World Neurosurg
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Comparative Study
Comparing Uniplanar and Multiaxial Pedicle Screws in the Derotation of Apical Vertebrae for Lenke V Adolescent Idiopathic Scoliosis: A Case-Controlled Study.
To compare effects of uniplanar and multiaxial pedicle screws on apical vertebral derotation efficiency in patients with Lenke V adolescent idiopathic scoliosis. ⋯ Both types of pedicle screws could provide effective correction, but the uniplanar pedicle screw was better for derotation of vertebrae and provided patients with better satisfaction. Skeleton immaturity was positively correlated with progression of vertebral rotation after surgery.
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To present treatment strategies for spinal extradural arteriovenous fistulas (AVFs) in relation to angioarchitecture. ⋯ Spinal extradural AVFs consist of 2 subtypes-type A with intradural drainage and type B without intradural drainage-characterized by regional differences at each spinal level in angioarchitecture, causes of myelopathy, and treatment goals.
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Delayed cerebral ischemia (DCI) is a major cause of disability after aneurysmal subarachnoid hemorrhage (aSAH). Activated platelets are surrogate markers for DCI occurrence and are reliably represented by mean platelet volume (MPV) to platelet count (PLT) ratio. If validated as a predictor of DCI, the ratio will allow clinicians to use it as a readily available tool in patient management. ⋯ Trend of MPV:PLT ratio after aSAH predicts DCI. This association alludes to significant early rise in reactive platelet population after aSAH in patients developing DCI.
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Gadolinium-based contrast agents are relatively safe for use in magnetic resonance imaging (MRI) of nervous system pathology. Few reports have been reported regarding the severe adverse effects. These are mostly mild anaphylactoid reactions, especially in the vulnerable group. ⋯ In addition to formal basic supportive treatment, cerebrospinal fluid irrigation of the toxic contrast material is the best management method in case of such an unexpected misadministration of gadoteric acid.
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Increased attention has been paid to limiting preoperative hemostatic screening because assessment of patient history can be used as an alternative. However, there may be some clinical pitfalls in overlooking acquired coagulopathies. Here, we present a case of newly diagnosed acquired hemophilia A (AHA) that manifested as a massive intracranial hemorrhage without unexplained bleeding history or abnormal hemostatic results. ⋯ Acquired coagulopathies are relatively rare but life-threatening. Because clinical history is insufficient to predict an acquired coagulopathy, preoperative hemostatic screening should be performed before each neurosurgical procedure.