World Neurosurg
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To evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. ⋯ The rate of wound complications was not higher in smokers undergoing PLF alone, but was significantly higher in smokers who underwent interbody fusion. However, multivariate analysis identified smoking as an independent predictor of organ/space infection irrespective of fusion technique used.
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Actinomycosis is an uncommon chronic suppurative infection that rarely affects the central nervous system (CNS). It is caused by filamentous Gram-positive anaerobic bacteria that is a normal commensal but causes suppurative and granulomatous inflammation after disruption of anatomical barriers. We report the largest series of 17 histologically confirmed cases of CNS actinomycosis and review clinical, imaging, and histopathologic features. ⋯ Histopathology remains the cornerstone for diagnosis of actinomycosis as on culture confirmation is very rare.
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Vessel transposition is the standard procedure in microvascular decompression (MVD), which necessitates more complex and difficult surgical techniques, including suturing in the deep operative field. We recently reported the usefulness of TachoSil tissue sealing sheets soaked with fibrin glue for vessel transposition in MVD, known as the "birdlime" technique. Here we describe various technical variations and improved adhesive strength of this material for safe and optimal vessel transposition without complications. ⋯ Modifications of the birdlime technique and reinforcement of the adhesive strength provide an easy and adjustable way to perform MVD safely and effectively to reduce the risk of intraoperative neurovascular injury.
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This is a case report of a 34-year-old man with hereditary multiple exostoses who presented with gradual tetraparesis. Neuroimaging evaluation revealed an important posterior spinal cord compression by a C3 bony formation. ⋯ Histopathologic examination of the intraspinal lesion confirmed the diagnosis of benign osteochondroma. The patient returned to a normal life without evidence of recurrence at 2-year follow-up.
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Case Reports
Successful Management of Extracranial Vertebral Artery Aneurysm by Artificial Vessel Reconstruction.
Unruptured extracranial vertebral artery (VA) aneurysms are uncommon and have rarely been described with treatment options. Here we report the successful reconstruction of an asymptomatic extracranial left VA aneurysm, highlighting the treatment for extracranial VA aneurysm and showing the superiority of a hybrid operating room in cerebral vascular diseases. ⋯ Extracranial VA aneurysm in the V1 segment can be well treated with open surgery using a prosthetic graft. Preserving the function of the affected VA should always be a point of concern.