World Neurosurg
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To evaluate the efficacy of surgery as a treatment for supratentorial cerebral cavernous malformation-associated epilepsy (SCCMAE) and determine the factors that influence outcomes. ⋯ This study supports the efficacy of using surgery to treat SCCMAE. A shorter duration of preoperative epilepsy was associated with better seizure control after surgery, and patient status at the 1-year follow-up was a reliable indicator of long-term Engel class I epilepsy control.
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Selection of the access myelotomy is a key issue in surgery for spinal intramedullary tumors. This study focused on surgical outcomes with the posterolateral sulcus (PLS) approach, equivalent to dorsal root entry zone myelotomy. ⋯ These findings suggest that the PLS approach can provide direct access to tumors with minimal tissue damage, when applied appropriately after careful case selection.
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Anterior cervical discectomy and fusion (ACDF) is a commonly used surgery for unstable hangman's fractures. This study investigated the rate of residual deformity after ACDF for these fractures and the effect of residual deformity on clinical and radiologic outcomes. ⋯ Residual deformity after ACDF for unstable hangman's fractures is not rare, and it seems to have no significant effect on clinical outcome during short-term follow-up. A severe deformity between C2-C3 after skull traction may be a predictor of residual deformity.
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Observational Study
Impact of Hospital Caseload and Elective admission on Outcomes Following Extracranial-Intracranial Bypass Surgery.
Limited information exists evaluating the impact of hospital caseload and elective admission on outcomes after patients have undergone extracranial-intracranial (ECIC) bypass surgery. Using the Nationwide Inpatient Sample (NIS) for 2001-2014, we evaluated the impact of hospital caseload and elective admission on outcomes after bypass. ⋯ Our findings serve as a framework for strengthening referral networks for complex cases to centers performing high volumes of cerebral bypass. Also, our study supports improved outcomes in select patients undergoing elective bypass procedures.
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Case Reports
Rotational Vertebral Artery Dissection Secondary to an Anomalous Entrance into Transverse Foramen: Case Report.
Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. ⋯ In the setting of codominant vertebral circulation and unilateral bony compression, the authors propose that neck rotation led to vertebral artery trauma, causing dissection complicated by thromboembolism. This is a novel and unusual entity that is different from Bowhunter's syndrome.