World Neurosurg
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Case Reports
Percutaneous endoscopic C2-C3 medial branches neurotomy for cervicogenic headache: a case report.
Cervicogenic headache (CEH) is characterized by unilateral posterior head and neck pain originating from cervical structures and may be improved or resolved by successful treatment of the causative cervical disorder or lesion. Cervical medial branch radiofrequency (RF) lesion therapy is effective in some CEH patients with no significant pathologic abnormalities that can be surgically corrected. However, patients with refractory CEH are often encountered clinically. ⋯ For patients with refractory CEH who failed medial branch RF lesion, which could be relieved briefly by diagnostic medial branch injection, percutaneous endoscopic C2-C3 medial branches neurotomy may alleviate their pain under the premise of full informed consent, accurate localization, careful intraoperative exploration, and stimulation testing.
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The postoperative infection rates for transforaminal lumbar interbody fusion (TLIF) have ranged from <2% to 4%. However, no consensus has been reached on the treatment strategies. TLIF cage preservation or revision surgery for lumbar spine reconstruction are 2 possible treatments. We aimed to determine the most effective method for organ/space infection control. ⋯ The most important factor contributing to TLIF cage retention failure was epidural fibrosis of the previous transforaminal route and biofilm adhesion on interbody devices affecting infection clearance. Thus, we would recommend a combined anterior and posterior approach or the transforaminal route for radical debridement with cage removal and fusion to achieve better clinical outcomes.
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Dural arteriovenous fistulas (DAVFs) with perimedullary venous drainage are very rare intracranial DAVFs. Treating DAVF via an endovascular electrocoagulation technique, to the best of our knowledge, has not been reported in the literature. We therefore report the first successful case. ⋯ The endovascular electrocoagulation technique is very effective in the management of complex DAVFs with perimedullary venous drainage.
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To evaluate values of cerebrospinal fluid (CSF) and serum procalcitonin (PCT) for diagnosis of intracranial infection after craniotomy and relationship between them and to explore value of PCT in guiding clinical use of antibiotics. ⋯ CSF PCT is a good marker for intracranial infection and could be used to help confirm intracranial infection and provide guidance for clinical use of antibiotics when combined with serum PCT.
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To investigate the clinical characteristics of hypopituitarism and its reversibility after surgery for nonfunctional pituitary adenoma (NFPA); analyze the correlation between tumor size and hypopituitarism incidence; and predict hypopituitarism by tumor volume and maximum diameter. ⋯ NFPA has a significant influence on gonadal hormone, IGF-1/GH, and thyroid hormone. NFPA can cause single- or multiple-hormone reduction in each pituitary target gland. Tumor size is positively correlated with the incidence and degree of hypopituitarism. NFPA-induced hypopituitarism is significantly recovered after surgical treatment.