Notes

Radiofrequency ablation to treat thyroid follicular neoplasm together with reduced Sport utility vehicle within PET/CT examine.
Neurosurgical nursing during the COVID-19 pandemic in developing countries requires transparent planning, implementation, and careful consideration of various telemedicine strategies.
Tubercular atlantoaxial, rotary dislocation warranting fixation (AARF) is an extremely rare event.

AARF was suspected in a 23-year-old female with painful torticollis. When diagnostic studies documented unilateral destruction of the left lateral mass of the atlas, she underwent removal of the lateral mass, reduction of the deformity, and C1-C2 fusion/reconstruction utilizing an iliac bone graft. Laboratory tests and the pathologic surveys were all consistent with the diagnosis of underlying tuberculosis.

We present a case of tubercular atlantoaxial, rotary dislocation (AARF) in a patient who warranted C1-C2 decompression, reduction, and fusion.
We present a case of tubercular atlantoaxial, rotary dislocation (AARF) in a patient who warranted C1-C2 decompression, reduction, and fusion.
Sphenoid wing dural arteriovenous fistula (SWDAVF) is rare that is typically fed by middle meningeal artery feeders and that drain through the sphenoparietal sinus or middle cerebral vein. Here, we report a case of SWDAVF treated by coils placed in the venous aneurysm through the contralateral cavernous sinus (CS).

A 37-year-old woman was admitted to our hospital with headache and bilateral oculomotor nerve palsy. Magnetic resonance images and an angiogram showed a venous aneurysm in the right middle cranial fossa. selleck chemicals A DAVF, consisting of two main feeders, was diagnosed based on the angiogram findings. The fistula drained into the left inferior petrosal sinus (IPS) through the left CS and right IPS. Given the remarkable extent of venous ectasia together with the headache and right abducens nerve paralysis, endovascular treatment was initiated. A transvenous approach through the right IPS was not feasible, as it is strenuous to insert the microcatheter into the right IPS. Thus, we tried an approach through the left IPS. The venous aneurysm was embolized with coils. The postoperative course was uneventful, and postoperative cerebral angiography confirmed disappearance of the fistula.

A SWDAVF is extremely rare. In our case, since the AVF drained into the contralateral CS, contralateral ocular symptoms occurred. Endovascular occlusion of the venous aneurysm and fistula was achieved through a transvenous approach.
A SWDAVF is extremely rare. In our case, since the AVF drained into the contralateral CS, contralateral ocular symptoms occurred. Endovascular occlusion of the venous aneurysm and fistula was achieved through a transvenous approach.
Due to its rarity, surgical treatments for a complete fifth lumbar osteoporotic vertebral burst fracture (L5 OVBF) have yet to be well documented as compared to that for osteoporotic vertebral fractures of the thoracolumbar spine. The current case report discusses details of the surgical outcomes following posterior decompression and fusion for a complete L5 OVBF.

Three women, ranging in age from 69 years to 82 years, were surgically treated for a complete L5 OVBF. Two of these patients were being treated for rheumatoid arthritis. Surgery was performed using the L5 shortening osteotomy or vertebroplasty, with one- or two-level posterior lumbar interbody fusion, and posterior spinal fixation for the L2 or L3 to the pelvis. Although the spinal alignment parameters, which included lumbar lordosis (LL), pelvic incidence-lumbar lordosis, T1 pelvic angle, and sagittal vertical axis, were better as compared to that observed before the surgery, these worsened at the final follow-up due to clinical fractures that occurred at the adjacent vertebral body and proximal junctional kyphosis. Compared to preoperative Japanese Orthopaedic Association (JOA) scores, postoperative JOA scores were improved and maintained at the final follow-up.

Posterior surgery of a complete L5 OVBF led to improvement of both the JOA score and spinal alignment after the surgery. Despite a worsening of the spinal alignment parameters, the JOA score was maintained at the final follow-up.
Posterior surgery of a complete L5 OVBF led to improvement of both the JOA score and spinal alignment after the surgery. Despite a worsening of the spinal alignment parameters, the JOA score was maintained at the final follow-up.
Permanent hearing loss after posterior fossa microvascular decompression (MVD) for typical trigeminal neuralgia (TTN) is one of the possible complications of this procedure. Intraoperative brainstem auditory evoked potentials (BAEPs) are used for monitoring the function of cochlear nerve during cerebellopontine angle (CPA) microsurgery. Level-specific (LS)-CE-Chirp® BAEPs are the most recent evolution of classical click BAEP, performed both in clinical studies and during intraoperative neuromonitoring (IONM) of acoustic pathways during several neurosurgical procedures.

Since February 2016, we routinely use LS-CE-Chirp® BAEPs for monitoring the function of cochlear nerve during CPA surgery, including MVD for trigeminal neuralgia. From September 2011 to December 2018, 71 MVDs for TTN were performed in our department, 47 without IONM of acoustic pathways (Group A), and, from February 2016, 24 with LS-CE-Chirp BAEP (Group B).

Two patients of Group A developed a permanent ipsilateral anacusia after MVD. In Group B, we did not observe any permanent acoustic deficit after surgery. In one case of Group B, during arachnoid dissection, intraoperative LS-CE-Chirp BAEP showed a temporary lag of V wave, resolved in 5 min after application of intracisternal diluted papaverine (0.3% solution without excipients).

MVD is widely considered a definitive surgical procedure in the management of TTN. Even though posterior fossa MVD is a safe procedure, serious complications might occur. In particular, the use of IONM of acoustic pathways during MVD for TTN might contribute to prevention of postoperative hearing loss.
MVD is widely considered a definitive surgical procedure in the management of TTN. Even though posterior fossa MVD is a safe procedure, serious complications might occur. In particular, the use of IONM of acoustic pathways during MVD for TTN might contribute to prevention of postoperative hearing loss.
Phosphorylated neurofilament heavy subunit (pNF-H) is a constituent protein of the nerve axon, which leaks into the peripheral blood in various central nervous disorders. This study examined the time course of pNF-H value up to 1 month after injury and investigated the correlation with clinical outcome.

Serum pNF-H concentration was measured on admission, and at 24 h, 72 h, 1 week, 2 weeks, and 1 month after injury in 20 patients, 15 males and 5 females aged 35-68 years (mean 52 years), with traumatic brain injury (TBI) transported to our hospital between April 2016 and March 2017. The clinical outcome at discharge was evaluated by Glasgow Outcome Scale.

The pNF-H value showed no increase in patients without brain parenchymal injury, but pNF-H value increased depending on the severity of brain damage. pNF-H value peaked at 2 weeks after injury. Two patients with peak value exceeding 10,000 unit had very severe injury and died during hospitalization. Peak pNF-H value was 3210 ± 1073 unit in 12 patients with good outcome and 9884 ± 2353 unit in 8 patients with poor outcome (
= 0.0119).

Serum pNF-H level tended to increase and peak at 2 weeks after injury, and the peak pNF-H value was correlated with clinical outcome after TBI. The temporal profile of blood pNF-H seems to be useful to predict the clinical outcome after TBI.
Serum pNF-H level tended to increase and peak at 2 weeks after injury, and the peak pNF-H value was correlated with clinical outcome after TBI. The temporal profile of blood pNF-H seems to be useful to predict the clinical outcome after TBI.
Extra-axial cavernomas at the cerebellopontine angle (CPA) are rare clinical entity that can radiologically mimic several lesions encountered at this location.

A 36-year-old female patient referred to our emergency service with acute decreased level of consciousness and vomiting. Neurological examination showed Glasgow Coma Scale of 12 with downbeat nystagmus of the right eye. Brain computed tomography scan and magnetic resonance imaging showed multilobulated extra-axial mass lesion located in the right CPA. The lesion was with various signal intensities in T1- and T2-weighted images suggestive of hemorrhages of different ages. T2 gradient echo sequences showed multiple sinusoid-like channels and diffuse hemosiderin deposition. These figures were compatible with cavernous malformation. The patient was operated by retrosigmoid approach. Dissection of the mass from the trigeminal, facial, vestibulocochlear, and lower cranial nerves was performed and total resection of the tumor was achieved. Histopathological examination confirmed the diagnosis of cavernoma.

Although CPA cavernomas are very rare, they should be considered for differential diagnosis when evaluating CPA lesions preoperatively for better intraoperative management and postoperative outcomes.
Although CPA cavernomas are very rare, they should be considered for differential diagnosis when evaluating CPA lesions preoperatively for better intraoperative management and postoperative outcomes.
Our aim was to evaluate differences in neurosurgeons versus orthopedists access to technologies needed to perform minimally invasive spine surgeries (MISS) in Latin America.

We sent a survey to members of AO Spine Latin America (January 2020), and assessed the following variables; nationality, level of hospital (primary, secondary, and tertiary), number of spinal operations performed per year, spinal pathologies addressed, the number of minimally invasive spine operations performed/year, and differences in access to MISS spinal technology between neurosurgeons and orthopedists.

Responses were returned from 306 (25.6) members of AO Spine Latin America representing 20 different countries; 57.8% of respondents were orthopedic surgeons and 42.4% had over 10 years of experience. Although both specialties reported a lack of access to most of the technologies, the main difference between the two was greater utilization/access of neurosurgeons to operating microscope (e.g., 84% of the neurosurgeons vs. 39% of orthopedic spine surgeons).

Although both specialties have limited access to MISS spinal technologies, orthopedic spine surgeons reported significantly lower access to operating microscopes versus neurosurgeons (
< 0.01).
Although both specialties have limited access to MISS spinal technologies, orthopedic spine surgeons reported significantly lower access to operating microscopes versus neurosurgeons (P less then 0.01).
Pineal cysts are common entities, with a reported prevalence between 10 and 54%. Management of pineal cysts has historically been expectant, with surgical treatment of these lesions usually reserved for patients with a symptomatic presentation secondary to mass effect. The appropriate management of pineal cysts in patients presenting with headache in the absence of hydrocephalus - often the most common clinical scenario - has been more ambiguous. Here, we report the results of a comprehensive systematic review of headache outcomes for surgically treated, non-hydrocephalic pineal cyst patients without signs of increased intracranial pressure (ICP).

Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to construct a systematic review. A comprehensive search of the PubMed, Embase, Scopus, and Web of Science databases was conducted from through June 2020. Relevant English-language articles were identified using the search terms "pineal cyst" and "headache." The following eligibility criteria were applied the inclusion of at least one surgically-treated, non-hydrocephalic pineal cyst patient presenting with headache in the absence of hemorrhage or signs and symptoms of increased ICP.
Website: https://www.selleckchem.com/