Neurosurgery
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Multicenter Study Comparative Study
Performing a cost analysis in spine outcomes research: comparing ventral and dorsal approaches for cervical spondylotic myelopathy.
Medical cost analysis is increasingly important, but the methodology is complex and varied. ⋯ The choice of cost methodology may substantially influence the final results of an economic study.
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Meningiomas represent about 20% of intracranial tumors and are the most frequent nonglial primary brain tumors. Diagnosis is based on computed tomography (CT) and magnetic resonance imaging (MRI). Mainstays of therapy are surgery and radiotherapy. ⋯ In the present article, we summarize PET imaging for meningiomas based on a thorough review of the literature. We discuss and illustrate the potential role of PET imaging in the clinical management of meningiomas. Finally, we indicate current limitations and outline directions for future research.
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Decompressive craniectomy (DC) is performed as a life-saving procedure in patients with intractably increased intracranial pressure after traumatic brain injury, bleeding, cerebral infarction, or brain swelling of other causes. However, the application of DC is as controversial in the pediatric population as it is in adults. ⋯ The current data indicate that DC in children with traumatic or nontraumatic brain swelling might be warranted, regardless of the underlying cause. Despite mydriasis, a favorable outcome might be achieved in a significant number of pediatric patients. Nevertheless, careful individual decision making is needed for each patient, especially when signs of cerebral herniation have persisted for a long time.
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The ventrolateral thalamus (ventral intermediate nucleus [Vim]) is the traditional target for neurosurgical treatment of essential tremor. The target, however, has varied substantially among different neurosurgeons. ⋯ More contacts yielding an optimal effect were found in the PSA group than in the Vim. Many patients operated on in the Vim got the best effect from a contact located in the PSA. This might suggest that the PSA is a more efficient target than the Vim.
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Cervical laminoplasty is often used for the decompression of multilevel cervical spondylotic myelopathy without creating spinal instability and kyphosis. ⋯ Laminoplasty for 4 or more cervical levels was associated with more axial pain and consequently poorer quality of life than laminectomy. There was a similar loss of sagittal alignment in both the laminectomy and laminoplasty groups over time. Our results suggest there is no clear benefit of laminoplasty over laminectomy in patients who do not have spinal instability.