World Neurosurg
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The most common pathology associated with an intraluminal carotid thrombus is underlying atherosclerosis. In rare cases, it may be associated with thrombocytosis. Currently there are no clear recommendations for the treatment of ischemic stroke associated with thrombocytosis. Our present case illustrates the use of plateletpheresis for the acute management of thrombocytosis complicated by an internal carotid artery thrombus resulting in a right middle cerebral artery stroke. ⋯ The role for plateletpheresis in treating secondary thrombocytosis is not well established. In cases with extreme thrombocytosis, immediate surgical thrombectomy may be contraindicated owing to a high risk of rethrombosis. Urgent cytoreduction with correction of the putative mechanism for thrombocytosis should be undertaken to provide optimal management.
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Percutaneous cervical nucleoplasty (PCN) is an effective treatment for cervical herniated intervertebral disc (C-HIVD). In this retrospective study, we evaluated clinical predictors that affect the successful outcome of PCN. ⋯ In this study, the success rate of PCN was 66.7% in patients with C-HIVD. Shorter pain duration, the absence of cervical central canal stenosis, pain location (i.e., unilateral radiculopathy vs. axial pain), and the use of the curved-tip technique were positive predictors of successful PCN.
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To explore accuracy and clinical efficacy of a novel patient-specific three-dimensional (3D) printed drill navigational guiding template in atlantoaxial pedicle screw placement. ⋯ Use of the novel patient-specific 3D printed drill navigational guiding template in surgical treatment of atlantoaxial fracture and dislocation can improve accuracy of pedicle screw placement and safety of the surgery, can reduce surgical risks, and can obtain satisfactory clinical curative effects.
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Observational Study
Independent Factors Affecting Postoperative Complication Rates After Custom-Made Porous Hydroxyapatite Cranioplasty: A Single-Center Review of 109 Cases.
Cranioplasties are an important neurosurgical procedure not only for improved cosmesis but also for improved functional recovery after craniectomy with a large cranial defect. The aim of this study was to identify predictive factors of postcranioplasty complications using custom-made porous hydroxyapatite cranioplasty. ⋯ This study identified possible predictive factors for postcranioplasty complications to help identify at-risk patients, guide prophylactic care, and improve morbidity of this important surgical procedure.
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Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. ⋯ Surgery with the EEA is an excellent option for managing giant pituitary adenomas. It results in superior clinical outcomes to those obtained using traditional microscopic transsphenoidal and transcranial approaches as reported in the literature.