World Neurosurg
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Review Meta Analysis
The reliability of fMRI in brain tumor patients: a critical review and meta-analysis.
Formal studies that validated functional magnetic resonance imaging (fMRI) against direct cortical stimulation (DCS) have shown inconsistencies. ⋯ The results from the present analysis of the available reported evidence suggest that fMRI itself (due to neurovascular uncoupling) or analysis of the findings have limitations regarding reliability when validated against DCS. From the existing studies, our results indicate that using fMRI alone for surgical planning could lead to undesirable outcomes.
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We sought to explore whether additional bone grafting of the atlantoaxial joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. ⋯ Additional bone grafting of the atlantoaxial joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion.
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Case Reports
Neonatal Hyponatremia in the Setting of Untreated Progressive Hydrocephalus: Case Report.
Hyponatremia in the neonatal population is an uncommon occurrence and can be associated with significant increase in morbidity and mortality. In the neonatal population, it is typically associated with an excess of antidiuretic hormone and rarely has been found to be associated with hydrocephalus, short of being caused by the subsequent treatment of hydrocephalus. ⋯ Hydrocephalus secondary to intraventricular hemorrhage is a notable complication in the premature neonatal population. Physicians should be aware of its potential association with hyponatremia and consider early neurosurgical intervention when other etiologies of the electrolyte disturbance cannot be identified.
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To study improvements in outcomes after surgery for intracranial meningiomas. ⋯ Meningioma surgery as well as patient population changed over the 2 decades considered in this study. We observed higher rates of gross total resection in the later period and the perioperative outcomes improved or were unchanged, which signifies better long-term outcomes, RFS, and OS.
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Case Reports
Cervical Kyphotic Deformity Worsening After Extensor Cervical Muscle Paralysis from Botox Injection: Case Report.
Botulinum toxin (Botox) has long been used therapeutically to treat a variety of diseases, including migraine headaches, cervical spine dystonia, and chronic cervical spine pain, among many others. Although quite useful, Botox has been reported to cause adverse events, some of which may lead to devastating morbidity. ⋯ This case illustrates a potential danger of using Botox in the neck of an elderly patient who may have pre-existing cervical spine instability, underlying cervical musculature weakness, and pre-existing cervical kyphosis. It demonstrates the need to evaluate patients who are predisposed to developing cervical kyphotic deformities before offering them Botox treatment.