World Neurosurg
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To analyze the clinical outcomes of our experience with the unilateral C2 translaminar screw technique and evaluate its feasibility as an alternative or salvage of the pedicle screw. ⋯ Patients with variant vertebral artery or osseous anomaly are good candidates for the hybrid translaminar screw technique as an alternative to or salvage of C2 pedicle screw.
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Although a controversial and complex issue, the prognostic factors of skull base chordomas are worth exploring. ⋯ Both pathologic and perioperative KPS score evaluations are significant in OS prediction of both primary and recurrent cases. The nomogram for primary lesions, consisting of preoperative functional status and its perioperative changes, appears useful for risk stratification of long-term survival.
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A 72-year-old man with bilateral chronic subdural hematomas was admitted to our department and treated using a YL-1 type hematoma aspiration needle. The treatment was complicated by hemorrhage of the basal ganglia and brainstem. This patient had no history of hypertension. We evaluated the relevant literature to analyze the causes of cerebral hemorrhage in similar patients. ⋯ This case report illustrates that the stability of the intracranial pressure should be closely monitored during the surgical treatment of chronic subdural hematomas, and large fluctuations in the cerebral perfusion pressure should be avoided during the operation. We also propose improvements in the technical details of the operative treatment of chronic subdural hematomas.
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Case Reports
Evolution of a stump aneurysm that transformed from a fusiform aneurysm in the middle cerebral artery: A case report.
A spontaneous fusiform aneurysm in the middle cerebral artery (MCA) can present with both ischemic and hemorrhagic symptoms, but this aneurysm's clinical course and prognosis are unclear because of its rarity. ⋯ This is the first case report in which serial images demonstrate the stepwise occlusion of an artery with fusiform change and the evolution of a stump aneurysm in the MCA over an extended period.
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Parkinson disease (PD) is a common neurodegenerative disease in elderly patients that may be treated with deep brain stimulation (DBS). DBS is an accepted surgical treatment in PD patients <70 years that demonstrates marked improvement in disease symptomology. Patients ≥70 years historically have been excluded from DBS therapy. Our objective is to evaluate the short- and long-term outcomes in patients with PD ≥70 years who underwent DBS at our center. ⋯ DBS is effective in treating elderly patients with PD. Patients experienced improvement in motor function, LEDD, and medication doses per day after DBS. Our results suggest that DBS is an effective treatment modality in elderly patients with PD.