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Vertebral artery surgery

Nicholas A Levine, Brandon R Rigby
Thoracic outlet syndrome (TOS) describes a group of disorders that are due to a dynamic compression of blood vessels or nerves, between the clavicle and first rib or cervical vertebral nerve roots. Individuals with TOS typically experience upper limb pain, numbness, tingling, or weakness that is exacerbated by shoulder or neck movement. The causes of TOS vary, and can include abrupt movements, hypertrophy of the neck musculature, and anatomical variations in which the brachial plexus roots pass through this musculature, edema, pregnancy, repeated overhead motions, the blockage of an artery or vein, or abnormal posture...
June 19, 2018: Healthcare (Basel, Switzerland)
Ahmad Iyad Mubarak, Ajaykumar C Morani
Klippel-Feil syndrome is an uncommon anomaly that may be asymptomatic. Early clinical signs such as restricted neck motion or short neck can be subtle and incorrectly treated as spasms. High incidence of associated craniovertebral junction (CVJ) anomalies such as occipitalized atlas predisposes them to serious neurologic complications requiring invasive procedures and surgeries. However, these often have anomalous vertebral artery course which is more prone to injury during CVJ procedures, and also sparsely known in radiology literature...
April 2018: Radiology Case Reports
Jimmy C Yang, Andrew S Venteicher, Matthew J Koch, Christopher J Stapleton, Gabriel N Friedman, Emma M Venteicher, John H Shin
BACKGROUND AND IMPORTANCE: Myopericytoma is an emerging class of neoplasm originating from the perivascular myoid cellular environment, previously classified as a variant of hemangiopericytoma. Most reported myopericytomas are found in soft tissues of the extremities; however, infrequent cases are described involving the central nervous system. Intracranial myopericytoma remains rare. Here, we describe the first report of myopericytoma occurring at the cervicomedullary junction in close proximity to the vertebral artery, mimicking a vascular lesion...
June 8, 2018: Neurosurgery
Ali Harati, Rolf Schultheiß
Background: There are several techniques for treating atlantoaxial instability, including the Magerl transarticular screw fixation and the Harms/Goel C1-C2 screw rod techniques. Here, we present a novel technique utilizing a polyaxial screw rod system and a combination of C1 lateral mass and C1-C2 transarticular screws. Methods: We retrospectively reviewed 14 patients (7 women, 7 men; mean age 62) who underwent surgery for type II odontoid fractures ( n = 7), pseudarthrosis after anterior odontoid screw placement ( n = 3), Os odontoideum ( n = 2), atlantoaxial instability after C3-C5 fusion ( n = 1), and craniovertebral rheumatoid arthritis ( n = 1)...
2018: Surgical Neurology International
Hao Zhang, Yan Zhao, Gargi Naha, Changkai Hou, Zhe Wang, Xinyu Yang
BACKGROUND: Unruptured extracranial vertebral artery (VA) aneurysms are uncommon and have rarely been described with treatment options. CASE DESCRIPTION: Here we report the successful reconstruction of an asymptomatic extracranial left VA aneurysm highlighting the treatment for extracranial VA aneurysm and the superiority of hybrid operating room in cerebral vascular diseases. The case reported a 57-year-old female who suffered an extracranial left VA aneurysm. MRA showed bilateral vertebral arteries as co-dominant in the vertebrobasilar system...
June 1, 2018: World Neurosurgery
Sheng Zhong, Jiaxin Ren, Yuan Zhang, Weihang Li, Hui Li, Siying Song, Gang Zhao, Ye Cheng
PURPOSE: This study aims to provide accurate and comprehensive data of craniocervical junction and its peripheral structures in order to provide a profound insight of craniocervical junction as well as to avoid complications during surgical procedures related to it. METHODS: Computed tomographic angiography (CTA) images of 120 individuals were reviewed, the measurements were performed on coronal, sagittal, and axial planes after 3-dimensional volume reconstruction...
May 31, 2018: Journal of Craniofacial Surgery
Koji Hirashita, Atsushi Matsumoto, Satoru Yabuno, Takahiro Kanda, Masatoshi Yunoki, Kimihiro Yoshino
In Japan, hepatic arterial infusion chemotherapy (HAIC) using reservoir system is recommended for patients with hepatocellular carcinoma (HCC) whose hepatic spare ability is favorable. Arterial infusion catheter is commonly detained in hepatic artery via femoral or brachial artery. In our hospital, catheter is often inserted by puncturing the left subclavian or brachial artery considering the patient's activities of daily living (ADL) during long-term detaining. However, it rarely causes posterior circulation ischemic stroke because of the left vertebral artery branches on the path of catheter...
May 30, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yuhua Jiang, Keyun Liu, Youxiang Li
To evaluate the feasibility and safety of the robot of endovascular treatment (RobEnt) in clinical practice, we carried out a cerebral angiography using this robot system. We evaluated the performance of application of the robot system to clinical practice through using this robotic system to perform the digital subtraction angiography for a patient who was suspected of suffering intracranial aneurysm. At the same time, through comparing the postoperative head nuclear magnetic and blood routine with the preoperative examination, we evaluated the safety of application of the robot system to clinical practice...
2018: Applied Bionics and Biomechanics
Hua Zhao, Sheng-Qiang Fan, Xu-Hui Wang, Xin Zhang, Yin-da Tang, Jin Zhu, Ping Zhou, Shi-Ting Li
OBJECTIVE: Due to the increasing use of gamma knife surgery (GKS) for trigeminal neuralgia (TN), physicians are bewildered over the problem of choosing an appropriate treatment if GKS fails. The aim of this study was to determine whether microvascular decompression (MVD) is a safe and effective alternative therapy for TN in patients with failed GKS. METHODS: Between January 1, 2010 and January 1, 2012, the information of 32 patients with TN who presented with persistent or recurrent pain after GKS and elected to undergo MVD were collected...
May 25, 2018: World Neurosurgery
Minhao Wu, Lin Cai, Feifei Yan, Keke Xu, Wenchao Sun, Zhouming Deng, Yuanlong Xie
Objective: To investigate the feasibility of one-stage total spondylectomy by anterior and posterior approaches for treating solitary plasmacytoma (SP) of cervical spine. Methods: Between June 2000 and March 2015, the clinical data, diagnosis, and treatment of 12 patients with SP of cervical spine were retrospectively analyzed. There were 8 males and 4 females, with a mean age of 46 years (range, 28-74 years). The mean disease duration was 8.4 months (range, 3-15 months)...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Yunsuk Choi, Sang Bong Chung, Myoung Soo Kim
PURPOSE: We evaluated anatomical characteristics and clinical significance of left vertebral artery (VA) originating from aortic arch (AA) by computed tomography (CT) angiography. METHODS: CT angiography was performed in 3460 patients between March 01, 2014 and November 30, 2015. We examined course of prevertebral VA (PVVA) segment and level of entry into the cervical vertebra transverse foramen (CVTF) of left VA originated from AA. RESULTS: One hundred fifty-three of 3460 patients had left VA originated from AA...
May 23, 2018: Surgical and Radiologic Anatomy: SRA
Thong Pham, Jeffrey Wesolowski, Jonathan D Trobe
Purpose: To report an unusual case of vertebrobasilar dolichoectasia causing both trigeminal neuralgia and ipsilateral sixth cranial nerve palsy. Observations: A patient had undergone surgical decompression of trigeminal neuralgia caused by dolichoectatic vertebral and basilar arteries years before presenting with ipsilateral sixth nerve palsy. Brain MRI showed deviant vertebrobasilar arteries that presumably now compressed the sixth cranial nerve. The unaffected left sixth cranial nerve was visible on MRI, but the affected right sixth cranial nerve was not...
June 2018: American Journal of Ophthalmology Case Reports
Rémy Pascot, Benjamin Parat, Yann Le Teurnier, Gilles Godet, Jean-Yves Gauvrit, Yann Gouëffic, Eric Steinmetz, Alain Cardon, Adrien Kaladji
BACKGROUND: The optimization of medical treatment regularly challenges the role of carotid surgery for asymptomatic patients. Current research seeks to determine which of these patients will benefit most from surgery. The goal of this study was to identify in a multi-center study, using MRI, the risk factors for postoperative silent cerebral ischemic lesions after carotid surgery for asymptomatic stenosis METHODS: The multicenter, retrospective study included patients with asymptomatic severe carotid stenosis suitable for surgical treatment and who did not have a history of cerebral ischemia...
May 14, 2018: Annals of Vascular Surgery
Xianli Lv, Wei Li, Huijian Ge, Hengwei Jin, Hongwei He, Chuhan Jiang, Youxiang Li
Background: Experience with respect to parent vessel sacrifice (PVS) for unclippable/uncoilable ruptured aneurysms is limited. Objective: The aim of the present systematic review was to evaluate the risk of PVS for unclippable/uncoilable ruptured aneurysms. Materials and Methods: The PUBMED and SCIENCEDIRECT databases were searched using "parent vessel occlusion OR parent artery occlusion" AND "acute subarachnoid hemorrhage" till December 27, 2015, and 1 journal was searched from November 1995 to April 2016 for relevant results...
May 2018: Neurology India
Ovidiu Palea, Haroon M Andar, Ramon Lugo, Michelle Granville, Robert E Jacobson
Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root...
March 14, 2018: Curēus
Alireza Movahed, David Majdalany, Marc Gillinov, William Schiavone
BACKGROUND: Myxomatous mitral valve disease (MMVD) is one of the most prevalent valvular heart diseases, while back pain, neck pain and upper-extremity numbness are some of the most common complaints in outpatient settings. Decreased thoracic kyphosis (straight back) is a known cause of hastening back or neck problems, radiculopathy, or even myelopathy. The study aim was to examine the relationship between MMVD, straight back, and the need for cervical fusion. METHODS: In this single-center retrospective study, patients who underwent mitral valve repair or replacement due to MMVD (cases) based on age, gender and body mass index (BMI), were matched with patients who underwent coronary artery bypass grafting (CABG) surgery and had no history of mitral valve disease (controls)...
September 2017: Journal of Heart Valve Disease
Nese Keser, Osman Kula, Merih Is, Ismail Yardimcioglu
AIM: Although it is well known that the occipital artery (OA) originates from the external carotid artery (ECA), the incidence of variations remains unknown. In our study, we investigated the prevalence of anomalously originating OA using angiography in a group of Turkish individuals. MATERIAL AND METHODS: The images recorded in the picture archiving and communication system for a total of 114 patients, in which the whole vertebral artery, as well as the ECA and its branches, were visualized, were retrospectively reviewed...
April 26, 2018: Turkish Neurosurgery
Masayuki Tanahashi, Haruhiro Yukiue, Eriko Suzuki, Naoko Yoshii, Shinsuke Kitazawa, Yasunori Kaminuma, Hiroshi Niwa
OBJECTIVE: The outcome of surgical treatment of non-small-cell lung cancer after induction chemoradiotherapy was investigated. SUBJECTS: The subjects were 74 patients with non-small-cell lung cancer who received induction chemoradiotherapy( ICRT) between 1998 and 2016. ICRT was administered to pT3 lung cancer invading the chest wall(20 patients), pT4 lung cancer invading the adjacent organ(22 patients), and cN2 lung cancer(32 patients). cN2 was confirmed by mediastinoscopy(13 patients) and endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)(19 patients)...
April 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Fulya Kamit Can, Soysal Turhan, Ayse Berna Anil, Kadir Burhan Karadem, Onur Aras Isik
Penetrating injuries of the carotid and vertebral arteries are rare, but life-threatening conditions. There are still challenges in the first intervention management and patient treatment. Deciding which methods to apply in the first intervention, whether to perform imaging, and the preferred appropriate treatment for the patient (open surgery or endovascular intervention) plays a main role in the patient's survival without neurological deficit. The general management of trauma in penetrating neck injuries and the knowledge of special approaches to carotid artery injury are important for pediatric trauma centers...
May 8, 2018: General Thoracic and Cardiovascular Surgery
Nancy E Epstein
Background: Too many patients, with or without significant cervical disease, unnecessarily undergo cervical epidural steroid injections (CESIs). These include interlaminar (ICESI) and transforaminal ESI (TF-CESI) injections that are not Food and Drug Administration (FDA) approved, have no documented long-term efficacy, and carry severe risks and complications. Methods: Here we reviewed recent reports of morbidity and mortality attributed to the various types of CESIS...
2018: Surgical Neurology International
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