Turk Neurosurg
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The surgical treatment of spinal metastases is still controversial. Due to developments in diagnostic imaging there has been a great evolution in minimally invasive surgical techniques for the spinal surgery. Most of the patients with spinal metastases are debilitated and under high risk of major surgical morbidity and mortality. ⋯ Minimal invasive techniques represent major advance in minimizing approach related morbidity in the treatment of spinal tumors. Because of the evolution of minimally invasive surgical techniques for the spinal surgery, minimally invasive techniques are alternative treatment to standard open approaches for the treatment of metastatic spinal tumors. Due to less complication rates there has been a trend toward the minimalization of spine surgery.
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Review Case Reports
Thoracic epidural blood patch for spontaneous intracranial hypotension: case report and review of the literature.
Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF). Treatment is directed at sealing the site of leak, which is often difficult to localize. We present a case of near fatal SIH that was treated with thoracic epidural blood patching. ⋯ Epidural blood patch was performed at the T1-2 level, the presumed location of the leak due to presence of a bone spur on computed tomography and the large corresponding CSF collection. This quickly led to resolution of the headache and cranial nerve palsies, and later to the complete resolution of his SDH. Through this case and review of the literature, we aim to demonstrate that directed cervical or thoracic blood patching should be considered for SIH as an alternative to the conventional lumbar blood patch.
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This study aimed to investigate the operative procedure for neuroendoscope-assisted microscopic resection of petroclival meningioma to improve prognosis. ⋯ Neuroendoscope-assisted microscopic resection for petroclival meningioma can improve the total and subtotal resection rates of the tumor. Moreover, this method does not increase postoperative short-term and long-term complications.
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The "trephined" syndrome is a relatively rare complication after a large skull bone defect, consisting of a sunken skin above the bone defect with neurological symptoms such as severe headaches, mental changes, focal deficits, or seizures. Emerging data show improvements in the patients' neurological status after cranioplasty, i.e. the surgical intervention to repair cranial defects. ⋯ His motor and neuropsychological status greatly improved after cranioplasty. Our results confirmed previous reports that cranioplasty may significantly improve neuropsychological and motor function, as evaluated by specific tests, in patients with skull bone defects, and even in patients with DOC.
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Randomized Controlled Trial
Enteral Nutritional Support in Patients with Head Injuries After Craniocerebral Surgery.
To explore the effect of early enteral (EN) and parenteral nutritional (PN) support on head-injured patients after craniocerebral surgery. ⋯ Early EN support is superior to PN support in head-injured patients after craniocerebral surgery.