World Neurosurg
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Review Case Reports
Basilar Invagination: Case Report and Literature Review.
Basilar invagination is a rare clinical condition characterized by upward protrusion of the odontoid process into the intracranial space, leading to bulbomedullary compression. It is often encountered in adults with rheumatoid arthritis. Transoral microscopic or endonasal endoscopic decompression may be pursued, with or without posterior fixation. We present a case of basilar invagination with C1-C2 autofusion and discuss an algorithm for choice of anterior versus posterior approaches. ⋯ Endoscopic endonasal odontoidectomy offers a safe and effective method for anterior decompression of basilar invagination. Preoperative assessment for existing posterior fusion, absence of posterior compression, and preservation of the anterior C1 ring during operative decompression help stratify the need for lone anterior approach versus a combined anterior and posterior treatment.
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Review
Functional and Structural Traumatic Brain Injury in Equestrian Sports: A Review of the Literature.
Sports-related concussions and traumatic brain injury (TBI) represent a growing public health concern. We reviewed the literature regarding equestrian-related brain injury, ranging from concussion to severe TBI. ⋯ Equestrian-related functional and structural TBI represent a significant public health burden. Rider and horse characteristics make the sport uniquely dangerous, as the athlete has limited control over an animal weighing a thousand pounds. Helmet use rates remain very low despite clear evidence of risk reduction. Health care providers are strongly urged to lobby professional and governmental organizations for mandatory helmet use in all equestrian sports.
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Review Meta Analysis Comparative Study
Comparison of the Therapeutic Efficacy of Surgery with or without Adjuvant Radiotherapy versus Radiotherapy Alone for Metastatic Spinal Cord Compression: A Meta-Analysis.
Spinal metastases are 20 times more common than primary spinal tumors and often cause metastatic spinal cord compression (MSCC). Clinical manifestations (e.g., pain and neurologic dysfunction) adversely affect patients' quality of life. Radiotherapy (RT), chemotherapy, and surgery are the major therapeutic strategies for MSCC. There is some evidence that combining surgery with adjuvant RT may be a better option. ⋯ Further studies are needed to investigate the effects of these interventions on quality of life and to identify the best therapeutic strategy for patients with MSCC.