✓ A case of an unusual distal posterior cerebral artery (PCA) aneurysm is presented. The saccular aneurysm arose from a fetal PCA distal to the posterior temporal branch of the P3 segment. The aneurysm was treated by placing a clip on the PCA distal to the anterior temporal branch of the P2 segment. A ventriculoperitoneal shunt was also placed. The patient's postoperative recovery was unremarkable and without residual neurological deficit. The highly unusual location of this aneurysm is discussed and the neurosurgical literature is reviewed in detail.
Richard K. Simpson Jr. and Warren D. Parker
Christopher R. Tomaras, J. Bob Blacklock, Warren D. Parker and Richard L. Harper
✓ A series of 200 patients who underwent outpatient surgical treatment for cervical radiculopathy is presented. The patients were selected on the basis of their willingness to undergo surgery in the outpatient setting and the absence of serious underlying medical conditions. All operations were performed using general anesthetic techniques with limited posterior dissections. A laminoforaminotomy was performed at each affected level, which had been determined by preoperative imaging and clinical examination. After being observed for several hours, the patients were discharged if they met specific criteria. No patient required subsequent hospital admission in the immediate postoperative period. Follow-up review in 183 patients ranged from 3 to 43 months, with a mean of 19 months. In cases in which Workers' Compensation claims were not involved, 92.8% of patients reported an excellent or good outcome and returned to work or comparable duties at a mean of 2.9 weeks. In cases in which Workers' Compensation claims were involved, 77.8% of patients reported excellent or good outcome and returned to work at a mean of 7.6 weeks postoperatively. Two patients whose cases involved Workers' Compensation claims did not return to work. There were seven patients (3.8%) who had a poor outcome. Two of these patients underwent a second posterior procedure and reported a good outcome at the time of follow-up review. The results of this study show that outpatient surgical treatment of cervical radiculopathy can be safely provided in selected patients with outcomes similar to the inpatient surgical management of these individuals.