World Neurosurg
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Review Comparative Study
Autologous and acrylic cranioplasty: a review of 10 years and 258 cases.
Cranioplasty is a well-accepted neurosurgical procedure that has application to a wide range of pathologies. Given the varied need for both autologous and synthetic cranial grafts, it is important to establish rates of procedural complication. ⋯ Cranioplasty carries a significant risk of infection and postoperative hematoma. In this large series comparing autologous and acrylic flaps, male patients, tumor patients, and those undergoing surgery at the county hospital were at increased risk of postoperative infection. Among traumatic brain injury cases, complex injuries and cases with surgical involvement of the frontal sinus may portend a higher risk.
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Review Case Reports
Three-dimensional imaging as a teaching method in anterior circulation aneurysm surgery.
Our objective is to present and asses the utility of three-dimensional (3D) intraoperative imaging as a teaching method for anterior circulation aneurysm surgery. ⋯ Real 3D imaging in anterior circulation aneurysm surgery is an excellent tool to enhance vascular training. Inexperienced trainees seem to benefit greatly from it. This technique might be of use in the future development of new technologies.
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Multicenter Study Comparative Study
Revision extension to the pelvis versus primary spinopelvic instrumentation in adult deformity: comparison of clinical outcomes and complications.
To evaluate the outcomes and complications of patients with adult spinal deformity treated in a primary versus revision fashion with long fusions to the sacropelvis. ⋯ Patients requiring revision extension of instrumentation to the pelvis can be treated with the same expectation of radiographic and clinical success as patients treated primarily with fusion to the sacropelvis. The complication rate for the revision procedure is not insignificant and may be similar to a primary procedure that includes pelvic fixation.
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Quantifying the clinical neurological impairment of individuals with traumatic spinal cord injury (SCI) is of great importance in managing the population. The current gold standard is the International Standards for Neurological Classification of SCI (ISNCSCI). Administered in isolation, this measure is not sensitive or specific enough to quantify impairment for the whole SCI population with the detail required for clinical trials and interventional studies. ⋯ The use of impairment measures alone will not provide clinicians with enough information regarding ability. Thus, the use of functional outcomes, such as the Spinal Cord Independence Measure, Functional Independence Measure, and other functional tests in addition to the neurological impairment measures, such as the ISNCSCI and the electrophysiologic measures, are required for adequate characterization of the deficits and abilities in the traumatic SCI population.
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Rapid visual deterioration may occur as the result of the quick growth of parasellar meningiomas in the high-hormone/increased fluid retention milieu of pregnancy; however, surgery before delivery entails increased maternal-fetal risk. We present our experience in the management of parasellar meningiomas that compress the optic apparatus during pregnancy, with a focus on decisions regarding the timing of surgery. ⋯ We recommend that surgery be offered to patients during pregnancy when a delay may result in severe permanent visual impairment.