World Neurosurg
-
To decrease vehicular traffic in major metropolitan cities throughout the United States, multiple ridesharing companies have launched dockless electric scooters and bicycles throughout cities. From September 2017 through November 2018, Washington, DC, launched a 15-month dockless vehicle pilot program to allow for the rapid entry and growth of electric scooters within the metropolitan area. This rapid growth resulted in a number of minor and significant injuries. ⋯ In this case series, we highlight more severe injuries that resulted in hospitalization or intervention, including skull fracture, central cord syndrome, and vertebral compression fracture. This case series aims to illustrate the potential severity of injuries related to electric scooters, raise awareness on the issues of safety and public health, and call for further investigation into injuries relating to electric scooters.
-
Gunshot wounds are the most common etiology of penetrating spine injuries and have been increasing in incidence in civilian populations. Although these injuries typically result in severe neurologic deficits, operative intervention remains is controversial and is usually reserved for patients with neurologic deterioration, a persistent externalized cerebrospinal fluid fistula, mechanical instability, metallic toxicity, or a bullet location at high risk of migration. ⋯ HO surrounding retained bullet fragments in the spine is a rare cause of progressive neurologic deterioration following gunshot wounds. Surgical excision of the shrapnel and heterotopic bone can lead to symptomatic relief, and therefore surgery should be considered as a treatment option in carefully selected patients.
-
The rosette-forming glioneuronal tumor (RGNT) is a rare World Health Organization grade I tumor, most often originating in the fourth ventricle and characterized by a predominant glial component, as well as a neurocytic component. Despite its benign grading, there are a few documented cases of RGNT displaying more aggressive behavior with malignant characteristics. ⋯ This case supplements and complements the handful of published cases available documenting the evolution of a particularly aggressive case of disseminated RGNT.
-
Comparative Study
Efficacy and safety of using high viscosity bone cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral cleft.
To evaluate and compare clinical outcomes and cement leakage of high-viscosity bone cement versus low-viscosity bone cement vertebroplasty in treating osteoporotic vertebral compression fractures with intravertebral cleft. ⋯ Percutaneous vertebroplasty using HVC to treat osteoporotic vertebral compression fractures with intravertebral cleft significantly reduces cement leakage and improves the safety of the operation. In terms of clinical efficacy and prevention of augmented vertebral recollapse, HVC may not have obvious advantages.
-
Comparative Study
Comparison of Subtracted CTA from CTP and Digital Subtraction Angiography in Residue Evaluation of Treated Intracranial Aneurysms.
Assessing clipped intracranial aneurysms for residues or incomplete occlusions is critical. Digital subtraction angiography (DSA) has been the gold standard for this. Previously, we presented subtracted computed tomography angiography (sub-CTA) from computed tomography perfusion as a more effective noninvasive technique for clipped aneurysms. The aim of this study was to compare effectiveness of sub-CTA with DSA in residue evaluation. ⋯ This is the first study comparing the effectiveness of sub-CTA from computed tomography perfusion with DSA in residue aneurysm evaluation. Our results were suggestive, but not conclusive. DSA is still the gold standard in residue evaluation. Sub-CTA from computed tomography perfusion can be a reliable method in evaluation of residual aneurysm >3 mm.