World Neurosurg
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The modified Rankin Scale (mRS) was developed to monitor functional recovery after stroke, but nowadays it is a treatment outcome measure in elective neurosurgery. Our objective was to study how mRS changes associate with short-term postoperative outcome. ⋯ The mRS changes after elective cranial neurosurgery are inconsistent. The mRS seems to represent functional changes, which do not necessarily associate with detected in-hospital complications.
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Case Reports
Delayed Abdominal Pseudohernia in a Young Patient After an LLIF Procedure: Case Report.
To describe a rare complication of the extreme lateral interbody fusion technique. ⋯ Abdominal pseudohernia is a rare complication of LLIF procedures. The interest of the present case is 3-fold: 1) it is the first delayed case of abdominal pseudohernia after an LLIF procedure; 2) it is the first case described in a young patient in whom risk factors have been identified and discussed; and 3) it is the first case that did not resolve spontaneously and required surgical repair. This exceptional complication must be borne in the mind of the spine surgeon when using the LLIF technique, and special precautions, such as laxatives or respiratory physiotherapy, apart from meticulous atraumatic dissection and closure of the abdominal wall and specific intraoperative monitoring, should be taken in high-risk patients to prevent it.
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Vein of Galen aneurysmal malformation (VGAM) is a rare pediatric vascular malformation of the brain. Genetic backgrounds are not well elucidated. We report on a monozygotic twin with VGAM and his endovascular treatment, and the genetic analyses of the twins and their parents. ⋯ We have reported a rare combination of a monozygotic twin and VGAM and the successful endovascular treatment. Phenotypic discordance in monozygotic twins established early in embryogenesis could be attributable to environmental or epigenetic factors.
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Reducing complications from unruptured aneurysms (UAs) treatment is important. We clarify the criteria for achieving safe and complete treatment for UAs ≤10 mm by clipping or coil embolization. ⋯ The treatment for UAs within the criteria, with the most recent points of concern, can lead to safe and complete results.
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The authors present reports of 2 cases in which there was manifest atlantoaxial instability and presence of retro-odontoid pseudotumor. The retro-odontoid tumor disappeared in the immediate postoperative phase after surgery, which involved facetal distraction and atlantoaxial fixation. The cases are discussed. Although regression of the retro-odontoid pseudotumor has been reported after atlantoaxial fixation, its disappearance in the immediate postoperative phase has not been recorded. ⋯ The retro-odontoid pseudotumor appears to be related to buckling of the posterior longitudinal ligament. Distraction of the facets probably assists in stretching of the posterior longitudinal ligament. Our experience reconfirms that retro-odontoid pseudotumor could be a manifestation of atlantoaxial instability and need not be directly handled by surgery.