World Neurosurg
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The role of chemotherapy (CT) in the treatment of adult patients with medulloblastoma (MB) is unclear. The aim of this study is to compare the survival difference between adult patients with MB treated with and without chemotherapy. ⋯ CT improved CSS for adult patients with MB. With therapeutic advances, adult patients with MB might benefit from the use of CT.
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Telemedicine use skyrocketed in March 2020 on implementation of shelter-in-place measures owing to the coronavirus disease 2019 (COVID-19) pandemic. Within the past year, shelter-in-place measures were lifted and the COVID-19 vaccine was released, resulting in many neurosurgeons returning to in-person outpatient clinics. This study aimed to determine the extent of usage of telemedicine in neurosurgery 1 year into the COVID-19 pandemic. ⋯ Telemedicine use in neurosurgery clinics continues 1 year after the COVID-19 outbreak. Even after the lifting of shelter-in-place measures, many neurosurgeons still use telemedicine, while the operative volume remains stable. Owing to the limited physical examination that can be performed via current telemedicine platforms, telemedicine use in spine neurosurgery is lower than peak use during the early pandemic, while use has remained high among tumor, vascular, and functional neurosurgery.
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Carotid near occlusions show a lower risk of stroke than other types of severe stenosis. However, emerging evidence suggests that near occlusion with full collapse differs from that without full collapse. The results of treatment with carotid artery stenting for near occlusion with full collapse are presented. ⋯ Carotid artery stenting for near occlusion with full collapse seems to be a feasible and safe procedure that can be performed by an experienced neuro-interventional team.
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Expanded endonasal approaches (EEA) have become the main approach to the anterior skull base. A specific questionnaire, the Sino-Nasal Outcome Test for Neurosurgery (SNOT-NC), was developed in German to assess quality of life after EEA. The aim of this study was the cross-cultural adaptation and validation of the Italian version of SNOT-NC. ⋯ The Italian version of SNOT-NC showed good internal consistency, test-retest reliability, construct, and clinical and group validity, as well as original version. It can be considered a good instrument to evaluate the impact of endoscopic EEA to the anterior skull base.
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Shaken baby syndrome occurs following inertial loading of the pediatric head, resulting in retinal hemorrhaging, subdural hematoma, and encephalopathy. However, the anatomically vulnerable cervical spine receives little attention. Automotive safety literature is replete with biomechanical data involving forward-facing pediatric surrogates in frontal collisions, an environment analogous to shaking. Publicly available data involving child occupants were utilized to study pediatric neck and head injury potential. We hypothesized that inertial loading provides a greater risk of injury to the cervical spine than to the head. ⋯ These data support the hypothesis that inertial loading of the head provides a greater injury risk to the cervical spine than to closed-head injury.