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Vertebral artery injury

Emre Muhittin Altunrende, Elif Evrim Ekin
BACKGROUND: Vascular injuries, which are rarely seen in all spinal area procedures, especially lumbar disc surgery, are vitally important. The relationship between the course of the iliac artery and vein and intervertebral disc distance was studied morphometrically in patients who had undergone computed tomography angiography for abdominal aorta. METHODS: This study was carried out retrospectively. A total of 100 patients who had undergone computed tomography angiography participated in the study...
March 2019: Turkish Journal of Trauma & Emergency Surgery: TJTES
Cleiton Formentin, Erion Junior de Andrade, Fernando Luis Maeda, Enrico Ghizoni, Helder Tedeschi, Andrei F Joaquim
OBJECTIVE: To present the surgical results of patients who underwent axis screw instrumentation, discussing surgical nuances and complications of the techniques used. METHODS: Retrospective case-series evaluation of patients who underwent spinal surgery with axis instrumentation using screws. RESULTS: Sixty-five patients were included in this study. The most common cause of mechanical instability was spinal cord trauma involving the axis (36 patients - 55...
February 2019: Revista da Associação Médica Brasileira
Juan Altafulla, Emre Yilmaz, Stefan Lachkar, Joe Iwanaga, Jacob Peacock, Zachary Litvack, R Shane Tubbs
Background: Cervical transforaminal epidural steroid injections (CTFESIs) are sometimes performed in patients with cervical radiculopathy secondary to nerve-root compression. Neck movements for patient positioning may include rotation, flexion, and extension. As physicians performing such procedures do not move the neck for fear of injuring the vertebral artery, we performed fluoroscopy and cadaveric dissection to analyze any movement of the vertebral artery during head movement and its relation to the foramina in the setting of CTFESI...
March 2019: Acta Radiologica Open
Konstantinos Panagiotopoulos, Roberto Gazzeri, Antonio Bruni, Umberto Agrillo
Full-endoscopic transforaminal lumbar discectomy is based on a puncture technique using a guide needle to reach the target area of the foramen via a percutaneous posterolateral/lateral approach. It may correlate with specific approach-related complications, as exiting nerve root injury. We report the first case of pseudoaneurysm of the lumbar segmental artery secondary to a transforaminal full-endoscopic surgery in the treatment of a lumbar herniated disc. A 39-year-old man underwent left L4-L5 full-endoscopic transforaminal lumbar discectomy for a herniated disc...
March 16, 2019: Acta Neurochirurgica
Chang-Hyun Lee, Dong Ho Kang, Ki-Jeong Kim, Sang-Woo Kim, Seok Won Kim, Young Jin Kim, Chun Kee Chung, Jun Jae Shin, Jae Keun Oh, Seong Yi, Jung Kil Lee, Jun Ho Lee, Ho Jin Lee, Hyoung-Joon Chun, Dae-Chul Cho, Yong Jun Jin, Kyung-Chul Choi, In Ho Han, Seung-Jae Hyun, Jung-Woo Hur, Jae Taek Hong, Geun Sung Song
BACKGROUND: In cervical spine surgeries (CSS), the overall incidence of iatrogenic vertebral artery injury (IVAI) was reported to be 0.07-1.4%. Although IVAI occurred during C1-2 fusion, there is no accurate information regarding the surgery-specific risk of IVAI. This study aimed to stratify the incidence of IVAI by surgical method and evaluate the correlation between IVAI and its sequelae. METHODS: We performed a retrospective, multicenter study involving clinical and radiological evaluations for IVAI...
March 13, 2019: World Neurosurgery
Ganggang Kong, Wei Ji, Junyu Lin, Qi Liu, Zucheng Huang, Qingan Zhu
BACKGROUND: A clival plate and screw fitted to craniovertebral junction (CVJ) were developed in our previous studies. However, the anatomy of intracranial structures related to clival screw placement has not been studied. OBJECTIVE: To measure intracranial anatomical parameters delineating the basilar plexus and vertebrobasilar artery (VBA) course, and determine the relationship between brainstem and clivus to for safer the screw placement. METHODS: Morphometric analysis of VBA was conducted on 95 (48 Males/47 Females) CT angiography (CTA) scans, basilar plexus and brainstem on 80 (44 Males/36 Females) MRI scans...
March 12, 2019: World Neurosurgery
Yuanxuan Xia, Risheng Xu, Thomas A Kosztowski, Seba Ramhmdani, A Karim Ahmed, Sheng-Fu L Lo, Ali Bydon
BACKGROUND: Few studies have described rates of proximal clinical adjacent segment pathology (CASP) after posterior cervical decompression and fusion (PCDF). OBJECTIVE: To investigate rates of proximal CASP at C2 vs C3 in PCDFs for degenerative spine disease. METHODS: A retrospective review of 380 cases of PCDF for degenerative disease with proximal constructs ending at C2 vs C3 was performed. Minimum follow-up was 12 mo. The primary outcome was proximal CASP requiring reoperation...
March 12, 2019: Neurosurgery
Sepand Rastegar, Avinash Parimisetty, Nora Cassam-Sulliman, Sandhya Narra Sai, Sabrina Weber, Maryam Rastegar, Wildriss Viranaicken, David Couret, Cynthia Planesse, Uwe Strähle, Olivier Meilhac, Christian Lefebvre d'Hellencourt, Nicolas Diotel
Adiponectin and its receptors (adipor) have been initially characterized for their role in lipid and glucose metabolism. More recently, adiponectin signaling was shown to display anti-inflammatory effects and to participate in brain homeostasis and neuroprotection. In this study, we investigated adipor gene expression and its regulation under inflammatory conditions in two complementary models: mouse and zebrafish. We demonstrate that adipor1a, adipor1b and adipor2 are widely distributed throughout the brain of adult fish, in neurons and also in radial glia, behaving as neural stem cells...
March 6, 2019: Journal of Comparative Neurology
Liehua Liu, Shiming Cheng, Qian Wang, Qiang Liang, Yong Liang, Weidong Jin, Qiang Zhou, Zili Wang
To observe the regional anatomy of the lumbar artery (LA) associated with the extrapedicular approach applied during percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), we collected 78 samples of abdominal computed tomography angiography imaging data. We measured the nearest distance from the center of the vertebral body puncture point to the LA (distance VBPP-LA, DVBPP-LA). According to the DVBPP-LA, four zones, Zone I, Zone II, Zone III and Zone IV, were identified. LAs that passed through these zones were called Type I, Type II, Type III and Type IV LAs, respectively...
2019: PloS One
Worawut Woraputtaporn, Tansita Ananteerakul, Sitthichai Iamsaard, Malivalaya Namking
The aim of this study was to show the incidence of vertebral artery of aortic arch origin, its level of entry into transverse foramen, including extra- and intracranial morphometry, and clinical significance. A total of 266 embalmed cadavers were studied. We found 14 left vertebral arteries (5.3%) emerging from aortic arch. Most of the left vertebral arteries of aortic arch origin (78.6%) entered the fifth cervical transverse foramina, whereas most of the vertebral arteries of subclavian origin (94.7% left and 99...
February 26, 2019: Anatomical Science International
M Caroline Nally, Catherine Kling, Kyle M Hocking, Heather Lillemoe, Julia M Boll, John A Curci, C Louis Garrard, Thomas C Naslund, R James Valentine
OBJECTIVE: Routine computed tomography (CT) imaging in trauma patients has led to increased recognition of blunt vertebral artery injuries (BVIs). We sought to determine the prevalence of strokes, injury progression, and need for intervention in patients with BVI. METHODS: Consecutive patients presenting with BVI during 2 years were identified from the institutional trauma registry. Inpatient records, imaging studies, and follow-up data were reviewed in detail from the electronic medical record...
February 18, 2019: Journal of Vascular Surgery
Victor Bilman, Bernardo Massière, Alberto Vescovi, Daniel Leal, Paula Vivas, Bruno Demier, Arno von Ristow
Complications such as pseudoaneurysms (PA) related to cervicothoracic venous access can be devastating. In this article, we present two similar cases in which technological advances impacted diagnosis, treatment, and results. Both patients developed massive PA after deep venous puncture attempts. The first case occurred in 1993 and was diagnosed by a duplex scan that revealed a large PA originating from the right subclavian artery. The artery was approached by median sternotomy with supraclavicular extension...
October 2018: Jornal Vascular Brasileiro
Richard Zhu, Kathryn Dean, Neel Mehta, Ajay Gupta, Jesse Gruber, Amitabh Gulati
INTRODUCTION: Determining safer techniques for lumbar injections is an important goal in pain medicine. This study aims to characterize the location of the T10-L5 spinal arteries using CT angiogram scans to define a safer approach for sympathetic and splanchnic blocks that minimizes intra-arterial injection. METHODS: CT angiograms of 68 patients were included this study. The path of the spinal arteries from the aorta origin along the vertebral body to the neural foramina was traced on axial CT images...
February 15, 2019: Regional Anesthesia and Pain Medicine
Jong Un Moon, Myoung Soo Kim
Extremely rarely, the vertebral artery (VA) enters the subarachnoid space via the intervertebral space of the C2-3 vertebrae. We have identified three cases with this anomalous VA in the literature. We report here another case involving aberrant VA penetration of the dura at the C2-3 vertebral level diagnosed by computed tomography (CT) angiography. A 71-year-old-woman with memory disturbance underwent brain CT and CT angiography. The right VA was aberrant and penetrated the dura at the C1-2 vertebral level...
February 14, 2019: Surgical and Radiologic Anatomy: SRA
Anna E Saw, Andrew S McIntosh, Alex Kountouris, Phil Newman, James E Gaida
BACKGROUND: Vertebral artery dissection (VAD) is a potentially catastrophic injury that may occur during sports participation. A comprehensive review is needed to collate documented cases to improve understanding and inform future preventative approaches. OBJECTIVE: This review aimed to understand the extent of VAD in sport and characterise trends suggestive of mechanisms of injury. METHODS: Electronic databases were searched using terms related to VAD and sport...
February 13, 2019: Sports Medicine
Frank V Bensch, Elina A Varjonen, Tuomo T Pyhältö, Seppo K Koskinen
PURPOSE: BCVI may lead to ischemic stroke, disability, and death, while being often initially clinically silent. Screening criteria for BCVI based on clinical findings and trauma mechanism have improved detection, with Denver criteria being most common. Up to 30% of patients do not meet BCVI screening criteria. The aim of this study was to analyze the effect of augmented Denver criteria on detection, and to determine the relative risk for ischemic stroke. METHODS: Denver screening criteria were augmented by any high-energy trauma of the cervical spine, thorax, abdomen, or pelvis...
February 12, 2019: Emergency Radiology
Kojiro Ishikawa, Takashi Yamanouchi, Takashi Mamiya, Shinji Shimato, Toshihisa Nishizawa, Kyozo Kato
An anomalous origin of the right vertebral artery is rare. The left vertebral artery from the aortic arch is where most of the anomalies occur. The next is an origin of the right vertebral artery from the right common carotid artery in association with the aberrant right subclavian artery. However, independent anomalous origin of the right vertebral artery from the right common carotid artery has not been well known in the previous literature. We present this anomaly, and able to understand the mechanism of the occurrence by embryological knowledge...
November 2018: Journal of Vascular and Interventional Neurology
Jingyu Guan, Jun Lin, Xueqing Guan, Qiang Jin
BACKGROUND: Contralateral C7 nerve transfer is widely applied for the treatment of brachial plexus injuries or central paralysis of the upper extremities. The surgical approach has evolved from the pre-cervical subcutaneous route to the prespinal route, which is currently the most commonly used one. We report a patient with central paralysis of the right upper extremity treated with contralateral C7 nerve transfer via the posterior spinal route. CASE PRESENTATION: A 59-year old female Han patient was admitted on July 3rd , 2018 with right hemiplegia...
February 7, 2019: World Neurosurgery
Liehua Liu, Haoming Wang, Qian Wang, Jiangang Wang, Yong Liang, Ying Li, Qiang Liang, Weidong Jin, Qiang Zhou, Zili Wang
OBJECTIVE: Observing the anatomical relationships between lumbar bicortical pedicle screws (BPSs) at two sagittal section angles (SSAs) and the lumbar artery (LA). METHODS: We observed two SSAs of the BPS, namely, the vertical angle and cephalic angle. Correspondingly, the positions at which the BPS breaks through the anterior vertebral cortex were defined as Point A and Point B. The distances from Point A and Point B to the LAs were measured and denoted DA-LA and DB-LA ...
January 29, 2019: World Neurosurgery
Ben Strickland, Courtney S Lewis, Martin H Pham
Vertebral artery injury is known to potentially occur in conjunction with blunt cervical spine trauma. Rarely, these injuries present bilaterally as complete occlusions. Twelve cases of bilateral vertebral artery occlusions after closed cervical spine trauma have been reported in the literature, nearly all of which demonstrated signs and symptoms of vertebrobasilar insufficiency and ischemia. Our patient presented after a trauatic C5-6 flexion-distraction injury resulting in bilateral locked facets and spinal cord injury as well as bilateral vertebral artery occlusions at the V1 segment, but did not show any cranial symptomatology despite his neurovascular injury...
January 23, 2019: World Neurosurgery
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