World Neurosurg
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This article retrospectively analyzed the data of all patients diagnosed with malignant tumors of the nasal cavity and sinuses by pathologic section in all patients (including outpatients and inpatients) in our hospital from January 2008 to December 2017 (10 years) to discuss the nasal cavity The clinical characteristics of sinus malignant tumors and the clinical characteristics (symptoms, signs, imaging examinations) of 35 cases of olfactory neuroblastoma with high incidence were analyzed, and their treatment methods and prognosis were summarized for future nasal tumors. ⋯ On the basis of our analysis, the following conclusions can be drawn: Of the 300 cases of malignant tumors of the nasal cavity and paranasal sinuses, age distribution tends to be younger, the overall incidence of males is higher than that of females, but the proportion of male and female olfactory neuroblastoma is equal, and the incidence of adenoid cystic carcinoma and sarcoma. The morphology of cancer can be divided as follows: the tissue source is epithelial tissue, the cancer is harder, paler, drier, and often forms cancer nests, the parenchymal and interstitial boundaries are clear, and the fibrous tissue is hyperplastic. The incidence rate of females is higher than that of males, with the primary origin in the sinuses. Among them, the maxillary sinus is more common. Olfactory neuroblastoma, lymphoma, and sarcoma are gradually increasing in malignant tumors of the nasal cavity and sinuses.
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No previous large population-based studies of traumatic spinal injury (TSI) rates, trends, and patterns exist. We aimed to fill this knowledge gap on TSI epidemiology using a population-based study of 13 million people. ⋯ The rate of TSI continues to rise in Ontario as the population ages. The rise is primarily attributed to a shift in the epidemiology and etiology of TSI from a younger male population toward an older female population, with falls as the primary injury mechanism. Establishing preventive measures to address this shift is essential.
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Carbamazepine (CBZ) is the first-line therapy for trigeminal neuralgia (TN), and microvascular decompression (MVD) is considered to be an effective surgical treatment for TN. However, the effect of preoperative CBZ treatment on MVD outcome is not clear. ⋯ For patients with classical TN, a longer preoperative medication history of CBZ treatment had no significant effect on short-term outcome of MVD, but CBZ treatment was associated with a poor long-term outcome following MVD.
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The proclivity to atlantoaxial instability (AAI) has been widely reported for conditions such as rheumatoid arthritis and Down syndrome. Similarly, we have found a higher than expected incidence of AAI in hereditary connective tissue disorders. We demonstrate a strong association of AAI with manifestations of dysautonomia, in particular syncope and lightheadedness, and make preliminary observations as to the salutary effect of surgical stabilization of the atlantoaxial motion segment. ⋯ This study draws attention to the potential for AAI to present with syncope or presyncope that is refractory to medical management, and for surgical stabilization of AAI to lead to improvement of these and other autonomic symptoms.
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Case Reports
Minimally Invasive Microsurgical Technique for Evacuation of Deep Intracerebral Hematomas.
Despite the lack of conclusive outcome data, surgical evacuation of large, symptomatic intracerebral hematomas (ICH) may be offered to patients on a case-by-case basis, aiming to prevent brain herniation, control intracranial pressure, relieve symptoms, and possibly facilitate or accelerate recovery.1-3 For deep ICH, minimally invasive techniques, which limit operative damage to healthy brain tissue, are generally preferred. Although new tube and endoscope-based techniques are currently being studied,4-7 those elaborate techniques are not widely available and often require special equipment and/or expensive disposable material. ⋯ We acknowledge that this technique or a modification thereof may currently be in use by other neurosurgeons in their practice.8 However, to the best of our knowledge, a step-by-step microsurgical video illustration of this technique has not been previously published. Although this technique can be broadly used by neurosurgeons, irrespective of the hospital setting, it would be particularly valuable in settings where expensive cutting-edge technology is not readily available.