World Neurosurg
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Review Case Reports
Orbital arteriovenous fistula coexistent with an arteriovenous hemangioma: a rare occurrence and review of literature.
Orbital arteriovenous fistula (AVF) is a rare entity with only 17 cases reported so far. An arteriovenous hemangioma is a distinct entity of an angioma that most frequently affects the skin. However, to our knowledge, there has not been a case arising in the orbit. ⋯ An AVF and arteriovenous hemangioma may simultaneously develop in the same orbit. In patients with symptomatic orbital AVF and coexisting other orbital pathology, strategies should be carefully planned before setting about the treatment.
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Review
Measures of health-related quality of life outcomes in pediatric neurosurgery: literature review.
Improving value in healthcare means optimizing outcomes and minimizing costs. The emerging pay-for-performance era requires understanding of the effect of healthcare services on health-related quality of life (HRQoL). Pediatric and surgical subspecialties have yet to fully integrate HRQoL measures into practice. The present study reviewed and characterized the HRQoL outcome measures across various pediatric neurosurgical diagnoses. ⋯ The HRQoL instruments used in pediatric neurosurgery are currently without standardized guidelines and thus exhibit high variability in use. Clinicians should support the development and application of these methods to optimize these instruments, promote standardization of research, improve performance measures to reflect clinically modifiable and meaningful outcomes, and, ultimately, lead the national discussion in healthcare quality and patient-centered care.
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Review
Delayed Myelopathy in Patients with Traumatic Preganglionic Brachial Plexus Avulsion Injuries.
Cervical and upper thoracic nerve root avulsions are preganglionic lesions that occur after extreme traction of the brachial plexus. The tearing of the roots from the spinal cord pia leads, not only to immediate and permanent deficits, but also to delayed neurologic complications. Symptomatic myelopathy can present in a late fashion owing to chronic sequelae from the inciting traumatic event. No unifying theory has yet been provided that can explain the causes of delayed spinal cord dysfunction after preganglionic brachial plexus injury. We have proposed a collective mechanism for the development of delayed spinal cord injury. ⋯ Four overlapping etiologies appeared to compose the primary foundation for delayed spinal cord dysfunction after brachial plexus injury. We have highlighted this continuum by providing institutional case examples and a review of the reported data.
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Review Case Reports
Pneumoventricle of Unknown Origin: A Personal Experience and Literature Review of a Clinical Enigma.
Pneumocephalus is an uncommon and life-threatening neurologic condition. Air within the ventricular system of the brain is also known as pneumoventricle (PV). It requires emergency treatments to prevent catastrophic neurologic outcomes. Head injury is the most common cause of PV, but there are other well-recognized etiologies in case there is no clear radiological evidence of skull discontinuity. ⋯ The aim of the present paper is to report a case of post-traumatic PV without radiological signs of skull base or convexity fracture in a 72-year-old man, underlining the diagnostic and clinical features, and review the relevant literature.
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Review Case Reports
Spinal Cord Stimulation in Adult Tethered Cord Syndrome: Case Report and Review of the Literature.
Spinal cord stimulation (SCS) is an evidence-based treatment for chronic neuropathic pain; however, there is a dearth of evidence investigating this modality in patients with tethered cord syndrome. ⋯ The literature review identified 2 other case reports of SCS in tethered cord syndrome with similar improvement in pain alleviation.