World Neurosurg
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Precisely defining complications, which are used to measure overall quality, is necessary for critical review of delivery of care and quality improvement in endovascular neurosurgery, which lacks common definitions for complications. Furthermore, in endovascular interventions, events that may be labeled complications may not always negatively affect outcome. Our objective is to provide precise definitions for quality evaluation within endovascular neurosurgery. Thus, we propose an endovascular-specific classification system of complications based on our own patient series. ⋯ We propose an endovascular-specific classification system of complications with 4 categories: mechanical, technical, judgment errors, and critical events. This system provides a framework for future studies and quality control in endovascular neurosurgery.
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Observational Study
Epidemiologic and Demographic attributes of Primary Spondylodiscitis in a Middle Eastern population sample.
The prevalence and characteristics of spontaneous spondylodiscitis in the Middle East are unknown. There seems to be an emerging dominance of pyogenic infections over tuberculosis and brucellosis. ⋯ Spontaneous infective spondylodiscitis affects older men with and without medical comorbidities equally. It often involves the lumbar spine and a third of patients are culture negative. Tuberculosis constitutes only about 17% of primary infections in the spine in this population sample.
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To introduce and assess a surgical treatment of occipitocervical (OC) dislocation with atlas assimilation and Klippel-Feil syndrome (KFS) using occipitalized C1 lateral mass and C2 fixation and reduction technique. ⋯ In patients with OC dislocation and KFS of C2-3 fusion and atlas assimilation, posterior manipulative reduction combined with occipitalized C1 lateral mass and C2 fixation provides a reliable and effective treatment.
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Intracranial spread of an adenoid cystic carcinoma (ACC) of the parotid gland is rare, and metastatic ACC to the splenium of the corpus callosum mimicking butterfly glioblastoma (GBM) has not been reported previously. We report a rare case of metastasis to the splenium of the corpus callosum from ACC of the parotid gland. ⋯ The treatment for this lesion is surgical debulking followed by radiation therapy; however, the overall prognosis remains grim because of limited chemotherapy options and a propensity for recurrence in both local and distant fashions. When a tumor with adenoid histological features and a "butterfly" phenotype grows in the corpus callosum in a patient with known parotid ACC, both metastasis and adenoid variant GBM should be considered. Careful clinical and radiological correlation is required to diagnose and treat this rare lesion.
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To evaluate the microsurgical anatomy of the fiber tract connections of the supplementary motor area (SMA) and pre-SMA, and examine its potential functional role with reference to clinical trials in the literature. ⋯ The SMA complex has numerous connections throughout the cerebrum. An understanding of these connections is important for presurgical planning for lesions in the frontal lobe and helps explain symptoms related to SMA injury.