World Neurosurg
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Observational Study
Elevated lactic dehydrogenase level predicts postoperative pneumonia of patients with aneurysmal subarachnoid hemorrhage.
Lactate dehydrogenase (LDH) is a nonspecific inflammatory biomarker and has been reported to be useful in predicting community-acquired pneumonia and Mycoplasma pneumoniae pneumonia. The connection between LDH level and postoperative pneumonia (POP) in patients with aneurysmal subarachnoid hemorrhage (aSAH) is still unclear. The aim of this study was to assess feasibility of predicting POP in patients with aSAH using LDH. ⋯ LDH might be a helpful predictor of POP occurrence in patients with aSAH.
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Integral dose (ID) defined as the product of mean dose and target volume, is a measure of the absorbed radiation energy. ⋯ Stereotactic radiosurgery can be individualized based on trigeminal nerve morphology to achieve durable pain relief in patients with trigeminal neuralgia. ID calculation aids in planning an optimal radiation dose based on the nerve morphology to provide durable pain relief of idiopathic trigeminal neuralgia.
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In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. ⋯ Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.
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Repair of spinal cord injury (SCI) using peripheral nerve graft (PNG) and acidic fibroblast growth factor (aFGF) has shown promising results in rats and a few human patients, but not in nonhuman primates. The aim of this study was to verify the effective use of PNG and aFGF for repairing incomplete SCI in nonhuman primates. ⋯ PNG plus aFGF for SCI in nonhuman primates yielded improvements in clinical behavior, electrophysiologic tests, and magnetic resonance imaging. This study suggests that the repair strategy is feasible and effective for nonhuman primate SCI. Further investigations are warranted to corroborate its effectiveness for clinical application.
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Case Reports
Complete Resection of an Intradural Extramedullary Foramen Magnum Cavernous Malformation.
Only few case reports of intradural extramedullary-located cavernous angiomas are available. This report describes an extra-axial hemorrhagic lesion located on the lateral surface of the medulla oblongata at the foramen magnum. Follow-up magnetic resonance imaing clearly demonstrated growth of the lesion, probably due to repetitive intralesional hemorrhaging. ⋯ Preoperatively, the lesion did not had the typical macroscopical aspect of a cavernoma and appeared rather as an expansive encapsulated multicystic vascular lesion. Nevertheless, pathologic analysis confirmed the diagnosis of a cavernous hemangioma. Complete microsurgical resection was obtained without neurologic impairment.