World Neurosurg
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To evaluate the efficacy and prognosis of intraventricular medication administered via the reservoir of Ommaya or ventricular shunt system to control leptomeningeal metastases, with or without ventricular shunt based on intracranial pressure, in combination with postoperative systemic therapy. ⋯ For leptomeningeal metastases, ventricular shunt not only significantly alleviates symptoms caused by intracranial hypertension but also avoids sudden death for those with severe intracranial hypertension. However, ventricular shunt placement only does not improve overall survival. Intraventricular medications controls effectively leptomeningeal metastases, significantly prolongs survival, enhances quality of life.
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Bifrontal craniotomy is one of the most common surgical approaches for dealing with anterior skull base lesions. However, this procedure occasionally present complications like anosmia, cerebrospinal fluid (CSF) leakage, infection, and cosmetic problems. Although previous reports suggested various solutions, there remains a need to further refine the procedure to ensure better outcomes. In this paper, we introduce our revised method and examine the clinical results. ⋯ Through diligent practices and attention to minute details, such as gentle manipulations to preserve the olfactory nerve, reliable procedures for frontal sinus closure, and maximum attention to esthetic results, surgical techniques can be refined and developed to the level of highly skilled expertise with low rate of complications.
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Radiographic evaluation of the presumed lowest instrumented vertebrae (LIV) is crucial for determining the optimal fusion level for adolescent idiopathic scoliosis (AIS) with main thoracolumbar/lumbar curves. However, few studies have examined its variations intraoperatively. This study aims to investigate the radiographic variations of the presumed LIV during fluoroscopic positioning to aid surgeons in decision-making. ⋯ This study firstly reports the radiographic variations of the presumed LIV using intraoperative positioning fluoroscopy for Lenke 5/6 AIS and establishes the correlation with baseline measurements. This information may assist surgeons in selecting the optimal LIV, but long-term follow-up is needed to evaluate its outcomes.
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Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE. ⋯ The published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.
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In recent years, several studies have shown the presence of a linear correlation between the pelvic incidence (PI) and spondylolisthesis. However, no study has attempted to investigate a potential association between facet sagittal angle and spinopelvic parameters, especially PI in the normal population. ⋯ The PI seems to be correlated to the other spondylolisthesis risk factors: facet tropism and female sex. It carries the heaviest load in the progression towards sagittally oriented facet joints, which might lead to segmental instability and eventual spinal pathologies.