World Neurosurg
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Review Case Reports
Re-recurrence of intracranial aneurysm with proximal vascular stenosis after primary clipping and secondary endovascular embolization: A case report and literature review.
It was known that a small number of patients could have intracranial aneurysm recurrences after either surgical clipping or endovascular embolization treatment. However, early recurrence within 1 month after the treatment and re-recurrence has rarely been reported before. ⋯ Re-recurrence of intracranial aneurysm could happen after initial successful treatment with surgical clipping and endovascular embolization. In addition to the patient's medical history and characteristics of the aneurysm, local vascular stenosis might also contribute to its recurrence. Close postoperative follow-up is required for these patients.
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Randomized Controlled Trial
Prediction of Objectively Measured Physical Activity and Self-Reported Disability Following Lumbar Fusion Surgery.
To investigate the predictive value of preoperative fear-avoidance factors (self-efficacy for exercise, pain catastrophizing, kinesiophobia, and depression), walking capacity, and traditional predictor variables for predicting postoperative changes in physical activity level and disability 6 months after lumbar fusion surgery in patients with chronic low back pain (LBP). ⋯ Patients with low levels of preoperative physical activity were more likely to increase their level of physical activity after lumbar fusion surgery, especially when their self-efficacy for exercise was high. However, most of these patients still had low levels of physical activity after surgery, and they may therefore need extra support in increasing their postoperative physical activity levels.
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Surgery for depressed skull fractures has developed over centuries to attain the consensus approaches currently used. This review outlines the last 200 years of development of surgical approaches to closed and open depressed skull fractures, fractures involving dural venous sinuses and ping-pong fractures involving infants. ⋯ However, experience has shown that each fracture category merits its own management strategies. Accepted approaches are based on observation only; there is little to no scientific evidence to support treatment for any fracture type.
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During the past decades, stereotactic radiosurgery, and Gamma Knife in particular, has proved its safety and efficacy for drug-resistant classic trigeminal neuralgia. However, few large series exist using linear accelerator (LINAC) reporting long-term follow-up. ⋯ Stereotactic radiosurgery with dedicated LINAC is associated with high rates of long-term pain relief, with minimal invasiveness and rare complications. LINAC is a possible therapeutic alternative for drug-resistant trigeminal neuralgia and could be proposed to selected patients as the first intention therapy, among other surgical solutions.
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Recent approval of unprecedented gene therapies has signaled the beginning of a new era in modern medicine. This rapidly changing landscape underscores the importance of neurosurgeons developing a fundamental understanding of gene therapy, because many neurologic disorders are caused by derangements in gene expression. ⋯ There are several methods to transfer genetic material to the nervous system through viral transduction. Here, we synthesize the latest developments in gene therapy for neurologic disorders and the neurosurgical approaches to treat them.