World Neurosurg
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Review Case Reports
Resolution of cystic deterioration of the C1-2 articulation with posterior fusion: treatment implications for asymptomatic patients.
The authors previously reported anterior decompression of C1-2 synovial cysts and subsequent posterior fusion in a large series. Although the surgical morbidity and mortality were acceptable, prior reports of stand-alone C1-2 fusion with resolution of cyst compression presumptively by correction of joint instability were intriguing and did not involve the morbidity associated with the transoral procedure. ⋯ In asymptomatic patients with a synovial cyst of the atlantoaxial junction, posterior fusion alone may lead to complete resolution of the cyst; however, in neurologically symptomatic patients with similar lesions, cyst decompression coupled with posterior fusion is recommended to ensure the highest chance of cyst resolution and clinical improvement.
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Case Reports
Multimodal treatment of hemorrhagic pituitary metastasis as first manifestation of renal cell carcinoma.
Metastatic tumors involving the pituitary gland are very rare, with only few cases reported so far in the literature. ⋯ This is the first report describing multimodality treatment of a patient with pituitary metastasis of unknown origin requiring presurgical embolization before successful tumor removal.
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The purpose of this study is to provide an institutional retrospective review of surgically treated brainstem cavernous malformations. ⋯ Our longitudinal experience has guided us to emphasize minimally invasive approaches during resection of the brainstem cavernous malformations, occasionally at the expense of achieving a complete resection, to improve patient outcomes.
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This overview of neurosurgery in India during the last six decades gives a holistic perspective of the phenomenal advances made. Neurosurgical education, the change in clinical spectrum of diseases and their presentation, evolution of various subspecialties and societies, the state of research, the issues peculiar to India, including the urban-rural health divide, the increasing role of information and communication technology in neurosurgery, and the gradual but definite global recognition of Indian neurosurgery will be addressed.