World Neurosurg
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Microvascular decompression (MVD) is considered the only etiological treatment for drug-resistant trigeminal neuralgia (TN). Nonetheless, despite the recent technological advances, the risks associated with MVD remain non-negligible. The aim of this study was to evaluate the impact of using neuronavigation on the surgical outcomes of patients with TN submitted for MVD. ⋯ Neuronavigation is a useful tool that significantly reduced craniotomy size, surgical duration, and CSF leak incidence in patients with TN submitted for MVD. We advise to routinely implement neuronavigation in this type of surgery.
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The aim of this study was to determine the impact of preoperative pulmonary risk factors (PRFS) on surgical outcomes after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). ⋯ Our study showed that PRF may be a risk factor for slightly longer hospital stays without higher rates of complication or unplanned readmission for patients with AIS undergoing PSF and thus should not preclude surgical management.
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The paper aims to understand the expression of nerve growth factor receptor (TrkA) in the ectopic and entopic endometrium of patients with adenomyosis and dysmenorrhea and, at the same time, explore and analyze the combination of hysteroscopy and ultrasound imaging based on multioperator algorithms. The clinical treatment value of color Doppler ultrasound in the diagnosis and treatment of endometrial polyps. The immunohistochemical avidin-peroxidase staining method (SP method) was used to detect 20 cases of ectopic endometrium and entopic endometrium in patients with dysmenorrhea of adenomyosis (study group) and 22 cases of uterine fibroids in the control group. ⋯ In the diagnosis of endometrial polyps, the area of receiver operating characteristic curve in the parallel combined diagnosis of ultrasound and hysteroscopy is significantly larger than that under the combined diagnosis of series. TrkA is widely expressed in the ectopic and entopic endometrium of patients with adenomyosis and dysmenorrhea and may play an important role in the onset of adenomyosis and dysmenorrhea. Hysteroscopy combined with color Doppler ultrasound can effectively improve the diagnostic accuracy of patients with endometrial polyps.
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Post-traumatic hydrocephalus (PTH) is a common complication of craniocerebral injury. If not diagnosed in time, PTH can lead to clinical deterioration and a poor prognosis. The early diagnosis of PTH can lead to success with early treatment. However, PTH can be easily ignored during rehabilitation. The main purpose of the present study was to investigate whether plasma S100B protein levels can be used as a biochemical predictive index of PTH. We also explored the correlation among S100B protein levels, intracranial pressure, and PTH severity. ⋯ Measurements of serum S100B can be used to predict for PTH. We found a positive correlation between S100B levels and intracranial pressure but no correlation with the severity of PTH. Thus, serum S100B could have important clinical significance for the early detection and evaluation of PTH.
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Case Reports
Beware the wandering needle: inadvertent intramedullary injection during an attempted cervical medial branch block.
A 27-year-old man developed sudden neck pain, severe quadriparesis, and right shoulder allodynia during an outpatient cervical medial branch block procedure. Cervical spine imaging revealed evidence of an interlaminar needle trajectory with abnormal signal in the right hemicord at the level of C4, consistent with intramedullary injection and contusion. Following a 48-hour stay in the intensive care unit, during which hemodynamic vasopressor support was administered to optimize spinal cord perfusion, the patient exhibited almost complete neurologic recovery with resolution of the neuropathic pain. He was eventually discharged home and underwent outpatient physical therapy for a mild residual right hemiparesis.