Mackayvittrup7675

The rate of local recurrence may be higher than that in our cohort. We proposed our flow chart for preparation of surgery for patients. Preoperative selective arterial embolization and intraoperative aortic balloon occlusion could provide the clear surgical vision and guarantee complete tumor excision by intralesional curettage. Preoperative selective arterial embolization, intraoperative aortic balloon occlusion and complete tumor excision by intralesional curettage can yield satisfactory results with a low rate of recurrence in adolescent patients with a sacral primary ABC.The superior cerebellar artery (SCA) is the most frequent offending vessel in trigeminal neuralgia. This study aims to elucidate the patterns of the SCA running in 34 patients with typical trigeminal neuralgia using three-dimensional computer graphics. The SCA which runs in the medial aspect of the trigeminal nerve compressed predominantly the root entry zone at the distal segment of the caudal loop. Meanwhile, the SCA which runs in the cranial or lateral aspect of the trigeminal nerve compressed predominantly the mid-third portion at the proximal segment of the caudal loop. The site of neurovascular compression differed depending on the shape of the initial segment of SCA. Transposition methods could not be performed in several patients with arch-shaped SCA. Three-dimensional computer graphics revealed different characteristics of the SCA running in trigeminal neuralgia depending on the site of neurovascular compression and shape of the SCA. These differences might affect procedures for microvascular decompression.In December 2019, COVID-19 outbroke in Wuhan, then sweeping the mainland of China and the whole world rapidly. On March 4, Beijing Ditan Hospital confirmed the existence of SARS-CoV-2 in the cerebrospinal fluid by gene sequencing, indicating the neurotropic involvement of SARS-CoV-2. Meanwhile, neurological manifestations in the central nervous system, peripheral nervous system and skeletal muscular were also observed, indicating the potential neuroinvasion of SARS-CoV-2. In particular, we focused on its neurological manifestations and specific pathogenesis, as well as its comparison with other viral respiratory infections. Finally, we further summarized the significance of the neuroinvasion and the follow-up issues that need to be paid attention to by scientists, so as to help neurologists understand the influence of SARS-CoV-2 on nervous system better and promote the accurate diagnosis and efficient treatment of COVID-19.Intraoperative localization within the thoracic spine in the prone position may be particularly difficult on account of absence of common landmarks such as the sacrum or the C2 vertebra, thus increasing the potential for wrong-level surgery that may lead to patient morbidity and potential litigation. Some current localization methods involve implantation of markers that are invasive and serve to add to procedural expense while yet still failing to entirely eliminate errors. We describe a novel, non-invasive, and inexpensive technique for intraoperative localization of the thoracic spine in the prone position using an esophageal temperature probe. Following patient positioning, anteroposterior fluoroscopy is used to localize the radiopaque tip of the esophageal probe relative to the thoracic spine. After determining the probe tip's location, it becomes the counting reference for all subsequent intraoperative fluoroscopic localizations during surgery. As the probe tip is generally visible in the same fluoroscopic image as the surgical level, error from parallax created when moving the fluoroscopy machine from an anatomic landmark either above or below is avoided and a shorter fluoroscopy time is needed. Use of an esophageal temperature probe as a landmark in localizing spinal level may serve as a reliable and It offers a safe, reliable, and inexpensive technique for proper localization of thoracic spine levels.Frequency and duration of outpatient clinic follow-up for patients with shunted hydrocephalus varies among clinicians and assessment of follow-up regimens is lacking. The aim of this study is to investigate whether routine clinic visits alter care and whether they identify patients requiring shunt revision surgery, as well as, to better understand how patients utilize the outpatient clinic and present for shunt revision evaluation. This is a single-centered retrospective study of 154 patients requiring shunt revision surgery from 2009 to 2018 who had at least one prior clinic evaluation. The median age for shunt placement and revision were 3 months and 11 years old, respectively. Routine clinic visits led to a change in care for 16 patients (10.4%); including additional imaging, follow-up, or a combination of the two. With regards to revision surgery, days from prior shunt surgery, Chiari II/myelomeningocele pathology, and shunt type (p less then 0.01) did affect time to presentation. Four patients (2.6%) requiring revision surgery were identified at routine clinic follow-up, while 92 (59.7%) and 47 (30.5%) presented to the emergency department and clinic sick visit, respectively. Presentation to clinic resulted in a statistically significant decrease in shunt revision surgery length-of-stay compared to presentation to the emergency department or inpatient admission for another condition. Even with increased emergency room utilization, increased clinic connectivity, and improved patient education, routine clinic visits remain an important component in the follow-up of patients with shunted hydrocephalus by helping to guide clinical care and identify patients requiring shunt revision surgery.

To introduce a tooth-supported personalized template-assisted foramen ovale (FO) puncture system for trigeminal neuralgia (TN) treatment, analyze its advantages, and review other previously reported methods.

Sixty-seven patients were included. According to the preoperative digital design, the personalized puncture path was determined. Then, a tooth-supported personalized template was designed and manufactured. Finally, surgery (radiofrequency thermocoagulation or balloon compression) was carried out with the assistance of the template. The puncture effect and puncture-associated complications were evaluated, and the related literature was reviewed.

The FO was successfully punctured in one attempt in all patients. The procedure was completed in 15s in 35 (52.24%) patients and in 15-30s in 28 (41.79%) patients. Birinapant in vivo The required position was accurately reached in all patients, and the center point error range was within 1mm. No complications associated with puncture occurred.

The tooth-supported personalized template-assisted FO puncture system reported in this paper is an exceedingly simple, highly effective and safe FO puncture method that is worth popularizing.

The tooth-supported personalized template-assisted FO puncture system reported in this paper is an exceedingly simple, highly effective and safe FO puncture method that is worth popularizing.There is growing evidence demonstrating the relationship between herpes simplex virus type 1 (HSV-1) infection and Alzheimer's disease (AD). We searched PubMed, Embase, and Cochrane databases for relevant articles. The Newcastle-Ottawa Scale (NOS) was used to evaluate the qualities of these studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. We also performed subgroup analyses stratified by apolipoprotein ε4 (APOE ε4), NOS score, and the method of confirming AD. A total of 21 studies between 1990 and 2020 were identified. The pooled OR suggested that HSV-1 infection is a risk factor of AD pooled OR 1.40 (95% CI 1.13-1.75; I2 = 3%, P = 0.42). In the subgroup analyses, the pooled ORs of HSV-1 infection associated with AD were 0.75 (95% CI 0.24-2.37) among the APOE ε4-positive individuals; 0.85 (95% CI 0.61-1.17) among the APOE ε4-negative individuals; 1.51 (95% CI 1.10-2.06) in the high NOS score studies; 1.23 (95% CI 0.85-1.76) in the moderate NOS score studies; 1.47 (95% CI 1.16-1.87) in the clinical diagnosis group, and 1.20 (95% CI 0.77-1.87) in the autopsy group. Our up-to-date systematic review and meta-analysis suggest that HSV-1 infection is a risk factor of AD.

Intraoperative aneurysm rupture (IAR) could cause a poor outcome. This study aimed to investigate the relationship between IARs and postoperative cerebral infarctions (CIs).

We retrospectively reviewed patients with asymptomatic unruptured intracranial aneurysms (UIAs) who received microsurgical clipping in two neurosurgical centers from January 2016 to June 2019. A propensity score matching was done to constitute a cohort. The data were collected regarding the clinical and radiological characteristics. The CI at 1-2weeks and the functional outcome at two weeks after clipping were recorded. Differences between IAR patients with CIs and without CIs were compared. The relationship between the IARs and postoperative CIs was investigated by using logistic regression analysis.

This study yielded 96 UIAs patients, including 48 patients undergoing IARs and 48 patients not. Twenty patients with CIs at 1-2weeks after clipping were identified. The rate of CIs in patients undergoing IARs was higher than that in patients not undergoing IARs (OR, 2.88; p=0.038); moreover, the mRS was also worse in patients undergoing IARs (OR, 1.58; p=0.015). For patients undergoing IARs, the significance was found in ischemic cerebrovascular disease (OR, 6.40; p=0.048), Essen stroke risk score (OR, 2.14; p=0.026), and severity of intraoperative rupture (OR, 5.63; p=0.023). The multivariate logistic analysis demonstrated the major IARs (OR, 6.09; CI, 1.18-31.53; p=0.031) as the independent risk factor related to postoperative CI.

IARs could increase the risk of postoperative CIs and worsen the functional outcome, and major IAR was the independent risk factor related to the postoperative CIs.

IARs could increase the risk of postoperative CIs and worsen the functional outcome, and major IAR was the independent risk factor related to the postoperative CIs.

Colloid cysts are a benign tumor that is almost exclusively found in the third ventricle and may cause hydrocephalus and rarely life-threatening acute deterioration and even sudden death. With very few cases of sudden death reported in literature not much is known about the patient and cyst characteristics in these patients. The authors present a review of 65 cases of colloid cyst attributed deaths in literature.

A literature search for sudden death with radiologically or pathologically identified colloid cyst was done on PubMed, google scholar, Medbase and clinicaltrials.org research drives. Patient demographics, symptoms and cyst characteristics were recorded and analyzed. A Bivaret Pearson correlationcoefficientwas used to analyze and compare the relationship between each antecedent symptom, cyst size, and, cyst hemorrhage in patients who subsequently succumbed and died in order to ascertain possible relation.

Most patients had a history of sudden severe headaches (p=0.01) with associated vomiting (p=0.03). Radiologically, cyst associated ventriculomegaly was seen in 97% (P=0.78) was a notable feature. Even more, the cyst size (p=0.01) and associated hemorrhage (p=0.02) were also major notable feature preceding sudden death in both gender group.

Acute deterioration in colloid cysts is rare, but can be fatal. Associated symptoms include severe headache and vomiting. Seizures are commonly seen in patients in the first two decades. Given the risk of acute deterioration and mortality, headaches should be thoroughly investigated and all patients diagnosed with a colloid cyst>1cm should be offered surgical management regardless of symptom profile.

1 cm should be offered surgical management regardless of symptom profile.