World Neurosurg
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Comparative Study
Quality of life after surgery for cerebral cavernoma: brainstem versus non-brainstem location.
We sought to analyze long-term outcome and quality of life after surgery of cerebral cavernomas (CCs) with special regard to localization (brainstem vs. nonbrainstem). ⋯ Clinical outcome was different depending on location: NBS recovered the same neurologic status as preoperatively and showed better QoL in physical health and lower working inability than BS. Surprisingly, there was no difference in mental health. Moreover, QoL of the operated cavernoma population after long-term follow-up did not differ from the norm. We conclude that surgery of cavernomas even in eloquent areas may result in favorable outcome and high patient satisfaction.
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Review Case Reports
Intramedullary Spinal Cord Germinoma - A Case Report and Review of Literature.
Primary spinal cord germinomas are an extremely rare group of tumors, most commonly reported as single cases in young Japanese adults. They usually present as intramedullary lesions located in the thoracic and thoracolumbar spine. The importance of preoperative diagnosis lies in the fact that by using radiotherapy and chemotherapy, even without surgery, a good cure rate can be achieved in patients with spinal cord germinoma. ⋯ Therefore, spinal mass surgery should commence with a biopsy and intraoperative frozen section analysis. In this way, attempting a gross total resection becomes unnecessary. With an approach of intraoperative biopsy and frozen section analysis, a considerable amount of postoperative neurologic deficits can be reduced.
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Randomized Controlled Trial Comparative Study
Evaluation of Interspinous Spacers Outcomes in Degenerative Lumbar Canal Stenosis: A Clinical Study.
Lumbar spinal stenosis is a common diagnosis in elderly individuals, and the rates of surgery have risen all over the world. The optimal approach to provide satisfactory decompression and minimize complications for lumbar spinal stenosis remains controversial. ⋯ Although decompression and additional implantation of an ISP are safe procedures, they do not show better improvement in clinical outcome as compared with decompressive laminectomy.
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To avoid surgical site infections (SSIs) by identifying patients at high risk for infectious complications, a better understanding of relevant risk factors is required. This manuscript describes a matched case-control study of patients undergoing cranial neurosurgery with postoperative surgical site infections and a systematic literature review. ⋯ This article provides information to ease the prospective assessment of patients at risk of SSI based on preoperative and postoperative risk factors. Lowering the incidence of SSIs will improve the patient outcomes and the overall quality of the healthcare delivered. To our knowledge, this is the first systemic literature review of SSIs in cranial neurosurgery and analysis of own cases in a wide spectrum.
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Review Case Reports
An Acute Cervical Subdural Hematoma as the Complication of Acupuncture; Case Report and Literature Review.
Several injuries in the cervical region as complications of acupuncture have been previously reported in the literature, including cord and medulla oblongata injuries, subdural empyema, and cervical hematoma. Spinal cord subdural hematoma is a rare condition mainly associated with coagulopathy, trauma, and iatrogenic procedures. We herein report an acute cervical subdural hematoma after cervical acupuncture for neck and shoulder pain. ⋯ Although rare, cervical spinal cord hematomas are disastrous complications of cervical acupuncture. These procedures should be performed under direct observation of trained physicians with appropriate knowledge of cervical anatomy to avoid these complications.