World Neurosurg
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Review Meta Analysis
Prognostic value of abnormal muscle response during microvascular decompression for hemifacial spasm: a meta-analysis.
To perform a comprehensive meta-analysis to systematically assess the value of abnormal muscle response (AMR) in predicting the surgical outcome of patients with hemifacial spasm. ⋯ The disappearance of AMR during microvascular decompression demonstrates limited prognostic value for a favorable short-term outcome, and does not appear effective in predicting the long-term outcome of patients with hemifacial spasm.
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Review Case Reports
Iatrogenic common iliac vessels injury during routine degenerative lumbar spine surgery: report of 2 cases and review of literature.
Injury of the iliac vessels is a rare complication of lumbar spine surgery with potentially life-threatening consequences. We present 2 cases of iliac vessel injury that were treated with minimally invasive techniques. ⋯ This case series emphasizes the benefit of quick minimally invasive vascular repair available in multidisciplinary centers.
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Randomized Controlled Trial Multicenter Study
Prognostic significance of the difference between mixed and jugular venous oxygen saturation after severe traumatic brain injury: A post-hoc analysis of the Brain Hypothermia study.
In patients postcardiac arrest, it has been reported that the small value of the difference between mixed venous oxygen saturation (Svo2) and jugular venous oxygen saturation (Sjvo2) is associated with poor neurologic outcome. However, the importance of the difference between mixed venous oxygen saturation and jugular venous oxygen saturation (ΔSo2 [v - jv]) remains unknown in severe traumatic brain injury (TBI). The aim of this study was to examine whether ΔSo2 (v - jv) is associated with neurologic outcome and mortality in patients with severe TBI. ⋯ The reduction in ΔSo2(v - jv) on day 3 was associated with high mortality in patients with severe TBI.
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Even for the most experienced neurosurgeons, foramen magnum meningiomas represent a surgical challenge owing to their delicate position surrounded by the brainstem, lower cranial nerves, and vertebral arteries. The treatment goal is gross total resection, but choosing the most appropriate approach is crucial. Basically, 3 surgical approaches are commonly used: posterolateral approach (far-lateral), anterolateral approach (extreme-lateral), and posterior midline approach. ⋯ Care must be taken with tumors with a more lateral and caudal extension (below the tip of the odontoid process), when a far lateral approach may be the best approach. In this surgical Video 1, we present the surgical details with a stepwise narrative of the EEA for ventrolateral foramen magnum meningiomas through an illustrative case of a 48-year-old woman. Institutional informed consent was obtained for surgery and publication of this video.
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Review Case Reports
"Two-Birds-One-Stone" Approach for Treating an Infant with Chiari I Malformation and Hydrocephalus: Is Cerebrospinal Fluid Diversion as a Sole Treatment Enough?
Chiari I malformation (CIM) is a disorder characterized by caudal displacement of the cerebellar tonsils below the foramen magnum. It is often associated with syringomyelia and occasionally with hydrocephalus. CIM is commonly treated by posterior fossa decompression with or without removal of the posterior arch of C1 and duraplasty, but the treatment for infants with symptomatic CIM is not well established. We present a case of symptomatic CIM in an infant that was successfully treated with a ventriculoperitoneal shunt (VPS) and discuss the importance of the pathophysiology in management decisions. ⋯ Ventriculoperitoneal shunting alone was successfully used to treat an infant with concurrent CIM, syrinx, and hydrocephalus. This case underscores not only the importance of hydrocephalus as the pathogenesis of CIM in some cases but also the possibility of avoiding the morbidity of decompressive surgery in infants.