| 1. |
- Blomstedt, Patric, et al.
(författare)
-
Rescue pallidotomy for dystonia through implanted deep brain stimulation electrode
- 2016
-
Ingår i: Surgical Neurology International. - : Scientific Scholar. - 2229-5097 .- 2152-7806. ; 7, s. S815-S817
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some patients with deep brain stimulation (DBS), where removal of implants is indicated due to hardware related infections, are not candidates for later re-implantation. In these patients a rescue lesion through the DBS electrode has been suggested as an option. In this case report we present a patient where a pallidotomy was performed using the DBS electrode.CASE DESCRIPTION: An elderly woman with bilateral Gpi DBS suffered an infection around the left burr hole involving the DBS electrode. A unilateral lesion was performed through the DBS electrode before it was removed. No side effects were encountered. Burke-Fahn-Marsden (BFM) dystonia movement scale score was 39 before DBS. With DBS before lesioning BFM score was 2.5 points. The replacement of the left sided stimulation with a pallidotomy resulted in only a minor deterioration of the score to 5 points.CONCLUSIONS: In the case presented here a small pallidotomy performed with the DBS electrode provided a satisfactory effect on the patient's dystonic symptoms. Thus, rescue lesions through the DBS electrodes, although off-label, might be considered in patients with Gpi DBS for dystonia when indicated.
|
|
| 2. |
- Eneling, Johanna, et al.
(författare)
-
Sphenopalatine arteriovenous fistula complicating transsphenoidal pituitary surgery: A rare cause of delayed epistaxis treatable by endovascular embolization.
- 2016
-
Ingår i: Surgical Neurology International. - : Medknow Publications. - 2229-5097 .- 2152-7806. ; 7:Suppl 41, s. S1053-S1056
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Vascular injuries in transsphenoidal surgery for pituitary adenomas are uncommon but can result in serious disability or death.CASE DESCRIPTION:A 46-year-old man, who underwent resection of a pituitary adenoma with suprasellar extension via a transsphenoidal approach, presented with massive epistaxis five days postoperatively. Angiography revealed an arteriovenous fistula (AVF) between the right sphenopalatine artery and a deep vein draining to the right internal jugular vein, as well as contrast agent extravasation at the fistula point. The AVF was catheterized and successfully occluded with N-butyl-2-cyanoacrylate.CONCLUSIONS:Transsphenoidal pituitary surgery can be complicated by massive epistaxis from a lesion of a small branch of the external carotid artery. Airway protection through intubation and investigation with conventional digital subtraction angiography is recommended. The treatment of choice is endovascular embolization because it can be done immediately at the angiography suite.
|
|
| 3. |
|
|
