World Neurosurg
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Growing rod techniques have been demonstrated to be a valuable treatment in early-onset scoliosis; however, repeated surgeries and general anesthesia cannot be avoided. ⋯ The novel growing rod system is safe and effective in immature swine, preserving spine growth potential and involving less surgical trauma.
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Observational Study
Lower Iron Levels Predict Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage.
We tested the hypothesis that low serum iron levels are associated with acute hydrocephalus following aneurysmal subarachnoid hemorrhage (aSAH). ⋯ Lower serum iron levels after aSAH was a predictor of acute hydrocephalus and unfavorable outcome.
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Review Case Reports
Occult transorbital intracranial injury by a windscreen wiper handle: a case report and review of the literature.
We present the case of a 51-year-old male with an occult transorbital intracranial injury after a car accident. The identified foreign object was a windshield wiper handle. To our knowledge, this is the first case reported. ⋯ Occult TII is a rare subtype of penetrating brain injury. Diagnosis requires high suspicion as it can be missed during physical examination. Computed tomography (CT) scan, CT angiogram, and magnetic resonance imaging should be performed in order to design the optimal treatment for each patient. Magnetic resonance imaging should be avoided when metallic density on CT is observed. The use of a broad-spectrum antibiotic regimen is critical.
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Cerebral cavernous malformations of the intracanalicular optic nerve are extremely rare lesions. Only a few case reports and 1 case series have been published. We report an additional case with atypical imaging and review the existing literature with attention to time to surgery and imaging characteristics. ⋯ A cerebral cavernous malformation should always be in the differential diagnosis of a lesion causing an optic neuropathy with visual acuity loss and visual field defect. Clinical presentation of an optic neuropathy requires medical imaging; magnetic resonance imaging is the modality of choice in the diagnosis of these lesions. The treatment of cerebral cavernous malformation is gross total resection.
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Slit-ventricle syndrome (SVS) is a recognized complication of ventricular shunt malfunction, resulting in cyclical symptoms without ventricular dilatation. We present a case of SVS with transient, repetitive, and progressive signs of brainstem herniation evidenced by pupillary dilatation, posturing, and unresponsiveness, with diffuse voltage attenuation on electroencephalogram (EEG). ⋯ SVS can lead to severe intermittent brainstem herniation syndrome in the setting of shunt malfunction. Seizure diagnosis should be reserved for cases with proven functional shunt and EEG confirmation of epileptiform activity.