World Neurosurg
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Case Reports
The coexistence of gliosarcoma and arteriovenous malformation with the BRAF V600E mutation: case report.
The authors report a case of a woman aged 33 years who suffered from the combination of primary gliosarcoma and arteriovenous malformation as the first clinical presentation of intracranial hemorrhage. ⋯ This case illustrates the occult and unusual feature of gliosarcoma. The pathogenesis of such coexistence might be related to underlying genetic alterations.
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Case Reports
Lumbar subdural hematoma detected after surgical treatment of chronic intracranial subdural hematoma: a case report.
Spinal subdural hematoma (SSDH), which can cause lower back pain, leg pain, and leg weakness, is rare and will usually be associated with a bleeding tendency, trauma, spinal vascular malformation, intraspinal tumor, or iatrogenic invasion. Only a few cases of SSDH after intracranial chronic subdural hematoma (CSDH) have been reported. We report a case of lumbar SSDH in the absence of predisposing factors after reoperation for recurrent intracranial CSDH, which improved with conservative treatment. ⋯ Although SSDH is rare, it is important for neurosurgeons and physicians to consider the possibility of a SSDH when lower limb pain or paresis occurs after procedures that will result in rapid intracranial pressure alterations such as drainage of an intracranial CSDH.
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Vagal nerve stimulation is a generally safe adjunctive treatment for medically refractory epilepsy. Nevertheless, reports of vocal cord dysfunction during stimulation can be found in the literature. When vagal nerve stimulation-induced vocal cord dysfunction is compounded with contralateral dysfunction, such as that which can occur after anterior cervical diskectomy and fusion, serious pulmonary complications can occur. ⋯ Vagal nerve stimulation-induced vocal cord paralysis is a rare but known complication. Given this potential for vocal cord dysfunction, neurosurgeons should plan further anterior cervical diskectomy and fusions accordingly to ensure that patients do not develop dysfunction of bilateral vocal cords. Should this develop, however, cessation of vagal nerve stimulation can improve or treat the pulmonologic complication that develops.
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The aim of this study was to report an experience with 190 cases of os odontoideum over 20 years. The management outcome following atlantoaxial fixation was analyzed. ⋯ Os odontoideum signifies chronic or long-standing atlantoaxial instability. Segmental atlantoaxial fixation is a reliable form of surgical treatment. Bone decompression is not necessary. Inclusion of occipital bone and subaxial vertebrae in the fixation construct is not necessary.
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To analyze hardware-related problems and their prognoses after anterior cervical discectomy and fusion (ACDF) using cages and plates for degenerative and traumatic cervical disc diseases. ⋯ Most hardware-related complications are not symptomatic and can be treated conservatively. Only a few cases need revision surgery. Precise surgical techniques are needed in multilevel anterior cervical discectomy and fusion (>3 levels) because of the increased complication rate.