World Neurosurg
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Case Reports
Muscle Forehead Flap: a salvage surgery for closure of cutaneous fistula after cranioplasty exposure.
Infection and skin fistula are well-known complications after cranioplasty leading to reconstruction exposure and usually requiring new surgical procedure with poor condition for cutaneous closure. We describe 2 cases using muscle forehead flap (MFF) to treat skin fistula and cranioplasty exposure. ⋯ MFF is a surgical option to treat complex cases of cutaneous fistula secondary to cranioplasty exposure of the anterior cranial fossa.
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Case Reports
Langerhans cell histiocytosis of the skull in the burr-hole site covered with hydroxyapatite material: a case report.
Langerhans cell histiocytosis (LCH) is a rare dendritic histiocytic disorder that affects the bones, especially the skull. Langerhans cell histiocytosis (LCH) developing in a burr hole site for chronic subdural hematoma is extremely rare. ⋯ If there is rapid proliferation of connective tissue at an operative site where artificial material has been used, LCH should be considered.
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Comparative Study Observational Study
Cost-effectiveness of a Radio Frequency Hemostatic Sealer (RFHS) in Adult Spinal Deformity surgery.
Patients undergoing posterior spinal fusion surgery can lose a substantial amount of blood. This can prolong operative time and require transfusion of allogeneic blood components, which increases the risk of infection and can be the harbinger of serious complications. Does a saline-irrigated bipolar radiofrequency hemostatic sealer (RFHS) help reduce transfusion requirements? ⋯ The cost-effectiveness analysis revealed that if we are willing to pay $108 to avoid 1 unit of blood transfusion, the use of the RFHS is a reasonable choice to use in open surgery for adult spinal deformity.
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Posterior lumbar fusions are performed to treat various spinal deformities, degenerative diseases, fractures, infections, and tumors. The possibility of episode-based bundled payments for spine surgery necessitates analysis of the factors predicting readmissions and postoperative complications. ⋯ Nonhome discharge patients experienced higher rates of complications and 30-day readmissions.
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Case Reports
Neoplastic cerebral aneurysm from metastatic lung adenocarcinoma with neuroendocrine features.
Neoplastic cerebral aneurysms are exceedingly rare. We describe a case of a ruptured, distal middle cerebral artery aneurysm as the presenting symptom leading to the identification of metastatic lung cancer. ⋯ Neoplastic cerebral aneurysms are rare, and there are insufficient data to support specific guidelines for management. This case is novel as the patient received adjuvant stereotactic radiosurgery to the operative bed, as well as systemic chemotherapy, and has maintained good functional status as of last follow-up at 6 months.