World Neurosurg
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The aim of this study was to evaluate the biomechanical stability and the clinical and radiographic outcomes in patients undergoing transforaminal lumbar interbody fusion (TLIF) using an oblique bridging cage with a particular focus on subsidence. ⋯ Regarding fusion, the use of an oblique PEEK cage with a cortical load-bearing design provided highly satisfactory clinical and radiologic results after 2 years. A review of the literature suggests a lower rate of cage subsidence after lumbar interbody fusion using bridging cages rather than single cages.
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To identify risk factors for predicting posttraumatic hydrocephalus (PTH) development after traumatic brain injury in patients who underwent decompressive craniectomy (DC). ⋯ GCS scores <6 on admission, presence of IVH on first head computed tomography scan, and need for bilateral DC might be used to predict whether patients with traumatic brain injury after DC will develop PTH. The reliability of this specific combination might be useful for clinicians to make a correct prediction.
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Antiplatelet therapy is common and complicates operative management of acute intracranial hemorrhage. Few data exist to guide antiplatelet reversal strategies. ⋯ When patients on antiplatelet medication present with operative intracranial hemorrhage, the majority of neurosurgeons do not perform qualitative platelet testing. Antiplatelet reversal strategies are significantly influenced by the antiplatelet therapy with more aggressive reversal strategies employed in the presence of ADP antagonists.
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To explore whether we should use the Pipeline embolization device (PED) as the primary treatment modality for small and tiny aneurysms at anterior circulation. ⋯ The PED is an alternative treatment for small and tiny aneurysms. However, SAC remains the safest and most efficient treatment modality. The PED should be reserved for ipsilateral multiple aneurysms.
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Paragangliomas of the head and neck region are not only rare but also unique in that they are derived from the parasympathetic system and are nonsecretory. Orbit represents 1 of the least common sites for head and neck paragangliomas. Orbital paraganglioma remains predominantly a disease of adults, and it has never been reported in infancy earlier. Therefore it is not known if these tumors in infancy behave any differently than their adult counterparts. ⋯ Orbital paraganglioma in infancy may be more aggressive than the adult counterparts. Although simple excision without adjuvant radiation may be tried in localized tumors with intact vision, recurrence tends to be high. Orbital exenteration with or without radiotherapy remains the only salvage option in such recurrences.