World Neurosurg
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A retrospective study was conducted to clarify the risk factors of postoperative low back pain (LBP) for low-grade degenerative spondylolisthesis. ⋯ LM IMAT and symptom duration were risk factors for postoperative LBP. Patients with severe LM IMAT reported more severe LBP before the operation. Postoperative LBP disappeared more often in patients with shorter symptom duration.
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Direct surgical resection remains the standard treatment for patients with tuberous sclerosis complex (TSC) with a large subependymal giant cell astrocytoma (SEGA). Rapamycin or everolimus is seldom used in these patients because of the risk of increased intracranial pressure and possibility of sudden death. ⋯ Preoperative mTOR inhibitors could be a potentially novel treatment modality in large TSC-SEGA with hydrocephalus. In this series, mTOR inhibitors were not only safe and well tolerated, but also beneficial for tumor resection.
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Case Reports
Guidewire Breakage During Cavernous Sinus Sampling: A Rare Complication and Its Treatment.
Venous sampling methods are valuable tools for the diagnosis of pituitary adenomas. However, these interventions also have complications, which may complicate the treatment process. ⋯ Current surgical experience on endoscopic skull base surgery allows management of diagnostic complications related to the cavernous sinus, such as safe access to materials which were inadvertently left during CSS, without the necessity for further interventions.
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Resident education in the United States and elsewhere has undergone significant changes in recent years owing to work hour restrictions, requiring didactics to fit within a limited schedule, while being increasingly effective at accomplishing educational goals. ⋯ Residents can be exposed to both clinical material and specialty-specific mores using focused and intentional educational techniques.
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It is difficult to evaluate the significant findings of epidural hematoma in magnetic resonance images (MRIs) obtained immediately after thoracic posterior screw fixation (PSF). ⋯ This study shows that epidural hematomas can be detected on MRI performed immediately after thoracic fixation surgery, despite metal artifacts and findings such as hematoma causing spinal cord compression. Loss of CSF space should be considered to be associated with neurologic deficit.