Background: It is well known that brainstem dysfunction may be caused by vascular compression of the medulla oblongata (MO). However, only a limited number of reports have found microvascular decompression (MVD) surgery to be an effective treatment for symptomatic patients with MO dysfunction, such as essential hypertension, pyramidal tract signs, dysphagia, and respiratory failure.
Case Description: This report describes 3 patients with vertebral artery compression of MO who presented with respiratory failure and/or dysphagia. MVD surgery using the transcondylar fossa approach was effective in relieving patient symptoms.
Conclusions: Although the pathogenic mechanisms of symptomatic vertebral artery compression of MO remain unclear, we should recognize that MVD surgery is effective for selected patients with brainstem dysfunction. The transcondylar fossa approach and the stitched sling retraction technique are appropriate in MVD surgery to relieve vertebral artery compression of MO.
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http://dx.doi.org/10.1016/j.wneu.2014.01.012 | DOI Listing |
Eur Spine J
January 2025
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing, China.
Purpose: To describe a novel alternative technique for C2 fixation under the concept of atlantoaxial joint distraction and fusion with intra-articular Cages, and to report its preliminary clinical outcomes.
Methods: Eighteen patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial joint distraction and fusion with intra-articular Cages. All patients had hypoplasia of the C2 isthmus prohibiting insertion of the pedicle screw.
Sisli Etfal Hastan Tip Bul
December 2024
Department of Radiology, Harran University Faculty of Medicine, Sanliurfa, Türkiye.
Objectives: To assess the efficacy of endovascular treatment and clinical outcomes in individuals with symptomatic intracranial stenosis who had not responded adequately to medical intervention.
Methods: The study included 32 patients who received endovascular treatment due to high-grade (70%-99% severity) intracranial atherosclerotic stenosis from December 2021 to December 2023. The patients had not experienced any acute ischemic or hemorrhagic infarction within the last three weeks, had a Modified Rankin Scale score of ≤3 at baseline, and developed a transient ischemic attack or non-disabling stroke despite having received the best medical treatment.
Sci Rep
January 2025
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, UAE.
The first cervical vertebra (C1) is atypical in shape and bears a complex relationship with important neurovascular structures such as the vertebral artery and cervical spinal cord which are at risk of injury during misplaced screw fixation of C1. Placement of screws into the lateral mass of C1 vertebra is performed for stabilization of the craniovertebral junction. The objective of this study was to describe ideal screw dimensions, precise entry points, safe bony corridors, and ideal trajectories for placement of lateral mass screws in the Emirati population.
View Article and Find Full Text PDFBackground: For patients with suspected traumatic vertebral artery injury (TVAI), CT angiography (CTA) is the first-line screening modality. Digital subtraction angiography (DSA) serves as the confirmatory diagnostic imaging, and is the gold standard for cerebrovascular injury assessment, due to its higher sensitivity and specificity. Among patients with TVAI based on CTA who have undergone follow-up DSA, this study aims to investigate how diagnostic information with additional imaging affects clinical management.
View Article and Find Full Text PDFJ Endovasc Ther
January 2025
Aortic Center, Hôpital Marie-Lannelongue, Groupe Hospitalier Paris Saint Joseph, Université Paris-Saclay, INSERM UMR_S 999, Le Plessis Robinson, France.
Introduction: Management of patients with large aortic arch aneurysms who are considered high risk for frozen elephant trunk technique have been challenging, especially when they have a dilated ascending aorta (AA) that precludes total endovascular branched repair (arch BEVAR). A viable option in our armamentarium is wrapping of the AA (AW), and zone 0 Ishimaru TEVAR.
Methods: Retrospective analysis of our aortic database from 2013 to 2024 to select high-risk patients with aortic arch aneurysm that had an AW and TEVAR.
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