Notes

Hemisphere stroke: affect the semantic lexical areas of terminology.
Transorbital neuroendoscopic surgery (TONES) offers a new level of minimally invasive, minimally disfiguring skull base surgery with maximal surgical visualization.

This review systematically assesses the body of published anatomic (cadaveric) and clinical evidence for the approach. PubMed, Cochrane Library, Ovid MEDLINE, and Embase were systematically searched for articles in which the TONES surgical technique was used in an anatomic, clinical, or combined study. The outcomes of interest included identification of the diseases, operative outcomes, and complication rates.

Twenty-three articles were selected for this systematic review 10 were purely anatomic, 10 were clinical, and 3 had both clinical and cadaveric components. The articles reported 69 patients undergoing transorbital or combined transorbital and transnasal intervention. A total of 30 cases of cerebrospinal fluid leak were documented; of these, 28 (93%) had successful resolution, 2 (7%) had recurrence, and 5 (15%) experienced complications. A total of 31 tumors were biopsied (n= 1), resected (n= 22), or debulked (n= 8). Meningiomas were the most common lesion managed via TONES, with 5 of 7 patients with meningioma who reported preoperative neurologic deficits experiencing an improvement in extraocular movement impairment, visual acuity, proptosis, and ptosis. Transient postoperative clinical sequelae, including diplopia and ptosis, were increasingly associated with the superior lid crease incision and the sole transorbital approach.

TONES is a significant development in transorbital skull base surgery. However, comprehensive, robust, comparative analyses and increasing use and generalizability of this technique in skull base surgery are awaited.
TONES is a significant development in transorbital skull base surgery. However, comprehensive, robust, comparative analyses and increasing use and generalizability of this technique in skull base surgery are awaited.Imaging in patients with Paget's disease of bone is very important clinically to show the presence of Pagetic abnormalities, assess disease progression, and identify adversely affected structures throughout disease course. Abnormalities and progression may be seen on radiographs, computed tomography, magnetic resonance imaging, and nuclear imaging. Herein, we report a case Paget's disease of bone showing diffuse characteristic pathology using technetium-99m-labelled diphosphonate tracer in bone scintigraphy (nuclear imaging). This case emphasizes the ability of nuclear imaging to rapidly visualize and assess progressive distribution of Pagetic involvement in a patient previously diagnosed with pituitary adenoma and mild Paget's disease of the skull.
Expandable cages for interbody fusion allow for in situ expansion optimizing fit while mitigating endplate damage. CQ211 Studies comparing outcomes after using expandable or static cages have been conflicting.

This was a meta-analysis A systematic search was performed in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines identifying studies reporting outcomes among patients who underwent minimally invasive lumbar interbody fusion (MIS-LIF).

Fourteen articles with 1129 patients met inclusion criteria. Compared with MIS-LIFs performed with static cages, those with expandable cages had a significantly lower incidence of graft subsidence (expandable incidence 0.03, I
22.50%; static incidence 0.27, I
51.03%, P interaction <0.001), length of hospital stay (expandable mean difference [MD] 3.55 days, I
97%; static MD 7.1 days, I
97%, P interaction <0.01), and a greater increase in disc height (expandable MD -4.41 mm, I
99.56%; static MD -0.79 mm, I
99.17%, P interaction= 0.02). There was no statistically significant difference among Oswestry Disability Index (expandable MD -22.75, I
98.17%; static MD -17.11, I
95.26%, P interaction= 0.15), fusion rate (expandable incidence 0.94, I
0%; static incidence 0.92, I
0%, P interaction= 0.44), overall change in lumbar lordosis (expandable MD 3.48 degrees, I
59.29%; static MD 3.67 degrees, I
0.00%, P interaction 0.88), blood loss (expandable MD 228.9 mL, I
100%; static MD 261.1 mL, I
94%, P interaction= 0.69) and operative time (expandable MD 184 minutes, I
95.32%; static MD 150.4 minutes, I
91%, P interaction= 0.56).

Expandable interbody cages in MIS-LIF were associated with a decrease in subsidence rate, operative time and greater in increase in disc height.
Expandable interbody cages in MIS-LIF were associated with a decrease in subsidence rate, operative time and greater in increase in disc height.
The posterior atlantooccipital membrane complex consists of the posterior atlantooccipital membrane and posterior atlantoaxial membrane. Posttraumatic, posterior atlantooccipital membrane complex injuries may have varied appearances on cervical magnetic resonance imaging. The purpose of this study was to identify the different types of posterior atlantooccipital membrane complex injuries that occur in trauma patients.

Patients who suffered a posterior atlantooccipital membrane complex injury were identified retrospectively using key word searches of cervical magnetic resonance imaging reports between 2013 and 2020 using Nuance mPower software. All relevant imaging studies were reviewed by 2 neuroradiologists. A description of the location and type of posterior atlantooccipital membrane complex injury was recorded, along with additional osteoligamentous trauma of the craniocervical junction and relevant clinical history.

Forty-one patients were identified with acute posterior atlantooccipital membrane coital membrane with C1-C2 dorsal epidural hematoma; and grade 4-frank disruption of the posterior atlantooccipital membrane at C1 with edema in the remaining posterior atlantooccipital membrane complex.
Although cases of trigeminal neuralgia (TN) induced by brainstem infarct have been reported, the neurosurgical literature lacks a comprehensive review for this subpopulation of patients. We present the first systematic review of the literature to discuss pathology, surgical management, and future directions for therapeutic innovation in this population.

Our systematic review was conducted according to PRISMA guidelines. Resulting articles were screened for those that presented cases of TN associated with brainstem infarct.

A review of the literature identified 18 case reports of 21 patients with TN induced by brainstem infarct 14 pontine infarcts and 7 medullary infarcts. Although many cases of ischemic brainstem lesions are caused by acute stroke, cerebral small vessel disease also plays a role in certain cases, and the relationship between these chronic lesions and TN is more likely to be overlooked. Furthermore, we found that reports of self-resolving TN pain after brainstem infarct is disproportionately biased, as most case reports published their data within the first few months after initial presentation.
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