World Neurosurg
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Case Reports
Temporary Bridge Occipitocervical Fixation for Comminuted Atlantoaxial Fracture: Technical Note.
We sought to evaluate the feasibility of temporary bridge occipitocervical fixation temporary bridge occipitocervical fixation (T-BOCF) for comminuted atlantoaxial fractures. ⋯ T-BOCF is a viable option for treatment of comminuted, undisplaced atlantoaxial fractures. The technique is easier than direct C1‒C2 fusion and can avoid complications associated with occipitocervical fusion or C1‒C2 screw fixation. The blood supply to the fracture site is preserved by avoiding subperiosteal stripping, and semispinalis cervicis insertion at the C2 spinous process is also circumvented. Furthermore, neck motion is preserved after implant removal.
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Case Reports
Spontaneous extrusion of ventriculo-pleural shunt catheter associated with pleural effusion: case report.
Ventriculopleural (VPL) shunts are used infrequently in management of hydrocephalus. The main complication associated with these shunts is pleural effusion. ⋯ To our knowledge, spontaneous extrusion of the distal catheter of a VPL shunt has not been previously reported in the literature. Physicians treating patients with hydrocephalus must be aware of this potential complication when a VPL shunt is inserted.
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Paralysis (paraplegia or quadriplegia) after posterior fossa surgery is a rare but devastating complication. We investigated previous reports of this complication to examine similarities among patients, risk factors, and methods by which it may be prevented. ⋯ Paralysis after posterior fossa surgery often involves spinal cord infarction apparently caused by cervical hyperflexion. Extreme care during patient positioning is needed in both the sitting or prone positions. Electrophysiologic monitoring might enable early identification of spinal cord dysfunction to minimize or avoid this complication.