World Neurosurg
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Review Case Reports
Trochlear nerve Neurofibroma in a clinically NF-1 negative patient; A case report and Review of literature.
Isolated orbital neurofibroma unassociated with systemic neurofibromatosis is relatively rare and may be difficult to clinically differentiate from other orbital tumors. Sensory branches of the trigeminal nerve-namely lacrimal, nasociliary, and frontal-are the most common nerves of origin for intraorbital neurofibroma, but we discovered a neurofibroma arising out of the right trochlear nerve, in absence of clinical stigmata of neurofibromatosis type 1, which is rare. ⋯ Isolated trochlear nerve neurofibromas, in the absence of clinical stigmata of NF1, are rare. Multiplicity, multilobulation, ring-configured contrast enhancement, and heterogenous MRI signal intensities help in the accurate preoperative imaging diagnosis. A possible cure is thus achievable with complete excision without damaging important adjacent neurovasculo-musculotendinous structures in the orbit. To the best of our knowledge, this is the fourth reported case of isolated trochlear nerve neurofibroma.
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Delayed cerebral ischemia (DCI) can cause significant morbidity and mortality in patients suffering from aneurysmal subarachnoid hemorrhage (SAH). Because arterial stiffness has been correlated with vascular risk factors, we evaluated whether the ankle-brachial index (ABI), the ratio of the ankle and brachial systolic blood pressures, can predict DCI. ⋯ In this small single-center study, lower ABI values were strongly associated with SAH-induced DCI, which may provide a tool for managing DCI in aneurysmal SAH.
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There is a lack of studies highlighting the outcome by different scores or parameters after surgery for recurrent disc herniations of the lumbar spine at the initial herniation site. This study assessed the quality of life after surgical treatment of recurrent herniations with different standardized validated outcome instruments. ⋯ Patients have to be informed carefully before surgery of recurrent lumbar disc herniations because of the less-promising outcome than after first time surgery for a lumbar disc herniation.
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Multicenter Study Comparative Study
Assessment of the radiation exposure of surgeons and patients during a lumbar microdiscectomy and a cervical microdiscectomy: a French prospective multicenter study.
Cervical and lumbar disk herniations are the most frequently carried out procedures in spinal surgery. Often, a few snapshots during the procedure are necessary to validate the level or to position the implant. The objective of this study is to quantitatively estimate the radiation received by a spine surgeon and patient during a low-dose radiation procedure. ⋯ Exposure to x-rays for surgeons and patients during surgery for lumbar disk herniation is higher than during surgery for cervical herniation disk. Our results show that radiation exposure to the spine surgeon is still far below the annual dose limits.