World Neurosurg
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Case Reports
A rare case of negative pressure hydrocephalus: a plausible explanation and the role of transmantle theory.
Negative-pressure hydrocephalus is a rare condition with the development of symptomatic hydrocephalus despite subnormal intracranial pressure (ICP). The etiology remains unclear. Some authors proposed that the differential pressure between the ventricular space and the subarachnoid space over cerebral convexity leads to the development of ventriculomegaly, namely as the transmantle pressure theory. ⋯ This negative-pressure hydrocephalus case report supports the main role of the transmantle pressure theory. The subatmospheric EVD method and a low-pressure valve resulted in excellent clinical and radiographic outcomes.
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To examine the effects of underlying liver disease on 30-day postoperative complications after elective posterior lumbar fusion (PLF). ⋯ As the long-term survival of patients with liver disease continues to increase, a better understanding of the relationship between liver dysfunction and surgical outcomes is needed. The identification of modifiable risk factors would allow them to be addressed and optimized preoperatively to decrease the incidence and severity of complications and improve patient outcomes after PLF.
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We sought to compare clinical outcomes of robot-assisted versus conventional freehand fluoroscopy-assisted lumbar pedicle screw insertion in patients with osteoporosis. ⋯ Robot-assisted pedicle screw insertion is a more effective surgical option for patients with osteoporosis who present with various spine diseases compared with fluoroscopy-assisted freehand screw placement techniques.
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The incidence of meningiomas increases with increasing age. Because the median age for the diagnosis is 65 years, the patients' general health condition, comorbidities, and procedural risks will influence the postoperative functional outcomes. The aim of our study was to assess the long-term impairments of health-related quality of life (HRQOL) after meningioma resection in different age groups of elderly patients. ⋯ Our findings suggest that Karnofsky performance scale and American Society of Anesthesiologists scores have a strong effect on long-term HRQOL, especially for older patients after meningioma resection. These data should be a substantial consideration in the preoperative decision-making process.
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Dexamethasone (DEXA) has been widely used in the management of peritumoral brain edema. DEXA, however, has many systemic side effects and can interact negatively with glioma therapy. Progesterone (PROG), however, is a well-tolerated and readily accessible anti-inflammatory and antiedema agent, with potent neuroprotective properties. We investigated whether PROG could serve as a viable alternative to DEXA in the management of peritumoral brain edema. ⋯ The present proof-of-concept pilot study has provided novel information on the use of PROG as a corticosteroid-sparing agent in brain tumor management. Further translational and clinical studies are warranted.