World Neurosurg
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Calcified disk herniation of the thoracic spine is by no means a rare clinical entity in neurosurgery. We present a 63-year-old woman with a long-standing giant calcified disk in the thoracic spine. ⋯ Given her benign neurologic examination and the presumed morbidity of attempting to resect the lesion, we elected to follow her closely with serial imaging. Over 3 years of consistent follow-up, the lesion has not grown and she has remained free of neurologic changes.
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Intracranial hemorrhage (ICH) is the most feared complication of endovascular treatment (EVT) for acute ischemic stroke because of anterior circulation large vessel occlusion (LVO). The purpose of this study was to identify cerebral hemodynamic predictors of ICH and poor outcome in patients with successful recanalization. ⋯ Early TCCS detection of a high PSVMCA ratio in successfully recanalized stroke patients indicates an increased risk of ICH, whereas cerebral hemodynamics normalization at 1 week in patients with postinterventional ICH predicts a relatively better 3-month outcome.
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Previous studies of percutaneous endoscopic lumbar discectomy (PELD) to treat lumbar disc herniation (LDH) have shown good clinical results. However, limited information has been reported regarding postoperative improvement in back muscle function. We aimed to determine whether changes in neuromuscular patterns, assessed using the flexion-relaxation phenomenon (FRP), could be observed after PELD. ⋯ PELD for individuals with LDH appears to normalize paraspinal muscle activation during lumbar flexion-extension movement. The gross range of motion and disability-related limitations of physical activity also improved.
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Sphenoid wing meningiomas are the third most common group of intracranial meningiomas. Their management is a challenge because of their bone invasion potential and their proximity to neurovascular structures and the cavernous sinus. ⋯ Sphenoid wing meningioma is a large group with characteristics associated with skull base meningiomas and convexity meningiomas. The results of surgery and other adjuvant treatments are heterogeneous.
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Traumatic brain injury (TBI) is major contributor to the global burden of disease, especially in low- and middle- income countries, where most TBIs are traffic-related. Evidence shows that helmets protect against severe TBI. Cambodia continues to have the greatest motorcycle fatality rate in Southeast Asia. We investigated whether the National Motorcycle Helmet Law introduced in January 2016 had an impact on the epidemiology of motorcycle-related TBI in a neurosurgical referral center in Phnom Penh. ⋯ With growing urbanization and motorization, TBI is a significant cause of morbidity and mortality in Cambodia. Two years after helmets became compulsory, most patients with TBI are still unhelmeted. Likely contributing factors are low penalty for noncompliance and inconsistent law enforcement. TBI is a major public health problem warranting further efforts to understand how to improve prevention strategies and advocate for change.