World Neurosurg
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Review Case Reports
Grade V thoracic spondylolisthesis in neurofibromatosis type-1: a case report and literature review.
Grade V thoracic spondylolisthesis secondary to neurofibromatosis type 1 (NF-1), especially combined with vertebral fusion, is rare. We reported a case of a 26-year-old female diagnosed with grade V T2spondylolisthesis and T2-T5 autofusion secondary to NF-1, which caused severe kyphotic deformity and neurologic deficits, and she was treated with posterior decompression, internal fixation, and fusion. ⋯ Grade V thoracic spondylolisthesis combined with vertebral fusion on T2-T5 level in NF-1 is rare. Early surgical intervention of posterior spinal decompression with internal fixation and fusion yielded satisfactory clinical outcomes.
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Review Historical Article
The Historical Evolution of Intracranial Pressure Monitoring.
Intracranial pressure (ICP) monitoring has become an important tool in neurocritical care. Despite being used in intensive care units all over the world, many are unfamiliar with its origins and the people and events that shaped the development of this technique. Herein, we provide a comprehensive historical review of the evolution of ICP monitoring, beginning with the earliest descriptions of cerebrospinal fluid (CSF). ⋯ Thenceforward, ICP monitoring technology underwent progressive improvements through the contributions of French scientists Jean Guillaume and Pierre Janny, Swedish neurosurgeon Nils Lundberg, among others. Nowadays, ICP monitoring can be performed via direct and indirect methods using a potpourri of devices such as, but not limited to, subarachnoid bolts, microtransducer catheters, and telemetric monitors. Nevertheless, despite advancements in ICP monitoring technology, the criterion standard remains an extraventricular drain catheter connected to an external pressure transducer.
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Ventriculopleural shunting (VPLS) is recognized as an alternative method when the standard ventriculoperitoneal shunting (VPS) is not applicable. Nevertheless, there is limited clinical evidence of its effectiveness including long-term patency. ⋯ It seems that VPLS survival has improved with more modern shunt technology. VPLS is a reasonable second-line option when VPS is not feasible. The possibility of pleural effusion is not negligible, but asymptomatic/mild effusions may be managed conservatively.
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Comparative Study
Cerebral Spinal Fluid collected by Lumbar Puncture has a higher diagnostic accuracy than collected by Ventriculostomy.
Patients harboring an external ventricular drain (EVD) who develop signs of infection require screening for infection in the central nervous system (CNS). The cerebrospinal fluid (CSF) can be collected by the EVD or by lumbar puncture (LP). If only one sample is analyzed, the diagnosis might be dubious or false-negative. The objective of this study was to compare the diagnosis accuracy of CNS infection of CSF samples collected from EVD and LP. ⋯ The CSF analysis exclusive from the EVD has a low sensibility and negative predictive value. CSF collected from LP has a sensibility 2.18 times higher than EVD.
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Review Case Reports
Minimally invasive resection of intracerebral amyloidoma; case report and systematic review of the literature.
Management of cerebral amyloidomas has lacked consensus owing to their rarity. We present a case and review 39 reported cases of amyloidomas in the literature, comparing their initial presentation, imaging characteristics, treatment, and progression. ⋯ To our knowledge, this is the first documented case of the use of diffusion tractography in preoperative planning for cerebral amyloidoma resection. Our systematic review of 39 reported cases of amyloidomas in the literature provided insight regarding how these rare lesions have manifested and progressed and further understanding of current theories regarding their etiology and pathophysiology. Cerebral amyloidomas are rare, localized, proteinaceous aggregates with variable presentation and prognosis and no apparent relationship to systemic amyloidosis. Biopsy may be useful in determination of progression. Diffusion tractography is a valuable tool for minimizing complications associated with resection.