World Neurosurg
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Venous thromboembolism (VTE) represents a significant source of morbidity and mortality in the inpatient population and is considered a leading preventable cause of death among inpatients. Neurosurgical inpatients are of particular interest because of the greater rates of immobility, steroid use, and potential consequences of postoperative hemorrhage. A consensus protocol for VTE screening in this population has not yet been developed, and institutional protocols vary widely. ⋯ Our findings lend support to preoperative screening of high-risk patients and suggest that routine postoperative VDUS surveillance of asymptomatic patients is unnecessary.
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Anterior spinal artery steal syndrome, radiculomedullary artery aneurysms, and pulmonary arteriovenous malformations with a systemic origin are each, considered individually, exceptional conditions. ⋯ Eventually, the lesion was treated with the exclusion of the left C8 spinal segmental branch and embolization of the arteriovenous malformation.
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Case Reports
Dilated Epidural Venous Plexus causing Radiculopathy: A Report of Two Cases and Review of the Literature.
A dilated epidural venous plexus (DEVP) is a rare cause of radiculopathy, back pain, cauda equina syndrome, and other neurological symptoms. This vascular mass can be secondary to inferior vena cava obstruction, portal hypertension, vascular agenesis, and hypercoagulable states. Although rare, DEVP should be considered in the differential diagnosis for patients who present with lumbar radiculopathy. ⋯ If a patient presents with an enhancing epidural lesion on magnetic resonance imaging and neurological symptoms, DEVP should be considered in the differential diagnosis. Additionally, a search for inferior vena cava thrombosis should be performed as well as risk factors for venous hypertension and hypercoagulable states.
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The operative environment poses many challenges to studying the relationship between surgical acts and patient outcomes in intracranial oncological neurosurgery. We sought to develop a framework in which neurosurgical performance and extent of resection could be precisely quantified in a controlled setting. ⋯ The developed framework can offer clinicians, learners, and researchers the ability to perform operative rehearsal, teaching, and studies involving brain tumor surgery in a controlled laboratory environment and represents a crucial step in the understanding and training of expertise in neurosurgery.
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The occurrence of spinal drop metastasis in patients diagnosed with glioblastoma multiforme (GBM) is rare. In previous reports, this diagnosis occurred after surgical resection of GBM, which was believed to increase the likelihood of tumor seeding. Diagnosis of spinal drop metastasis prior to surgery remains rare. ⋯ The awareness of the possibility of spinal drop metastasis prior to surgical resection of GBM is important. The use of routine MRI of the whole neuroaxis in patients diagnosed with GBM can aid in prognosis and management options.