World Neurosurg
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Counts are the commonest method used to ensure that all sponges and neuropatties are removed from a surgical site before closure. When the count is not reconciled, plain radiographs of the operative site are taken to determine whether the missing patty has been left in the wound. The purpose of this study was to describe the detectability of commonly used neuropatties in the clinical setting using digital technologies. ⋯ Under simulated operating room conditions and using currently available neuropatties and plain radiograph imaging technology, small ¼-in and ½-in neuropatties are poorly visible/detectable on digital images.
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Central nervous system lymphoma (CNSL) is typically treated with chemotherapy and external beam radiation therapy (EBRT). Optimal management of recurrent CNSL is poorly defined. ⋯ Stereotactic radiosurgery for patients with recurrent CNSL is well tolerated and has a high rate of radiographic response. A marginal dose of 15.5 Gy or greater, a Karnofsky score of 80 or greater, and the absence of pre-SRS WBRT were associated with significantly longer overall survival. Stereotactic radiosurgery may be beneficial as an initial salvage therapy in the treatment of recurrent CNSL for properly selected patients.
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For the diagnosis and surgical treatment of diseases around the cavernous sinus (CS), radiologists should achieve complete mastery of the sectional anatomy of the CS, and neurosurgeons need to understand the stereoscopic orientation of the CS and circumjacent structures. However, despite the complicated structure of the CS, the current educational resources for its sectional and stereoscopic anatomy are insufficient. Another problem is that the definition of CS walls varies for each researcher. The purpose of this study is to redefine the walls of the CS and to provide related educational materials. ⋯ The combination of the hexahedron theory, the sectioned images, and the 3D models in this study will enhance the efficiency of studying CS anatomy. The educational resources of this study can be obtained free of charge by medical students, radiologists, and neurosurgeons requiring knowledge of CS anatomy.
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The role for nucleus caudalis (NC) and spinal dorsal root entry zone (DREZ) lesioning in the management of chronic pain emanating from increased electrical activity in the dorsal horn of the spinal cord and brainstem remains largely uncharted. ⋯ Spinal and NC DREZ lesioning can provide effective relief in well-selected patients with intractable chronic pain conditions arising from trigeminal pain, spinal cord injury, brachial plexus avulsions, post-herpetic neuralgia, and phantom limb pain.
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Risk Factors for Graft Infection After Cranioplasty in Patients with Large Hemicranial Bony Defects.
To identify infection incidence and related risk factors in patients who underwent cranioplasty (CP) after unilateral decompressive craniectomy (DC). ⋯ The incidence of wound infection was high. Risk factors included motor deficits, Glasgow Outcome Scale score <4, lower hemoglobin levels, recent systemic infections, interval between DC and CP of 29-84 days, and DC and CP performed during the same hospitalization. Performing CP during a different hospitalization may reduce the risk of graft infection because the hemoglobin level would be higher, and patients would be less dependent and free of recent infection.