Neurosurg Focus
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The objective of this study was to assess the feasibility and efficacy of treating spondylolisthesis-related spinal stenosis via unilateral approach bilateral decompression in which METRx-MD instrumentation is placed. ⋯ By following the authors' procedure, minimally invasive bilateral decompression of acquired spinal stenosis associated with spondylolisthesis can be successfully performed on an outpatient basis, with reasonable operative times, minimal blood loss, and acceptable morbidity.
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The prognosis for intraventricular neurocysticercosis (IVNCC) is poorer than that for parenchymal NCC, making prompt diagnosis and treatment especially important. Although active, viable intraventricular cysts produce no reaction in the host; they can cause noncommunicating hydrocephalus, the onset of which is frequently abrupt. With the death of the larva comes a local granulomatous ependymitis, generalized ventriculitis, and meningoencephalitis. The authors report on 18 patients with IVNCC (accrued from a larger case series of 62 patients with NCC treated over an 11-year period), detailing clinical presentation, neuroimaging findings, treatment, and outcome. ⋯ An extensive review of the literature on IVNCC has been prepared, with the goal of providing the reader with the information necessary to diagnose and treat this complex and potentially fatal disease in a timely and effective manner.
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Review Case Reports
Intramedullary spinal cysticercosis. Case report and review of the literature.
Cysticercosis is the most common parasitic infection of the central nervous system. It infrequently affects the spine, but when it does, it can present with symptoms similar to other more common spinal diseases. The authors present a case of isolated intramedullary cysticercosis of the cervical spine and review the literature.
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Worldwide, cysticercosis is the most common parasitic infection of the central nervous system. In endemic regions, the incidence of neurocysticercosis (NCC) approaches 4% of the general population. The disease is predominantly intracranial, the authors of most series generally report the incidence of spinal NCC as only 1.5 to 3% of all cases. ⋯ Medical therapy should be carefully considered in selected patients in whom symptoms are stable and nonprogressive. Surgical intervention is required when severe or progressive deficits occur to prevent permanent injury. In some patients recovery may be limited as a result of inflammatory injury to the spinal cord or arachnoidal adhesions.
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The authors report their experience in the treatment of 12 symptomatic patients with intradural spinal neurocysticercosis. ⋯ The authors discuss their findings in these cases. Additionally they briefly review the literature, pathophysiology, and therapeutic and/or surgical strategies involved in this disease.