World Neurosurg
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The presence of clear high-grade rotatory subluxation, in addition to an odontoid fracture, is a definite indication for surgery. However, the presence of a more subtle subluxation-Grades 1, 2, or 3-can often be overlooked, and as a result, prognostic associations with second cervical vertebrae (C2) fractures are rare. In light of this, we assessed the failure rate of conservative management in patients with both an odontoid fracture and a concurrent first and second cervical vertebrae (C1‒C2) rotatory subluxation. ⋯ In our series, C2 Alonzo fractures with a C1‒C2 rotatory subluxation had a 10-fold increased risk of secondary displacement and subsequent need for surgery. Further research on this association could improve the management of these conditions.
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In poor-grade aneurysm subarachnoid hemorrhage (PaSAH), the use of external ventricular drainage (EVD) may be closely related to the occurrence of shunt-dependent hydrocephalus (SDHC). The purpose of this study was to investigate the effect of EVD on SDHC and prognosis after microsurgically clipping patients with PaSAH. ⋯ EVD implantation is an independent risk factor for SDHC after PaSAH, and a large drainage volume in the first 3 days after EVD implantation is an independent risk factor for SDHC after PaSAH. The drainage volume on the first day after surgery is the best predictor of SDHC after PaSAH. SDHC after PaSAH is the strongest independent risk factor for poor prognosis and prolongs hospital stay.
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To evaluate the accuracy of stereotactic coordinates to target the ansa lenticularis (AL) using 2 surgical planning methods, the conventional millimeter method (MM) and the normalized Tenths method (TM), assessed through individualized probabilistic tractography. ⋯ TM surpasses MM in identifying the structural connectivity between the AL and predefined ROIs, underscoring the advantages of coordinate normalization. However, variations in AC-PC line lengths and Euclidean distances between methods could lead to inaccuracies in the coordinate settings, potentially affecting the precision of structural connectivity and the efficacy of therapeutic outcomes.