World Neurosurg
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Revascularization is an important strategy when treating cerebrovascular occlusive disease and complex aneurysms. Radial artery fascial flow-through free flaps (RAFFs) are flexible grafts that provide direct and indirect revascularization. RAFFs can be especially useful for large territory revascularization and can be combined with other direct bypasses. ⋯ Postoperative angiography demonstrated patency of both direct grafts. The patient suffered small pericallosal infarcts because of retraction and perforator sacrifice at the revascularization site. At early follow-up, the patient was at his neurologic baseline, and at 1-year follow up, the patient had no additional infarcts on imaging and was living independently.
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Migration of distal ventriculoperitoneal (VP) shunt catheter into another body part has been described as a potentially serious surgical complication. We present the first case of sepsis caused by transcardial and pulmonary migration of a distal catheter into the heart and pulmonary artery, which was subsequently colonized by Klebsiella pneumoniae. ⋯ Migration of a distal VP shunt catheter into the heart should be considered in patients with a previously placed VP shunt presenting with cardiopulmonary problems, arrhythmia, and/or fever. Neurosurgeons should be involved as soon as possible, and a multidisciplinary approach is warranted.
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We have discussed the clinical features and neuroimaging findings and investigated the correlations between the clinical characteristics and different neuroradiologic phenotypes of cerebral small vessel disease (CSVD). ⋯ The present study has provided a comprehensive analysis of the clinical correlation of characteristics and neuroradiologic phenotypes in patients with CSVD. The insights from these findings could be used to refine the management strategy for patients with CSVD.
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To investigate effectiveness of brace treatment in patients with adolescent idiopathic scoliosis with curve between 40° and 45° and to determine predictive factors associated with bracing outcome. ⋯ Bracing may produce a favorable outcome in certain patients with curve between 40° and 45°. It should be cautiously used in this situation, as there was a higher probability of bracing failure. It is important to differentiate patients at high risk of curve progression at an early stage to avoid overtreatment.
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To determine the safety and effectiveness of the combined halo gravity traction and dual growing rod technique in achieving and maintaining scoliosis correction while allowing spinal growth. ⋯ The combined halo gravity traction and dual growing rod technique can safely and effectively correct NF1-associated scoliosis. This is an ongoing study that requires long-term follow-up.