World Neurosurg
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Although the incidence of idiopathic normal-pressure hydrocephalus (iNPH) can be 1.20 cases/1000 inhabitants/year in individuals ≥ 70 years old, in most series, the incidence of shunt-responsive iNPH appears to be <1/100,000 inhabitants/year. We report the results of a prospective 10-year longitudinal study of the incidence of iNPH in a northern Spanish population. ⋯ Even with a protocol for patient referral in place, reported iNPH incidence was lower than predicted, reflecting a persistent problem of underdiagnosis in our population.
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Hypertension and smoking are risk factors for aneurysm formation or rupture. We aimed to identify differences in aneurysm morphologies associated with hypertension or smoking in patients with anterior communicating artery (AcoA) aneurysms. ⋯ Aneurysm size was an independent morphologic parameter associated with smoking in patients with ACoA aneurysms compared with other aneurysm morphologies. Smoking may be associated independently with increased aneurysm size and should be given up in patients with AcoA aneurysms.
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Case Reports
Neuroendoscopic Intraventricular Biopsy in Children with Small Ventricles using Frameless Varioguide® System.
Endoscopic biopsy for intraventricular tumors in pediatric patients with small ventricles is a challenging procedure because of the risk of morbidity during the intraventricular approach. We describe the use of the VarioGuide system for intraventricular endoscopic biopsy in 9 consecutive pediatric patients with intraventricular lesions and small ventricular size. All patients had lesions in the anterior part of the third ventricle with a median frontal and occipital horn ratio of 0.33. ⋯ Diagnoses included germinomas in 4 patients, hamartoma in 1 patient, hypothalamic astrocytoma in 2 patients, and craniopharyngioma in 2 patients. The use of the VarioGuide system for intraventricular endoscopic biopsy is highly recommended for pediatric patients with small ventricle size. This technique may help minimize the risk of unnecessary brain damage during the entrance to small ventricles.
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Obesity can be associated with increased complications and potentially worse outcomes. We aimed to evaluate the impact of obesity on complications and outcomes in patients with adult spinal deformity (ASD) who underwent minimally invasive surgery (MIS). ⋯ Our results suggest that obesity does not negatively impact complication rate or clinical outcomes in patients with ASD treated via MIS approaches.
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Traumatic brain injury is a major general health concern. This study aims to evaluate a possible relationship between the serum level of glucose during admission and the outcome of patients with severe traumatic brain injury. ⋯ Admission serum glucose is not a significant indicator of outcome in patients with severe head trauma.