case_images: PMC10927220_01
case_images: Noncontrast computed tomography of the head showing right intraparenchymal and subarachnoid hemorrhage due to aneurysm rupture of the right middle cerebral artery in patient 1.
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case_images: F1
case_images: A 42-year-old female originally presented with a ruptured right middle cerebral artery (MCA) aneurysm treated with successful aneurysm clipping and subsequent cranioplasty [Figure 1].
case_images: (a) Thoracic and (b) cervical X-rays of the spine showing placement of the thoracic and cervical paddle leads in patient 1.
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case_images: F2
case_images: Neurontin or Cymbalta. Nine months after her original surgery, she underwent a thoracic laminectomy and implantation of a 5-column paddle lead SCS system with somatosensory evoked potential monitoring (i.e., this followed a prior successful thoracic SCS trial resulting in 90% LLE pain relief) [Figure 2a]. As the thoracic stimulator significantly relieved LLE pain, the patient later underwent a cervical laminectomy and implantation of a 5-column paddle lead SCS system to address her LUE pain [Figure 2b].
case_images: Cervical spinal cord stimulator settings used for satisfactory pain relief in the left upper extremity of patient 1.
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case_images: F3
case_images: With the combined SCS systems, the patient reported 80-90% pain relief (i.e., using BurstDR programming) [Figure 3].
case_images: PMC10927220_02
case_images: T2 brain magnetic resonance imaging showing left thalamic infarct (arrow) after the second stroke in patient 2.
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case_images: F4
case_images: One week later, she additionally sustained a left thalamic MCA stroke, resulting in weakness, an abnormal gait, aphasia, and a CPSP [Figure 4].
case_images: Lateral X-ray showing placement of a high cervical paddle lead in patient 2.
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case_images: F5
case_images: Ten months following the initial consultation, she underwent a C1 laminectomy with implantation of a high cervical 5-column paddle lead SCS system (i.e., following a prior successful SCS trial) [Figure 5].
case_images: Cervical spinal cord stimulator settings used for satisfactory pain relief in the right upper extremity of patient 2.
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case_images: PMC10927220_02_SNI-15-60-g006.jpg
case_images: F6
case_images: Nine months postoperatively, the right hemibody pain and function of the right upper and lower extremities had improved (i.e., using BurstDR programming) [Figure 6].