Expansively growing cervical spine osteoblastomas are rare but can cause severe neurological damage as a result of their anatomical relationship to nerve structures. Also, cerebral vessels, especially the vertebral artery in its transvertebral position, are often covered by tumor tissue. In complete resection of the tumor, it is sometimes possible to retain the affected vessel. In addition to conventional radiographic diagnostics, computed tomography, and magnetic resonance imaging, angiography and Doppler sonography of the intracranial arteries executed in parallel can provide evidence of the dimension of the neurological deficit to be expected during resection. This case report describes the staged diagnostic procedure and successful complete resection, retaining the affected vertebral artery, of an osteoblastoma of the 5th cervical body with massive intraspinal expansion in an 11-year-old child.
The Cologne Apraxia Screening (KAS) was developed to diagnose apraxia following left-hemisphere (LH) stroke. The present study aims at developing a diagnostic tool for patients with right-hemisphere (RH) stroke (KAS-R) by modifying the test material of the KAS and reducing the test items based on psychometric analyses.A total of 100 patients with RH stroke and 77 healthy control participants were tested. Psychometric analyses led to the exclusion of 8 KAS items. The final KAS-R, consisting of 12 items, shows good internal consistency (α = 0.795) as well as high sensitivity (79.4 %) and specificity (84.4 %). Applying a cut-off value of ≤ 46 (out of 48) points, 39 RH stroke patients were diagnosed with apraxia. Significant correlations were found between the KAS-R and an imitation test as well as expert ratings, indicating high construct validity. The results suggest that the KAS-R is a reliable and valid diagnostic tool for apraxic deficits after RH stroke.
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