World Neurosurg
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Hypertrophic olivary degeneration (HOD) is a rare form of transsynaptic degeneration, caused by injury to the dentato-rubro-olivary pathway (DROP). Radiologically, this manifests as T2 hyperintensity, with or without enlargement of the inferior olivary nucleus. The purpose of the study was to evaluate the incidence, associated imaging characteristics, potential etiologies, latency period, and temporal progression of HOD in patients undergoing surgical resection of posterior fossa tumors (PFTs). ⋯ HOD is a frequently overlooked postoperative complication following PFT resection. Increased recognition of HOD by neuroradiologists is essential for timely diagnosis and avoidance of unnecessary diagnostic procedures.
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Adult isthmic spondylolisthesis (AIS) results in the anterior translation of the vertebral body with neural encroachment. Although oblique lumbar interbody fusion (OLIF) is minimally invasive technique that uses a retroperitoneal plane to achieve indirect decompression compared to transforaminal lumbar interbody fusion (TLIF), research on OLIF for AIS remains limited. Therefore, we aimed to compare the clinical and radiologic outcomes of these 2 surgical techniques for AIS. ⋯ OLIF is more advantageous than TLIF in terms of blood loss, operative time, hospital stay, and anterolisthesis correction. In addition, good clinical outcomes were obtained with indirect decompression alone, regardless of the severity of foraminal stenosis. Therefore, OLIF is a good surgical option for the treatment of AIS.
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This study aimed to identify risk factors for major adverse events (AEs) after lumbar fusion surgery in patients aged 75 and older and evaluate the role of several common geriatric comprehensive assessment items in predicting postoperative major AEs. ⋯ Preoperative frailty, hypoalbuminemia, female sex, greater body mass index, and higher Charlson comorbidity index grade were risk factors for 90-day major AEs after lumbar fusion surgery in older patients. The predictive nomogram that we developed using this data can enhance preoperative risk counseling and optimization for older patients.
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To investigate the potential of composite inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), in predicting outcomes in patients with posterior circulation large vessel occlusion who underwent mechanical thrombectomy (MT). ⋯ Among the assessed markers, NLR emerged as the strongest predictor of clinical outcomes following MT for posterior circulation large vessel occlusion.
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Laser interstitial thermal therapy (LITT) is a minimally invasive modality for addressing intracranial pathology. LITT is recognized as a primary therapeutic option for a range of intracranial pathologies, particularly in inaccessible lesions. In the present study, we systematically review the evidentiary base supporting contemporary applications of LITT. ⋯ In MTLE, LITT offers comparable rates of seizure freedom and reduction compared to anterior temporal lobectomy with potentially improved neuropsychiatric outcomes. LITT is an advantageous option for treating brain tumors, RN, and MTLE, among other pathologies. Continued investigation in emerging LITT applications can help clinicians expand the use of magnetic resonance imaging-guided stereotactic laser ablation technology into the treatment of a broad spectrum of central nervous system pathologies.