World Neurosurg
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Though primarily considered entertainment, cinema is a mirror of society. The portrayal of neurosciences is common in cinema, but none could do it better than Jack Nicholson. We give a brief overview of his contribution to neurosciences by analyzing his acting skills.
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Comparative Study
Comparison of outcomes of anterior-, posterior- and transforaminal lumbar interbody fusion surgery at a single lumbar level with degenerative spinal disease.
The fusion rate in spinal surgery may vary in relation to the technique, and it remains unknown which surgical technique provides the best fusion rate and surgical outcome. We aimed to compare radiologic and surgical results between 3 surgical techniques used for lumbar interbody fusion. ⋯ ALIF was associated with better restoration of segmental lordosis. The fusion rate on CT scan and with segmental ROM did not differ between the 3 groups. TLIF was associated with a better postoperative visual analog scale. PLIF showed the lowest cage subsidence rate. Therefore, it is difficult to know which surgical technique is better among the 3 groups because each surgical method has its own advantages.
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Several studies have looked for an association between radiologic findings and neurologic outcome after cervical trauma. In the current literature, there is a paucity of evidence proving the prognostic role of soft tissue damage or bony integrity. Our objective is to determine radiologic findings related to neurologic prognosis in patients after incomplete acute traumatic cervical spinal cord injury, regardless of initial neurologic examination results. ⋯ Early MRI has an intrinsic prognostic value. Ligamentous injury and larger edema are strong predicting factors of a bad neurologic outcome at long-term follow-up.
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Review Case Reports
Case Report of a Primary Pituitary Abscess and Systematic Literature Review of Pituitary Abscess with a Focus on Patient Outcomes.
Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2%-1.1% of operative pituitary lesions. Diagnosis can be challenging, because this disorder shares many similarities with other pituitary lesions in terms of signs and symptoms and radiographic findings. Most pituitary abscesses are categorized as secondary, arising from preexisting pituitary lesions or in conjunction with transsphenoidal surgery, sepsis, meningitis, or sinusitis. There have been only a few reports of primary pituitary abscess, which occurs without any of the aforementioned risk factors. ⋯ A PubMed search was performed; all cases of pituitary abscess reported in the literature were screened, and 200 cases including our case were analyzed with a focus on outcomes. The most common presentations were headache, visual disturbance, and endocrine abnormalities. Approximately 66.1% of patients achieved partial or complete recovery of pituitary function; 75.7% with vision deficits recovered visual function. Treatment via a craniotomy had a recurrence rate of 17.2% compared with 9.7% via a transsphenoidal approach. To our knowledge, this is the first systematic review on the topic and the largest series reported.
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Observational Study
The association of surgical method with outcomes of acute subdural hematoma patients: experience with 643 consecutive patients.
We investigated the association of decompressive craniectomy (DC) and osteoplastic craniotomy (OC) with outcomes in consecutive patients undergoing surgical evacuation of acute subdural hematoma (ASDH) and analyzed prognostic indicators to determine optimal surgical management strategy for patients with ASDH. ⋯ DC was performed more often in younger and more severely injured patients. DC is associated with greater mortality and handicap rates independent of disease severity. Clinical trials investigating optimal surgical management strategy of patients with ASDH are needed.