World Neurosurg
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Hemorrhage in the basal ganglia is a common type of intracerebral hemorrhage and has high mortality and poor prognosis. In our study, we aimed to evaluate surgical outcomes and functional recovery after evacuation of hematoma using either craniotomy or endoscopy. ⋯ Evacuation by endoscopy had better surgical outcomes, recovery of neurologic function, and aphasia recovery than evacuation by craniotomy. It appears that endoscopy is the surgical treatment of choice for middle-aged and elderly patients with a basal ganglia hemorrhage volume of >35 mL.
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In thoracolumbar (TL) burst fractures, vertebral body height loss (VBHL) indicates the degree of instability and constitutes one of the decision criteria for surgical treatment. However, the relative reliability and variability of different measurement techniques for VBHL are unknown. We compared the reliability of different methods used to assess VBHL. ⋯ Based on comparative reliability analyses, we recommend the APCR method as the first-line technique and the AHCP as an alternative technique for measuring VBHL in TL burst fractures.
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Histologic types and grades are critical in the diagnosis and treatment of spinal tumors. Intraoperative frozen section is a fast and easy method in confirming pathologic diagnosis during the operation. This study was undertaken to reveal the accuracy of intraoperative frozen section biopsy in order to make proper treatment plans. ⋯ Pathologic findings from frozen biopsy for spinal cord tumors could not be corresponded to final diagnosis, especially when the results of frozen biopsy were ependymoma or astrocytoma. Therefore careful decision making for treatment plans is required.
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Iatrogenic spinal cord injury (iSCI) during spinal corrective surgery can result in devastating complications, such as paraplegia or paraparesis. Perioperatively, iSCI often occurs as a direct injury during spinal cord instrumentation placement. Currently, treatment of iSCI remains limited to posttraumatic hypothermia, which has demonstrated some value in recent clinical trials. Here we report the outcomes of preinjury hypothermia initiated preprocedurally and maintained for a considerable time after iSCI. ⋯ The use of prophylactic hypothermia before iSCI was significantly associated with an increased survival rate, higher BBB scores, and improved neurophysiological measures.
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To describe a new method for cranial reconstruction after posterior fossa craniectomy in the surgical treatment of Chiari 1 malformation through a technical note and presentation of 3 illustrative cases. ⋯ 3D virtual surgical planning provides feasible tools for the planning of posterior fossa decompression and intraoperative fabrication of accurate patient-specific suboccipital cranioplasty.