World Neurosurg
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Review Case Reports
Hypertrophic Olivary Degeneration and Holmes' Tremor: Case Report and Review of the Literature.
Hypertrophic olivary degeneration (HOD) is very rare type of degeneration that causes hypertrophy rather than atrophy. The classical presentation of HOD is palatal myoclonus. However, HOD may rarely present with Holmes tremor (HT). HT is unusual symptomatic tremor characterized by combination of rest and intention tremor. It has been reported in small case series, so far. ⋯ Although pontine-midbrain hemorrhage may cause HT in the late period, HOD can be revealed on magnetic resonance imaging. Tract anatomy, especially the Guillain-Mollaret triangle, should be considered to explain the relationship between HT and HOD.
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Most patients with spinal tumors suffer no symptoms or have mild symptoms, but about 14% of patients have refractory pain caused by mechanical instability, or symptoms of spinal cord damage caused by epidural spinal cord compression. The Spinal Instability Neoplastic Score (SINS) and Kostuik classification are commonly used to evaluate spinal stability, and help to make a more detailed operation plan. The objectives of this study are to evaluate the reliability and reproducibility of the SINS and Kostuik classification, and to explore their clinical application value. ⋯ Compared with the Kostuik classification system, the SINS scoring system has better interobserver reliability and intraobserver reproducibility, which can be widely used in clinical practice and has great significance in the decision-making of spinal tumor treatment. Although the Kostuik classification system is often used in clinical practice, it shows inferior reliability and reproducibility in our study.
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The pterion is an H-shaped suture complex. This study's goal was to determine the location of its external and internal surfaces and extension and emphasize and discuss its surgical importance. ⋯ By using a subdivision into 4 quadrants, and considering our anatomic findings, we determined the way surgical procedures can be performed more easily and reliably. Even with modern localization technologies, anatomic landmarks can be useful to the neurosurgeon.
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To investigate the changes in the sagittal parameters of the cervical spine and the clinical efficacy of C2∼3 anterior cervical discectomy and fusion (ACDF) combined with internal fixation for unstable hangman's fractures. ⋯ For patients with unstable hangman's fractures, C2∼3 ACDF combined with internal fixation can achieve immediate stability of the upper cervical vertebrae, effectively correct the forward displacement and angulation of C2, and restore the sagittal balance of the cervical spine. The rate of osseous intervertebral fusion is high, and there are few complications. This method can effectively promote the recovery of spinal nerve function and preserve the motor function of the cervical vertebrae.
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Case Reports
Foot Drop after Ilio-Caval Vein Stenting: Radicular syndrome from stent misplacement in the spinal canal.
Endovascular procedures have become more and more prevalent in both general vascular and neurosurgical practices. Because these procedures rely on real-time bidimensional control through fluoroscopic guidance, they can be prone to spatial misplacement in the third dimension when not controlled in 2 different radiologic planes. ⋯ The complex venous anatomy of the lumbar region and lumbar epidural space is illustrated in this unique case. We believe this may serve both vascular surgeons and neurosurgeons in their daily practice.