World Neurosurg
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The intradural filum terminale (iFT) connects the conus medullaris (CM) with the dural sac (DS), and the extradural filum terminale (eFT) connects the DS to the coccyx. The aim of the present study was to update the description of the FT and integrate these data in a physiological and pathological context. ⋯ Consistently with their common embryological origin, a real anatomical and histological continuum is present between the CM and FT. The FT should, therefore, no longer be considered a simple ligament but, rather, a complex fibrocellular structure.
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Cervical spine immobilization, including cervical collars, has been recommended in most trauma guidelines. However, cervical spine immobilization can be associated with harm, and an increasing body of evidence has demonstrated associated complications. We hypothesized that older trauma patients placed in cervical collars for >24 hours were at greater risk of developing collar-related complications compared with those placed in cervical collars for ≤24 hours. ⋯ Among older patients without a cervical vertebral fracture, duration of cervical collar use for >24 hours was associated with the development of collar-related complications. We recommend attention to early collar clearance for older trauma patients.
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Case Reports
Stereotactic aspiration in the management of a rare case of tuberculous cerebellar abscess.
Tuberculous brain abscess is an extremely rare form of central nervous system tuberculosis. This lesion usually occurs in the supratentorial space. ⋯ Most of these cases occur in immunocompromised patients. We report an immunocompetent individual with tuberculous abscess of the cerebellum and discuss the role of stereotactic aspiration in the management of these rare lesions.
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The aim of the present study was to investigate the relationship between vacuum facet phenomena and lumbar instability in patients with degenerative spondylolisthesis (DS) in L4-L5. ⋯ A linear correlation was found between the degree of segmental motion and the width of the vacuum facet phenomenon in patients with DS at L4-L5. Our study has shown that vacuum facet phenomena detected on the CT images of patients with DS are highly predictive of segmental instability.
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Clinical examination, including pre- and postoperative assessment of olfaction function, should be included in evaluating surgical outcomes in patients with pituitary adenomas. Most of the studies are lacking assessment of olfactory function. ⋯ Assessment of olfactory function should be included in the analysis of pituitary adenoma surgery results. This prospective study showed low risk of olfaction deterioration if an endoscopic endonasal approach is used without any mucosal flaps for skull base reconstruction. Further studies that include objective olfaction assessment are warranted.