World Neurosurg
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Osteopetrosis is a heterogeneous group of uncommon congenital disorders that causes bony sclerosis and remodeling. Patients who are symptomatic can show significant neurologic consequences with the involvement of cranial nerves and symptoms of increased intracranial pressure (ICP). ⋯ In conclusion, in patients with symptomatic osteopetrosis, cranioplasty can be considered as an option to treat high ICP-related symptoms.
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Case Reports
Medullary decompression by sling repositioning of the Vertebral Artery with operative video: Technical Case Report.
Vascular compression of the medullary pyramid resulting in neurologic compromise is rare; therefore diagnosis is difficult and ultimately delayed. Most patients present with a combination of cranial nerve, autonomic, and/or motor and sensory dysfunction. Presentation with a single sign such as hemiparesis is rare. The low number of cases reported has made it impossible to define a standard treatment for this unusual disorder. ⋯ Vascular decompression using a sling has proven to be a valuable option for treatment of symptomatic vascular brainstem compression.
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Patient-reported outcome measures (PROMs) are the most widely accepted means of measuring outcomes after spine procedures. We sought to determine the current status of worldwide use of PROMs in Latin America (LA), Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine the barrier to its full implementation. ⋯ We found that 31.9% of spine surgeons do not use the PROMs questionnaire routinely. This appears to occur because of lack of knowledge regarding their importance, absence of reimbursement for this extra work, minimal financial support for clinical research, the cost of implementation, and lack of concern among physicians.
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Parkinson disease (PD) is a major risk factor during spine surgery, and its frequency is increasing as the population ages. The study aim was to examine the influence of PD specifically on lumbar decompression surgery. ⋯ There is a significantly greater rate of perioperative complications in patients with PD undergoing elective decompression surgery. Although the difference in major complication rates was minimal, minor complications were more frequent in patients with PD.
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To present a case series of blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA) and an assessment of diagnosis and treatment options, attempting to identify surgical or endovascular management of BBAs with a low complication rate and a functional outcome. ⋯ Preoperative diagnosis of BBAs is essential for proper management. Once the BBA has ruptured, the emergency clipping operation should be performed with caution. Moreover, based on lessons learned from direct clipping and a literature review, interventional therapy appears to be a more physiologic and more definitive treatment option for BBAs of the ICA, with a more favorable patient outcome.