World Neurosurg
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To assess the impact of fixation to pelvis on 30-day outcomes after posterior spinal fusions in pediatric spine deformities. ⋯ In contrast to adult spinal deformity literature, pediatric patients undergoing a fixation to pelvis are at a greater risk of experiencing adverse outcomes within 30 days of surgery. Providers should use these data for preoperative counseling and/or risk-stratification to improve quality-of-care in the acute postoperative period in these patients.
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Comparative Study
Endocrine and metabolic outcomes following transcranial and endoscopic endonasal approach for primary resection of craniopharyngiomas.
Craniopharyngiomas have traditionally been resected through the transcranial approaches (TCA). The endoscopic endonasal approach (EEA) has recently been developed as an alternative for surgeons, but controversy remains regarding which approach has better outcomes. We compared the endocrine and metabolic outcomes of TCA and EEA in patients who underwent primary resection of craniopharyngiomas. ⋯ EEA may provide the same gross total resection rate for craniopharyngioma as TCA while providing better protection of anterior pituitary function.
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To determine if there is a difference in reoperation rates for symptomatic nonunions in atlantoaxial (C1-C2) fusions with or without bone morphogenetic protein (BMP) using data from a national spine registry and to analyze the different types of bone grafts used in the non-BMP group. ⋯ Using one of the largest retrospective studies on C1-C2 fusions with and without BMP, we found no difference in reoperation rates for symptomatic nonunions. For the non-BMP group, we found that lamina (+/- allograft) or allograft alone may also be just as effective as iliac crest graft (+/- allograft) in having no reoperations for symptomatic nonunions.
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Case Reports
Laser Ablation Therapy for Pediatric Patients with Intracranial Lesions in Eloquent Areas.
Laser interstitial thermal therapy (LITT) is an alternative, less-invasive, and, in some circumstances, effective treatment for patients with intracranial pathology including epilepsy and some tumors. For intracranial lesions in eloquent areas, resection by conventional craniotomy proves often to be a challenge, including in the care of pediatric patients. Herein, we reviewed our experience with magnetic resonance imaging (MRI)-guided LITT as treatment for pediatric patients with intracranial lesions in eloquent areas and evaluate neurologic function and clinical outcomes. ⋯ For intracranial lesions in the eloquent cortex, conventional craniotomy with surgical resection is a challenge for neurosurgeons, especially pediatric patients. MRI-guided LITT provides a less-invasive and potentially effective option for treatment in the management of pediatric epilepsy and tumors.
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Case Reports
Hemorrhagic Atypical Planum Sphenoidale Meningioma with Intermittent Vision Loss-A Rare Presentation of Apoplexy.
Symptoms that mimic pituitary apoplexy may be encountered with other neoplastic or infectious lesions. ⋯ As the most common benign intracranial tumors, meningiomas should remain in the differential for patients presenting with apoplectiform symptoms.