported to occur most frequently from 2 to 6 weeks after trauma and they range from 1 to 3 cm in diameter. The authors present a case of a patient with an atypical delayed rapid growing pseudoaneurysm, who had undergone neurosurgery after head trauma 20 years ago.A 72-year-old woman underwent craniotomy and extradural hemorrhage removal through a left temporoparietal incision caused by head trauma after a traffic accident 20 years prior...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28574330/role-of-intraoperative-dynamic-magnetic-resonance-myelogram-in-management-of-giant-dorsolumbar-spinal-extradural-arachnoid-cyst-case-report
#8
Rakesh Kumar Mishra, Nupur Pruthi, Rose Dawn Bharath, Bhaskara Rao Malla
Giant dorsolumbar spinal arachnoid cysts are a complex, poorly understood, and difficult to manage clinical entity. Traditional CT myelography is technically difficult to use in these cases to detect the site of leakage preoperatively. The authors report a novel technique for detecting the site of the leak by using sequential, dynamic intraoperative MR myelography. To the authors' knowledge, there is no other similar report in the literature.
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28559068/vitom-%C3%A2-3d-for-exoscopic-neurosurgery-initial-experience-in-cranial-and-spinal-procedures
#9
Joachim M Oertel, Benedikt W Burkhardt
BACKGROUND: In this manuscript the authors describe the application of a new exoscope which offers three-dimensional (3D) visualization in cranial and spinal neurosurgery in detail. METHODS: Five cranial and eleven spinal procedures were performed using a 3D-exoscope. Instrument handling, repositioning of the exoscope, handling of the image control unit, the adjustment of magnification and focal length, the depth perception, the image quality, the illumination, and the comfort level of the posture during the procedure were assessed via a questionnaire...
May 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28552139/endovascular-treatment-of-spinal-arteriovenous-malformations
#10
Waleed Brinjikji, Giuseppe Lanzino
Spinal arteriovenous malformations (AVMs) are a rare but treatable cause of myelopathy and spinal cord hemorrhage. The clinical presentation and ideal treatment of these lesions vary widely, primarily due to differences in anatomic and angioarchitectural features. Six well-defined types of fistula have been defined: (1) intradural dorsal AVM; (2) intramedullary AVM; (3) extradural-intradural AVM; (4) intradural ventral AVF; (5) extradural/epidural AVF; and (6) conus medullaris AVM. Each of these lesions have unique clinical presentations and variable natural histories and endovascular treatment options...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552138/spinal-arteriovenous-malformations-surgical-management
#11
David S Xu, Hai Sun, Robert F Spetzler
Spinal arteriovenous malformations (AVMs) are a diverse population of vascular lesions associated with significant long-term morbidity and neurologic impairment. Spinal AVMs can be classified into three categories: intramedullary, extradural-intradural, and conus, depending on their angioarchitecture and anatomy. Extradural-intradural lesions are typically incurable due to their diffuse nature, but patients may benefit from targeted therapy of symptomatic components. Intramedullary and conus AVMs are amenable to safe surgical resection when combined with endovascular embolization and use of a pial dissection technique that spares entry into the neural parenchyma...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552136/epidemiology-clinical-presentation-diagnostic-evaluation-and-prognosis-of-spinal-arteriovenous-malformations
#12
Alp Ozpinar, Gregory M Weiner, Andrew F Ducruet
Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. An updated method has changed AVM classification from five categories of lesion based on source and location of feeder vessels to three categories based on pathophysiology. These categories include extradural arteriovenous fistulae (AVFs), intradural AVFs, extradural-intradural AVFs, intramedullary AVMs, and conus medullaris AVM each with individual subclassifications...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28543518/green-discolouration-of-urine-following-propofol-infusion-in-a-dog
#13
D Flaherty, A Auckburally
A three-year-old, female neutered Weimaraner was presented with a history of neck pain and tetraparesis. MRI revealed an extradural mass at the level of C3 vertebra, which was thought to be a spinal abscess, and the dog was scheduled for surgical exploration the following morning. Overnight the dog developed an exaggerated ventilatory pattern, with paradoxical inward movement of the thorax on inspiration. Arterial blood gas analysis revealed respiratory acidosis and ventilator support was initiated to prevent excessive respiratory fatigue...
May 25, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28533826/a-novel-triage-tool-optic-nerve-sheath-diameter-in-traumatic-brain-injury-and-its-correlation-to-rotterdam-computed-tomography-ct-scoring
#14
Sudha Kiran Das, Sachin P Shetty, Kamal Kumar Sen
BACKGROUND: Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. MATERIAL/METHODS: Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28531285/paratrigeminal-paraclival-precavernous-or-all-of-the-above-a-circumferential-anatomical-study-of-the-c3-c4-transitional-segment-of-the-internal-carotid-artery
#15
Eleonora Marcati, Norberto Andaluz, Sebastien C Froelich, Lee A Zimmer, James L Leach, Juan Carlos Fernandez-Miranda, Almaz Kurbanov, Jeffrey T Keller
BACKGROUND: Although the term paraclival carotid pervades recent skull base literature, no clear consensus exists regarding boundaries or anatomical segments. OBJECTIVE: To reconcile various internal carotid artery (ICA) nomenclatures for transcranial and endoscopic-endonasal perspectives, we reexamined the transition between lacerum (C3) and cavernous (C4) segments using a C1-C7 segments schema. In this cadaveric study, we obtained a 360°-circumferential view integrating histological, microsurgical, endoscopic, and neuroradiological analyses of this C3-C4 region and identified a distinct transitional segment...
May 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521347/sequential-extradural-release-of-the-v3-vertebral-artery-to-facilitate-intradural-v4-vertebral-artery-reanastomosis-feasibility-of-a-novel-revascularization-technique
#16
Ali Tayebi Meybodi, Michael T Lawton, Arnau Benet
BACKGROUND: Revascularization of the intradural vertebral artery (VA) usually involves V3-V4 bypass using an interposition graft. The interposition of a graft increases surgical time, adds risks, and requires 2 suture lines. OBJECTIVE: To assess the feasibility of an excision-reanastomosis of V4 by sequentially releasing V3. METHODS: Twenty specimens were prepared for surgical simulation of a far-lateral approach. The third and fourth segments of the VA were exposed through the far-lateral approach bilaterally...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28515372/spinal-arteriovenous-shunts-angioarchitecture-and-historical-changes-in-classification
#17
Keisuke Takai
The purposes of this study were to review historical changes in the classification of spinal arteriovenous (AV) shunts and to propose a practical classification system. The associated literature regarding the classification of spinal AV shunts was reviewed in the angiography era between 1967 and 2015. The classification systems of spinal AV shunts and a proposed classification system were presented with neuroradiological imaging and medical illustrations. There have been seven major classification systems based on the evolution of diagnostic methods as well as treatments for spinal AV shunts: the first description of spinal AV shunts diagnosed and classified using spinal angiography in 1971; the second classification based on a case report of intradural direct perimedullary arteriovenous fistulas (AVFs) treated by microsurgery in 1987; the third classification based on a case series of intradural perimedullary AVFs treated by endovascular interventions in 1993; the fourth and fifth classification systems based on a case series of spinal AVFs and arteriovenous malformations (AVMs) treated by microsurgery or endovascular interventions in 2002; the sixth classification based on a case series of cranio-spinal dural AV shunts in 2009; and the seventh classification based on a case series of extradural AVFs treated by microsurgery and endovascular interventions in 2011...
May 18, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28514500/histology-of-the-distal-dural-ring
#18
Christopher S Graffeo, Avital Perry, William R Copeland, Aditya Raghunathan, Michael J Link
BACKGROUND: The distal dural ring (DDR) is a conserved intracranial anatomic structure marking the boundary point at which the internal carotid artery (ICA) exits the cavernous sinus (CS) and enters the subarachnoid space. Although the CS has been well described in a range of anatomic studies, to our knowledge no prior study has analyzed the histologic relationship between the ICA and DDR. Correspondingly, our objective was to assess the relationship of the DDR to the ICA and determine whether the DDR can be dissected from the ICA and thus divided, or can only be circumferentially trimmed around the artery...
May 17, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28507828/multiple-large-perineural-tarlov-cysts-in-the-sacrum-of-a-cadaver-a-case-report-and-review
#19
Jocelyn Gonzales, Joe Iwanaga, Nitsa Topale, Rod J Oskouian, R Shane Tubbs
Tarlov or perineural cysts are cerebrospinal fluid (CSF)-filled sacs found between the perineurium and epineurium of the nerve roots. It is still unsure whether the origin of these cysts is intradural or extradural. They can either be asymptomatic or create a variety of negative impacts on comfort and quality of life. In this case report, we describe the presentation of multiple Tarlov cysts including one large cyst discovered during a routine cadaveric spinal dissection and the relevant and related literature...
April 12, 2017: Curēus
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#20
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
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