Quantitative magnetic resonance angiography in the evaluation of the subclavian steal syndrome: report of 5 patients.

Background And Purpose: The indications for surgical or endovascular treatment of patients with subclavian stenosis (SS) or occlusion remain controversial. Multiple studies have shown that in most patients, SS results in steal that is evident radiographically, but requires no treatment.

Methods: This report describes 5 cases of SS, analyzed with phase contrast quantitative MRA (QMRA).

Prospective randomized comparison of safety and efficacy of nicardipine and nitroprusside drip for control of hypertension in the neurosurgical intensive care unit.

Objective: The calcium channel blocker nicardipine (NC) is effective for acute control of hypertension. However, efficacy and safety in neurosurgical patients have not been evaluated. We sought to compare NC with the most commonly used agent, sodium nitroprusside (SNP), in patients with subarachnoid or intracerebral hemorrhage.

Flow-assisted surgical cerebral revascularization.

Extracranial-intracranial bypass surgery has advanced from a mere technical feat to a procedure requiring careful patient selection and a justifiable decision-making paradigm. Currently available technologies for flow measurement in the perioperative and intraoperative setting allow a more structured and analytical approach to decision making. The purpose of this report is to review the use of flow measurement in cerebral revascularization, presenting algorithms for flow-assisted surgical planning, technique, and surveillance.

The superficial temporal artery trunk as a donor vessel in cerebral revascularization: benefits and pitfalls.

Object: The superficial temporal artery (STA) is the mainstay of donor vessels for extracranial-intracranial bypass in cerebral revascularization. However, the typically used STA anterior or posterior branch is not always adequate in its flow-carrying capacity. In this report the authors describe the use of the STA trunk at the level of the zygoma as an alternative donor and highlight the benefits and pitfalls of this revascularization option.

Detection of cerebral ischemia in neurovascular surgery using quantitative frequency-domain near-infrared spectroscopy.

Object: There is great value in monitoring for signs of ischemia during neurovascular procedures. Current intraoperative monitoring techniques provide real-time feedback with limited accuracy. Quantitative frequency-domain near-infrared spectroscopy (Q-NIRS) allows measurement of tissue oxyhemoglobin (HbO2), deoxyhemoglobin (HHb), and total hemoglobin (tHb) concentrations and brain tissue oxygen saturation (SO2), which could be useful when monitoring for evidence of intraoperative ischemia.

Astroblastoma presenting with intracerebral hemorrhage misdiagnosed as dural arteriovenous fistula: review of a rare entity.

Background: Astroblastoma is one of the most unusual types of tumors whose histogenesis has been recently clarified. It occurs mainly among children and young adults. It is grossly well demarcated and shows histologically characteristic perivascular pseudorosettes with frequent vascular hyalinization.

Aneurysmal bone cyst of the cervical spine in a child: case report and review of the surgical role.

Background: Surgical treatment of aneurysmal bone cysts of the cervical spine, frequently affecting pediatric patients, is a challenge to operating surgeons. Complete tumor resection offers the best chance for cure.

Case Description: We present the case of a child with an expansile aneurysmal bone cyst of the cervical spine that involves all 3 spinal columns.

Clinical outcome of surgical treatment of failed back surgery syndrome.

Background: Failed back surgery syndrome (FBSS) is a condition in which there is failure to improve satisfactorily after back surgery. It is characterized by intractable pain and various degrees of functional disability after lumbar spine surgery. It is estimated that this complication occurs in 5% to 10% of patients after spinal surgeries.

Thoracic splenosis mimicking thoracic schwannoma: case report and review of the literature.

Background: Thoracic splenosis is a rare entity. It occurs sometime after splenic and diaphragmatic injury, and it is rarely symptomatic.

Case Description: We report a case of left upper thoracic paraspinal splenosis 25 years after a thoracoabdominal penetrating trauma that required a splenectomy.