World Neurosurg
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Here we report the application of optical frequency domain imaging (OFDI), a new optical coherence tomography device, for intravascular visualization in the treatment of a recanalized unruptured internal carotid artery aneurysm that was treated initially by stent-assisted coil embolization. ⋯ OFDI/OCT appears to be a useful diagnostic tool for evaluating stent-strut apposition over the vessel wall and the grade of neointimal endothelialization across the neck of the aneurysm in aneurysmal recanalization.
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This report analyzes the significance of osteophytes in the overall pathologic scheme in patients with single-level or multilevel cervical spinal degeneration. ⋯ Spinal stabilization reduces the size of osteophytes. Facet distraction spacers are more effective in reduction of the size of DOL in both immediate and delayed postoperative periods.
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Case Reports
Intraventricular tension pneumocephalus after subarachnoid haemorrhage and removal of an external ventricular drain.
Pneumocephalus is defined as an accumulation of air or gas in the intracranial space. It is a common complication after skull surgery or craniofacial trauma, sometimes also caused by gas-producing organisms in the context of an infection, and reported with cerebrospinal fluid draining procedures. ⋯ The acute management included therapy with normobaric oxygen. Despite the large volume of trapped air and its diffuse distribution inside the skull and spine, therapy with 100% normobaric oxygen appears to be safe and efficient for a rapid improvement of the patient's symptoms and the neuroradiological imaging.
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The minimum clinically important difference (MCID), an important concept to evaluate the effectiveness of treatments, might not be a single "magical" constant for any given health-related quality of life (HRQoL) scale. Thus, we analyzed the effects of various factors on MCIDs for several HRQoL measures in an adult spinal deformity population. ⋯ The results from the present study have demonstrated that MCIDs change in accordance with the baseline scores and direction of change but not by age or gender. The MCID, in its current state, should be considered a concept rather than a constant.
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Idiopathic normal pressure hydrocephalus (iNPH) negatively affects gait and cognition abilities and urine continence in the elderly. It is associated with systemic hypertension, although the exact pathophysiology is still unknown. A correlation to increased intracranial pulsatility and decreased compliance was suggested. Transcatheter aortic valve implantation (TAVI) is increasingly used in the treatment of severe AS. New-onset systemic hypertension affects some patients after TAVI. ⋯ This is the first case series of symptomatic NPH after TAVI. In this unique subgroup, NPH symptoms can develop rapidly. Post-TAVI iNPH represents a novel interaction between the blood and CSF circulations.