World Neurosurg
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Optical neuronavigation without rigid pin fixation of the head may lead to inaccurate results because of the patient's movements during awake surgery. In this study, we report our results using a skull-mounted reference array for optical tracking in patients undergoing awake craniotomy for eloquent gliomas. ⋯ A skull-mounted reference array is a simple and safe method for optical neuronavigation tracking without rigid pin fixation of the patient's head.
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Comparative Study
Healthcare costs of spontaneous aneurysmal subarachnoid hemorrhage for rehabilitation, home care and in-hospital treatment for the first year.
Given the young age of onset and high probability of long-term disability after subarachnoid hemorrhage (SAH), the financial impact is expected to be substantial. Our primary objective was to highlight subsequent treatment costs after the acute in-hospital stay, including rehabilitation and home care, compared with costs for ischemic stroke. ⋯ Aneurysmal SAH prevalently affects working individuals with long-term occupational disability necessitating long-term medical rehabilitation for most patients and subsequent nursing care in one third of survivors. Overall, SAH treatment generates far higher costs than reported for ischemic stroke.
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Radiation-induced meningioma (RIM) is an uncommon late risk of cranial irradiation. We conducted an exhaustive review of individual patient data to characterize RIM. ⋯ For patients treated with cranial radiotherapy, the risk of secondary meningioma warrants a longer follow-up period beyond the standard time frame typically designated for determining the risk of primary tumor relapse.
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To investigate the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between 3-column and 5-column paddle lead SCS in patients with failed back surgery syndrome. ⋯ Although clinical efficacy of SCS using three-column and five-column paddle lead was not significant different from each other, significant inclination of paddle lead in posterior epidural space with significant reduction in T9 canal area were observed in both groups. The degree of inclination in the 5-column group was more than that in the 3-column lead group. Close approximation of paddle lead contacts to dorsal spinal cord with reduced dorsal cerebrospinal fluid space and intraoperative neurophysiologic guidance might have contributed to the high rate of trial success and long-term pain control.
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Total disc replacement (TDR) is typically indicated in young patients with a cervical soft disc herniation. There are few data on the activity level of patients after cervical TDR, in particular from young patients who are expected to have a high activity level with frequent exercising. The expectation is that returning to active sports after cervical TDR is not restricted. ⋯ We found that cervical TDR did not prohibit sporting activities. All patients recovered and were able to take part in their previous activities at an appropriate intensity level.