World Neurosurg
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Volumetry of cerebral ventricles is a far more sensitive measure for shunt-induced reduction of ventricular size than traditional 2-dimensional (2D) measures, such as Evans index. However, available ventricle segmentation methods are time-consuming, resulting in limited use in clinical practice. Quantitative MRI (qMRI) obtains objective measurements of physical tissue properties, enabling automatic segmentation of white and gray matter and intracranial cerebrospinal fluid. The aim of this study was to evaluate the reliability and processing time of both manual and manually corrected automatic ventricular volumetry through the application of 3D qMRI. ⋯ 3D qMRI is a reliable and time-efficient method to obtain relevant volumetric measures of intracranial cerebrospinal fluid spaces for both clinical and research purposes. The corrected automatic segmentations provide a feasible time expenditure for clinicians caring for patients with iNPH.
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Giant pituitary neuroendocrine tumors (GPitNETs) are challenging tumors with low rates of gross total resection (GTR) and high morbidity. Previously reported machine learning (ML) models for prediction of pituitary neuroendocrine tumor extent of resection (EOR) using preoperative imaging included a heterogenous dataset of functional and nonfunctional pituitary neuroendocrine tumors of various sizes leading to variability in results. ⋯ Utilizing preoperative imaging parameters in a 3-dimensional manner proves highly valuable in predicting the EOR for nonfunctioning GPitNETs. These predictions can be easily calculated using an online open-access application: http://emoryskullbase.shinyapps.io/giant_pituitary_adenoma_resection/.
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Cervical stenosis (CS) is the pathologic narrowing of the central canal of the cervical spine. It is often incidentally discovered. It is unclear whether pre-existing CS can lead to worse outcomes and higher incidences of post-traumatic spinal cord injury (SCI). ⋯ Though patients with pre-existing CS do not have higher odds of SCI in studies with internal controls, we find that patients with CS do have higher incidences of SCI and are over-represented in the population of SCI patients. In select CS patients with active lifestyles, close follow-up and consideration of various treatment options may be indicated.
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Previous studies have found that percutaneous vertebroplasty (PVP) can effectively improve the local pain (LP) of the affected vertebra caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) regardless of unilateral or bilateral puncture, but there are few reports on whether it is equally effective for the accompanying distant lumbosacral pain. The objective of this study was to analyze the clinical efficacy of unilateral or bilateral PVP in the treatment of thoracolumbar OVCF with distant lumbosacral pain. ⋯ PVP can not only improve the LP and ODI index of the responsible vertebra of OVCF in the thoracolumbar region, but also improve the accompanying distant lumbosacral pain symptoms, and the puncture approach does not affect the improvement of postoperative pain and function.
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Neurosarcoidosis tends to occur in younger patients and shows poorer prognosis. Central nervous system involvement is found in approximately 10% of the sarcoidosis patients. ⋯ Neurosarcoidosis is known to be a master of disguises since it has variable imaging presentation and frequently mimicks meningioma. Neurosarcoidosis presenting as multiple discrete dural based mass lesions without any other systemic involvement is rarer.