World Neurosurg
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Despite the increasing evidence of the association between breast cancer and meningioma in women, the relationship between these tumors remains improperly examined. In this study, we aim to identify the sociodemographic and clinicopathologic features of women with breast cancer associated with a higher risk of developing a meningioma. ⋯ Our study corroborated the known association between these tumors and found a 26% risk of meningioma development in women with breast cancer, with younger patients and those with a more aggressive disease having a higher than expected risk.
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Stereotactic localization of neurosurgical targets traditionally relies on computed tomography (CT), which is considered the optimal imaging modality for geometric accuracy. However, in-depth investigations that characterize the precision and accuracy of CT images are lacking. We used a CT phantom to examine interscanner precision and interprotocol accuracy in coordinate localization. ⋯ We found evidence of clinically relevant inconsistency between 2 CT scanners used for stereotactic localization. SS image acquisition was superior to helical scanning with respect to localization accuracy. Interscanner consistency cannot be assumed. Institutions would benefit from identifying the errors inherent in their CT scanners.
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Sentinel headache (SH) is often assumed to portend an increased risk of delayed cerebral ischemia (DCI) and aneurysm rebleeding. This study aimed to re-evaluate the associations between SH and aneurysm rebleeding, DCI, and outcome after SAH. ⋯ A history of sentinel headache before the clinical diagnosis of SAH does not imply an increased risk of DCI or further rebleeding, and carries no prognostic significance.
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Comparative Study
Comparison of radiation exposure between O-arm navigated and C-arm guided screw placement in minimally invasive transforaminal lumbar interbody fusion.
Instrumentation in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is highly dependent on image guidance. Guidance with fluoroscopy (C-arm) and cone-beam computed tomography (O-arm) with navigation are common options. The intraoperative radiation exposure to patients with the different image modalities has not been compared, however. The present study aimed to compare the radiation exposure of the C-arm guidance and O-arm navigation techniques during MIS-TLIF surgery. ⋯ For level 1 MIS-TLIF (4 percutaneous screws), patients in the ON group had almost double the radiation exposure as those in the CG group. For level ≥2 (≥6 screws) or obese patients, the O-arm with navigation has the advantage of similar radiation exposure to the patient and less (almost no) radiation to the operating room staff.