Unruptured anterior communicating artery aneurysm with co-existing blister aneurysms: Case report and review of literature

Blister aneurysms are a separate class of vascular malformations with a unique etiopathogenesis and clinical profile, elusive to radiological imaging and complex to manage. Unless identified and managed appropriately they often lead increased morbidity intra and post operatively. They are commonly reported in internal carotid artery. We are reporting a rare case of intraoperatively diagnosed blister aneurysm of the anterior cerebral artery, the management options and the importance of constant vigilance in cases where the aneurysm appears unruptured intraoperatively

Comparison of Radiological and Clinical Outcomes between Expandable and Non-expandable Cages Following Cervical Corpectomy: A Systematic Review and Meta-analysis

Anterior cervical corpectomy and fusion is considered the mainstay of surgical treatment in cervical pathology. Expandable and non-expandable cages are preferred over autogenous bone graft because of donor-related morbidity. However, the choice of the cage type remains a debatable topic as studies report conflicting results. Thus, we evaluated the outcomes of expandable and non-expandable cages following cervical corpectomy. Studies were searched in various electronic databases (MEDLINE, PubMed, EMBASE, CINAHL, Scopus, and Cochrane) between 2011 and 2021. Forest plot was made to compare the radiological and clinical outcomes between expandable and non-expandable cages following cervical corpectomy. Altogether, 26 studies (1,170 patients) were included in the meta-analysis. The mean change in segmental angle was significantly greater in the expandable cage group than in the non-expandable cage group (6.7° vs. 3.0°, p0.05). The improvement in segmental angle is better with expandable cages. Higher subsidence is a major problem with non-expandable cages, but it seems to be beneficial as evidenced by the high fusion rate and minimal effect on clinical outcome in patients with this cage

Broken lumbar pedicle screw – a short report

Spinal fixation is one of the common surgical procedure performed by spine surgeons. Among the various spinal fixation technique, pedicle screw fixation is of paramount importance especially when instability is in dorsolumbar and sacral region of spine. Like any surgical procedure, pedicle screw fixation is not devoid of complications. Broken pedicle screws are one of the rare complication of this procedure with a great challenge to deal with such situation. We are reporting one of the rare complication of pedicle screw fixation with literature review and our philosophy to deal such complication

Dengue hemorrhagic fever: A rare cause of pituitary tumor hemorrhage and reversible vision loss

Dengue hemorrhagic fever leading to hemorrhage in pituitary adenoma is not reported till date: We herein report the first case of bilateral visual loss secondary to pituitary adenoma hemorrhage associated with dengue hemorrhagic fever. Urgent transnasal trans sphenoidal decompression of the macroadenoma prevented permanent visual loss in this patient. Pituitary apoplexy should be considered as differential diagnosis of visual deterioration apart from retinal hemorrhage, maculopathy, and optic neuropathy in cases of dengue hemorrhagic fever. Early decompression of optic nerves helped in the restoration of vision

Low velocity penetrating head injury with impacted foreign bodies in situ

Penetrating head injury is a potentially life-threatening condition. Penetrating head injuries with impacted object (weapon) are rare. The mechanism of low velocity injury is different from high velocity missile injury. Impacted object (weapon) in situ poses some technical difficulties in the investigation and management of the victims, and if the anticipated problems are not managed properly, they may give rise to serious consequences. The management practice of eight patients with impacted object in situ in context of earlier reported similar cases in literature is presented

Mucocele of the sphenoid sinus: A rare cause of reversible 3rd nerve palsy

Ophthalmoplegia due to 3rd nerve palsy is a common occurrence, and is usually a sign of diabetes mellitus or a serious intracranial disease. We report a rare case of pupil sparing 3rd nerve palsy caused by mucocele of the sphenoid sinus. The patient regained 3rd nerve functions after successful decompression of the mucocele. Early and correct diagnosis of this relatively benign condition is important to prevent permanent neurological deficits, including visual loss by optic nerve atrophy. Etiology, clinical manifestations and treatment of the sphenoid mucoceles is discussed and available literature is reviewed