Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Review Case Reports
Surfer's myelopathy: A rare presentation in a teenage gymnast and review of the literature.
This article describes a novel setting for a rare nontraumatic spinal cord injury referred to as Surfer's myelopathy. The patient is a 16 year-old female cheerleader who presented following a gymnastics practice where she was repeatedly performing back handsprings. She demonstrated progressively worsening midthoracic back pain and evolving paraplegia and hypesthesia of the lower extremities. ⋯ The clinical and radiologic findings for this patient are consistent with previous case reports of Surfer's myelopathy. The authors also provide a summary of the current literature describing Surfer's myelopathy, which to date includes 64 reported cases. The diagnosis of nontraumatic spinal cord injury, referred to as Surfer's myelopathy, in a gymnast highlights the importance of greater physician and patient awareness of this rare condition.
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Incidental dural tear is one of the most common intraoperative complications in lumbar spine surgery. Yet, its technical management for the prevention of CSF leak is controversial. The technique of managing dural tears depends on the location of the dural tears as well on the length and anatomical characteristics of the dural tear. ⋯ Three patients underwent re-do spinal surgery for CSF leak repair. We recommend different management technique depending on the type of tear. For type I, we recommend the use of tissue-glue coated collagen sponge or fibrin glue application, without dural suturing.
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Retraction Of Publication
WITHDRAWN: Association between TPMT*3C and decreased thiopurine S-methyltransferase activity in patients with neuromyelitis optica spectrum disorders in China.
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Refractory chronic subdural hematoma (CSDH) is rare but remains a difficulty for neurosurgeons, and no consensus on treatment procedures has been established. To discuss effective surgical procedures for refractory CSDH, we analyzed our surgical procedures and outcomes for refractory CSDH. We defined patients with refractory CSDH as those who presented with two or more recurrences. ⋯ When selecting a surgical procedure, assessing whether the CSDH is organized is crucial. Embolization of the MMA may be considered as one of the optional treatments for refractory CSDH without organized hematoma. On the other hand, for refractory cases of organized CSDH, hematoma evacuation and outer membranectomy with large craniotomy or mini-craniotomy assisted by an endoscope may be suitable, as previous reports have recommended.
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Atypical meningioma has an aggressive clinical course. Distinguishing atypical from benign meningioma preoperatively could affect surgical planning and improve treatment outcomes. In this study, we examined whether pre-operative magnetic resonance imaging (MRI) features could distinguish between benign and atypical meningioma. ⋯ Further multivariate analyses suggests that edema, draining vein and necrosis are all positive predictors of tumor volume (p < .0001). Overall, these data suggest that radiographic features including presence of tumor necrosis, and tumor location along the falx or convexity may be predictive of higher-grade meningioma when considered alone. However, most strikingly, our data point to tumor volume as the most robust pre-operative indicator of higher-grade meningioma.