[Vertebral artery dissection during traumatic injury of the cervical spine, two case reports]. / Nyaki gerinc traumás sérülése során jelentkezo arteria vertebralis dissectio, két esetbemutatás.

If severe cervical spinal cord injury or severe cervical vertebral fracture, subluxation or luxation is confirmed, 20-40% of the cases have vertebral artery dissection or occlusion. These can be asymptomatic, but can cause additional neurological damage in addition to cervical myelon and cervical nerve root symptoms. Vertebral artery dissection can be caused by direct injuries, stab wounds or gunshot wounds. Indirect vertebral artery dissection can occur at the same time as subluxation, luxation, or complex fractures of the cervical vertebra. CTA is the examination procedure of choice. In many cases, digital subtaction angiography examination and, if necessary, neurointerventional treatment must precede open neurosurgery. In our report, in the first patient, complete luxation of the C.VI vertebra caused unilateral vertebral artery 2-segment dissection-occlusion, while in our second patient, a stab injury caused direct vertebral artery compression and dissection. The occlusion of the vertebral artery did not cause neurological symptoms in any of the cases. In both of our cases, parent vessel occlusion was performed at the level of the vertebral artery injury before the neurosurgical operation.

[Az arteria meningea media embolisatio szerepe a krónikus subduralis haematoma kezelési algoritmusában, legújabb evidenciák és saját tapasztalataink]. / Az arteria meningea media embolisatio szerepe a krónikus subduralis haematoma kezelési algoritmusában, legújabb evidenciák és saját tapasztalataink.

Chronic subdural hematoma is one of the most common diseases requiring a neurosurgical operation that affect elderly and fragile patients. In addition to standard neurosurgical operations (trepanation and craniotomy), embolization of the meningeal artery media is an alternative solution. Several review aerticles have confirmed the very high rate of success and safety of the endovascular treatment. We present the technical details and results of our 10 consecutive selective media meningeal artery embolization procedures for residual chronic subdural hematomas. Our interventions were performed without complications and all resulted in complete recovery. 

[Middle meningeal artery embolization to treat acute epidural haematoma, case report and literature review]. / Akut epiduralis haematoma kezelése arteria meningea media embolisatióval, esetismertetés és irodalmi áttekintés.

The treatment of acute epidural haematoma is surgery as soon as possible, elimination of the source of bleeding and evacuation of the haematoma. In case of small epidural haematoma, strict neurological and radiological follow-up is necessary. In a significant percentage of cases, open surgery must also be performed within a few days. In case of small epidural haematomas, embolization of the middle meningeal artery is considered as an alternative solution. We review the literature on middle meningeal artery embolization and present our first treatment. Our case report is the first European report about an acute epidural haematoma which was treated by embolization of middle meningeal artery. Our case study is the first report in which a patient was treated with both open surgery and endovascular treatment for acute epidural haematoma within a year.