World Neurosurg
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Comparative Study
Differences in the electrophysiological monitoring results of spinal cord arteriovenous and intramedullary spinal cord cavernous malformations.
Spinal arteriovenous malformations (SAVMs) and intramedullary spinal cord cavernous malformations (ISCCMs) have a very low incidence of disease. The purpose of this study was to compare the differences in electrophysiologic monitoring in these 2 surgeries. ⋯ Electrophysiological monitoring provides effective guidance during operation on spinal vascular malformations. Electrophysiologic monitoring revealed that surgical resection of SAVMs resulted in more permanent changes and postoperative dysfunction when compared with ISCCMs. The incidence of both false-positive and -negative results suggests that electrophysiologic monitoring cannot fully predict the complete function of the patients.
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Distal middle cerebral artery aneurysm (DMCAAn) is rare, and the clinical features and the etiology are not well understood. Segmental artery mediolysis (SAM) is a pathologic entity that affects the media of the muscular artery and can cause arterial dissection and a hemorrhagic event. Subarachnoid hemorrhage (SAH) due to SAM in the vertebral artery has been documented. However, SAH from a ruptured DMCAAn due to SAM has not yet been described. ⋯ Our case suggests that SAM can also occur in the middle cerebral artery and result in DMCAAn.
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Case Reports
Langerhans cell histiocytosis of the skull in the burr-hole site covered with hydroxyapatite material: a case report.
Langerhans cell histiocytosis (LCH) is a rare dendritic histiocytic disorder that affects the bones, especially the skull. Langerhans cell histiocytosis (LCH) developing in a burr hole site for chronic subdural hematoma is extremely rare. ⋯ If there is rapid proliferation of connective tissue at an operative site where artificial material has been used, LCH should be considered.
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Comparative Study Observational Study
Patient-Oriented Aesthetic Outcome After Lumbar Spine Surgery: A 1-Year Follow-Up Prospective Observational Study Comparing Minimally Invasive and Standard Open Procedures.
Despite recent treatment developments, back pain and related disabilities still represent a challenge for practitioners. Among the available surgical techniques, many different features and outcomes have been investigated; however, aesthetic result was missing among them. The present investigation was designed to prospectively compare patient-oriented aesthetic results after minimally invasive surgery (MIS) and standard open surgery (SOS) for the lumbar spine. ⋯ Patients seem to prefer the aesthetic result from a single midline incision after SOS compared with MIS. The use of specific techniques could be considered if there is scientific evidence reporting greater aesthetic outcome, having similar clinical and functional ones.
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The risk of hemorrhage remains after radiosurgery for patients with arteriovenous malformations (AVMs), especially during the latency period. The effect of venous outflow stenosis on postradiosurgery AVM hemorrhage has been understudied. The present study sought to clarify the effect of venous stenosis on postradiation hemorrhage. ⋯ We identified statistically significant risk factors for postradiosurgery AVM hemorrhage, which included advanced age, female gender, the presence of venous stenosis, a larger AVM volume, and previous hemorrhage. We recommend cautious selection of patients for radiosurgery with close follow-up after treatment, especially for patients with these risk factors.