• Title/Summary/Keyword: Neurosurgery

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Internal maxillary artery (IMax) - middle cerebral artery bypass in a patient with bilateral atherosclerotic carotid occlusion: A technical case report

  • Javier Degollado-Garcia;Martin R. Casas-Martinez;Bill Roy Ferrufino Mejia;Juan C. Balcazar-Padron;Hector A. Rodriguez-Rubio;Edgar Nathal
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.1
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    • pp.51-57
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    • 2024
  • Since the first description of the possible utilization of the internal maxillary artery for bypass surgery, there are some reports of its use in aneurysm cases; however, there is no information about the possible advantages of this type of bypass for cerebral ischemic disease. We present a 77-year-old man with a history of diabetes, hypertension, systemic atherosclerosis, and two acute myocardial infarctions with left hemiparesis. Imaging studies reported total occlusion of the right internal carotid artery and 75% occlusion on the left side, with an old opercular infarction and repeated transient ischemic attacks in the right middle cerebral artery territory despite medical treatment. After a consensus, we decided to perform a bypass from the internal maxillary artery to the M2 segment of the middle cerebral artery using a radial artery graft. After performing the proximal anastomosis, the calculated graft's free flow was 216 ml/min. Subsequently, after completing the bypass, the patency was confirmed with fluorescein videoangiography and intraoperative Doppler. Postoperatively, imaging studies showed improvement in the perfusion values and the hemiparesis from 3/5 to 4+/5. The patient was discharged one week after the operation, with a modified Rankin scale of 1, without added deficits. The use of revascularization techniques in steno-occlusive disease indicates a select group of patients that may benefit from this procedure. In addition, internal maxillary artery bypass has provided a safe option for large areas of ischemia that cannot be supplied with a superficial temporal artery - middle cerebral artery bypass.

Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki;Cho, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.408-413
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    • 2012
  • Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

Image-guided Stereotactic Neurosurgery: Practices and Pitfalls

  • Jung, Na Young;Kim, Minsoo;Kim, Young Goo;Jung, Hyun Ho;Chang, Jin Woo;Park, Yong Gou;Chang, Won Seok
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.58-63
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    • 2015
  • Image-guided neurosurgery (IGN) is a technique for localizing objects of surgical interest within the brain. In the past, its main use was placement of electrodes; however, the advent of computed tomography has led to a rebirth of IGN. Advances in computing techniques and neuroimaging tools allow improved surgical planning and intraoperative information. IGN influences many neurosurgical fields including neuro-oncology, functional disease, and radiosurgery. As development continues, several problems remain to be solved. This article provides a general overview of IGN with a brief discussion of future directions.

Synchronous Carotid Body and Glomus Jugulare Tumors : A Case Report and Review of Literature

  • Md Atikur Rahman;Tejas Venkataram;Riad Habib;Nwoshin Jahan;Farid Raihan;Shamsul Alam;Ehsan Mahmood;Giuseppe E Umana;Bipin Chaurasia
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.122-129
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    • 2024
  • Paragangliomas are rare neuroendocrine tumors that are usually benign in nature. They may be either familial or sporadic in their occurrence. Numerous neuroendocrine tumors are collectively included under the umbrella of paragangliomas. Among them, carotid body tumors and glomus jugulare tumors are extremely rare. Thus, we present a rare case of 29-year-old male who was admitted with hearing difficulties and tinnitus in the left ear, with swelling on the left side of the neck. Based on clinical and radiological findings, a diagnosis of left-sided glomus jugulare with carotid body tumor was made. The patient underwent a two-stage surgery with an interval of approximately 2 months. Histopathology revealed a paraganglioma. Herein, we present the clinical features, imaging findings, management, and a brief review of literature on the classification, evaluation, and management of carotid body and glomus jugulare tumors. Paraganglioma is a slow-growing tumor. The synchronous occurrence of carotid body and glomus jugulare tumors is infrequent. Microsurgical resection remains the primary treatment modality. Therefore, our patient underwent two-stage surgery. The rarity of occurrence and the proximity and adherence to vital neurovascular structures have resulted in the treatment of paragangliomas remaining a challenge.

Early Recurrence of a Lateral Ventricle Meningioma with Malignant Transformation - A Case Report - (악성형질변환으로 조기 재발한 측뇌실내 수막종 - 증 례 보 고 -)

  • Joo, Sung-Pil;Jung, Shin;Lee, Jung-Kil;Kim, Tae-Sun;Kim, Jae-Hyoo;Kim, Soo-Han;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.514-517
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    • 2001
  • Although malignant transformation of meningiomas has been reported, it is extremely rare in meningiomas of ventricular system. Less than 2% of all meningiomas show malignant transformation from benign meningioma. We report a case of meningioma with early recurrence and malignant transformation and investigated possible underlying factors using immunohistochemistry for PCNA and p53 protein expression.

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Krukenberg Tumor Presenting with Brain Metastasis - A Case Report - (뇌 전이를 동반한 크루켄베르크 종양 - 증 례 보 고 -)

  • Kwon, Taek-Hyun;Cho, Tai-Hyoung;Lim, Dong-Jun;Park, Jung-Yul;Park, Youn-Kwan;Chung, Yong-Gu;Chung, Hung-Seob;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1267-1270
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    • 2000
  • Krukenberg tumor has been traditionally defined as gastrointestinal malignancy metastatic to the ovary, and is known to account for 1 to 3% of ovarian neoplasms. The nature and behavior of this particularly virulent tumor still remains unclear. We have experienced a case of Krukenberg tumor with brain metastasis. A clinical description of our case is presented with a review of the literature.

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