World Neurosurg
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Case Reports
Cervical Kyphotic Deformity Worsening After Extensor Cervical Muscle Paralysis from Botox Injection: Case Report.
Botulinum toxin (Botox) has long been used therapeutically to treat a variety of diseases, including migraine headaches, cervical spine dystonia, and chronic cervical spine pain, among many others. Although quite useful, Botox has been reported to cause adverse events, some of which may lead to devastating morbidity. ⋯ This case illustrates a potential danger of using Botox in the neck of an elderly patient who may have pre-existing cervical spine instability, underlying cervical musculature weakness, and pre-existing cervical kyphosis. It demonstrates the need to evaluate patients who are predisposed to developing cervical kyphotic deformities before offering them Botox treatment.
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Gamma Knife radiosurgery was introduced in the 1960s and is currently used worldwide. The internet has become a foremost source of information used by patients and their families. In this study, we aim to evaluate the accuracy and reliability of the Gamma Knife radiosurgery-related YouTube videos. ⋯ Patients and caregivers turn to online sources to gather information about the disease. However, the available YouTube published videos are published without proper academic monitoring, as in such a free platform, published videos tend to catch a general audience for different purposes, which leads to diminishing quality control. Academic medical institutions should consider a proper monitoring process for videos to improve the accuracy of the published information for the patients.
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Cerebral arteriovenous malformations (CAVMs) are characterized by altered hemodynamics and associated with angioanatomic changes, such as aneurysms. We encountered a patient with a CAVM-associated dissection of the medial trunk of the posterior inferior cerebellar artery (PICA) instead of an aneurysm. ⋯ This is the first report of a hyperdynamic flow-related dissection of a CAVM-associated feeding vessel. Microsurgical resection of the CAVM allowed for spontaneous resolution of the dissected area by restoration of normal rheodynamics.
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Transient tumor attack is a rare but well-known phenomenon. Described by Ross in 1983, it demonstrated a transient ischemic attack-like picture in patients with intracranial mass lesions. Usually these attacks were recognized at sites anatomically away from the primary lesion that were not explained by primary mass effect of the lesion. The exact pathophysiology of such transient tumor attacks is postulated to be due to either a vascular steal phenomenon or compression of a vessel or localized prothrombotic state. ⋯ We try to shed some light on the pathophysiology of this unusual phenomenon.
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To compare the clinical accuracy and perioperative outcomes for pedicle screw placement in transforaminal lumbar interbody fusion (TLIF) between the robot-assisted (RA) technique and fluoroscopy-guided (FG) technique. ⋯ RA pedicle screw placement is an accurate and safe procedure in TLIF for lumbar degenerative disease.