World Neurosurg
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Current literature remains inconclusive as to whether multilevel posterior cervical fusions (PCFs) involving the C7 vertebra should cross the cervicothoracic junction (CTJ). The objective of this systematic review was to assess the differences in clinical outcomes, fusion, and reoperation rates, between patients undergoing multilevel PCFs ending at C7 and those undergoing PCF crossing the CTJ. ⋯ Our results indicate that based on current evidence, multilevel PCFs that cross the CTJ may have higher fusion rates and lower reoperation rates compared with fusions that stop at C7. These results are important to assist the surgeon in decision making regarding the lower instrumented level when performing a multilevel PCF.
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Review Case Reports
Jugular bulb dysmaturation in torcular dural sinus malformation, clinical images and a review of literature.
We present unique clinical images of jugular bulb dysmaturation (JBD) in an infant with torcular dural sinus malformation (tDSM). Lasjaunias et al hypothesized that the former possess a pivoting role for development of the latter. ⋯ The combination of magnetic resonance imaging angiography, computed tomography angiography, and digital subtraction angiography imaging of JBD is unique. Moreover, we reviewed current tDSM literature and showed that the presence of JBD in tDSMs correlates significantly with a higher mortality.
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Spine surgeons at a Level 1 Trauma Center have observed a high incidence of spine and spinal cord injuries owing to falls from tree stands. These injuries have been retrospectively reviewed in the context of the Thoracolumbar Injury Classification and Severity (TLICS) and the Subaxial Cervical Injury Classification and Severity (SLICS) classification systems to assess inter-user reliability and validity. We hypothesize that the inter-rater reliability will be similar between neuroradiology and neurosurgery raters and validity of the scoring system will be maintained at our institution. ⋯ The TLICS and SLICS systems provide good-to-excellent inter-rater reliability. SLICS validity was poor, whereas TLICS was reasonable for nonoperative cases and moderate for operative cases. Systems such as the TLICS and the SLICS may be best applied in the educational setting to confirm the fracture morphology and presence or absence of ligamentous injury between surgeons and radiologists.
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Superior cerebellar artery (SCA) aneurysms can be divided into 2 types: basilar artery (BA)-SCA junction aneurysms and peripheral SCA aneurysms. The peripheral SCA aneurysm is a distinct entity from its BA-SCA counterpart. No comprehensive literature review for endovascular management of peripheral SCA aneurysms has been conducted. ⋯ Peripheral SCA aneurysms are rare cerebrovascular lesions and should be treated as a specific entity. EVT is an efficient and safe option in peripheral SCA aneurysms. Permanent and fatal procedure-related complications are rare. Further prospective and larger-scale studies are warranted to better elucidate the role of EVT in peripheral SCA aneurysms.
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The carotid sinus nerve branches off the glossopharyngeal nerve just after its appearance from the jugular foramen, descends along the internal carotid artery, and enters the carotid sinus. There have been many studies of the pathway and the course of the carotid sinus nerve and its communications with surrounding nerves. ⋯ Acknowledgment of its anatomic diversity can be important in specific operations dealing with this area. Herein we review the anatomy, variations, pathology, and clinical applications of the carotid sinus nerve.