Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2014
The role of laminoplasty in preventing spinal deformity in adult patients submitted to resection of an intradural spinal tumor. Case series and literature review.
Laminectomy has normally been used as a standard approach for intradural spinal tumors but this procedure is associated with spinal instability and deformity. Laminoplasty was developed to overcome these limitations. Controversies still exist regarding its actual role in preventing spinal deformity in adults. The aim of our study was to determine the impact of laminoplasty on the prevention of spinal deformity's onset or worsening in adult patients submitted to intradural spinal tumors resection. ⋯ No new-onset spinal deformities, no CSF leaks and a lower rate of spinal deformity progression were observed after laminoplasty for intradural intra- or extra-medullary tumor resection.
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Clin Neurol Neurosurg · Oct 2014
Treatment of thoracic or lumbar spinal tuberculosis complicated by resultant listhesis at the involved segment.
The purpose of this study was to present a singular pathological process of thoracic or lumbar spinal tuberculosis contributing to listhesis at the involved site, with special focus on clinical features and management of this disorder. ⋯ Treatment of this rare pathology aims to restore good spinal alignment, radical debridement, and permanent stability. A reasonable surgical strategy may be the combination of posterior reduction, anterior debridement, and supportive graft fusion. This strategy can safely and effectively achieve all of the therapeutic goals in one step.
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Clin Neurol Neurosurg · Oct 2014
Review Case ReportsA review of cavernous malformations with trigeminal neuralgia.
Cavernous malformation with trigeminal neuralgia is relatively rare; only 10 cases have been reported. In deciding treatment strategies, it is helpful to classify cavernous malformation according to its origin, as follows: in the Gasserian ganglion (Type G); between the cisternal and intra-axial portions of the trigeminal nerve root (Type C); in the intra-axial trigeminal nerve root in the pons (Type P); or in the spinal tract of the trigeminal nerve root (Type S). A 62-year-old male presented with left trigeminal neuralgia (V2 area) and left facial hypoesthesia. ⋯ Histological examination confirmed a cavernous malformation. In this case, the cavernous malformation was Type C. We review cases of cavernous malformation with trigeminal neuralgia and discuss therapeutic strategies according to the area of origin.
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Clin Neurol Neurosurg · Oct 2014
Accuracy of C2 pedicle screw placement using the anatomic freehand technique.
The objective of this study is to evaluate the incidence and prognostic factors of breach rates following the placement of C2 pedicle screws using the anatomic, freehand technique. ⋯ In this cohort study on the anatomic freehand placement of C2 pedicle screws, the breach rate was 17.3%. Lateral breaches were more common than medial breaches. Screw length was not statistically correlated with cortical violation or severity of breach. Therefore, screw length is not a prognostic factor for C2 pedicle screw misplacement.
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Clin Neurol Neurosurg · Oct 2014
Prediction of ventriculoperitoneal shunt placement based on type of failure during external ventricular drain wean.
There are multiple etiologies for failure while weaning an external ventricular drain (EVD) after subarachnoid hemorrhage (SAH), but there is little data on the relationship between etiology of wean failure and ventriculoperitoneal shunt (VPS) placement. ⋯ There is a significant association between wean failure due to clinical changes and requirement for VPS placement after SAH.