Surg Neurol
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Pitfalls in a parieto-occipital interhemispheric precuneus approach for the ventricular trigonal region of a dominant hemisphere have been rarely reported. We described a case with memory disturbance after surgery using this approach. ⋯ An interhemispheric precuneus approach is a useful alternative to trigonal tumors with few surgical complications, but postoperative memory disturbance can be one pitfall of this procedure.
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Clinical Trial
Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery.
In spinal surgery, repair of the dura is difficult when it is torn or fragile or is ossified as in cases with ossification of posterior longitudinal ligament. We report our experience with a nonsuture dural repair technique in patients undergoing spinal surgery; it uses a dura substitute composed of polyglycolic acid (PGA) mesh and fibrin glue. Here, we report the efficacy and safety of nonsuture duroplasty using PGA mesh and fibrin glue (PGA-fibrin sheet). ⋯ In combination with CSF diversion, the PGA-fibrin sheet is a viable alternative method for dural repair in spinal surgery.
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Comparative Study Controlled Clinical Trial
Bedside twist drill craniostomy for chronic subdural hematoma: a comparative study.
Although the bedside twist drill craniostomy is used to treat chronic subdural hematomas, the efficacy of this technique has not been compared with that of standard treatments (operative bur hole or craniotomy). ⋯ Twist drill craniostomy performed at the bedside is just as effective in treating chronic subdural hematomas as bur holes or craniotomy in the operating room. This procedure can most often be the first line of treatment in patients with symptomatic chronic subdural hematomas.
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An alternative approach for the treatment of the degenerative or unstable lumbar spine using retroperitoneal lateral LIF with anterolateral screw-plate or screw-rod fixation is introduced. Special attention is given to application of this procedure in patients who have undergone prior lumbar surgery. ⋯ Retroperitoneal lateral LIF with anterolateral instrumentation is an attractive alternative for the treatment of the degenerative or unstable lumbar spine in the absence of significant spinal stenosis. This approach is particularly useful for treating spondylolisthesis or degenerative foraminal stenosis in the postoperative lumbar spine.
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We evaluated the prognostic and clinical value of radiological findings including prevertebral hyperintensity (HI), cord compression, intramedullary high-signal intensity (IMHSI) and instability in patients with traumatic central cord syndrome without evidence of fracture and dislocation. ⋯ The presence of prevertebral HI, IMHSI, and cord compression influenced the neurologic status of the patients. The instability was significantly associated with poor prognosis for neurologic outcome. Prevertebral HI on T2 MR imaging may be a possible indicator of instability in patients with central cord syndrome after hyperextension injury.