Turk Neurosurg
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Case Reports
Extreme elongation of the transverse processes of the fifth lumbar vertebra: an unusual variant.
The fifth lumbar vertebra has massive transverse processes that are continuous with the pedicle and encroach the body of the vertebra. These processes are mainly meant for the attachment of the iliolumbar ligament. ⋯ The authors present the incidental discovery of extremely elongated transverse processes of the fifth lumbar vertebra in a 45-year-old woman who underwent surgery for an intervertebral disc herniation. We also propose a possible pathogenesis to explain this rare condition and conclude that this unusual variant may be caused by calcification of the iliolumbar ligament rather than a congenital anomaly.
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Surgical outcome for giant intracranial aneurysms (GIA) is suboptimal. Reasons for higher complication rates in large and GIA surgery are the occlusion of perforators or parent arteries during aneurysm clipping, or prolonged temporary occlusion of main arteries. In this article, results of clipping of large and GIAs of anterior circulation are presented. ⋯ Clipping is still the most common surgical method of dealing with these lesions. Clipping of all large and giant aneurysms of anterior circulation was achieved in our patients with 10% mortality and 0% morbidity rates. These rates are similar to figures reported in previous series. Clipping of large and giant aneurysms is still the best definitive treatment, and is applicable in majority of the patients.
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Spinal cord injury (SCI) leads to an inflammatory response that generates substantial secondary damage within the tissue besides the primary damage. Ghrelin, 28 amino-acid peptide, has been shown to modulate the release of proinflammatory cytokines and exert antiinflammatory effects. The aim of the current study was to investigate the anti-inflammatory effects of ghrelin, in a rat model of SCI. ⋯ The present study suggests that ghrelin could reduce SCI-induced oxidative stress and exert anti-inflammatory effects in the spinal cord following trauma.
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Review Case Reports
Total resection of inferiorly located sacral chordoma with posterior only approach: case report and review of the literature.
Chordoma is a primary sacral neoplasm of ectodermal origin and makes up %1- 4 of all primary bone tumors. It is usually present on the midline cerebrospinal axis and the most common locations are the spheno-clival region and the sacrum. ⋯ Using the retrorectal fat tissue as a cleavage line in the posterior approach guides the neurosurgeon to resect the tumor totally and reduce the hemorrhage in sacral chordomas. In this case report, we tried to discuss the advantages of using of retrorectal fat tissue as a cleavage line in sacral chordomas under the literature.
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Case Reports
Is spontaneous spinal epidural hematoma in elderly patients an emergency surgical case?
Spontaneous spinal epidural hematoma (SSEH) is a rare condition requiring urgent diagnosis and treatment. Patients with SSEH typically present with acute onset of severe back pain and rapidly develop signs of compression of the spinal cord. The authors present a case with spontaneous resolution of SSEH which is extremely rare. ⋯ The neurological deficits showed complete recovery on the 25th day of the clinical course. SSEH is rare and immediate surgical decompression is suggested. Rapid neurological deterioration followed by early and progressive neurological recovery, confirmed by radiological resolution of the lesion, may indicate nonoperative treatment.