World Neurosurg
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Review Case Reports
Non-traumatic multiple vertebral compression fractures induced by primary hyperparathyroidism: A case report and literature review.
Primary hyperparathyroidism (PHPT) is one of the causes of osteoporosis and is known to increase the fracture risk of bone. However, multiple vertebral compression fracture because of PHPT is extremely rare. ⋯ When a patient has multiple compression fractures without any trauma history and a very low T score, the presence of other underlying diseases should be investigated.
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Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide the neuromodulation society worldwide into "believers" and "nonbelievers." A European expert meeting was organized in Brussels, Belgium by the Benelux Neuromodulation Society in order to develop uniform MCS protocols in the preoperative, intraoperative, and postoperative courses. ⋯ Substantial commonalities but also important methodologic divergencies emerged from the discussion of MCS experts from 7 European Centers. From this meeting and questionnaire, all participants concluded that there is a need for more homogenous standardized protocols for MCS regarding patient selection, implantation procedure, stimulation parameters, and follow-up-course.
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PHACE syndrome (Posterior fossa malformations, large cervicofacial infantile Hemangiomas, Arterial anomalies, aortic coarctation and Cardiac abnormalities, and Eye abnormalities) is a neurocutaneous disorder including posterior fossa malformations, hemangiomas, arterial lesions, cardiac defects, and eye abnormalities. PHACE arteriopathies may be progressive and recently have been categorized based on the risk of acute ischemic stroke, increasing attention to the potentially devastating consequences of cerebrovascular complications in this syndrome. In contrast, the natural history of arteriopathy in PHACE syndrome remains poorly understood. At the moment, there are no established surgical guidelines for high-risk vasculopathies, including quasi-moyamoya, in this syndrome. ⋯ Although the natural history of arteriopathy in PHACE syndrome is poorly understood, patients with high-risk vasculopathies, such as quasi-moyamoya disease, may benefit of revascularization by using encephaloduroarteriosynangiosis and encephalomyosynangiosis.
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Case Reports Multicenter Study
Initial Clinical Experience with AView-A Clinical Computational Platform for Intracranial Aneurysm Morphology, Hemodynamics, and Treatment Management.
The management of intracranial aneurysm (IA) is challenging. Clinicians often rely on varied and intuitively disparate ways of evaluating rupture risk that may only partially take into account complex hemodynamic and morphologic factors. We developed a prototype of a clinically oriented, streamlined, computational platform, AView, for rapid assessment of hemodynamics and morphometrics in clinical settings. To show the potential clinical utility of AView, we report our initial multicenter experience highlighting the possible advantages of morphologic and hemodynamic analysis of IAs. ⋯ AView has the potential to confirm decisions to treat IAs, suggest which among multiple aneurysms to treat, and guide treatment decisions. Furthermore, the flow visualization it affords can inform aneurysm treatment planning and potentially avoid poor outcomes.
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Comparative Study
A Retrospective Study of Thoracolumbar Fractures Treated with Fixation and Non-fusion Surgery of Intra-vertebral Bone Graft Assisted with Balloon Kyphoplasty.
Posterior fixation and fusion is the primary treatment for thoracolumbar fractures, although this treatment may sacrifice range of motion (ROM) to achieve stability, rather than treating the fracture itself. Two issues addressed when treating thoracolumbar fractures are 1) replacing the fractured vertebrae, especially the upper end plate of the injured vertebrae and 2) providing strong fixation with biomechanical stability and flexibility. ⋯ Nonfusion treatment of intravertebral bone graft assisted with balloon kyphoplasty showed good fracture reduction, deformity correction, fracture healing, and ROM maintenance. There were no complications associated with the implant.