Major risks and complications of cervical epidural steroid injections: An updated review

Nancy E. Epstein

Date of publication: 23-Apr-2018

Background:Too many patients, with or without significant cervical disease, unnecessarily undergo cervical epidural steroid injections (CESIs). These include interlaminar (ICESI) and transforaminal ESI (TF-CESI) injections that are not Food and Drug Administration (FDA) approved, have no documented long-term efficacy, and carry severe risks and complications.

Carotid artery stenting vs. carotid endarterectomy in the management of carotid artery stenosis: Lessons learned from randomized controlled trials

Mohamed M. Salem, Abdulrahman Y. Alturki, Matthew R. Fusco, Ajith J. Thomas, Bob S. Carter, Clark C. Chen, Ekkehard M. Kasper

Date of publication: 16-Apr-2018

Background:Carotid artery stenosis, both symptomatic and asymptomatic, has been well studied with several multicenter randomized trials. The superiority of carotid endarterectomy (CEA) to medical therapy alone in both symptomatic and asymptomatic carotid artery stenosis has been well established in previous trials in the 1990s. The consequent era of endovascular carotid artery stenting (CAS) has offered another option for treating carotid artery stenosis. A series of randomized trials have now been conducted to compare CEA and CAS in the treatment of carotid artery disease. The large number of similar trials has created some confusion due to inconsistent results. Here, the authors review the trials that compare CEA and CAS in the management of carotid artery stenosis.

Epidural abscess presenting as severe depression with suicidal ideations: Case report

Erin D'Agostino, Vyacheslav Makler, David F. Bauer

Date of publication: 16-Apr-2018

Background:Epidural abscess (EDA) is an uncommon form of intracranial infection that generally presents with fever, headache, and focal neurologic deficit. Imaging generally reveals a lentiform collection with diffusion restriction on diffusion weighted image. We present an interesting case in which a patient with EDA presented with three weeks of depression with suicidal ideations. The patient displayed no notable infectious signs and the imaging was suggestive of chronic subdural hematoma (SDH) rather than EDA.

Occipital artery to extracranial vertebral artery anastomosis for bilateral vertebral artery stenosis at the origin: A case report

Masahito Katsuki, Yasunaga Yamamoto, Naomichi Wada, Yukinari Kakizawa

Date of publication: 16-Apr-2018

Background:Revascularization of posterior circulation is essential in patients with severe bilateral vertebral artery (VA) stenosis despite administering maximal medical treatment, due to the high mortality of posterior circulation stroke.

Incidence of dysphagia after odontoid screw fixation of type II odontoid fracture in the elderly

Rudy D. Marciano, Brian Seaman, Saurabh Sharma, Teresa Wood, Chris Karas, Kailash Narayan

Date of publication: 16-Apr-2018

Background:Although surgery may reduce mortality rates from type II odontoid fractures in the elderly population, post-operative dysphagia resulting from screw fixation remains a serious complication.

Acute cauda equina syndrome following orthopedic procedures as a result of epidural anesthesia

Lisa B. E. Shields, Vasudeva G. Iyer, Yi Ping Zhang, Christopher B. Shields

Date of publication: 10-Apr-2018

Background:Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction.

Mirror image of bilateral DACA aneurysm with its successful surgical management

Saraj K. Singh, Kapil Jain, Vijendra K. Jain, Arun Saroha

Date of publication: 10-Apr-2018

Background:Among various locations of intracranial aneurysms reported in the literature, two different aneurysms situated symmetrically opposite on bilateral distal anterior cerebral arteries (DACA) are very rare.

Spinal angiolipoma mimicking a schwannoma: A case report

Abrar A. Wani, Arif H. Sarmast, Altaf U. Ramzan, Abdul Q. Khan, Sarabjit S. Chhibber, Nayil K. Malik, Feroz Shaheen

Date of publication: 10-Apr-2018

Background:Angiolipomas rarely involve the spinal canal/foramina, and may prove difficult to differentiate from schwannomas.

Accuracy of percutaneous pedicle screw insertion in spinal fixation of traumatic thoracic and lumbar spine fractures

Tamer Orief, Mohammad Alfawareh, Mohammad Halawani, Walid Attia, Khaled Almusrea

Date of publication: 10-Apr-2018

Background:Percutaneous insertion of pedicle screws was developed as a minimally invasive alternative to the different open spinal procedures. Here, we determined the accuracy of percutaneous pedicle screw insertion.