World Neurosurg
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Neuromuscular electrical stimulation (NMES) has emerged as a viable alternative for venous thromboembolism prophylaxis. Electrical stimulation of the peroneal nerve using NMES may potentially interfere with somatosensory-evoked potential (SSEP) acquisition. This feasibility study evaluates a NMES device and its effect on SSEP acquisition as an initial step in a randomized clinical trial to assess NMES for intraoperative venous thromboembolism prophylaxis. ⋯ As a preliminary step to testing NMES intraoperatively for venous thromboembolism prophylaxis, interference with SSEP acquisition was investigated in the outpatient laboratory setting. Within a small sample of healthy volunteers, no significant changes were seen in P37 cortical latencies to suggest interference between the NMES device and SSEP waveforms.
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Subdural empyema (SDE) is a well-known entity in pediatric populations and is associated with a high rate of morbidity and mortality. Large scale evacuation of empyema, although effective, places the bone flap at risk of failure when replaced. ⋯ Endoscopic-assisted burr hole evacuation of large panhemispheric and loculated SDE is feasible, effective, and safe. The primary advantage over conventional open evacuations is that it negates the need for a bone flap and its potential complications related to a secondary infection.
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Case Reports
Intradiploic Epidermoid Cyst Causing Otitis Media with Effusion: Case Report and Review of the Literature.
Epidermoid cysts are rare, slow-growing, benign tumors. They commonly occur at the cerebellopontine angle or the suprasellar region, and they can also occur in the skull. Intradiploic epidermoid cysts are often detected incidentally, but their progression can cause various symptoms. ⋯ We experienced a case of occipital bone intradiploic epidermoid cysts diagnosed in conjunction with otitis media with effusion.
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Osteogenesis imperfecta (OI) is characterized by bone fragility and is often accompanied by spinal deformity. Surgical treatment for early-onset scoliosis in patients with OI is hazardous and difficult due to the bone fragility and rigidity of the deformity. A case of early-onset scoliosis with OI that was treated using growing-rod surgery is presented. ⋯ This case demonstrates the successful use of the growing rod for early-onset scoliosis in patients with OI. The treatment strategy, which included pedicle screw insertion as anchors to create the foundations in advance, sublaminar tape, intraoperative traction, and preoperative bisphosphonate administration, might have led to the good outcome.
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Recurrent hydrocephalus may occur as a complication of neurosarcoidosis with chronic inflammation. We present a case that required a combination of multistage endoscopic diversion of the cerebrospinal fluid pathway and shunt surgery. ⋯ Endoscopic diversion of the cerebrospinal fluid pathway should be actively considered for treating hydrocephalus without a shunt and performing biopsy simultaneously. Even if a subsequent shunt is needed, complex hydrocephalus can be avoided with a combination of endoscopic techniques.