Mullinsbruce4890

8% (P less then 0.001 and P = 0.042, respectively), respectively. However, the CSA of the semispinalis capitis muscle did not differ significantly between the two groups. In terms of the level, conservation of the multifidus muscle was significantly different according to the approach at all levels, and the conservation of the deep extensor muscles was significantly different at the C3-4 level. Conclusions MPA was effective in preserving the volume of deep cervical extensor muscles and helping minimize postoperative musculoskeletal complications. In addition, muscle preservation was more effective at the C3-4 level.Background Ecchordosis physaliphora (EP) is a congenital, uniformly asymptomatic, hamartomatous lesion of the primitive notochord. Herein we report, to our knowledge, the first credible case report of unprovoked intra-sphenoidal rupture resulting in recurrent pneumocephalus and cerebrospinal fluid (CSF) leak, definitively captured over serial imaging during clinical and radiologic surveillance. Case description A 68-year old woman with Marfan syndrome presented to the Emergency Department with the worst headache of life. Imaging demonstrated extensive pneumocephalus and revealed a small, dorsal midline clival lesion consistent with EP and a trans-sphenoidal defect. Remote imaging encounters confirmed typical EP without pneumocephalus or cortical defect, and an uneventful clinical course years preceding presentation. Over the ensuing months during neurosurgical follow-up, the patient reported recurrent headaches, imbalance, and unprovoked clear rhinorrhea. Further imaging demonstrates an apparently enlarging the first documented spontaneous rupture of EP resulting in recurrent pneumocephalus, credibly captured over serial radiologic surveillance. Clinical presentation A 68 year-old woman with history of hypertension, hyperlipidemia, and Marfan syndrome presented to the Emergency Department reporting the "worst headache of her life" after engaging in an interpersonal dispute the evening preceding presentation.Background Glioblastomas are among the most common primary brain tumors with an abysmal prognosis. The significance of glucose metabolism in glioblastoma cell metabolism and proliferation is well-known. However, a significant correlation between the systemic metabolic status of the patient and the cellular proliferation of glioblastomas hasn't yet been established. Methods Our aim was to observe and analyze a possible correlation of the glioblastoma cellular proliferation with the patient's HbA1c levels as a marker of chronic systemic glycemia. We analyzed 25 patients and compared their Ki67 values to their preoperative HbA1c values. Results We observed a stastistically significant correlation (p less then 0.03) between the patients' chronic glycemia (measured with HbA1c) and the cellular proliferation of the glioblastomas (measured with cellular Ki67 expression). Conclusions These results imply a possible positive correlation between glioblastoma cell proliferation and the chronic systemic glycemia, a correlation which so far hasn't been reported. Further research in this area could not only lead to better understanding of glioblastomas but could have significant clinical application in treating this devastating disease.Objective Although post-traumatic olfactory disturbances are frequent, yet they have a poor prognosis. Our study aims to investigate the impact of clinical factors on progress of these olfactory disturbances. Patients & methods Amongst patients admitted with evidence of head trauma, only suspected cases of post-traumatic olfactory disturbances were included. Patients were examined by the Sniffin' Sticks test, early post-traumatic and then later after recovery. Factors such as age, gender, olfactory bulb status, and observation period were enrolled in logistic regression analysis since they are considered with a possible influence on olfactory function improvements. Amelioration of olfaction was expressed as an alteration in olfactory function to a better level. Results 70 cases were involved, with a mean age of 38 years. The mean follow-up period was 6 months. click here Twelve patients (17.1%)) had olfactory function improvements. In univariate and multivariate analyses, no clinical factors were found with an impact on olfactory recovery (all p > 0.05) except for olfactory bulb integrity, which seems to influence improvement in olfactory function (p=0.0327, and 0.0293). Conclusion olfactory bulb integrity, probably the solitary prognostic factor for post-traumatic olfactory recovery, where frank damage to such a structure carries the poor prognosis of post-traumatic olfactory function.Background Percutaneous endoscopic interlaminar discectomy (PEID) is widely used as a minimally invasive procedure that shows satisfying outcomes for the treatment of L5/S1 and even L4/5 disc herniation. PEID can be divided into direct and indirect approaches according to the established method of the working channel. The direct approach mainly utilizes the puncture needle directly through the intervertebral space into the intervertebral disc under non-direct vision and insertion of the guidewire into the puncture needle to guide the dilator and working channel to retract the ligamentum flavum, dural sac and nerve roots. This approach requires a skilled puncture technique, as damage to the nerve roots and dural sac can easily occur. Therefore, we improved this interlaminar access procedure; we placed the puncture target at the inferior endplate and performed preoperative epidurography to expose the spinal nerve roots and dural sac after the puncture needle was passed through the ligamentum flavum. Then, we poectively evaluated the 321 patients with more than 30 (range 12-48) months of follow-up. The therapeutic effects were assessed using scores of the visual analogue scale (VAS), Oswestry disability index (ODI), Macnab standard and infrared thermal imaging. Results The mean VAS score for radicular pain improved from 6.3 ± 1.01 preoperatively to 1.01 ± 0.35 at the final follow-up (P less then 0.01). The mean ODI score improved from 85.5 ± 12 preoperatively to 12.4 ± 3.7 at the final follow-up (P less then 0.01). According to the Macnab standard, the excellent and good outcome scores were 96.5%. The infrared thermal imaging scores indicated that the skin temperature of both lower extremities significantly improved 1 week after surgery compared with the preoperation temperature (P less then 0.01). Conclusion The inferior endplate approach for percutaneous endoscopic interlaminar discectomy provides a safe and very effective alternative for the treatment of lumbar disc herniation.