World Neurosurg
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Cavernous malformations are low-flow fragile vascular lesions prone to extralesional bleeding that can occur in the cerebral hemispheres, the brainstem, or the spinal cord. This paper reports the case of a 32-year-old right-handed man with acute-onset headaches associated with right-sided tinnitus, right-sided hemianesthesia, and binocular diplopia related to cranial nerve IV palsy. Neuroimaging displayed left-sided isolated cavernous malformation of the inferior tectal plate, with evidence of extralesional bleeding. ⋯ At the 3-month follow-up consultation, symptoms had improved aside from diplopia, which required wearing prism eyeglasses. Tectal cavernous malformations account for 18% of midbrain cavernomas. It was explained that surgical excision using the supracerebellar infratentorial approach would be performed within 2 months after a second extralesional bleeding episode causing disabling symptoms.
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Despite its association with lower survival rates among patients in various disease states, financial toxicity is often overlooked in health care. The aims of our study are to elucidate the effect of financial toxicity on the care of glioma patients. ⋯ Our results suggest there is a strong association between financial toxicity, socioeconomic status, and the standard of care following GBM resection. They also shed light on the financial toxicities associated with the care of these patients.
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To investigate the treatment effect and prognosis of posterior fossa epidural hematoma in children by different surgical methods. ⋯ The effect of minimally invasive skull trepanation and drainage in the treatment of posterior fossa epidural hematoma in children is similar to that of craniotomy hematoma removal, but the operation is simpler, less trauma, less intraoperative bleeding, and short operation time, which is worthy of clinical application.
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This study endeavored to investigate the influencing factors of pedicle screw torque measured during surgery and the correlation between manual palpation scores and screw torque. ⋯ The BMD of the lumbar is an independent factor that influences the measured torque applied to pedicle screws during surgery. A significant and robust positive correlation exists between the intraoperative screw placement tactile sensation and the torque experienced. It is advisable to reinforce the screw channel with bone cement when the tactile score is ≤2.5 and the torque is ≤ 1.3 Nm.