World Neurosurg
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Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can reduce motor symptoms in patients with Parkinson disease (PD) and improve their health-related quality of life (HRQoL). The effect of STN DBS on activities of daily living (ADL), an important component of quality of life, is poorly understood. We aimed to investigate effects of STN DBS on HRQoL and ADL in patients with PD. ⋯ STN DBS caused a marked improvement in HRQoL at 3 and 6 months; however, HRQoL remained stable at the 12-month postoperative follow-up. Moreover, we have shown a significant correlation between ADL performance and HRQoL after STN DBS.
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Prediction of traumatic brain injury (TBI) among children is of great importance for accurate clinical decision making. ⋯ At a cut-off score of 3, the Rotterdam system can be used to predict TBI outcome among children with acceptable sensitivity and specificity.
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White fiber dissection using a gyrus-based approach was performed to study the various associations, commissural, and projection fiber bundles of the brain. ⋯ When planning the surgical trajectory, knowledge of the location of white matter tracts is essential to help minimize the occurrence of postoperative deficits. Fiber dissection using the Klingler technique is useful in gaining an understanding of the complex 3-dimensional nature of these white matter tracts and can provide a valuable resource in neurosurgical training.
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Management of meningiomas with major dural venous sinus involvement is challenging. We present our case series and perspective on reconstruction of the sinuses. ⋯ These meningiomas present in a younger population, are more likely to be World Health Organization grade II or III, necessitating a more aggressive tumor resection strategy. Aggressive resection coupled with sinus reconstruction results in good long-term surgical outcome and low recurrence rates.
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We report a retrospective analysis of hardware failure in patients requiring instrumentation for spinal metastasis. ⋯ The rate of hardware failure in this cohort was 13.8%, although operative revision rate was 3.4%. Spinal instrumentation in patients with poor preoperative functional status or multiple myeloma may be more likely to develop instrumentation failure.