World Neurosurg
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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.
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Growing rod techniques have been demonstrated to be a valuable treatment in early-onset scoliosis; however, repeated surgeries and general anesthesia cannot be avoided. ⋯ The novel growing rod system is safe and effective in immature swine, preserving spine growth potential and involving less surgical trauma.
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Compression of the common fibular nerve at the level of the fibular neck is considered to be the most frequent lower limb entrapment syndrome, which can be either idiopathic or secondary. Decompressive surgery is indicated only after failure of conservative treatment and/or severe neurologic deficit. The effectiveness of microsurgical decompression has been established only for secondary entrapment syndrome. The aim of this study is to assess the results of microsurgical decompression and establish the prognosis of idiopathic severe common fibular nerve entrapment. ⋯ Microsurgical decompression should be considered early in the context of severe idiopathic common fibular nerve entrapment in order to get a favorable outcome.
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Visuospatial features of neuroanatomy are likely the most difficult concepts to learn in anatomy. Three-dimensional (3D) modalities have gradually begun to supplement traditional 2-dimensionanl representations of dissections and illustrations. We have introduced and described the workflow of 2 innovative methods-photogrammetry (PGM) and structured light scanning (SLS)-which have typically been used for reverse-engineering applications. In the present study, we have described a novel application of SLS and PGM that could enhance medical education and operative planning in neurosurgery. ⋯ The application of 3D computer graphics to neurosurgical applications has shown great promise. SLS and PGM can facilitate the construction of VMs with high accuracy and quality that can be used and shared in a variety of 3D platforms. Similarly, the technical demands are not high; thus, it is plausible that neurosurgeons could become quickly proficient and enlist their use in education and surgical planning. Although SLS is preferable in settings in which high accuracy is required, PGM is a viable alternative with a short learning curve.
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Case Reports
Reversible severe brainstem herniation and obstructive hydrocephalus from cystoperitoneal shunt overdrainage.
We present a case of symptomatic intracranial hypotension secondary to CSF overdrainage from a cystoperitoneal shunt system. Brain MRI shows distortion of the midbrain with secondary occlusion of the cerebral aqueduct resulting in obstructive hydrocephalus. The symptoms, brainstem herniation, and hydrocephalus resolved after tie occlusion of the shunt.