World Neurosurg
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The study aimed to investigate optimal surgical timing, methods, and clinical efficacy of bifrontal decompression craniotomy (BDC) on traumatic bifrontal contusions (TBC). ⋯ TBC progressed gradually and deteriorated rapidly; this should be strictly and dynamically observed, and patients should be operated on in a timely manner. Changing the operation-timing score is the gold standard for surgery. Amended BDC can significantly improve the prognosis of patients.
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Controlled Clinical Trial
The analysis of the petrosal vein to prevent venous complications during the anterior transpetrosal approach in the resection of petroclival meningioma.
The anterior transpetrosal approach (ATPA) has been used in the resection of petroclival meningioma (PCM) for more than 20 years. Although PCM sometimes involves the petrosal vein and its preservation has been an important issue, the precise risk of petrosal vein sacrifice and subsequent venous complications associated with the use of the ATPA in patients with PCM has not yet been elucidated. ⋯ Our study demonstrated that the ATPA could be performed safely on patients with PCM from the viewpoint of venous preservation. Preoperative CT-DSV is important for assessing the petrosal vein and its tributaries to facilitate a safer operation.
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The efficacy of epidural spinal cord stimulation on chronic neuropathic pain due to failed back surgery syndrome or nerve root lesions is well reported. There is even literature reporting the effects of spinal cord stimulation in controlling peripheral vascular lesions as in peripheral arteriopathies or diabetic neuropathies and in complex regional pain syndrome type II. This is probably due to an effect of epidural spinal cord stimulation, mainly on the parasympathetic nervous system. ⋯ This is the first case report of severe chronic pain syndrome due to a widespread lymphangioma successfully treated by means of epidural spinal cord stimulation.
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Comparative Study
Is Carotid Revascularization Safe for Patients with Concomitant Carotid Stenosis and Intracranial Aneurysms?
The safety of carotid revascularization in patients with concomitant extracranial carotid stenosis and cerebral aneurysm is rarely reported. We examine the risk of subarachnoid hemorrhage, aneurysm growth, ipsilateral transient ischemic attack, or stroke after revascularization in patients with both carotid stenosis and cerebral aneurysms. ⋯ Our study suggests that revascularization procedures for carotid stenosis should be considered safe and effective in patients with concomitant extracranial carotid occlusive disease and cerebral aneurysms.
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With vertebral compression fractures (VCF), height loss has been associated with kyphotic deformity and intractable pain, 2 indications for potential surgical intervention. Consequently, assessment of factors associated with continual height loss can provide insights regarding management. Computed tomography (CT) Hounsfield units (HU), a measure of radiodensity, have been implicated for the assessment of bone quality. No studies have assessed the relationship between CT HU and traumatic VCF. Consequently, the objective of this study was to evaluate this relationship. ⋯ Age, BMI, and CT HU values are independent predictors of worsening VCF. These factors can help determine appropriate clinical follow-up and need for surgical intervention.