Ectatic vertebral artery associated medullary compression treated with microvascular decompression: a case report and review of literature.

Background: Vertebral artery compression syndrome is a rare condition defined as the clinical presentation of dizziness, vertigo, ataxia, dysarthria, dysphagia, progressive or acute paralysis, hemisensory loss, and cervical myelopathy secondary to compression of the medulla and upper spinal cord by the vertebral artery.

Case Description: Here we describe a 57-year-old Mexican-American male with bulbar symptoms, positional vertigo, and diplopia. The patient's symptoms were managed through microsurgical decompression of the medulla utilizing a far lateral transcondylar approach.

Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.

Safety and cost of stent-assisted coiling of unruptured intracranial aneurysms compared with coiling or clipping.

Objective: Stent-assisted coiling (SAC) of unruptured intracranial aneurysms is a treatment alternative to clipping or coiling, although high complication and procedure-related mortality rates have been reported.

Methods: A retrospective study was conducted of patients undergoing SAC, coiling or clipping of unruptured intracranial aneurysms between 2003 and 2010. Rates of residual aneurysm, recanalization, complications, cost (adjusted to 2010), length of stay (LOS) and outcome were compared between groups.

Computed tomography-guided cement augmentation for pain relief of a symptomatic sternal fracture.

The authors report a novel application of cement augmentation for treatment of a symptomatic sternal fracture. Sternal fractures often cause debilitating pain and can affect ventilation. Given the success of vertebroplasty in patients in treating back pain, the authors used a similar technique in a 56-year-old woman with chronic obstructive pulmonary disease and an acute comminuted sternal fracture refractory to conservative management.