World Neurosurg
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Review Historical Article
Syrinx in Spinal Cord in Mummified Individual from West Thebes (Egypt).
We analyzed a total of 36 partial or complete mummies containing neural structures from Sharuna and Qarara (Middle Egypt) and Dra Abu-el Naga, West Thebes (Upper Egypt). Individual TT16 13.3-B06-Ind07 corresponded to a partial mummy from T2 to T11. At distal levels, it showed a structure compatible with the lower spinal cord (SC). ⋯ Field radiograph confirmed a structure compatible with the SC with a syrinx that shows a maximum diameter of 3.2 mm measured by digital caliper. Bearing in mind the normal shrinking mechanism at work in mummification, a pathologic condition such as syringomyelia during the individual's life is a distinct possibility. After a thorough review of the literature, this would be the earliest report of syringomyelia.
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Multicenter Study
Discharge to Inpatient Care Facility After Vertebroplasty/Kyphoplasty: Incidence, Risk Factors, and Postdischarge Outcomes.
Vertebral compression fractures are a common clinical occurrence in elderly individuals with osteoporosis. No current evidence exists on risk factors and clinical impact of discharge to inpatient (IP) care facility after vertebral augmentation procedures. ⋯ Discharge to IP care facilities after vertebroplasty/kyphoplasty is associated with a 3.6 times greater odds of mortality as compared with home discharge. Providers can use the risk profile data to better allow preoperative stratification of patients to ensure that discharge location is appropriate to a patient's need to minimize the risk of adverse outcomes.
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Review Case Reports
Successful Conservative Management of Delayed Cervical Spondylodiscitis with Epidural Abscess Caused by Esophageal Diverticulitis: A Case Report and Review of Literature.
Cervical spondylodiscitis with spinal epidural abscess (SEA) is not a rare medical condition and usually requires urgent decompression of neural structures and stabilization of the spine followed by antibiotic therapy for the prevention of severe neurologic deficits. ⋯ Physicians need to be aware of this rare case of SEA secondary to esophageal diverticulitis. An early diagnosis and prompt administration of antibiotics is a key factor to avoid neurologic deterioration for the treatment of SEA caused by diverticulitis. Endoscopic or surgical repair of diverticulum may be warranted to avoid the recurrence of such infection.
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Review Case Reports
"A Giant craniospinal intramedullary neurenteric cyst in an infant"- A case report and review of literature.
Neurenteric cysts are rare congenital lesions derived from an anomalous connection between the primitive ectoderm and endoderm. ⋯ We report and discuss the clinical presentation, pathogenesis, and neuroradiologic findings in an infantile case of a giant craniospinal intramedullary neurenteric cyst. Early recognition is beneficial because of its benign nature and good clinical outcome following total surgical resection.
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Review Case Reports
Bow Hunter's syndrome: surgical vertebral artery decompression guided by dynamic intraoperative angiography.
Bow hunter's syndrome is a symptomatic vertebrobasilar insufficiency resulting from a rotational stenosis or occlusion of a dominant vertebral artery (VA). The VA is dynamically compressed by cervical osteoarthritis (discovertebral structure or osteophytes) during head rotation or neck extension. Diagnosis is based on dynamic computed tomography angiography and confirmed with dynamic catheter angiography. Surgery tends to be the best treatment option in most cases. Dynamic intraoperative assessment of VA decompression seems to improve surgical results but remains poorly evaluated in the literature. ⋯ Surgical decompression guided by dynamic intraoperative catheter angiography leads to selective VA release and allows real-time assessment of the efficacy of the decompression. This multidisciplinary treatment involving neurosurgical and neuroradiologic teams is a simple and effective treatment. Dynamic intraoperative catheter angiography is an essential guide to perform selective decompression of the VA, and implementation of an intra-arterial remodeling balloon can improve the safety of surgery making this method valuable compared with other intraoperative assessment techniques, such as Doppler ultrasound and indocyanine green fluorescent videography.