World Neurosurg
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This systematic review and meta-analysis evaluated the clinical efficacy and complications of unilateral biportal endoscopy (UBE) for treating cervical spondylosis (CS), providing evidence-based guidance for optimal treatment decisions. ⋯ UBE demonstrates strong efficacy and safety in treating CS, with significant improvements in pain and disability scores, shorter operative times, and lower complication rates.
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We describe a 2-stage strategy utilizing the endoport-assisted endoscopic technique for the evacuation of severe intraventricular hemorrhage (IVH) with a cast third ventricle, and discuss potential pitfalls in the implementation of this method in clinical practice. ⋯ The endoport-assisted 2-stage endoscopic technique marks a significant advancement in treating severe IVH with a cast third ventricle. By combining dry and underwater approaches, it provides an innovative solution for effectively and safely clearing hematomas in both lateral and third ventricles. This technique addresses the crucial need for early cerebrospinal fluid circulation restoration, potentially improving outcomes for patients with these complex cases.
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A rare presentation of unilateral carotid rete mirabile (RM) in a 70-year-old male manifesting as limb-shaking transient ischemic attacks, a disorder typically associated with carotid artery stenosis. The patient experienced recurrent left-sided limb shaking and numbness, with angiography revealing an anomalous microarterial collateral network replacing the right internal carotid artery's cavernous segment, indicative of RM. ⋯ The patient's management involved antiplatelet therapy and lifestyle changes, following which he reported no further cerebrovascular events. This case underscores the importance of considering RM in differential diagnoses of limb-shaking transient ischemic attack and suggests conservative management as a favorable approach.
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The incidence rate of primary intramedullary spinal cord astrocytoma (IMSCA) is approximately 0.047 per 100,000 individuals per year, making it the second most common type of intramedullary spinal cord tumor. Due to its rarity, there is a scarcity of related research, and prognostic factors remain unclear. The aim of this study is to identify risk factors affecting the prognosis of patients with primary IMSCA. Based on these factors, we aim to develop and visualize a prognostic model for predicting the overall survival time of patients with this condition, thereby facilitating individualized predictions of overall survival time for patients with primary IMSCA. ⋯ Lower World Health Organization's tumor grade, younger age groups, and undergoing gross total resection surgery are significant protective factors affecting the prognosis of patients with primary IMSCA. Among patients with Grade II astrocytoma, being female appears to be a protective factor, whereas being male seems to be a protective factor in Grade III astrocytoma. Radiation therapy and chemotherapy do not appear to improve long-term survival; specifically, radiation therapy may lead to worse outcomes for low-grade spinal cord astrocytomas. The study found no impact of tumor size, year of diagnosis, race, or marital status on prognosis. We have developed the first model and nomogram to predict the prognosis of patients with primary IMSCA, which demonstrates good predictive ability. The nomogram performed well in internal validation, offering a tool to help clinicians predict the overall survival time of patients with primary IMSCA on an individual basis.