World Neurosurg
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The use of health-related quality-of-life scales has expanded into most areas of medicine. Established quality-of-life scales are used in several areas of neurosurgery, but none have been validated for use in patients with symptomatic Tarlov cysts. The majority of symptomatic Tarlov cysts are found in the sacral spinal canal of women. We, therefore, validated a site-specific quality-of-life measure for women with symptomatic sacral nerve root compression caused by Tarlov cysts. ⋯ We prospectively validated a site-specific, health-related quality-of-life survey for women with symptomatic sacral Tarlov cysts. This measure will be useful in future studies to inform clinicians and researchers about the progression of Tarlov cysts and patient response to surgical treatment.
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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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This study assesses cervical alignments after 2-level cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) with anterior plate fixation. ⋯ ACDF and CDA are viable options for 2-level degenerative disc disease in carefully selected patients. Both approaches produced equivalent postoperative alignment changes in a 2-level operation.
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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.
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Aqueduct stenosis is a recognized cause of obstructive hydrocephalus in children and can be treated effectively with endoscopic third ventriculostomy. Preoperative magnetic resonance imaging is often diagnostic of the cause of aqueduct stenosis. ⋯ We believe these 2 reported cases demonstrate a previously unreported phenomenon whereby concealed tectal gliomas presenting with hydrocephalus are only unmasked following relief of hydrocephalus and decompression and normalization of the ventricular system. We aim to raise awareness about this unusual phenomenon and recommend routine postoperative interval imaging following endoscopic third ventriculostomy to avoid missing underlying pathology masquerading as aqueduct stenosis.