World Neurosurg
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Sports-related injuries are the third commonest cause of spine fractures. Spinal fractures incurred as a result of partaking in sport by their nature are different from those associated with frailty and road traffic accidents. The patient demographics and nature of fractures associated with sports activities are not well documented. We aim to describe the management and outcome of patients with a sports-related spine fracture in a single U.K. major trauma center in a 6-year time period. ⋯ Within our population, sports most commonly associated with spinal fractures were horse riding, cycling, and boating. The majority of cases were managed nonoperatively. Further research is required to establish evidence-based guidelines on the management of sports-related spinal fractures.
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Neurosurgeons are frequently consulted for traumatic brain injuries (TBIs) resulting in intracranial hemorrhage (ICH). After inpatient confirmation of hemorrhage stability, outpatient head computed tomography (CT) is often performed to assess for hemorrhage resolution. Our objective was to assess the practice patterns and clinical utility of routine outpatient head CT scans for patients with mild TBI (mTBI). ⋯ Routine outpatient head CT scans before follow-up for low-risk mTBI patients without an SDH appears to have limited clinical utility. In low-risk mTBI patients with an SDH, obtaining an outpatient head CT is reasonable to monitor for resolution.
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Esophageal fistulae are rare, though serious, complications of anterior cervical surgery. Hardware-related issues are important etiologic factors. Patient-specific implants (PSIs) have increasingly been adapted to spinal surgery and offer a range of benefits. Zero-profile implants are a recent development primarily aimed at combating postoperative dysphagia. We report the first use of a 3-dimensional (3D)-printed zero-profile PSI in managing implant failure with migration and a secondary esophageal fistula. ⋯ Zero-profile 3D-printed PSIs may combat common and serious complications of anterior cervical surgery including postoperative dysphagia and esophageal fistulae. Further research is required to validate their widespread use for either cervical corpectomy or diskectomy and interbody fusion.
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To evaluate the applicability of corticocortical evoked potentials (CCEP) for intraoperative monitoring of the language network in epilepsy surgery under general anesthesia. To investigate the clinical relevance on language functions of intraoperative changes of CCEP recorded under these conditions. ⋯ The application of CCEP monitoring is possible and safe in epilepsy surgery under general anesthesia. Putative AL and PL can be identified using noninvasive presurgical neuroimaging. Decrease of N1 amplitude >15% from baseline may predict postoperative language deficits.
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We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) using the EmboTrap Revascularization Device (EmboTrap) in patients with ischemic stroke treated >6-24 hours after stroke onset. ⋯ This real-world study provides evidence that EVT using EmboTrap is safe and effective in the late treatment window in patients with large vessel occlusion.