World Neurosurg
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Review Case Reports
The Incremental Value of Magnetic Resonance Neurography for the Neurosurgeon: Review of the Literature.
Magnetic resonance neurography (MRN) is a newer imaging technique that is increasingly used for detailed visualization of peripheral nerves not reliably achieved with conventional imaging modalities. Although MRN has been previously characterized in the literature, few studies have assessed its utility to neurosurgery, where there is potentially substantial impact particularly with preoperative assessment. In this article, we performed a retrospective review of cases in which MRN was used for clinical evaluation and surgical decision making. ⋯ MRN is an underused resource with great potential value in the diagnoses, surgical planning, and postoperative assessment of various neurosurgical conditions. These present incremental utility to the neurosurgeon as well as socioeconomic benefit in the detection of potentially surgically treatable lesions.
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Review Case Reports
Repositioning Technique for the Decompression of Symptomatic Dolichoectatic Vertebrobasilar Pathology: A Comprehensive Review of Sling Characteristics and Surgical Experiences.
The repositioning of a dolichoectatic vertebrobasilar artery (VBA) for arterial decompression has been extensively used in the clinical setting. We aimed to describe and summarize the technical characteristics and clinical results of the sling technique. ⋯ The excellent surgical outcomes and durable long-term results suggest that the repositioning technique is highly effective in resolving symptoms related to the compression of DVB pathology. The wrap-sling technique might be the preferred option owing to the simultaneous symptom relief and lower rate of temporary complications. However, cranial nerve manipulation should be meticulously implemented to avoid permanent negative effects.
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Review Case Reports
Primary Diffuse Leptomeningeal Melanomatosis: Case Report and Review of the Literature.
Primary diffuse leptomeningeal melanomatosis (PDLM) is an extremely rare pathologic condition that can mimic several other neurologic disease states. ⋯ PDLM is an extremely rare disease, and diagnosis is difficult because of nonspecific clinical, radiographic, and laboratory findings. In approximately half of cases, no distinct mass is shown on imaging workup, which may further complicate diagnosis. PDLM should be on the differential diagnosis for cases of diffuse dural enhancement. Neurosurgical intervention is often limited to ventriculoperitoneal shunting for increased intracranial pressure and dural and cranial biopsy to obtain diagnosis. If the initial biopsy is nondiagnostic, hypermetabolic activity as seen on positron emission tomography may be helpful to find an alternative biopsy site.
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Review Historical Article
Neurological Functional Surgery in Mexico: From Pre-Columbian Cranial Surgery to Functional Neurosurgery in the 21st Century.
From the predominance of the pre-Columbian cultures to the present, an interest has existed in Mexico in brain structure and function, in both normal and pathological conditions. This interest has resulted in both medical and surgical attempts to treat some neurological conditions. ⋯ At present, functional neurosurgery in Mexico constitutes, similar to that in other countries, a recognized surgical subspecialty that provides valuable information to treat brain dysfunctions such as movement disorders, pain, epilepsy, and other conditions. In the present report, we have briefly described the main historical aspects of the emergence and development of functional neurosurgery in Mexico.
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Case Reports
Continuous activity tracking using a wrist-mounted device in adult spinal deformity: A proof of concept study.
Sagittal imbalance in adult spinal deformity (ASD) likely influences balance and ambulatory capacity because of muscular demand, pain, and disability. Disability measures for ASD rely heavily on ambulatory function; however, current metrics may fail to fully capture its contribution. We sought 1) to determine the utility of continuous remote step count monitoring and activity tracking in ASD using a consumer-friendly accelerometer, and 2) to investigate trends and patterns both before and after surgical intervention. ⋯ Wrist-mounted devices are a noninvasive and effective measure to track daily activity and ambulatory capacity of patients with spinal deformity. In a single case, progressive deformity correlated with worsening activity levels, whereas deformity correction improved SC and activity level. These results support remote activity monitoring as an exploratory outcome for future studies.