Turk Neurosurg
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In this paper we present an adult patient with the Currarino triad, associated with six habitual abortuses and chronic constipation. Our aim is to report the effectiveness of a simple surgical technique in the treatment of anterior sacral meningocele in the Currarino Syndrome. The presentation of the Currarino Syndrome in adulthood is extremely uncommon. ⋯ There were no additional neurological deficits and no recurrence of the presacral mass over the 2-year follow up period. When an adult female with habitual abortus and chronic constipation is seen, the possible presence of the Currarino Triad should be investigated and treated. The anterior sacral meningocele in a case of the Currarino Triad regresses over time following transdural ligation of its neck.
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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.
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Case Reports
Posterior atlantal lateral mass fixation technique with polyaxial screw and rod fixation system.
Atlantoaxial instability may result from various pathologic conditions and operative treatment may be required to correct the deformity, provide stability and prevent neurological deficits. We presented our clinic's experience using C1-C2 fusion with polyaxial screw and rod fixation for C1 and C2 instability for various reasons. ⋯ C1 lateral mass/C2 pedicle polyaxial screw fixation is a safe technique and can be used to achieve rigid and immediate atlantoaxial stabilization.
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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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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.