World Neurosurg
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Despite its relative rarity, the potential for loss of productive years makes aneurysmal subarachnoid hemorrhage (SAH) a considerably important entity in young adult patients (20-39 years of age). This study aimed to analyze outcomes of microsurgery (MS) and endovascular treatment (EVT) for saccular intracranial aneurysms (IAs) in young adult patients. ⋯ Both MS and EVT are safe for treating IAs in young adult patients. MS showed better durability of treatment and may be preferred over EVT in young patients in view of their longer life expectancy compared with older patients.
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The opioid crisis has been declared a "public health emergency." Spine surgeons are treating more patients with substance use disorders (SUDs). ⋯ Patients with SUD are at increased risk of complications and inadequate follow-up. Additional studies are warranted to determine whether additional perioperative education, psychiatry consultations, or prescription of opioid addiction treatment regimens will improve drug use cessation and outcomes.
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Split cord malformation (SCM) is a rare anomaly characterized by a split along the midline of the cord, which divides it into 2 symmetric or nonsymmetric entities. SCM surgical indications and outcomes are still debatable, the signs and symptoms are generally nonspecific and are commonly associated with other anomalies and deficits. ⋯ Most patients with SCM present during childhood. Postoperative complications after SCM corrective surgery are generally minimal, and the overall outcomes, mainly including partial or complete symptomatic improvement and/or symptom stability and hydronephrosis resolution, were favorable.
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In microvascular decompression (MVD) surgery for hemifacial spasm (HFS), preservation of the lesser occipital nerve (LON) will prevent occipital sensory disturbance, a frequent complication of MVD, but the long-term outcome is unknown. This study was designed to evaluate the long-term efficacy of LON preservation. ⋯ Our long follow-up study has demonstrated that preservation of the LON during MVD prevents sensory disturbance of the occipital scalp. Efforts to preserve the LON appear to be worthwhile when the suboccipital approach is chosen.
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Stereotactic body radiotherapy (SBRT) is an effective treatment of spinal metastases in the vertebral body. However, variation has existed between practitioners regarding the appropriate target delineation. As such, we compared the tumor control, rates of compression fractures, and pain control for patients who had undergone SBRT for spinal metastases to either the lesion only (LO) or the full vertebral body (FVB). ⋯ Given that we found no difference in tumor control, pain reduction, or fracture rate between patients treated to the FVB versus the. LO, it might be reasonable to consider SBRT to the LO for select patients.