World Neurosurg
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To evaluate the microsurgical anatomy of the fiber tract connections of the supplementary motor area (SMA) and pre-SMA, and examine its potential functional role with reference to clinical trials in the literature. ⋯ The SMA complex has numerous connections throughout the cerebrum. An understanding of these connections is important for presurgical planning for lesions in the frontal lobe and helps explain symptoms related to SMA injury.
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The C1-C2 joint has multiple degrees of freedom of movement and C1-C2 dislocation (AAD) is often multiplanar. The existing methodology to assess the dislocation is limited to few planes. The object of this study is to redefine and objectively assess congenital AAD in each possible plane, before and after the operation. ⋯ The objective assessment of C1-C2 dislocation and joints in each plane was to determine its management and help in achieving multiplanar correction.
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Case Reports
Management strategy of a transorbital penetrating pontine injury by a wooden chopstick.
Transorbital penetrating pontine injuries from small spear-like objects, which are extremely rare, provide neurosurgeons with life-threatening and challenging conditions to manage. ⋯ Preoperative imaging, correct diagnosis, and surgical treatment are necessary to manage transorbital penetrating pontine injuries caused by spear-like objects, with specific attention paid to effective exposure and inventive means with total removal of the foreign object without causing further injury. A trajectory through the superior orbital fissure and paralateral to the cavernous sinus and into the pons seems to be the most prevalent and influences management of removal and injuries.
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Microendoscopic discectomy (MED) has been widely accepted for its advantage of minimal injury in the treatment of lumbar disc herniation. Recurrence after successful MED has been reported; however, the risk factors responsible for the MED recurrence were still unclear. ⋯ Age (≥50 years old) was the most robust risk factor for MED recurrence. Obesity (BMI ≥25) and modic change were also highly involved in the recurrent herniation after successful MED. Taking these risk factors into consideration before surgery may be instrumental in pursuing a personalized operative method, which may lead to a more satisfactory operative outcome and a relatively lower recurrence rate.
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To evaluate the obliteration rate and clinical outcome following linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) for intracranial arteriovenous malformation (AVM) in pediatric patients (age ≤18 years). ⋯ A modest median marginal dose of 15 Gy (16 Gy in the obliterated AVM group vs. 12 Gy in the nonobliterated group) resulted in an obliteration rate of 66.7% after LINAC-based SRS for intracranial AVM, with low rate.