World Neurosurg
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Colloid cysts (CCs) are rare cystic lesions derived from the endoderm of the central nervous system. Although they appear most commonly in the anterior roof of the third ventricle, there are only a few reports of CCs located in the suprasellar region. Although CCs are considered to be slow-growing benign tumors, their developmental process remains unclear. ⋯ This case suggests that CC may be one of several possible diagnoses in patients who present with suprasellar cystic lesions. Even if CCs in the suprasellar region remain asymptomatic, radiological follow-up is required due to possible progressive enlargement of the cyst.
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This study aimed to compare radiographic outcomes of adult spinal deformity (ASD) surgery with or without 2-level prophylactic vertebroplasty (PVP) at the uppermost instrumented vertebra (UIV) and the vertebra 1 level proximal to the UIV. ⋯ PVP at UIV and vertebra 1 level proximal to the UIV cannot prevent PJK, PJF, and PJFX; however, it plays a positive role by delaying their progression. Furthermore, PVP tends to lower the reoperation rate after PJFX in ASD surgery.
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Although pituitary adenoma (PA) and Rathke cleft cyst (RCC) share a common embryologic origin, concurrent appearances have rarely been reported. We present a case of intractable RCC hidden behind a coexisting giant PA. ⋯ The presence of a nonenhanced cyst with a PA on magnetic resonance imaging suggests the possibility of coexisting RCC and PA.
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In thoracolumbar spinal instrumentation surgery, pedicle screw fixation is widely used, whereas screw loosening occurs only occasionally over time. It is common to evaluate screw loosening by the radiographic lucent zone around screws, which can neither evaluate loosening quantitatively nor detect slight screw loosening. In the present technical note, we describe a novel assessment technique of screw loosening by generating 3-dimensional screw images from computed tomography data and superposing them in time series. ⋯ This technique enables the quantitative evaluation of screw loosening and loosening between screws and rods. In conjunction with conventional methods of assessing radiographic lucent zone, we are able to obtain more accurate information regarding screw loosening after spinal instrumentation surgery.
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Patients with refractory chronic primary headache disorders have extremely debilitating symptoms, severe comorbidities (e.g., anxiety, depression), and a significant reduction in quality of life. The headaches are extremely difficult to treat, as they are often refractory to pharmacologic and procedural interventions. Neuromodulation with stimulation of the occipital and supraorbital nerves has been proposed as a viable treatment for these refractory headaches. We retrospectively review the long-term (33.5 ± 20 months) results of supraorbital occipital nerve circumferential stimulation (SOCS) in patients with chronic primary headache disorders. ⋯ The results (82% response) suggest that SOCS may be an effective treatment and should be studied more extensively. Occipital nerve stimulation alone has shown 40% to 50% response rate in published studies. However, the relatively high complication rate highlights an obstacle for the approach for the treatment of refractory headache disorders and room for device optimization.