Internal jugular vein fistula mimicking dural arteriovenous fistula after cardiac pacemaker placement.

Carotid jugular arteriovenous fistulas are a documented complication of cannulation of the internal jugular vein. They may present with neck pain, headache, and cardiovascular aberrations. However, carotid jugular fistula secondary thrombus formation after jugular cannulation with radiographic presentation similar to dural arteriovenous fistula has not yet been reported in the literature. Below, we report the case of a 68-year-old male with an incidentally found carotid-jugular fistula secondary to pacemaker placement who had intracranial reflux on imaging, which was ultimately treated successfully through an endovascular approach.

Chronic intermittent tachycardia as a consequence of vagus nerve injury after anterior cervical discectomy and fusion: case report of a previously unreported complication.

Background: The surgical approach of an anterior cervical discectomy and fusion (ACDF) navigates many important neurologic and vascular structures in the neck. More frequently reported complications are dysphagia, postoperative hematoma, cerebrospinal fluid leaks, and dysphonia. Case description: This case report details an ACDF in a 49-year-old female with intractable neck pain and radicular symptoms. Following the procedure, she developed intermittent tachycardia at rest, which worsened with exertion. Outcome: The cardiac workup was negative. A neck ultrasound demonstrated hypoechoic thickening of the vagus nerve, providing the diagnosis of vagus nerve injury. The patient's tachycardia has been managed with beta-blockers. Conclusions: Although previously unreported, vagus nerve injury following ACDF is possible, causing sympathetic disruption, which can be managed with beta blockers.

Eagle syndrome causing cerebral sinus hypertension: Case report.

Eagle Syndrome is a rare condition with a variety of presentations, resulting from an enlarged styloid process or calcified stylohyoid ligament. Due to the variety of presentations, diagnosis can be difficult. In this report, we present a case of ES that presented with a constellation of neurological symptoms, including headache and visual disturbance, ultimately found to be due to cerebral sinus hypertension, exacerbated by certain movements, caused by an enlarged styloid process with calcification of the stylohyoid ligament, consistent with ES. The patient underwent styloidectomy with immediate resolution of symptoms. This case report illustrates the diagnostic quandary often posed by ES and hopes to add further understanding to its presentation and diagnosis.

Arthroscopic Chondral Defect Repair With Extracellular Matrix Scaffold and Bone Marrow Aspirate Concentrate.

Chondral defects of the knee are prevalent and often encountered during arthroscopic procedures. Despite the limited healing potential of chondral defects, several treatment options have been proposed. However, microfracture, osteochondral autograft (or allograft) transfer, autologous chondrocyte implantation, and matrix-induced autologous chondrocyte implantation are all associated with their respective shortcomings. As such, the optimal treatment for chondral defects of the knee remains unclear. Recently, many authors have advocated treating chondral defects with biological therapies and scaffold-based treatments. Bone marrow aspirate concentrate, a cell-based injection, has gained particular attention because of its differentiation capacity and potential role in tissue regeneration. In addition, scaffold cartilage treatments have emerged and reached clinical practice. BioCartilage is one form of scaffold, which consists of extracellular matrix, and has been claimed to promote the regeneration of hyaline-like cartilage. This article presents our technique of arthroscopic chondral defect repair using BMAC and BioCartilage.

Oral Pathogen Porphyromonas gingivalis Can Escape Phagocytosis of Mammalian Macrophages.

Macrophages are phagocytic cells that play a key role in host immune response and clearance of microbial pathogens. Porphyromonas gingivalis is an oral pathogen associated with the development of periodontitis. Escape from macrophage phagocytosis was tested by infecting THP-1-derived human macrophages and RAW 264.7 mouse macrophages with strains of P. gingivalis W83 and 33277 as well as Streptococcus gordonii DL1 and Escherichia coli OP50 at MOI = 100. CFU counts for all intracellular bacteria were determined. Then, infected macrophages were cultured in media without antibiotics to allow for escape and escaping bacteria were quantified by CFU counting. P. gingivalis W83 displayed over 60% of the bacterial escape from the total amount of intracellular CFUs, significantly higher compared to all other bacteria strains. In addition, bacterial escape and re-entry were also tested and P. gingivalis W83, once again, showed the highest numbers of CFUs able to exit and re-enter macrophages. Lastly, the function of the PG0717 gene of P. gingivalis W83 was tested on escape but found not related to this activity. Altogether, our results suggest that P. gingivalis W83 is able to significantly avoid macrophage phagocytosis. We propose this ability is likely linked to the chronic nature of periodontitis.