World Neurosurg
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To review the surgical outcomes of the octogenarian population at a single institution after spinal traumatic injury. ⋯ Although the octogenarian population has increased risk for postoperative events after acute spinal injuries, surgical intervention may be worthwhile in the elderly population. Although direct surgical complication rates are not higher, medical risks are significantly higher after surgery.
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To describe a minimally invasive decompression technique for symptomatic spinal epidural lipomatosis using percutaneous biportal endoscopic surgery. ⋯ Percutaneous spinal endoscopy is a minimally invasive muscle-preserving technique for spinal lipomatosis that achieves neural decompression directly by lipoma removal and indirectly by partial bone and ligament removal.
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Shunt-dependent hydrocephalus (SDH) is a common complication after aneurysmal subarachnoid hemorrhage and affects its outcome significantly. Whether fenestration of the lamina terminalis (FLT) during anterior circulation aneurysm clipping for aneurysmal subarachnoid hemorrhage can decrease the occurrence of SDH is still controversial. ⋯ This meta-analysis suggests that FLT during anterior circulation aneurysm clipping reduces the incidence of SDH. However, a well-designed, randomized controlled trial is necessary to prove the efficacy of FLT to reduce SDH.
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Review Case Reports
Perineal and Radicular Pain Caused By Contralateral Sacral Nerve Root Schwannoma: Case Report and Review of Literature.
Sacral schwannomas are very rare nerve sheath tumors. Patients usually present with a variety of nonspecific symptoms, which often lead to a delay in diagnosis. Although most schwannomas are benign, they present surgical challenges owing to their proximity to neurologic and other anatomic structures. ⋯ Sacral schwannomas can present with a variety of nonspecific symptoms. They pose unique challenges given their location, size, and involvement of surrounding structures. Complete surgical resection is the main goal of sacral schwannoma treatment. A combined anterior-posterior surgical approach and a multidisciplinary surgical team are associated with improved outcomes.
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Burr hole craniotomy is a daily procedure in neurosurgery. Defects after burr hole craniotomies will not spontaneously heal and can result in skin dents and cosmetic dissatisfaction. We have introduced a self-made, reusable, and adjustable bone plug packer to use in the repair of burr holes via packing of autologous bone dust. Our bone plug packer is free of charge and can be readily available in neurosurgical operating rooms. ⋯ We have introduced a practical, convenient, and cost-effective bone packer device. Bone plugs formed using our device can be a potential substitute for expensive covering materials in countries with limited access to other repair options. Providing proper evidence will require the performance of large studies to assess our suggested method in the long term and, possibly, compare it with the usual options in controlled studies.