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The impact of excessive use of smart portable devices on neck pain and associated musculoskeletal symptoms. Prospective questionnaire-based study and review of literature 过度使用智能便携设备对颈部疼痛及相关肌肉骨骼症状的影响。前瞻性问卷调查研究与文献综述
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-06 DOI: 10.1016/j.inat.2023.101952
Kassem El Shunnar , Mahmoud Afeef Nisah , Zeina H. Kalaji

Background

The rapid advancement of the digital revolution, normalization of portable smart gadgets, and internet-based communication have resulted in a perceptible shift and enhancement in human spine posture. They have also resulted however, in the emergence of health issues connected to the technique of usage. Neck pain, as well as other related symptoms, are the most commonly reported, as evidenced by the Coronavirus pandemic. People were urged to work from home when educational institutions and businesses were shut down. Students were given access to online learning facilities.

Aim

The aim of this study is to demonstrate and clarify the increase in the number of young patients who suffer from neck pain and its associated symptoms; especially during the COVID 19 pandemic. The objective of this study is to investigate the impact of the excessive use of smart portable devices on neck pain and associated symptoms. This is most likely related to the incorrect posture of the neck, spine and body during utilization of these technologies. In addition, it aims to educate people about possible methods to prevent these medical morbidities.

Methods

A cross-sectional study was conducted at Mediclinic City Hospital, Dubai Healthcare City, United Arab Emirates. Fifty-six patients were seen and evaluated as outpatients in the Neurosurgery clinic for neck pain. The Numerical Rating Pain Scale questionnaire (NMQ) was utilized to evaluate neck pain and other associated complaints such as back and musculoskeletal pain in general. The data was collected using a questionnaire with a 100% response rate from the patients. Cross tabulation and Chi Square analysis tool were designed to meet the study’s objective.

Results

The findings show that smart phone and laptop use have significant effects on pain severity ranking among patients. For the factors “Time spent using smart phone/day” and Time spent using Laptop/day” were found to have a P value of 0.041 and 0.023; respectively.

Conclusion

This research found a link between length of time spent using a mobile phone or laptop and the degree of neck discomfort.

背景 数字革命的快速发展、便携式智能小工具的普及以及基于互联网的通信,使人类脊柱的姿势发生了明显的变化和改善。然而,它们也导致了与使用技术相关的健康问题的出现。颈部疼痛以及其他相关症状是最常见的报告,冠状病毒大流行就是证明。当教育机构和企业关闭时,人们被敦促在家工作。本研究旨在证明并澄清颈部疼痛及其相关症状的年轻患者人数增加的情况,尤其是在 COVID 19 大流行期间。本研究的目的是调查过度使用智能便携设备对颈部疼痛及其相关症状的影响。这很可能与使用这些技术时颈部、脊柱和身体的不正确姿势有关。此外,该研究还旨在向人们宣传预防这些病症的可行方法。方法在阿拉伯联合酋长国迪拜保健城的Mediclinic城市医院进行了一项横断面研究。56名患者因颈部疼痛在神经外科门诊就诊并接受评估。采用疼痛数字分级量表(NMQ)来评估颈部疼痛和其他相关主诉,如背部疼痛和一般肌肉骨骼疼痛。数据是通过问卷收集的,患者的回复率为 100%。研究结果表明,智能手机和笔记本电脑的使用对患者疼痛严重程度的排名有显著影响。使用智能手机的时间/天 "和 "使用笔记本电脑的时间/天 "这两个因素的 P 值分别为 0.041 和 0.023。
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引用次数: 0
Delayed postoperative incomplete paraplegia due to development of extensive thoracolumbar dural ossification in an ankylosing spondylitis patient following lumbar pedicle subtraction osteotomy: A case report 一名强直性脊柱炎患者在腰椎椎弓根减压截骨术后因出现广泛的胸腰椎硬膜骨化而导致术后延迟性不完全截瘫:病例报告
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-05 DOI: 10.1016/j.inat.2023.101953
Xu Chen , Bang-ping Qian , Yong Qiu

Dural ossification (DO) is a degenerative phenomenon of endorhachis characterized by the displacement of dura by proliferative osseous tissue, which is a common complication of spinal ligament ossifications. Precisely preoperative diagnosis and elaborate surgical manipulation are the focus of clinicians since incorrect management of DO during surgery could induce cerebrospinal fluid leakage (CSF) and spinal cord injury (SCI). However, there has been no case of postoperative DO which was reported in ankylosing spondylitis (AS). Herein, we reported a 49-year-old AS patient who presented delayed incomplete paraplegia due to the development of extensive thoracolumbar DO after L3 pedicle subtraction osteotomy (PSO), aiming to help spinal surgeons to have a more comprehensive understanding of the possible pathogenic mechanism, diagnosis, surgical and prognostic implications of DO in AS patients.

硬脊膜骨化(Dural ossification,DO)是脊柱内膜的一种退行性病变,其特点是增生的骨组织使硬脊膜移位,是脊柱韧带骨化的常见并发症。术前的精确诊断和精心的手术操作是临床医生关注的焦点,因为手术中对 DO 的错误处理可能会诱发脑脊液漏(CSF)和脊髓损伤(SCI)。然而,强直性脊柱炎(AS)患者术后出现 DO 的病例尚未见报道。在此,我们报告了一名49岁的强直性脊柱炎患者在L3椎弓根减压截骨术(PSO)后因发生广泛的胸腰椎DO而出现迟发性不完全性截瘫的病例,旨在帮助脊柱外科医生更全面地了解强直性脊柱炎患者DO的可能致病机制、诊断、手术和预后影响。
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引用次数: 0
Total resection of a recurrent trigeminal cavernous malformation 复发性三叉神经海绵畸形全切除术
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2024-01-03 DOI: 10.1016/j.inat.2023.101949
Sean Connelly , Benjamin Succop Jr. , Deanna Sasaki-Adams

Background

Cerebral cavernous malformations (CMs) are benign lesions of thin, hyalinized blood vessels without brain parenchyma. These lesions can result in various neurologic symptoms resulting from mass effect or focal neuropathies. A rare proportion of CMs have grown along the trigeminal nerve, causing trigeminal neuralgia as the principal presenting symptoms.

Observations

We report a recurrent case of a 63 year old female with a CM growing near the Obersteiner-Redlich zone of her right trigeminal nerve resulting in symptoms consistent with trigeminal neuralgia. This lesion was initially thought to be a neoplasm and was incompletely resected during the initial surgery with a plan to follow on final pathology. Interval growth of the lesion was appreciated over a period of 3 months, resulting in recurrence of her symptoms, making this case the first publication of recurrent trigeminal neuralgia secondary to cavernous malformation. A right retrosigmoid craniotomy was successfully performed for gross total resection of the lesion.

Lessons

This case highlights the importance of including CMs on the differential for trigeminal Obersteiner-Redlich zone lesions and emphasizes the necessity of gross total resection to prevent recurrence. It is the first published case report to include intraoperative video of the resection.

背景脑海绵状畸形(CM)是一种没有脑实质的血管变细、透明化的良性病变。这些病变可因肿块效应或局灶性神经病变而导致各种神经系统症状。我们报告了一例 63 岁女性的复发性病例,她的右侧三叉神经 Obersteiner-Redlich 区附近生长了一个 CM,导致了与三叉神经痛一致的症状。该病变最初被认为是肿瘤,在初次手术中未完全切除,计划在最终病理检查后再行手术。3个月后发现病灶间隙性增生,导致她的症状复发,这也是首个发表的继发于海绵畸形的复发性三叉神经痛病例。本病例强调了将海绵畸形列入三叉神经 Obersteiner-Redlich 区病变鉴别诊断的重要性,并强调了为防止复发而进行全切的必要性。这是第一份发表的包含术中切除视频的病例报告。
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引用次数: 0
Endoscopic Third Ventriculostomy vs. Ventriculoperitoneal Shunt in Aqueductal Stenosis: A Systematic Review and Meta-Analysis 内镜下第三脑室造口术与脑室腹腔分流术治疗导水管狭窄:系统回顾与元分析
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-30 DOI: 10.1016/j.inat.2023.101951
Rohadi Muhammad Rosyidi , Bambang Priyanto , Januarman , Wahyudi , Rozikin , Dewa Putu Wisnu Wardhana

Objectives

To evaluate the evidence for Endoscopic Third Ventriculostomy vs. Ventriculoperitoneal Shunt in congenital hydrocephalus with Aqueductal Stenosis (AS). Materials and Methods: A PRISMA-based study selection is used to screen for studies, including (1) AS report cases and (2) the intervention undertaken, which can either be ETV or VPS. Furthermore, an extended criteria for quantitative analysis is added to include the following: (3) Comparing the failure rate between ETV vs VPS; (4) Infants aged < 24 months; and (5) Reporting the number of failed cases. A review of all the included studies was then summarized. Outcome Measure: ETV and VPS failure rates, specifically in infants younger than 24 months with aqueductal stenosis (AS). Results: Literatur search identified 628 studies from Pubmed, Directory of Open Access Journal (DOAJ), and manual search. Screening of the study resulted in 576 being excluded. Forty studies were screened for full article eligibility screening, resulting in 11 studies included in the systematic review and 3 in the meta-analysis. Meta-analysis indicated more failure in infant patients with AS < 24 months old who received ETV (OR 1.74, 95 % CI 0.85 – 3.58). Conclusion: This systematic review shows that ETV has a good and stable status, but in the age of infants, it indicates that ETV has a higher risk of failure than shunt despite the patient's external quality of life and long-term health status is no different between the two. Both primary and secondary ETV also do not show a significant difference in the degree of complications. As well as the technique of doing ETV is also increasingly expanding in efforts to increase the success of ETV itself. Our meta-analysis indicates a higher failure rate in ETV for infants less than two years of age with AS compared to VPS.

目的 评估内镜下第三脑室造口术与脑室腹腔分流术治疗先天性脑积水伴导水管狭窄(AS)的证据。材料与方法:采用基于 PRISMA 的研究筛选方法筛选研究,包括:(1)AS 报告病例;(2)采取的干预措施,可以是 ETV 或 VPS。此外,还增加了定量分析的扩展标准,包括以下内容:(3) 比较 ETV 与 VPS 的失败率;(4) 年龄为 24 个月以下的婴儿;(5) 报告失败病例的数量。然后对所有纳入的研究进行了综述。结果测量:ETV 和 VPS 的失败率,特别是 24 个月以下患有导水管狭窄 (AS) 的婴儿。结果:文献检索从 Pubmed、Directory of Open Access Journal (DOAJ) 和人工检索中发现了 628 项研究。经过筛选,576 项研究被排除在外。对 40 项研究进行了全文资格筛选,最终有 11 项研究被纳入系统综述,3 项研究被纳入荟萃分析。荟萃分析表明,24 个月大的 AS 婴儿患者接受 ETV 治疗的失败率更高(OR 1.74,95 % CI 0.85 - 3.58)。结论本系统综述表明,ETV 具有良好和稳定的状态,但在婴儿年龄段,尽管患者的外部生活质量和长期健康状况与分流术无异,但它表明 ETV 比分流术有更高的失败风险。原发性和继发性 ETV 在并发症程度上也没有明显差异。此外,为了提高 ETV 本身的成功率,ETV 的技术也在不断扩展。我们的荟萃分析表明,与 VPS 相比,对两岁以下患有 AS 的婴儿进行 ETV 的失败率更高。
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引用次数: 0
Trehalose: A promising new treatment for traumatic brain injury? A systematic review of animal evidence 曲哈洛糖:治疗创伤性脑损伤的有前途的新疗法?对动物实验证据的系统回顾
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-29 DOI: 10.1016/j.inat.2023.101947
Mohammad Ghorbani , MohammadAli Abouei Mehrizi , Mahboobeh Tajvidi , Mohmmad Amin Habibi , Mohammad Mohammadi , Saeid Esmaeilian , Paria Torabi , Elham Rahmanipour , Mahyar Daskareh , Aynaz Mohammadi

Background

TBI is a major global health issue due to its high morbidity and mortality rates. Persistent neurodegeneration following secondary brain injuries is a significant concern. Trehalose, a naturally occurring disaccharide, has shown potential therapeutic effects in preclinical TBI models. This study systematically reviews the preclinical and clinical data on trehalose as a potential TBI treatment.

Methods

We conducted a systematic review of trehalose’s role in TBI treatment following PRISMA guidelines. Our search spanned from the inception of PubMed, EMBASE, SCOPUS, and Web of Science until August 2023. Google Scholar was also manually searched. The quality of the studies was assessed using SYRCLE’s risk of bias tool for animal studies.

Results

Out of sixty-six records reviewed, four animal studies were included. These studies indicated that trehalose enhanced motor and cognitive functions, reduced oxidative damage and inflammation, regulated metal dyshomeostasis, increased neurotrophic factors and synaptic proteins, and improved autophagy and mitochondrial function in mouse/rat TBI models. However, a significant risk of bias was noted.

Conclusion

Trehalose demonstrates potential as a TBI treatment. However, more rigorous, and comprehensive research is needed to confirm its safety and efficacy in humans.

背景由于发病率和死亡率较高,脑损伤是一个重大的全球性健康问题。继发性脑损伤后的持续神经变性是一个重大问题。曲哈洛糖是一种天然存在的二糖,已在临床前创伤性脑损伤模型中显示出潜在的治疗效果。本研究系统回顾了有关曲哈洛糖作为一种潜在的 TBI 治疗方法的临床前和临床数据。我们的搜索时间跨度从 PubMed、EMBASE、SCOPUS 和 Web of Science 开始,直至 2023 年 8 月。谷歌学术也进行了人工搜索。我们使用 SYRCLE 的动物研究偏倚风险工具对研究质量进行了评估。这些研究表明,在小鼠/大鼠创伤性脑损伤模型中,曲哈洛糖可增强运动和认知功能,减少氧化损伤和炎症,调节金属失衡,增加神经营养因子和突触蛋白,改善自噬和线粒体功能。结论曲哈洛糖具有治疗创伤性脑损伤的潜力。然而,要确认其对人体的安全性和有效性,还需要进行更严格、更全面的研究。
{"title":"Trehalose: A promising new treatment for traumatic brain injury? A systematic review of animal evidence","authors":"Mohammad Ghorbani ,&nbsp;MohammadAli Abouei Mehrizi ,&nbsp;Mahboobeh Tajvidi ,&nbsp;Mohmmad Amin Habibi ,&nbsp;Mohammad Mohammadi ,&nbsp;Saeid Esmaeilian ,&nbsp;Paria Torabi ,&nbsp;Elham Rahmanipour ,&nbsp;Mahyar Daskareh ,&nbsp;Aynaz Mohammadi","doi":"10.1016/j.inat.2023.101947","DOIUrl":"https://doi.org/10.1016/j.inat.2023.101947","url":null,"abstract":"<div><h3>Background</h3><p>TBI is a major global health issue due to its high morbidity and mortality rates. Persistent neurodegeneration following secondary brain injuries is a significant concern. Trehalose, a naturally occurring disaccharide, has shown potential therapeutic effects in preclinical TBI models. This study systematically reviews the preclinical and clinical data on trehalose as a potential TBI treatment.</p></div><div><h3>Methods</h3><p>We conducted a systematic review of trehalose’s role in TBI treatment following PRISMA guidelines. Our search spanned from the inception of PubMed, EMBASE, SCOPUS, and Web of Science until August 2023. Google Scholar was also manually searched. The quality of the studies was assessed using SYRCLE’s risk of bias tool for animal studies.</p></div><div><h3>Results</h3><p>Out of sixty-six records reviewed, four animal studies were included. These studies indicated that trehalose enhanced motor and cognitive functions, reduced oxidative damage and inflammation, regulated metal dyshomeostasis, increased neurotrophic factors and synaptic proteins, and improved autophagy and mitochondrial function in mouse/rat TBI models. However, a significant risk of bias was noted.</p></div><div><h3>Conclusion</h3><p>Trehalose demonstrates potential as a TBI treatment. However, more rigorous, and comprehensive research is needed to confirm its safety and efficacy in humans.</p></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"36 ","pages":"Article 101947"},"PeriodicalIF":0.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221475192300230X/pdfft?md5=18d81bec42efcd5437337fe0ee80c266&pid=1-s2.0-S221475192300230X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139090301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coiling of an iatrogenic aneurysm of the distal posterior inferior cerebellar artery via a Marathon microcatheter 通过马拉松微导管夹闭小脑后下动脉远端先天性动脉瘤
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-29 DOI: 10.1016/j.inat.2023.101950
Xin Wang, Jinlu Yu

Iatrogenic distal posterior inferior cerebellar artery (PICA) aneurysms are rare, and parent artery occlusion (PAO) via Marathon microcatheters can be an option for coiling. We reported such a case. A 60-year-old woman with an epidermoid cyst of the posterior fossa suffered subarachnoid hemorrhage after open surgery for the removal of an epidermoid cyst and fell into a coma. Digital subtraction angiography confirmed a distal PICA iatrogenic dissecting aneurysm. Due to the PICA being tortuous, routine microcatheters that deliver coils cannot access the aneurysm. However, a Marathon microcatheter over a Synchro 10 guidewire was able to successfully access the aneurysm. An Axium Prime coil was advanced easily into a Marathon microcatheter. After the coil was detached in the Marathon microcatheter, the Synchro 10 guidewire was able to push the detached coil through the Marathon microcatheter tip into the dissecting aneurysm, and then another coil was deployed to complete PAO. Postoperatively, due to acute hydrocephalus, an Ommaya catheter with a reservoir was deployed into the lateral ventricle to aspirate cerebrospinal fluid. One week postoperatively, a computed tomography scan showed acute infarction of the cerebellar hemisphere with no mass effect. During follow-up, no rebleeding occurred. Six months later, the patient did not wake up and was declared to be in a vegetative state. By reporting this case, it was found that for iatrogenic distal PICA aneurysms, PAO is feasible with an Axium Prime coil deployed via a Marathon microcatheter.

先天性远端小脑后下动脉(PICA)动脉瘤非常罕见,通过马拉松微导管进行母动脉闭塞(PAO)是一种卷曲疗法。我们报告了这样一个病例。一名患有后窝表皮样囊肿的 60 岁女性在开放手术切除表皮样囊肿后发生蛛网膜下腔出血,并陷入昏迷。数字减影血管造影证实,PICA远端先天性剥离动脉瘤。由于PICA迂曲,常规的微导管无法进入动脉瘤。不过,在 Synchro 10 导丝上的马拉松微导管能够成功进入动脉瘤。Axium Prime线圈被轻松推进马拉松微导管。线圈在马拉松微导管中脱落后,Synchro 10导丝能够将脱落的线圈通过马拉松微导管顶端推入剥离的动脉瘤,然后再部署另一个线圈完成PAO。术后,由于急性脑积水,医生在侧脑室部署了带储液器的 Ommaya 导管,以抽吸脑脊液。术后一周,计算机断层扫描显示小脑半球急性梗死,但无肿块效应。随访期间没有再出血。六个月后,患者没有醒来,被宣布为植物人。通过报告该病例,我们发现对于先天性远端 PICA 动脉瘤,通过马拉松微导管部署 Axium Prime 线圈进行 PAO 是可行的。
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引用次数: 0
A unique variant of abducens nerve duplication in a case of a large vestibular schwannoma 一例巨大前庭分裂瘤患者的独特外展神经重复变体
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-27 DOI: 10.1016/j.inat.2023.101946
Ufuk Erginoglu, Mario Wolak Junior, Cagdas Ataoglu, Abdullah Keles, Mustafa K. Baskaya

Vestibular schwannomas (VS) are slow-growing benign tumors commonly found in the cerebellopontine angle, potentially compressing brain structures and cranial nerves, including the abducens nerve (AN), responsible for lateral gaze. Although large VSs may compress the AN, postsurgical AN palsy is rare, and the clinical significance of AN variations, particularly in VS cases, remains unclear. We report a unique case of a 29-year-old female with a large left vestibular schwannoma. The patient underwent a left-sided microsurgical two-stage excision with an uneventful recovery (House-Brackmann facial grade I). During surgery, a rare variant of the AN was identified. This AN originated as two separate trunks and merged 3 mm distal to its origin in the same segment. To the best of our knowledge, arising and merging in the cisternal segment of AN variation has not been reported previously. Recognizing AN variations is vital for successful skull base surgeries, especially in preserving both branches during vestibular schwannoma surgery and ensuring ocular function.

前庭分裂瘤(VS)是一种生长缓慢的良性肿瘤,常见于小脑视角,有可能压迫大脑结构和颅神经,包括负责侧视的外展神经(AN)。虽然大的VS可能会压迫AN,但手术后AN麻痹的情况并不多见,AN变异的临床意义,尤其是VS病例中的AN变异,仍不清楚。我们报告了一例独特的病例,患者是一名 29 岁女性,患有左侧前庭大面积分裂瘤。患者接受了左侧显微外科两期切除术,术后恢复顺利(House-Brackmann 面部分级 I 级)。在手术过程中,发现了一种罕见的前庭裂隙瘤变异。这条AN起源于两条独立的主干,在同一节段起源远端3毫米处合并。据我们所知,AN变异在蝶骨段的起源和合并以前从未报道过。识别AN变异对颅底手术的成功至关重要,尤其是在前庭裂孔瘤手术中保留两个分支并确保眼部功能。
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引用次数: 0
Neurobrucellosis after a cranioplasty: A case report and literature review 颅骨成形术后的神经布鲁氏菌病:病例报告和文献综述
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-25 DOI: 10.1016/j.inat.2023.101941
Changdong Li , Yipeng Jiang , Zhihong Wang

Background

Brucellosis is a zoonotic infectious disease. Neurobrucellosis occurs when Borrelia burgdorferi infects the nervous system and is a complication of brucellosis. Infection is a common post-cranioplasty complication, although co-infection with B. burgdorferi is rare. In this article, we report a case of neurobrucellosis caused by B. burgdorferi infection after cranioplasty in a female patient with traumatic brain injury and review the literature.

Case Description

A 37-year-old woman with traumatic brain injury underwent emergency clot removal and decompression craniectomy. Three-dimensional titanium mesh cranioplasty was performed 4 years later. Unfortunately, only 1 year later, the skull repair material had to be removed because of a localized scalp infection in the area of the skull repair. Cranioplasty was performed 5 months later with polyetheretherketone material. The patient remained free of symptoms until July 27, 2022, when the patient was readmitted for a headache. The final diagnosis of neurobrucellosis was made after relevant examinations, tests, and subcutaneous puncture of aspirated pus for bacterial cultures and special genus tests. Following the standard protocol, the patient was treated effectively.

Conclusion

Neurobrucellosis occurs after a patient contracts a neurological infection through contact with the excrement of an infected animal or ingestion of food from an infected or diseased animal. Any postoperative complications of specific infections can cause physical pain and a heavy financial burden on the patient because of the special and expensive materials used for cranial repair. Therefore, we recommend screening patients from areas at epidemiological risk for relevant diseases before undergoing cranioplasty.

背景布鲁氏菌病是一种人畜共患病。神经布鲁氏菌病是布鲁氏菌感染神经系统时发生的疾病,也是布鲁氏菌病的一种并发症。感染是颅骨成形术后常见的并发症,但同时感染布氏杆菌的情况很少见。在本文中,我们报告了一例脑外伤女性患者在颅骨成形术后感染布氏菌引起的神经布鲁氏菌病,并回顾了相关文献。4 年后进行了三维钛网开颅手术。不幸的是,仅仅 1 年后,由于颅骨修复区域的局部头皮感染,不得不取出颅骨修复材料。5 个月后,使用聚醚醚酮材料进行了颅骨成形术。直到 2022 年 7 月 27 日,患者因头痛再次入院,之前一直没有任何症状。经过相关检查、化验和皮下穿刺抽取脓液进行细菌培养和特殊种属检测,最终确诊为神经布鲁氏菌病。结论神经布鲁氏菌病发生于患者通过接触受感染动物的排泄物或摄入受感染或患病动物的食物而感染神经系统疾病之后。特殊感染的术后并发症会给患者带来身体上的痛苦,而且由于颅骨修复使用的材料特殊且昂贵,还会给患者带来沉重的经济负担。因此,我们建议来自流行病高危地区的患者在接受颅骨成形术前对相关疾病进行筛查。
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引用次数: 0
Case Reports: Two Different Onset Types of Chronic Encapsulated Intracerebral Hematoma related to cerebrospinal fluid perfusion identified prior to and following surgery 病例报告:与手术前后脑脊液灌注有关的两种不同发病类型的慢性包裹性脑内血肿
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-25 DOI: 10.1016/j.inat.2023.101945
Jota Tega , Koichiro Suzuki , Takaaki Amamoto , Toshiyuki Enomoto , Hiromasa Kobayashi , Takashi Morishita , Koichiro Takemoto , Yoshihisa Kawano , Hiroshi Abe

Hypertensive intracerebral hemorrhage rarely develops into chronic encapsulated intracerebral hematoma (CEIH). We encountered 2 cases of CEIH, one with initial CEIH and the other with CEIH following minimally invasive endoscopic surgery for hypertensive intracerebral hemorrhage. Case 1 was a 46-year-old man with Glasgow Coma Scale (GCS) 12 (E4V3M5), complete hemiplegia, and motor aphasia who was brought to our hospital. A head computed tomography scan showed a left putaminal hemorrhage, and he was treated conservatively. However, because the hematoma enlarged and cerebral herniation appeared, we performed endoscopic hematoma removal. His paralysis improved and he transferred to a convalescent hospital with modified Rankin Scale 2. Case 2 was an 84-year-old man with GCS 9 (E3V2M4), right conjugate deviation, and complete hemiplegia who was brought to our hospital. We performed endoscopic hematoma removal. Because of gradual regrowth of the hematoma and cerebral herniation, endoscopic hematoma removal was performed again on day 12 after surgery. His consciousness improved postoperatively, and he was transferred to a convalescent hospital. The pathogenesis of CEIH is still not known, and we newly suggest the involvement of pia mater collapse and cerebral spinal fluid accumulation. We report the effectiveness of minimally invasive endoscopic surgery and reconsider the mechanism of CEIH based on a literature review.

高血压性脑出血很少发展为慢性包裹性脑内血肿(CEIH)。我们遇到过两例慢性包裹性脑内血肿病例,一例最初为慢性包裹性脑内血肿,另一例是在高血压脑内出血内镜微创手术后出现的慢性包裹性脑内血肿。病例 1 是一名 46 岁的男性,格拉斯哥昏迷量表(GCS)12(E4V3M5),完全偏瘫,运动性失语,被送到我院。头部计算机断层扫描显示他左侧副乳突腔出血,他接受了保守治疗。然而,由于血肿扩大并出现脑疝,我们为他实施了内镜下血肿清除术。他的瘫痪状况有所改善,转入康复医院,改良 Rankin 评分为 2 分。病例 2 是一位 84 岁的老人,GCS 9(E3V2M4),右侧联合偏斜,完全偏瘫,被送到我们医院。我们为他实施了内窥镜血肿清除术。由于血肿和脑疝逐渐再生,术后第 12 天再次进行了内镜下血肿清除术。术后,他的意识有所改善,并被转往疗养医院。CEIH的发病机制尚不清楚,我们新近提出桥膜塌陷和脑脊液积聚参与其中。我们报告了微创内窥镜手术的有效性,并根据文献综述重新考虑了 CEIH 的发病机制。
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引用次数: 0
Cavernous angioma of the cauda equina: A case report 马尾海绵状血管瘤:病例报告
IF 0.4 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-25 DOI: 10.1016/j.inat.2023.101942
Annelies Mondelaers , Thomas Vermeulen , Eline De Smet , Maarten Vanloon , Tomas Menovsky

Cavernous angiomas are benign vascular malformations that are occasionally found in the central nervous system. They comprise about 3% of all subdural spinal cord tumors, with only 24 cases of cavernomas of the cauda equina described in the literature.

This paper reports the case of a 55-year-old man who presented with back pain radiating to both legs. The patient followed several sessions of physiotherapy with only short pain relief. A lumbar magnetic resonance imaging showed a lesion with diameter of 12 mm located at the L1/L2 level under the conus medullaris. The patient underwent L2 and partially L1 laminectomy with complete resection of the lesion. The pathohistological examination was consistent with a cavernous angioma of the cauda equina. Full recovery of the patient was obtained without any neurological deficit.

海绵状血管瘤是一种良性血管畸形,偶尔会出现在中枢神经系统中。在所有硬膜下脊髓肿瘤中,海绵状血管瘤约占 3%,文献中描述的马尾海绵状血管瘤仅有 24 例。本文报告了一例 55 岁男性患者的病例,该患者因背部疼痛向双腿放射而就诊。患者接受了多次物理治疗,但疼痛仅得到短暂缓解。腰椎磁共振成像显示,位于 L1/L2 水平髓核下的病变直径为 12 毫米。患者接受了 L2 和部分 L1 椎板切除术,完全切除了病灶。病理组织学检查结果与马尾海绵状血管瘤一致。患者完全康复,没有出现任何神经功能障碍。
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引用次数: 0
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Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
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