World Neurosurg
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This study aimed to clarify the risk factors of treatment for unruptured cerebral aneurysms (UCAs) in elderly patients by comparing the morbidity at discharge between surgical clipping and endovascular coiling in nonelderly (<65 years) and elderly (≥65 years) patients based on a national database in Japan. ⋯ Endovascular coiling after control of diabetes mellitus was recommended for the treatment of UCA in elderly patients. The ICA location of aneurysm in the elderly should be paid attention as the treatment risk.
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Ehlers-Danlos syndrome can be associated with cerebrospinal fluid (CSF) disturbances including recurrent CSF leak and Chiari I malformations. Persistent pseudomeningoceles are known to be associated with raised intracranial pressure. We present an unusual case of a compressive epidural CSF collection occurring after a computed tomography-guided L5 nerve root block and describe an effective management strategy.
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Preoperative tumor-related edema of the optic tract (EOT) is often found along the white matter tract of the visual system. However, the relationship of EOT with visual function and outcome remains unclear. Therefore we aimed to elucidate whether the presence of EOT is associated with visual outcome in patients with sellar and suprasellar tumors. ⋯ This study reveals that EOT caused by sellar and suprasellar tumors is associated with worse visual function and poor improvement postoperatively.
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The reported incidence of postoperative ileus (POI) after spine surgery depends on the surgical approach and definition used. It is therefore possible that the overall incidence is substantially higher than previously thought. POI has consequences for both the patient and hospital resources, and can significantly increase health care costs. ⋯ Despite use of early interventions, the median LOS remains significantly longer in patients who develop POI after complex spine surgery. Knowledge of the associated predictive risk factors could potentially assist with the development of rigorous, evidence-based preventative strategies.
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We evaluated the technical feasibility and potential advantages of transcranial insertion of an atlas screw for atlantoaxial fixation. ⋯ Transcranial insertion of atlas screw can be used as a salvage procedure when the conventional method of screw insertion is not possible because of technical difficulties.