World Neurosurg
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To evaluate the differences in surgical outcomes of patients with cervical spondylotic myelopathy with and without congenital cervical spinal stenosis (CCSS). ⋯ Postoperatively, compared with non-CCSS patients, patients with congenital cervical stenosis reported equal quality of life for all markers. Our findings suggest that in patients with CCSS and relatively mild symptoms of myelopathy, equal consideration should be given for surgical intervention. The findings of this study warrant further large-scale, multi-institutional investigation to further understand the generalizability of these surgical outcome results.
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Case Reports
First Report of Extraspinal Lead Migration along a Thoracic Spinal Nerve after Spinal Cord Stimulation.
Spinal cord stimulation for failed back surgery syndrome and chronic pain is a well-established treatment regimen today. Lead migration is the most common complication; mainly epidural caudal more than cranial electrode migration from the primary position is described repeatedly throughout the literature. ⋯ Lead migration remains a challenge in spinal cord stimulation regardless of the fixation method. Rare unusual migration patterns in addition to simple caudal or cranial migration might pose a challenge for revision surgery and thus might reduce overall treatment efficacy.
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To determine the effect of offering a subset of the Emergency Neurological Life Support (ENLS) course modules on provider knowledge and self-reported confidence in acute management of neurocritically ill patients in a low-middle income country (LMIC). ⋯ Provision of ENLS course module content increased LMIC provider self-reported knowledge and confidence in acute management of neurocritically ill patients immediately postcourse. Tailoring ENLS course presentation to a particular LMIC setting warrants additional investigation, as does the effect of ENLS course training on neurocritically ill patient outcomes in the LMIC setting.
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Utility of interval imaging during focused radiation therapy for residual cystic craniopharyngiomas.
In the present study, we investigated the changes in cyst volume detected on interval computed tomography (CT) in patients undergoing radiation therapy (RT) for residual cystic craniopharyngioma after surgery. ⋯ Cyst expansion will occur in nearly one fifth of patients with cystic craniopharyngioma during the course of RT. As nearly all these expansions are asymptomatic, interval CT scans midway through RT are essential to avoid geographic miss of the tumor.
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To add to the confusion in the debate on pathogenesis of os-odontoideum, an additional report of its occurrence in two members of the same family is reported. ⋯ Following atlantoaxial fixation, both recovered in their symptoms. Investigations revealed no genetic abnormality. Literature on the subject is briefly reviewed.