World Neurosurg
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The cerebellar tonsil tip position (TP) is a common parameter used for the radiologic diagnosis of Chiari malformation type 1 (CM1). However, these paramedian structures are usually not properly visualized in the midsagittal section. Such mismatch may be a source of bias in TP measurements based on the McRae line (ML) traced between median craniometric points. This study aims to evaluate the intraoperator and interoperator reliability and agreement of 2 protocols to trace the ML in magnetic resonance imaging (MRI) for the cerebellar tonsil tip localization, adding a 3-dimensional multiplanar reconstruction (MPR) approach to the midsagittal plane. ⋯ The standardization of the LM tracing by the MPR method improves the acquisition of data regarding the position of the tonsils.
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The purpose of this study was to investigate differences between measurements of spine on two-dimensional (2D) radiography and three-dimensional (3D) computed tomography (CT) images taken of patients with adolescent idiopathic scoliosis. ⋯ Significant differences among the 2D, 2D XP, and 3D measurement methods were observed on both the sagittal plane and coronal plane of the scoliotic spines as a result of variations in posture during imaging and differences in measurement methods.
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Case Reports
Hypertrophic Olivary Degeneration Postoperatively Following Pilocytic Astrocytoma Resection.
A 25-year-old male presented with headaches 3 weeks after a car accident. His magnetic resonance imaging images showed a hemorrhagic vermis mass with fourth ventricle effacement. ⋯ This condition is caused by disruption to the dento-rubro-olivary pathway with magnetic resonance imaging enlargement of the inferior olivary nucleus and increased T2 signal. Hypertrophic olivary degeneration should be considered after cerebellar surgery and should not be mistaken for tumor recurrence.
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Although posterior procedures are used for most cases of basilar invagination, transoral decompression is an important tool in complex deformities with severe degeneration and neural compression. ⋯ With proper patient selection, transoral odontoidectomy can be safely performed in a limited-resource setting.
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Even in the era of advanced medical treatment, brain abscess still has a high mortality rate. At our institution, brain abscess has been treated mainly using stereotactic or echo-guided aspiration followed by relatively long-term antibiotic treatment, achieving favorable outcomes. To evaluate the efficacy of our strategy involving less-invasive aspiration surgery and long-term selective antibiotic administration for brain abscess, a single-institution series of cases was investigated. ⋯ Most patients underwent aspiration surgery and achieved favorable outcomes. Along with antibiotic treatment for a sufficiently long period to cover anaerobes, this approach can be expected to yield good results.