Surgical neurology international最新文献

Are variations in ventricular catheter placement related to design of the catheter? A single-center cohort study. 心室导管放置位置的变化与导管的设计有关吗？单中心队列研究。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_577_2024

Emily Harland, Justin Oh, Matthew Protas, Satish Krishnamurthy

{"title":"Are variations in ventricular catheter placement related to design of the catheter? A single-center cohort study.","authors":"Emily Harland, Justin Oh, Matthew Protas, Satish Krishnamurthy","doi":"10.25259/SNI_577_2024","DOIUrl":"https://doi.org/10.25259/SNI_577_2024","url":null,"abstract":"Background: The use of intracranial catheters is a common procedure used for neurosurgical patients with a variety of pathologies. Despite its frequency of use, shunt failure and revision have been reported to be a common problem. Given that depth of insertion can significantly affect the catheter tip position, a single institution retrospective chart review was performed to examine the accuracy of shunt and external ventricular drain (EVD) placement.Methods: Computed tomography (CT) images of the head following shunt or ventriculostomy insertion were analyzed to determine the delta between the final length of the intracranial catheter and the intended depth described in the operative notes.Results: We found that there was a statistically significant difference in the accuracy of placement when comparing EVDs to shunts. The most used EVDs at our institution are marked with a solid black line in increments spaced 2 cm apart. The most used ventricular shunt catheter has a marking at 5 cm and 10 cm from the tip of the catheter. We believe that the visual confirmation that is afforded by metric unit markings on the EVD allows for better final placement of the catheter at the outer table of the calvarium.Conclusion: The addition of regular millimeter metric unit markings by the manufacturer is imperative in decreasing the chances of error in the insertion of ventricular catheters and preventing potential neurovascular injury to the surrounding structures.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"385"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant intracranial tuberculomas in children: An unexpected diagnosis and difficult management - About two cases and review of the literature. 儿童颅内巨大结核瘤：意料之外的诊断和困难重重的治疗--关于两个病例和文献综述。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_327_2024

Mohammed Yassine Haouas, Amine Elkhamouye, Khalid Aadoud, Abdelkouddous Laaidi, Khadija Ibahioin, Said Hilmani, Abdelhakim Lakhdar

{"title":"Giant intracranial tuberculomas in children: An unexpected diagnosis and difficult management - About two cases and review of the literature.","authors":"Mohammed Yassine Haouas, Amine Elkhamouye, Khalid Aadoud, Abdelkouddous Laaidi, Khadija Ibahioin, Said Hilmani, Abdelhakim Lakhdar","doi":"10.25259/SNI_327_2024","DOIUrl":"https://doi.org/10.25259/SNI_327_2024","url":null,"abstract":"Background: Giant intracranial tuberculomas are rare space-occupying lesions in the brain parenchyma, with a diameter >2.5 cm. They can mimic gliomas, meningiomas, and metastases. Diagnosis of this disease can be difficult without histological evidence. Tuberculosis (TB) affects people of all ages but is a major health problem among children. Misdiagnosis is common, as many clinical and radiological features are non-specific.Case description: Case 1: A 4-year-old child presented with intracranial hypertensive syndrome and Brave- Jackson seizures. Imaging showed a left temporoparietal lesion with intense peripheral ring enhancement after gadolinium injection, and attaching to the dura mater. Total surgical excision was performed, and histological analysis confirmed granulomatous TB. A month later, he presented to the emergency department with neurological deterioration. Magnetic resonance imaging revealed disseminated TB of the central nervous system, with tuberculomas in the brain stem. The child died after a month in intensive care. Case 2: An 11-year-old boy presented with a headache that had been progressively worsening for 7 months. Imaging revealed a right frontal process mimicking a high-grade glial tumor. The child underwent surgery with total excision of the tumor. After a few days, he developed tubercular miliaria and was put on anti-bacillary treatment.Conclusion: Treatment includes antituberculosis therapy combined with surgery. This article describes the value of surgery for giant intracranial tuberculomas in two children under our care, with a review of the literature. We believe that the results of surgery for giant intracranial tuberculomas in children are favorable.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"378"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Frictional forces in stent retriever procedures: The impact of vessel diameter, angulation, and deployment position. 支架回流手术中的摩擦力：血管直径、角度和部署位置的影响。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_709_2024

Kazuma Tsuto, Masataka Takeuchi, Yu Shimizu, Takashi Matsumoto, Satoshi Iwabuchi

{"title":"Frictional forces in stent retriever procedures: The impact of vessel diameter, angulation, and deployment position.","authors":"Kazuma Tsuto, Masataka Takeuchi, Yu Shimizu, Takashi Matsumoto, Satoshi Iwabuchi","doi":"10.25259/SNI_709_2024","DOIUrl":"https://doi.org/10.25259/SNI_709_2024","url":null,"abstract":"Background: Mechanical thrombectomy has improved the outcome of patients with acute ischemic stroke, but complications such as subarachnoid hemorrhage (SAH) can worsen the prognosis. This study investigates the frictional forces exerted by stent retrievers (SRs) on vessel walls, hypothesizing that these forces contribute to vascular stress and a risk of hemorrhage. We aimed to understand how vessel diameter, curvature, and stent deployment position influence these forces.Methods: Using a silicone vascular model simulating the middle cerebral artery, we created virtual vessels with diameters of 2.0 mm and 2.5 mm, each with branching angles of 60° and 120°. A Trevo NXT (4 × 28 mm) SR was deployed and retracted through these models, measuring the maximum static frictional force at the moment the SR began to move. The stent deployment position relative to the curvature (straight, distal 1/4, center, and proximal 1/4) was also varied to assess its impact on frictional forces. Each condition was tested 15 times, and the results were statistically analyzed.Results: The highest frictional force was observed in the 2.0 mm/120° model, followed by the 2.0 mm/60°, 2.5 mm/120°, and 2.5 mm/60° models. Narrower and more sharply curved vessels exhibited significantly higher frictional forces. Friction also increased with more distal stent deployment, particularly in the narrower vessels.Conclusion: Smaller vessel diameters, greater curvature, and more distal stent deployment positions increase frictional forces during thrombectomy, potentially leading to SAH. These findings highlight the importance of selecting appropriately sized SRs and considering stent deployment positions to minimize vascular stress.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"384"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring of visual-evoked potentials during fat packing in endoscopic resection of a giant pituitary adenoma. 在内窥镜下切除巨大垂体腺瘤的脂肪填充过程中监测视觉诱发电位。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_719_2024

Christopher S Hong, Jakob Ve Gerstl, C Eduardo Corrales, Timothy R Smith, Eva K Ritzl

{"title":"Monitoring of visual-evoked potentials during fat packing in endoscopic resection of a giant pituitary adenoma.","authors":"Christopher S Hong, Jakob Ve Gerstl, C Eduardo Corrales, Timothy R Smith, Eva K Ritzl","doi":"10.25259/SNI_719_2024","DOIUrl":"https://doi.org/10.25259/SNI_719_2024","url":null,"abstract":"Background: Endoscopic transsphenoidal surgery has become a mainstay surgical approach for sellar pathologies and can effectively decompress mass effects on the optic nerves. Visual-evoked potentials (VEPs) have been utilized as an intraoperative adjunct during endoscopic transsphenoidal surgery to monitor the integrity of the optic pathways, but the data surrounding its reliability and efficacy remain heterogeneous.Case description: An 80-year-old male underwent endoscopic transsphenoidal resection of a pituitary macroadenoma with preoperative visual deficits related to optic nerve compression. During fat packing of the resection cavity, a decrease in VEPs was noted, which seemingly improved after partial fat removal, although with paradoxically reduced VEP latencies. Despite this, the patient developed a visual field deficit postoperatively, requiring re-operation for further removal of the fat packing.Conclusion: This was a case of initially poorly formed VEPs that deteriorated and apparently improved following surgical intervention. The finding of shortened latencies of the VEPs was likely from noise contamination, creating the illusion of improved signal amplitudes. We recommend careful assessment of VEP data for baseline reproducibility, particularly in patients with pre-existing visual field deficits. Appropriate anesthetic selection is also important to reduce noise interference from the electroencephalogram.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"387"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Drainage of middle cranial fossa epidural abscess through mastoidectomy: Our experience and review of the literature. 通过乳突切除术引流中颅窝硬膜外脓肿：我们的经验和文献综述。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_674_2024

Max Feng, Alexandra Vacaru, Vikrum Thimmappa, Brian Hanak

{"title":"Drainage of middle cranial fossa epidural abscess through mastoidectomy: Our experience and review of the literature.","authors":"Max Feng, Alexandra Vacaru, Vikrum Thimmappa, Brian Hanak","doi":"10.25259/SNI_674_2024","DOIUrl":"https://doi.org/10.25259/SNI_674_2024","url":null,"abstract":"Background: Otitis media (OM) can uncommonly lead to intracranial complications. Epidural abscesses represent a large proportion of cases; however, literature regarding the optimal surgical management of otogenic epidural abscesses is sparse. Favorably located epidural abscesses may be amenable to drainage through a transmastoid approach because the tegmen mastoideum lies immediately inferior to the middle cranial fossa (MCF).Case description: We report 3 pediatric patients with OM complicated by epidural abscesses of the MCF. The ages ranged from 3 to 6 years old, with 2 females and 1 male. All 3 patients had acute mastoiditis with an abscess of the MCF ranging from 1.6 cm to 6.3 cm at the largest dimension. All patients underwent canal wall-up mastoidectomy with the evacuation of the MCF abscess through a small window, 0.7 × 0.7 cm or less, created in the tegmen mastoideum. All patients were successfully treated through this approach and had complete resolution of their infection on follow-up imaging. There were no postoperative temporal lobe encephaloceles.Conclusion: This is one of the few descriptions of the treatment of an otogenic epidural abscess of the MCF through a transmastoid approach. Collaboration with neurosurgery is vital because their familiarity with the intracranial space helped to guide the accurate direction of dissection. This highlights the importance of a multidisciplinary approach in the treatment of epidural intracranial abscess of the MCF through this approach. The risk of postoperative temporal lobe encephalocele was minimized due to the small tegmen defect size.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"389"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Awake lumbar spine surgery performed under spinal versus conventional anesthesia. 脊髓麻醉与常规麻醉下的清醒腰椎手术。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_747_2024

Mohamed M Mohi Eldin, Ahmed Salah-Eldin Hassan Abdelaaty, Omar Youssef, Alaa A Abdulkawy, Mohamed Eltoukhy

{"title":"Awake lumbar spine surgery performed under spinal versus conventional anesthesia.","authors":"Mohamed M Mohi Eldin, Ahmed Salah-Eldin Hassan Abdelaaty, Omar Youssef, Alaa A Abdulkawy, Mohamed Eltoukhy","doi":"10.25259/SNI_747_2024","DOIUrl":"https://doi.org/10.25259/SNI_747_2024","url":null,"abstract":"Background: Lumbar spine surgery for discectomy or laminectomy is mostly performed under general anesthesia (GA). Here, we explored whether, in a series of 84 patients, better peri-operative outcomes and lower complication rates could be achieved for those undergoing diskectomy/laminectomy under spinal anesthesia (SA) versus GA.Methods: From 2022 to 2023, 84 patients were randomly assigned to undergo lumbar discectomy/laminectomy for stenosis under SA: 42 patients versus GAGA: 42 patients. For these two populations, we analyzed and compared multiple variables, including duration of anesthesia, estimated blood loss (EBL), and outcomes (i.e., including pre/post-operative Visual Analogue Scale, Oswestry disability index, and short-form 36 questionnaires).Results: Major advantages of SA versus GA included a reduced mean EBL, shorter mean operative time, reduced mean hospital length of stay, and fewer post-operative side effects. Notably, baseline heart rate or mean arterial blood pressure showed no significant differences between SA and GA groups.Conclusion: Based on this small preliminary sample of patients undergoing lumbar disc/stenosis surgery, it appeared that SA reduced the mean EBL, offered shorter mean operative times, mean hospital lengths of stay, and fewer post-operative side effects versus GA.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"388"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transarterial embolization for anterior cranial fossa dural arteriovenous fistula based on multi-modal three-dimensional imaging. 基于多模态三维成像的经动脉栓塞治疗前颅窝硬脑膜动静脉瘘。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_698_2024

Masashi Kotsugi, Kengo Konishi, Shohei Yokoyama, Ai Okamoto, Kenta Nakase, Ryosuke Maeoka, Ryosuke Matsuda, Ichiro Nakagawa

{"title":"Transarterial embolization for anterior cranial fossa dural arteriovenous fistula based on multi-modal three-dimensional imaging.","authors":"Masashi Kotsugi, Kengo Konishi, Shohei Yokoyama, Ai Okamoto, Kenta Nakase, Ryosuke Maeoka, Ryosuke Matsuda, Ichiro Nakagawa","doi":"10.25259/SNI_698_2024","DOIUrl":"https://doi.org/10.25259/SNI_698_2024","url":null,"abstract":"Background: Dural arteriovenous fistula (DAVF) in the anterior cranial fossa (ACF) is known to show a high risk of intracranial hemorrhage. Recently, multi-modal fusion imaging with computed tomography angiography, computed tomography venography, and three-dimensional (3D) rotation angiography have been used preoperatively to ensure anatomical safety. We report on endovascular treatment as a first-line approach for ACFDAVF based on the understanding of vascular anatomy obtained from multi-modal fusion imaging.Methods: All patients with ACF-DAVF treated endovascularly as a first-line approach were included in this study. Analyses took into account complications (particularly visual function), immediate angiographic outcomes, and follow-up findings in consecutive patients with ACF-DAVF treated with interventional treatment based on multi-modal fusion imaging.Results: Five patients with ACF-DAVF underwent six sessions of transarterial embolization (TAE) in our institution. The five male patients (mean age, 74.5 years; range, 60-84 years) were treated with liquid embolic agents (Onyx, four procedures; n-butyl 2-cyanoacrylate, two procedures). No difference was seen between preoperative image evaluation and image evaluation during the endovascular procedure, and in all cases, a microcatheter was navigated into a target artery assumed from preoperative multi-modal imaging, allowing treatment completion in a single procedure. In all cases, the shunt disappeared completely and visual function after procedure was maintained. At the last follow-up, all patients showed a modified Rankin scale score of 0 or 1 with no recurrences.Conclusion: Multi-modal fusion imaging facilitates a 3D understanding of the vascular anatomy, allowing TAE as the first-line treatment for ACF-DAVF.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"386"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Wrapping method for better fat handling in endoscopic trans-sphenoidal surgery. 在内窥镜经蝶窦手术中更好地处理脂肪的包裹方法。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_626_2024

Fumihiro Matano, Shigeyuki Tahara, Yujiro Hattori, Yohei Nounaka, Koshiro Isayama, Akira Teramoto, Akio Morita

{"title":"Wrapping method for better fat handling in endoscopic trans-sphenoidal surgery.","authors":"Fumihiro Matano, Shigeyuki Tahara, Yujiro Hattori, Yohei Nounaka, Koshiro Isayama, Akira Teramoto, Akio Morita","doi":"10.25259/SNI_626_2024","DOIUrl":"https://doi.org/10.25259/SNI_626_2024","url":null,"abstract":"Background: Fat is commonly used for preventing cerebrospinal fluid (CSF) leakage during endoscopic transsphenoidal surgery (ETSS). However, fat is soft, slippery, and sometimes not easy to handle. The present study aimed to examine the efficacy of our Surgicel® wrapping method, which allows for better fat handling, in preventing the occurrence of CSF leakage among patients undergoing ETSS.Methods: We used fat tissues removed from the abdomen. The fat was cut with scissors into pieces that were approximately 5 mm in size. Surgicel® was also cut into 2.5 cm2. The fat tissues were encased with these Surgicel® squares and slightly moistened with a saline solution.Results: Between January 2023 and August 2024, 34 patients aged 18-86 years (average 54.9 years) underwent ETSS. Among these patients, 20 had pituitary tumors, 6 had Rathke's cysts, and 8 had other conditions. None of the patients had CSF leakage postoperatively. The use of Surgicel®-wrapped fat during ETSS is better than the use of fat alone.Conclusion: The Surgicel® wrapping method allows for better fat handling during ETSS.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"390"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A ruptured craniocervical junction perimedullary arteriovenous fistula successfully treated through flow diversion: A case report. 通过血流分流成功治疗颅颈交界处髓周动静脉瘘破裂：病例报告。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_631_2024

Pablo Albiña-Palmarola, Ali Khanafer, Amgad El Mekabaty, Michael Forsting, Oliver Ganslandt, Hans Henkes

{"title":"A ruptured craniocervical junction perimedullary arteriovenous fistula successfully treated through flow diversion: A case report.","authors":"Pablo Albiña-Palmarola, Ali Khanafer, Amgad El Mekabaty, Michael Forsting, Oliver Ganslandt, Hans Henkes","doi":"10.25259/SNI_631_2024","DOIUrl":"https://doi.org/10.25259/SNI_631_2024","url":null,"abstract":"Background: Spinal arteriovenous fistulae (AVF) located at the craniocervical junction (CCJ) are rare and usually present with hemorrhage. Bleeding is usually attributed to arterial feeders arising from the anterior spinal artery (ASA) and aneurysms located on such feeders. Perimedullary AVFs are typically found on the ventral surface of the spinal cord, which makes them difficult to treat through traditional microsurgical methods. In addition, their unique vessel angioarchitecture frequently precludes safe embolization. We present the first case of a CCJ perimedullary AVF successfully treated using flow diversion.Case description: A 76-year-old man was brought to the emergency department after suddenly losing consciousness. On further evaluation, infratentorial subarachnoid hemorrhage and a perimedullary AVF at the ventral surface of the spinal cord were identified. The ASA originated from the left V4 segment, providing a single feeder to the lesion associated with a 2 mm aneurysm. After initial antiplatelet loading, 8 hydrophilic polymer-coated flow diverters were deployed to cover the ASA's origin in two sessions, achieving the complete occlusion of the lesion and the aneurysm 5 months later, without evidence of ischemic lesions.Conclusion: CCJ perimedullary AVFs can bleed with devastating consequences. These lesions can be challenging to treat through traditional microsurgical or endovascular techniques. Progressive occlusion with flow diversion is feasible in single-feeder AVFs, theoretically allowing blood flow reorganization to the cervical spinal cord.","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"381"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142636165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alzheimer's disease is treatable by increased cerebral blood flow (CBF) from omentum to compensate for a decreased CBF in aging. 老年痴呆症可以通过增加网膜的脑血流量（CBF）来治疗，以弥补因衰老而减少的CBF。

Surgical neurology international Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_680_2024

Harry Sawyer Goldsmith

引用次数: 0