Neurosurgery
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Chiari II deformity is associated with open spinal dysraphism. A causal relationship has been proposed by McLone and Knepper. This article evaluates that hypothesis. ⋯ A relatively high proportion of fetuses with open spinal dysraphism do not have Chiari II deformity in utero. There is a lack of correlation between indicators of spinal dysraphism severity and the extent of the posterior fossa abnormality. This raises some interesting questions about the causality of the Chiari II deformity.
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Comparative Study
An in vitro biomechanical comparison of single-rod, dual-rod, and dual-rod with transverse connector in anterior thoracolumbar instrumentation.
After thoracolumbar corpectomy, standard anterolateral instrumentation may consist of dual rods with cross-connectors. However, when the vertebral bodies are small or involved with disease, only 1 rod may be possible. ⋯ In our in vitro model of anterior spinal stabilization after corpectomy and grafting, a single-rod construct is significantly less rigid than the intact spine. Addition of a second rod returns the rigidity of the spine to the intact state. A dual-rod cross-connector construct is significantly more rigid than a single-rod construct.
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Case Reports
Flow-diverting stent for ruptured intracranial dissecting aneurysm of vertebral artery.
The treatment of ruptured dissecting aneurysms of the intracranial vertebral artery (VA) with parent vessel preservation is a challenge for neurosurgeons and interventional neuroradiologists. ⋯ A flow-diverting stent may be considered an option to treat ruptured dissecting aneurysms of the VA, providing remodeling of the parent vessel and complete exclusion of the aneurysm.
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For neuroepithelial tumors, the surgical goal is maximum resection with preservation of neurological function. This is contributed to by intraoperative magnetic resonance imaging (iMRI) combined with multimodal navigation. ⋯ Intraoperative visualization of language-related cortical areas and the connecting pathways with DTI-based fiber tracking can be successfully performed and integrated in the navigation system. In a setting of intraoperative high-field MRI this contributes to maximum tumor resection with low postoperative morbidity.
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Awareness of having an unruptured intracranial aneurysm can affect quality of life and provoke feelings of anxiety and depression, even in treated patients, because of fear of recurrence of aneurysms. ⋯ Patients with an unruptured aneurysm have a reduced quality of life compared with the reference population, mainly in physical domains, but without an apparent effect on mood or anxiety. The extent of reduction in quality of life is similar in patients with and without aneurysm occlusion.