World Neurosurg
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Odontoid fractures in association with a C1-C2 rotatory luxation reports are seldom found in the literature. The fusion between the lateral mass of C1 and C2 could be of interest to ensure adequate treatment in these particular cases. We report 23 cases where there was coexistence of an odontoid fracture and rotatory subluxation, which were treated surgically using cages between C1 and C2 or just traditional Goel-Harms technique. We evaluated the radiologic fusion rate, reoperation rate, and complications. ⋯ C2 fractures associated with C1-C2 rotatory dislocation are rare. The fusion rate at the level of the odontoid in these patients appears to be lower than that reported in patients without rotatory dislocation. It may be of special interest to obtain a clear fusion at the C1-C2 joint, where this type of implant seems to offer an advantage.
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Spontaneous intracerebral hemorrhage (ICH) is a common stroke subtype, and patients often develop intraventricular hemorrhage (IVH) and hydrocephalus (H). It is essential to promptly recognize factors that can predict the need for permanent cerebrospinal fluid shunt. This study aims to assess the potential of the IVH score as a predictor for shunt-dependent H in ICH patients. ⋯ The IVH score is a valuable predictor of shunt-dependent H in patients with spontaneous supratentorial ICH. Its simplicity allows for easy integration into routine clinical practice, aiding in better patient risk stratification and informed decision-making regarding permanent CSF shunt placement.
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Posterior circulation aneurysms are more likely to rupture than those in the anterior circulation but also pose more of a challenge for endovascular treatment or neurosurgical clipping. Aneurysms arising from the posterior cerebral artery are rare; dissecting aneurysms are even rarer. Dissecting posterior cerebral artery aneurysms can be spontaneous or post traumatic. Our case depicts a patient with acute subarachnoid hemorrhage due to a ruptured, dissecting posterior cerebral artery aneurysm who underwent successful endovascular treatment by means of flow diversion.
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Case Reports
Cervical Spondylotic Amyotrophy Initially Misdiagnosed as Amyotrophic Lateral Sclerosis.
A 63-year-old man diagnosed with mixed-type cervical spondylotic amyotrophy exhibited severe atrophy in the right biceps brachii, teres major, and intrinsic hand muscles, resulting in level 3 muscle weakness. Magnetic resonance imaging showed symmetrical high signal, also referred to as the snake eye sign. ⋯ At present, his right upper limb muscles display minimal atrophy compared with the left, with muscle strength nearing level 4, which is considered normal. We believe that prompt surgical intervention on diagnosis of cervical spondylotic amyotrophy, along with comprehensive postsurgery rehabilitation, can halt further deterioration of the condition and accelerate recovery.
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Case Reports
Bone but not Bone: Systemic Calcinosis presenting as Lumbar Facet Pseudohypertrophy with Neurogenic Claudication.
Systemic sclerosis affects 14-21 per million persons annually and can present with calcinosis-deposition in the skin and subcutaneous tissues. In rare circumstances, paraspinal depositions are also seen, which can cause neural element compression requiring surgical intervention. ⋯ Such pseudohypertrophy is often refractory to medical therapy, necessitating surgical intervention. Last, owing to the fluid nature of the calcinotic fluid, decompression is often easier than would be expected based on preoperative imaging alone.