Neurosurgery
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There are a myriad of head and neck pathologies that extend from the extracranial to the intracranial compartment, traversing the skull base, and knowledge of the imaging appearance of this pathology is critical to practicing neurosurgeons. This article reviews some of the important inflammatory or acquired head and neck pathology along the skull base, neoplastic skull base lesions, and the intracranial extension of head and neck malignancy. Focus will be on the relevant anatomy, appropriate imaging protocols to evaluate these processes, as well as the differentiating imaging findings on computed tomography and magnetic resonance imaging.
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Minimally invasive techniques are increasingly being used to access intra-axial brain lesions. ⋯ We provide our experience in using keyhole craniotomies for resecting frontal gliomas. Our data demonstrate the feasibility of using minimally invasive techniques to safely and aggressively treat these tumors.
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To date, the traditional approach to intraspinal tumors has been open laminectomy or laminoplasty followed by microsurgical tumor resection. Recently, however, minimally invasive approaches have been attempted by some. ⋯ This study both demonstrates that it is feasible and safe to remove select, primary intradural spinal tumors using MIS, and augments the previous literature in favor of MIS for these tumors.
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Several studies suggest significant variation in cost for spine surgery, but there has been little research in this area for spinal deformity. ⋯ The rate of adult spinal deformity surgery and the mean case cost increased from 2001 to 2013, exceeding the rate of inflation. Both patient and hospital factors are important contributors to cost variation for spinal deformity surgery.
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Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). ⋯ Psychiatric patients who need to be sedated and immobilized must be monitored closely, as BPI can occur from high-thoracic restraints. When such an injury occurs, the patient must be referred to a center specialized in peripheral nerve surgery and rehabilitation.