Turk Neurosurg
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The redundant nerve root syndrome is defined as the association of high-grade extradural lumbar spinal stenosis with large, elongated and tortuous nerve roots. Acquired elongation of nerve roots due to the mechanical trapping at the level of lumbar spinal stenosis is assumed to be the possible mechanism. ⋯ Although lumbar spinal canal stenosis is common, the entity has rarely been discussed in the literature. Here we present the MR imaging and intraoperative appearance of the condition with a brief discussion in a 71-year-old woman.
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Case Reports
Aplasia cutis congenita of the scalp, skull and dura associated with Adams-Oliver syndrome.
A 1-day-old boy with the characteristics of Adams-Oliver syndrome was presented. Adams-Oliver syndrome has a wide spectrum of anomalies ranging from aplasia cutis congenita, cutis marmorata telangiectatica congenita and transverse limb defects to lethal anomalies. Our patient had aplasia cutis congenita with scalp, skull and dura defect. ⋯ Besides these he had bilateral clubfoot, cortical fissure and nail hypoplasia in the hands, scrotal hyperpigmentation and generalized cutis marmorata telangiectatica congenita. He was operated on the 3rd day of life. The herniated brain tissue was resected and the dura was repaired with a synthetic dural graft.
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Various types of revascularization surgery have been performed for moyamoya disease, and there have been controversies about the surgical procedures. In this report, we introduce our surgical strategy of moyamoya disease and discuss the various surgical procedure options. ⋯ The surgical management of moyamoya disease has various aspects depending on the individual subject and very specific surgical management might be required.
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Controlled Clinical Trial
Do we need bispectral index monitoring during total intravenous anesthesia for lumbar discectomies?
The aim of this study was to investigate the effect of bispectral index (BIS) monitoring on hemodynamic parameters, drug consumption and awareness during total intravenous anesthesia (TIVA) with remifentanil and propofol in lumbar discectomies. After institutional ethical committee approval, ASAI-II 56 patients were divided as control and BIS groups. Anesthesia was induced by bolus remifentanil 1 mug/kg in both groups; propofol 2 mg/kg in was used in the control group while propofol was titrated to BIS 45- 65 values in the BIS group. ⋯ Standard anesthesia titration considering hemodynamic parameters was enough for most ASA I-II patients for lumbar discectomies. BIS might be more helpful for patients who cannot show hemodynamic responses to noxious stimuli. More studies are needed to investigate the correlation between positioning and awareness using BIS monitoring.
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Frontal mucocele usually presents with visual complaints like diplopia, diminution of vision, visual field defect, ptosis, orbital swelling, retro-orbital pain, displacement of eye-globe and proptosis. Very rarely it can present as a subcutaneous swelling. ⋯ Authors report an unusual case of frontal mucocele in a 53-year- old female who presented with painless slowly progressive subcutaneous swelling of five-year duration on the forehead. The case is discussed and the pertinent literature is reviewed.