World Neurosurg
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Focal thoracolumbar kyphotic deformities require operative correction through osteotomies to restore normal spinal balance. Traditional osteotomies, such as the pedicle subtraction osteotomy, that are often used in the lumbar spine are less useful in the thoracolumbar region. The super-pedicle osteotomy is a pedicle-sparing wedge osteotomy that can be used for correction of kyphosis in patients with thoracolumbar deformities. ⋯ In this small series of patients with thoracolumbar kyphosis, the super-pedicle osteotomy technique was clinically useful. More robust examination is required to determine the safety, utility, and durability of this osteotomy technique.
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Observational Study
Awake craniotomy in low-resource settings: Findings from a retrospective cohort in the Philippines.
Awake craniotomy is a technique used to maximize resection of lesions in eloquent areas of the brain and preserve function. Although its use in high-income centers is well documented for tumors and vascular lesions, reports of its use in low-middle-income countries are limited. There are no published series from the Philippines. ⋯ Our experience shows that awake craniotomy is feasible in low-middle-income country settings and is safe and effective for excision of tumors, arteriovenous malformations, and cavernomas.
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Extracranial metastases from atypical meningioma are not usually found; they are sometimes found in lung, bone or scalp, but atypical meningioma in the liver is extremely rare. ⋯ We have analyzed the cytological findings of a metastastic meningioma with particular focus on pathological and immunohistochemical assessment. These results could improve the knowledge of surgeons about meningioma types and guide them to solve clinical incidents.
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Limited studies exist to support the safety of performing neuromodulation surgeries in patients whose anticlotting medication has been held. Here, we assess the safety of performing deep brain stimulation (DBS) in this patient population. ⋯ We found no increased risk of complications in patients routinely on anticlotting medication undergoing DBS lead placement. We show that our protocol was successful in balancing increased risks of bleeding and of thromboembolic events in this patient group.
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Case Reports
Cerebrospinal Fluid Spread in a Child with Pleomorphic Xanthoastrocytoma: A Report with Cytopathological Evidence.
Pleomorphic xanthoastrocytoma (PXA), a relatively uncommon, World Health Organization grade II tumor of astrocytic origin, occurs in children and in general carries good prognosis. The recently identified anaplastic PXA (grade III) type shows poor outcome. Rarely, these said tumors can display an aggressive clinical course with features of leptomeningeal spread. Such cases are mostly seen in adults, with rare instances reported in the pediatric age group. ⋯ The case is an indicator of the need for craniospinal screening protocol in patients with PXA, especially the anaplastic variety, both at the time of initial diagnosis and follow-up.