World Neurosurg
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Review Case Reports
Large intraosseous lipoma of the skull:A case report and review of the literature.
Intraosseous lipomas occurring within the skull are rare. Currently, the known locations include the frontal bone, parietal bone, temporal bone, and ethmoid bone. Thus far, we have found only 12 cases of lipoma at the top of the forehead on the skull, and only 2 cases of recurrent intraosseous lipoma have been reported. The patient with intraosseous lipoma we have described was a 3-year-old boy, the youngest of the 12 known patients with intraosseous lipoma of the skull, and the patient had repeated relapses. ⋯ For large intraosseous lipomas occurring in the skull, owing to its special position and the tendency for repeated relapses to develop, extending the excision is an effective surgical approach. For swelling involving a wide range, surgery should involve specialists in craniofacial surgery.
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Multicenter Study
Intra- and Peri-operative Complications Associated with Endoscopic Spine Surgery: A multi-institutional study.
To report on intra- and perioperative complications associated with working channel endoscopic spine surgery. ⋯ Endoscopic spine surgery is associated with a favorable rate of intra- and perioperative complications compared with reported rates of minimally invasive ortraditional open spine surgeries. Our report proposes safe and effective strategies for management of these complications.
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Review Case Reports
Trans-Oral Endoscopic Resection of High Cervical Osteophytes with Long-term Symptom Resolution: Case Series, Imaging, and Literature Review.
Anterior cervical osteophytes (ACOs) are a common radiologic finding in the elderly; rarely, they can cause dysphagia, dysphonia, and dyspnea. Symptomatic ACOs are most commonly found between C4 and C7 and much less commonly at higher cervical levels. Here, we present a case series, with an example case of a 57-year-old woman with high cervical osteophytes at C1-C2 causing globus sensation, dysphagia, and dysphonia. Additionally, we provide a literature review regarding the causes, diagnosis, and treatment of ACOs, with a focus on management of high ACOs. ⋯ ACOs are a potential cause of dysphagia, and their diagnosis is best made with computed tomographic imaging and oropharyngeal swallow study. Although high ACOs at C1-C2 are a rare finding, here we show with an exemplary case and small case series that they can be effectively treated with transoral endoscopic osteophytectomy.
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Review Case Reports
Radiological features and clinical course of chronic spinal epidural hematoma Report of four cases and literature review.
Spinal epidural hematoma (SEH) is a potentially devastating problem that requires rapid diagnosis and surgical intervention. A chronic course is rarely seen following SEH, and the clinical characteristics are quite different from acute cases. The epidemiology, clinical history, and radiologic findings of chronic SEH (CSEH) are not well understood, although the detection rate has increased with the widespread use of magnetic resonance imaging. The purpose of this article was to report 4 cases of surgically confirmed CSEH and clarify the radiologic features and clinical scenarios by reviewing all published cases of CSEH. ⋯ CSEH is a rare disease, and it is difficult to diagnose preoperatively on the basis of diagnostic imaging. The incidence of a low-intensity rim on T2*-weighted images and bone erosions on computed tomography may help differentiate rare CSEH from other lumbar degenerative diseases and epidural space-occupying masses.
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Review
The Superior Hypogastric Plexus and its Surgical Implications During Spine Surgery: A Review.
The superior hypogastric plexus (SHP) is a complex nervous collection located at the lumbosacral region below the level of the aortic bifurcation. As a part of the autonomic nervous system, it is an extension of the preaortic plexuses and continues bilaterally as the hypogastric nerves that ultimately contribute to the inferior hypogastric plexus. Although commonly described as a plexiform structure, several morphologic variations exist. ⋯ Visceral afferents travel in the SHP and are responsible for transmitting pain. Management therapies such as SHP blockade or presacral neurectomy can reduce pelvic pain caused by cancer and nonmalignant etiologies. This review highlights some of the recent findings regarding the nature of the SHP.