World Neurosurg
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Idiopathic spinal cord herniation is a rare condition that involves spinal cord herniation through a defect in the ventral dura. ⋯ Idiopathic spinal cord herniation is an uncommon spinal cord disorder with a paucity of data reported. Our case report of a classic case of idiopathic spinal cord herniation presenting as Brown-Sequard syndrome and managed surgically will contribute to the data in this field.
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Dumbbell-shaped spinal schwannomas with intradural and extradural components are associated with higher complication rates. This may be in part due to epineurial dissection of the extradural component, which inevitably damages the functioning nerve fibers beneath the epineurium and may lead to dural defects that are often difficult to repair. ⋯ The radical intracapsular dissection technique described herein represents an alternative technique for the removal of dumbbell-shaped spinal schwannomas with intradural and extradural components.
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Case Reports
Atlantoaxial fixation as treatment of trigeminal neuralgia in a patient having basilar invagination.
Trigeminal neuralgia can rarely be identified in association with basilar invagination. The presented case report observes that the treatment of basilar invagination by atlantoaxial fixation can result in lasting relief from trigeminal neuralgia. ⋯ The pathogenesis of trigeminal neuralgia and its relationship with atlantoaxial instability is speculated.
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Case Reports
Large epileptogenic type IIIb dysplasia: a radiological and anatomopathological challenge.
Type IIIb dysplasia is a subtype of focal cortical dysplasia associated with a tumor, most frequently with gangliogliomas then with dysembryoplastic neuroepithelial tumors (DNETs). Their preoperative diagnosis often remains equivocal since specific features are missing. The functional results (i.e., seizure free) is good with 81%-87% of Engel Ia at 5-year follow-up. ⋯ We describe a rare condition of type IIIb dysplasia combining a focal cortical dysplasia with a DNET. Preoperative diagnosis of the lesion was of utmost difficultly, thereby rendering mandatory a thorough histopathological examination of resected specimen in the vast majority of cases. Increased recognition of the condition brings up the hypothesis of a genetic continuum or linkage between the 2 conditions. Functional results on seizure activity after ablative surgery are good and maximal safe resection should be the goal.
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To evaluate the efficacy and safety of tranexamic acid (TXA) in patients with adolescent idiopathic scoliosis undergoing corrective surgery. ⋯ TXA was effective in reducing surgical time, intraoperative estimated blood loss, and blood transfusion without increasing complications in patients undergoing corrective surgery for adolescent idiopathic scoliosis. TXA had no influence on postoperative hemoglobin and hemoglobin change.