World Neurosurg
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A woman in her 60s with well-controlled dyslipidemia presented with anterior chest pain. The electrocardiogram, chest radiograph, and echocardiogram were unremarkable; however, cardiac enzymes levels were elevated. Coronary angiography performed after dual antiplatelet therapy revealed spontaneous coronary artery dissection (SCAD). ⋯ Autopsy confirmed dissections of the coronary and vertebral arteries. Although SCAD is rare, it often coexists with extracoronary vascular abnormalities due to systemic arterial fragility. Therefore, consider cerebrovascular disorders and promptly implementing diagnostic and management strategies in patients with SCAD and headaches is necessary.
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Craniocerebral trauma is one of the main causes of death and disability worldwide. Decompressive craniectomy is a common emergency measure in the treatment of craniocerebral trauma, aimed at relieving intracranial pressure. However, cranial bone reconstruction (CP) following this surgery is crucial for the patient's long-term recovery. Despite this, research on complications and prognostic factors after ultra-early cranioplasty remains limited. Therefore, this study aims to explore the complications of ultra-early cranioplasty with titanium mesh and its impact on prognosis. ⋯ Ultra-early CP can promote the recovery of neurological function, reduce the disturbance of consciousness, improve daily living ability, and improve cognitive function in patients with craniocerebral trauma, but there is a high risk of postoperative complications. In addition, age and postoperative NIHSS score are related factors affecting the poor prognosis of ultra-early CP patients.
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A retrospective study was performed to observe and measure the safe distance between the uncinate process (UP) and the V2 vertebral artery (VA). ⋯ UP and PT could be seen as landmarks in the operations of anterior cervical discectomy and fusion. The safe space outside UP is about 4 mm and more care should be taken when operating on the caudal spine. The safe space outside PT is about 10 mm and more care should be taken when operating on the cephalad spine. The safe space for operation from the PT to the ventral side is about 4.5 mm, and more care should be taken when operating on the cephalad side of the cervical spine.
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Delayed symptomatic hyponatremia (DSH) is one of the common complications following endoscopic endonasal surgery (EES). Currently, published studies have predominantly focused on delayed postoperative hyponatremia, while there is relatively limited research on DSH. ⋯ The incidence rate of DSH after EES in patients was 16.8%. Knosp grade ≥3, intraoperative cerebrospinal fluid leaks, serum sodium concentration on the second day after surgery, and postoperative DI were associated with the occurrence of DSH.
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Anterior and posterior compression of the cervical spinal cord is usually called pincer cervical spondylotic myelopathy (p-CSM), and surgery is generally recommended; however, there is some controversy about the choice of surgical approach because single anterior or posterior surgery cannot effectively relieve contralateral compression, and combined surgery may cause problems related to trauma and effects on cervical spine function. ⋯ ACDF is an effective method for treating pincer spinal cord compression in terms of neurologic recovery, radiologic parameters, fusion rates, and complications, especially for patients younger than 60 years of age with single operative segments.