World Neurosurg
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Multicenter Study
Spontaneous Spinal Epidural Hematoma: Correlation of Timing of Surgical Decompression and MRI Findings with Functional Neurological Outcome.
Spontaneous spinal epidural hematoma (SSEH) is a rare and morbid entity, with the prognosis affected by delayed diagnosis and surgical intervention. The correlation between the timing of the intervention and neurological recovery has not been clearly reported. We present a retrospective study of SSEH to determine the correlation between the timing of surgical intervention and changes in the spinal cord signal on magnetic resonance imaging (MRI) with the neurological outcome. ⋯ Significant neurological recovery after surgical decompression of SSEHs can be achieved, despite the significant preoperative neurological deficits, spinal cord changes on MRI, and delayed timing of intervention.
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Review Case Reports
Symptomatic Tuberculous Ligamentum Flavum Cyst Treated by Full Endoscopic Resection: A Review with Technical Notes.
Tuberculosis (TB) of the posterior spinal element is an uncommon condition. In a developed country its diagnosis is becoming difficult due to low incidence. ⋯ TB of the posterior elements of the spine is a diagnostic challenge in developed parts of the world. We describe the first likely case of tubercular ligamentum flavum cyst, which was managed by a full endoscopic uniportal approach.
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Review Case Reports
Intractable repeated intracerebral hemorrhage due to primary dural leiomyosarcoma: A case report and literature review.
There are few case reports of primary leiomyosarcoma originating from the dura mater. We herein report a case of primary dural leiomyosarcoma that presented with repeated intracranial hemorrhage. ⋯ In the present case, primary dural leiomyosarcoma may have invaded the dural sinus and repeated intracranial hemorrhage occurred due to a venous circulatory disturbance. The aggressive clinical course observed is rare. A clearer understanding of the route of invasion and a careful evaluation after primary treatment are needed in order to avoid hemorrhagic complications.
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Review Case Reports
Clinical Management of Prostate Cancer Metastasis to the Pineal Gland: case report and review of the literature.
Prostate cancer is the most common cancer among American men, with an incidence of approximately 233,000 cases per year. Intracranial metastases are rare and, specifically, metastasis to the pineal gland has only been reported in 2 postmortem cases in the literature. ⋯ This is the first report of the clinical management of metastatic prostate cancer to the pineal region and description of the clinical outcome. Although prostate cancer is the most common cancer in American men, metastasis to the pineal has only been reported twice from autopsy examinations. Overall, pineal tumors in the geriatric population are exceedingly rare and the age and comorbidities in this patient made management quite unique.
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Among the proposed hypotheses for C5 palsy, the most acceptable etiologies have been the tethering effect of the spinal nerve or reperfusion injury of the spinal cord. We performed a meta-analysis to determine a potential etiology of C5 palsy. ⋯ With no significant difference found in the incidence of C5 palsy between anterior and posterior cervical decompression in patients with myelopathy, the tethering effect of the spinal nerve might not be a plausible etiology for C5 palsy. In contrast, we found a significantly greater incidence of C5 palsy in patients with myelopathy compared with those with radiculopathy undergoing anterior decompression, which might support the reperfusion injury of the spinal cord as the etiology of C5 palsy.