World Neurosurg
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Biography Historical Article
Liangfu Zhou: Clinical neurosurgeon, Academician, teacher, and friend.
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Case Reports
Use of multimedia messaging system (MMS) by junior doctors for scan image transmission in neurosurgery.
Multimedia Messaging Service (MMS) is used by neurosurgical residents to transmit scan images to the attending neurosurgeon in conjunction with telephone consultation. This service has been well received by the attending neurosurgeons, who felt that after viewing scan images on their phones, they felt increased confidence in clinical decision making and that it reduced the need for recall to the hospital. ⋯ It is feasible and safe for junior doctors to utilize MMS to transmit computed tomographic images to a neurosurgeon while making an urgent referral. The images selected are representative of the disease pathology and facilitate clinical decision making.
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Review Meta Analysis Comparative Study
Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas.
Craniopharyngiomas have traditionally represented a challenge for open transcranial or transsphenoidal microscopic neurosurgery because of their anatomical location and proximity to vital neurovascular structures. The extended endoscopic endonasal transsphenoidal approach has been more recently developed as a potentially surgically aggressive, yet minimal access, alternative. To gain a more comprehensive assessment of the benefits and limitations of the various approaches to resection of craniopharyngiomas, we performed a systematic review of the available published reports after endoscope-assisted endonasal approaches and compared their results with transsphenoidal purely microscope-based or transcranial microscope-based techniques. ⋯ The endoscopic endonasal approach is a safe and effective alternative for the treatment of certain craniopharyngiomas. Larger lesions with more lateral extension may be more suitable for an open approach, and further follow-up is needed to assess the long-term efficacy of this minimal access approach.
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To determine the effectiveness of C2 nerve root decompression and C2 dorsal root ganglionectomy for intractable occipital neuralgia (ON) and C2 ganglionectomy after pain recurrence following initial decompression. ⋯ In the third largest series of surgical intervention for ON, most patients experienced favorable postoperative pain relief. For patients with pain recurrence after C2 decompression, salvage C2 ganglionectomy is a viable surgical option and should be offered with the potential for complete pain relief and improved quality of life (QOL).
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Paraspinal textiloma (ParaTex) is a well-known complication after posterior lumbar surgery. However, there are few articles on this topic, probably because of medicolegal concerns. In addition, patients with ParaTex can remain asymptomatic for months or even years unless it causes complications. The purpose of this study is to review our experience on this "undesirable" topic to increase awareness among spinal surgeons and radiologists and avoid unnecessary morbidity, which is still being encountered. ⋯ ParaTexs are more common in obese patients, after emergency surgery, and with unplanned changes in surgical procedure. On computed tomography scan, the classic spongiform appearance is highly suggestive. Magnetic resonance imaging findings are variable and less specific, but confrontation of imaging data with the surgical history helps with the preoperative diagnosis. In the early postoperative period symptoms are related to the exudative response; at later times symptoms may be linked to pseudotumor formation clinically and radiologically. Appropriate antibiotic therapy is recommended when a septic complication is present or suspected. Strict measures must be taken to prevent this complication. Surgical sponges should always be counted at least three times (preoperatively, at closure, and at the end), radiopaque markers should be used, and if there is doubt, intraoperative radiography must be performed.