World Neurosurg
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To evaluate the efficiency of a comprehensive treatment strategy for patients with Enneking stage 3 thoracic aggressive vertebral hemangioma (AVH). ⋯ We recommend a comprehensive treatment strategy for patients with Enneking stage 3 thoracic AVH that includes preoperative embolization, vertebroplasty, posterior decompression, and internal fixation. We recommend that absorbable gelatin sponge particles be used for intraoperative embolization prior to the injection of bone cement, which may significantly reduce intraoperative bleeding, operative time, and occurrence of surgery-related complications.
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An unruptured anterior circulation, nongiant saccular cerebral aneurysm (located at the clinoid segment [C3] of the internal carotid artery [ICA] and growing into the carotid cave) was detected at a medical checkup and diagnosed from subsequent examinations. The aneurysm was observed and followed up with radiologic examinations. An examination performed 12 years after diagnosis revealed the disappearance of the aneurysm. This observation should be kept in mind, that it is possible for an unruptured aneurysm to undergo spontaneous thrombosis without any intervention.
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Case Reports
Adjacent Level Tuberculous Spondylodiscitis Leading To Proximal Junctional Kyphosis: Rare And Unusual Presentation.
Vertebral osteomyelitis manifesting as a compression fracture misdiagnosed in the setting of steroid-induced or senile osteoporosis is very rare, although such patients are prone to infection or reactivation, as their immune system is exhausted. Spondylodiscitis occurring at adjacent levels following instrumented spinal fusion leading to pathologic fracture and proximal junctional failure, especially caused by tuberculosis, to our knowledge, has not been discussed in the literature. ⋯ Adjacent segment spondylodiscitis should be suspected and intraoperative biopsy must be considered for histopathologic and microbiologic examination to rule out subclinical infection in immunosuppressed patients with multiple comorbidities. Management should be individualized, considering the context of infection, causative organism, extent of bone destruction, and neurologic involvement.
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IgG4-related disease (IgG4-RD) is an immune-mediated, systemic, fibroinflammatory disease. IgG4-RD may manifest in almost every part of the human body. Here, we describe 3 patients with a skull base manifestation of IgG4-RD that mimicked malignancy. ⋯ The described cases emphasize the broad clinical spectrum of IgG4-RD. The diagnostic workup may be challenging, and serum IgG4 may be normal, as demonstrated in these cases. Careful histopathologic examination of the tissues remains essential. Timely diagnosis of IgG4-RD is important to prevent secondary organ damage in patients with active disease.
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The Internet has become a popular resource for patients to research diagnosed or suspected medical diseases. Medical institutions provide comprehensive online education resources about various conditions to the general public. The U.S. National Institutes of Health and American Medical Association recommend that patient education materials aimed at the general population should be written at or below eighth-grade reading level. The goal of this study is to assess the readability of patient education materials for central nervous system tumors across tertiary-care institutions. ⋯ Online neuro-oncology patient education materials from tertiary institutions are written above recommended reading levels. Future efforts should be taken to improve the readability of brain tumor-specific patient education materials, particularly with information relating to treatment.