World Neurosurg
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This study sought to show and analyze the main authors' experience (P.R. and J.M.C.) in previously coiled aneurysm surgery as an emerging challenge in today's neurosurgical practice. ⋯ Surgical management of previously coiled aneurysms is an emerging challenge in neurosurgery. Incomplete or ineffective embolizations pose an increased risk for the patient, thus requiring surgical treatment. Although not advisable, coil removal might be necessary when in the vicinity of the aneurismal neck in order to place the clip correctly. The authors believe that adequate patient selection and careful preoperative planning are essential to reduce the incidence of patients with unsuccessful coils who will later need surgical treatment.
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Isolated cerebral aspergillosis (ICA) traditionally has been associated with immunocompromised patients with dismal outcomes. Cases of ICA in immunocompetent patients are very rare and poorly described. We describe our experience of 5 immunocompetent patients with ICA and compare our experience with the literature. ⋯ ICA in otherwise healthy immunocompetent hosts seems to have a more favorable prognosis than what is reported for immunocompromised hosts.
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This study sought to evaluate the presence of atlanto-occipital and atlantoaxial instabilities as well as their clinical significance in patients with Down syndrome. ⋯ High cervical instability in patients with Down syndrome can also be observed among adults, and there is a low correlation between the radiological findings and symptoms. These findings emphasize the importance of periodic follow-up on these patients, particularly when sports activities are considered.
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Intraoperative ultrasound displays dynamic processes intraoperatively. Performing burr-hole biopsies under a real-time visual control is an interesting option for the neurosurgeon. However, the percentage of conclusive diagnoses obtained by this technique and the rate of complications must be evaluated in a larger series. ⋯ When intraoperative ultrasound-navigated biopsies were used they obtained a similar percentage of conclusive diagnoses as stereotactic biopsies. The complication rate is comparable as well. Emerging intracranial complications such as hemorrhages can be observed. However, their incidence cannot be decreased.
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There are many factors associated with the symptom presentation of lumbar disc herniation (LDH). However, there are only few reports regarding the clinical feature of LDH in military medicine. The objective of this study is to determine the factors that affected the symptoms of LDH in young Korean soldiers. ⋯ Our data showed that the military rank was associated with the symptom presentation of LDH and reflected the characteristics of military life.