World Neurosurg
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To explore correlations of 3 novel radiographic parameters with myelopathy induced by posterior atlantoaxial dislocation (PAAD) secondary to os odontoideum (OO) and assess their reproducibility. ⋯ The OP/C4 SAC ratio and the C1 posterior inclination angle seem to be 2 effective and objective radiographic parameters for relating myelopathy in patients with OO with PAAD. When the OP/C4 SAC ratio is <0.93 and/or the C1 posterior inclination angle is >20°, the risk of developing myelopathy should be highly suspected in patients with OO with PAAD.
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The incidence of ischemic stroke in young adults (18-45 years old) is increasing gradually. However, performing nutritional assessment in stroke patients is often challenging due to the lack of an accepted standard for nutritional assessment. ⋯ PNI has a statistically predictive value for the 90-day prognosis of young stroke patients.
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The current standard of care for patients with glioblastoma (GBM) is maximal safe resection followed by adjuvant radiation therapy with concurrent temozolomide chemotherapy. Previous studies that identified this treatment regimen focused on younger patients with GBM. The proportion of patients with GBM over the age of 80 years is increasing. We investigate whether elderly patients benefit from the current standard of care with additional maximal safe resection. ⋯ For elderly patients with KPS >70, GTR followed by radiation and temozolomide is associated with maximum OS.
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Despite growing interest in the endoscopic endonasal approach (EEA) to the medial orbital apex (OA), a comprehensive description of the multilayer topology lying at the intersection of the regional compartments is missing. ⋯ Understanding cranial landmarks and the folds of the layers covering the orbito-cavernous-pterygopalatine interface can facilitate tailoring an EEA to the medial orbital space and avoid unnecessary exposure of sensitive anatomy in the vicinity.
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It remains unclear whether spinal cord untethering is necessary to reduce the chances of neurologic decline in children with myelomeningocele and complex closed spinal dysraphism who undergo thoracolumbar fusion for scoliosis. We sought to determine the neurologic and functional outcomes of children with spinal dysraphism undergoing spinal fusion for scoliosis with and without prophylactic spinal cord untethering. ⋯ Our data suggest that prophylactic spinal cord untethering in children with spinal dysraphism undergoing thoracolumbar fusion for scoliosis may not be necessary in patients with moderate curvatures. Our conclusions are limited by the small sample size. A larger review of registry data may yield more powerful conclusions on the necessity of prophylactic spinal cord untethering in this patient population.