Electroconvulsive Therapy in Patients With Cerebral Aneurysms.

ABSTRACT: Subarachnoid hemorrhage due to cerebral aneurysm rupture is a devastating event with a high mortality and significant morbidity. The safety of patients undergoing electroconvulsive therapy (ECT) in the presence of an aneurysm is not clear and is a cause of anxiety for both health care workers and patients. The present article collated the available evidence related to ECT in the presence of an aneurysm and found that there were no case reports where ECT directly led to the rupture of an aneurysm, although 1 case reported a rupture of an aneurysm between sessions of ECT. The epidemiology of cerebral aneurysms is discussed, as are key clinical considerations related to the care of patients with aneurysms who require ECT.

High mitotic activity in a capillary hemangioma of the cauda equina: Case report and review of the literature.

BACKGROUND: Capillary hemangiomas of the skin and soft tissue are a common entity, while capillary hemangiomas of the central nervous system are an extremely rare pathology. There are less than 20 published cases of intradural lesions involving the cauda equina. CASE PRESENTATION: Herein, we describe a young patient with a capillary hemangioma of the cauda equina that underwent successful surgical resection. CONCLUSION: Natural history and post-operative follow-up for patients with spinal intradural capillary hemangioma are uncertain. This is the sole case to have not recurred at 12 months which underwent gross total resection and had a high proliferative index.

Recurrent haemorrhagic pontine cavernoma resection via a retrosigmoid microsurgical approach.

BACKGROUND: Brainstem cavernomas occasionally require surgical treatment. Appropriate patient selection and thorough understanding of the anatomy and technical nuances involved in microsurgical resection is a pre-requisite in undertaking these challenging cases. CASE DESCRIPTION: We present a video case of a patient with a recurrent haemorrhagic pontine cavernoma. A step-by-step commentary of surgical footage is provided along with clinical, anatomical and technical learning points pertinent to the safe surgical management of these lesions.

Cerebral abscesses after endovascular coiling of a paraophthalmic aneurysm: Case report and review of the literature.

BACKGROUND: Intracranial infections are a rare complication of therapeutic neuroendovascular procedures. CASE DESCRIPTION: We present a case of a 72-year-old female with multiple unilateral cerebral hemisphere abscesses after endovascular embolization of a right paraophthalmic aneurysm and also provide a comprehensive review of the literature on cerebral abscesses following neurovascular embolization. CONCLUSION: Infection following coil embolization of cerebral aneurysm is rare. However, it is likely to increase in the setting of increased used of neuroendovascular techniques in the future. Therefore, we suggest that extreme care is taken to ensure proper asepsis during embolization, and a high index of suspicion is maintained in patients with predisposing characteristics (large hemorrhage, ischemia, recurrent endovascular procedures, right-to-left shunt, and concomitant infection). Given the fact that the majority of abscesses occurred in patients who have had ruptured aneurysms, we suggest consideration is given to prophylactic intraprocedural intravenous antibiotics use as seen with open aneurysm treatment.