World Neurosurg
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To examine the surgical results of unilateral lumbar discectomy in patients with bilateral leg pain and discuss short- and long-term outcomes within the limits of lumbar decompression. ⋯ Conventional lumbar disc surgery alone is sufficient for the ipsilateral side of radiologically demonstrated disc herniation in patients with bilateral leg pain.
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Aneurysmal bone cysts are benign bone lesions affecting long bones and vertebrae; only 2%-6% have cranial involvement, and even fewer show sphenoid or intraorbital involvement. Gross total resection is the treatment of choice. ⋯ To our knowledge, this is the youngest patient reported to have a spheno-orbital aneurysmal bone cyst. Such lesions in this age group present practical management challenges. By using a modified osteoplastic orbitozygomatic craniotomy, we achieved a gross total resection with minimal brain retraction, avoided the need for plating and suturing at the orbital rim, maintained a vascularized bone flap that is less susceptible to infection, and maintained normal temporalis muscle anatomy with excellent cosmetic results.
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Pseudarthrosis and rod fracture (RF) remain significant concerns after fusion for adult spinal deformity (ASD). Although a radiographic system of fusion grade has been proposed, the correlation between fusion grade and health-related quality of life measures (HRQoL) is not known. ⋯ Radiographic fusion grade after ASD surgery did not significantly impact HRQoL in the absence of RF. RFR was associated with significantly worse clinical outcomes. Fusion grade may be less predictive of clinical outcomes than the occurrence of RF.
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Encephaloduroarteriosynangiosis (EDAS) as a form of indirect revascularization has been recently proposed as a potentially promising alternative for patients with intracranial atherosclerotic disease (ICAD). The object of this study was to compare the prognostic roles between isolated EDAS and medical therapy in patients with atherosclerotic middle cerebral artery occlusion (MCAO). ⋯ In the long-term, isolated EDAS can be considered effective and safe for patients with atherosclerotic MCAO, whereas it may need additional medical therapy support in the short-term.
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Lhermitte-Duclos disease is an extremely rare pathologic entity characterized by a cerebellar mass composed of enlarged cerebellar folia containing abnormal ganglion cells. This entity usually presents in young and middle-aged adults and rarely in children. There is no study in the literature analyzing the long-term clinical course of this disease to assess the behavior primarily because of its rarity. ⋯ LDD is seen rarely and demands a high degree of suspicion in patients presenting with cerebellar mass and/or imaging characteristics. It is prudent to keep these patients in close follow-up for early detection of malignant transformation.