World Neurosurg
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Review Biography Historical Article
History of the Neurosurgery Department of Pontificia Universidad Católica, Santiago, Chile.
Pontificia Universidad Católica de Chile's medical school was founded in 1929. An interest in neurosurgical development arose in the minds of the Dean, Dr. Cristobal Espíldora, and the Chief of Surgery, Dr. ⋯ Since then, intensive efforts have been made to develop neurosurgery and its science. As a result, it is now a center capable of achieving high-quality standards in vascular, oncologic, and endoscopic neurosurgery; stereotactic and radiosurgery; complex spine surgery; pediatric neurosurgery; and epilepsy surgery. This article tells the story of a university hospital neurosurgery service in a country at the southern end of the world and how it became one of the most important neurosurgical centers in Chile and South America.
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Review Case Reports
Cervical Osteochondroma Causing Myelopathy in Adults: Management Considerations and Literature Review.
Osteochondromas are the most frequent benign bone tumors but only rarely occur along the spinal column and even more rarely induce symptoms from spinal cord compression. ⋯ We discuss the role of surgical intervention, management, and postoperative follow-up in adult patients with cervical osteochondromas. Recommended management includes radiographic imaging and surgical intervention, particularly when evidence of spinal cord impingement occurs. Consistent postoperative follow-up is necessary to ensure appropriate recovery of neurologic function. Surgical management of cervical osteochondromas typically results in excellent and stable clinical outcomes with rare recurrence.
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Comparative Study
Use of a zero-profile device for contiguous two-level anterior cervical discectomy and fusion: comparison to cage with plate construct.
A new zero-profile, standalone device (Zero P) was recently developed and has shown a lower incidence rate of complications and competitive clinical outcomes compared with anterior cervical cage with plate construct (CP) in single and multilevel anterior cervical diskectomy and fusion (ACDF). However, there is still concern whether Zero P is appropriate for multilevel ACDF. In addition, there have been few reports of contiguous 2-level ACDF used in conjunction with Zero P. ⋯ For 2-level contiguous ACDF, the use of a zero-profile device has the capacity to show compatible outcomes in correction and maintenance of segmental angle if the anterior titanium alloy plate is properly positioned at the anterior vertebral line.
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Review Case Reports
Accidental intrathecal injection of ionic contrast: case report and review of the literature.
Ionic contrast, if accidentally injected into the intrathecal space during routine imaging studies or interventional procedures, may significantly interfere with neuronal activity, potentially causing ascending tonic-clonic seizure syndrome and even death. As a result, ionic contrast is strictly contraindicated for intrathecal use. Rapid recognition of the condition followed by prompt management, typically involving aggressive cerebrospinal fluid (CSF) drainage, is critical to improving patient outcome. Lumbar drain has previously been well described as a management strategy. ⋯ Our literature review and analysis of the previously published cases demonstrate that aggressive CSF drainage is essential to improve outcomes, and in some cases an external ventricular drain alone may be effectively used.
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Review Case Reports
Poor prognosis and challenging in treatment of optic nerve malignant gliomas: A literature review and case report series.
Malignant optic glioma of adulthood is a rare, invasive neoplasm of the anterior visual pathway. In this article, the clinical features of a case series of 3 malignant optic nerve glioblastomas (World Health Organization grade IV) are presented, and the modalities of treatment and their associated survivals are discussed through a review of the existing literature to date. ⋯ Malignant optic glioma is a rare and fatal disease in adults. Despite the modalities of treatment, the treatment outcomes remain unsatisfactory. There is no significant difference in the median OS of patients with malignant optic nerve, as compared with those diagnosed with other supratentorial glioblastoma. Chemoradiotherapy with temozolomide currently remains the best treatment in terms of OS. Advances in the understanding of tumor biology have yet failed to translate into effective treatment regimens.