No abstract

Background Data: Chiari malformation type-I (CM-I) is a challenging subject to wrap our hands around table. Chiari symptoms often range from, unexplained, and/or occipital Valsalva type headache, chronic fatigue syndrome, to lower cranial nerve abnormalities, or brain stem compression, till severe neurological insult which augmented by syringomyelia, or syringobulbia. Exact diagnostic and prognostic tools carry a great controversy which ranged from simple MRI study to MR imaging-based CSF velocity measurements, morphological, dynamic craniocervical junction assessments, subarachnoid pressure recordings, and compliance calculations were compared before and after surgical treatment.

Background Data: Spinal cord ependymomas can arise in different locations throughout the spinal cord, with the most frequent location being the cervical spine. Ependymomas usually grow slowly, compressing rather than infiltrating spinal tumors. Among different prognostic and predictor factors, the extent of resection has been the strongest predictor of outcomes. Multimodal intraoperative neurophysiological monitoring (IONM) helps maximize the extent of resection with minimal postoperative neurological complications. Purpose: To assess the impact of IONM on the extent of surgical resection and outcomes of spinal cord ependymomas. Study Design: A retrospective cohort study. Patients and Methods: Twenty-five patients who underwent spinal cord ependymoma resection in 4 centers between March 2014 and February 2018 were eligible for the inclusion criteria of this study. Patients were divided into two groups: the IONM group and the non-IONM group. IONM consisted of electromyography (EMG), transcranial motor evoked potentials (tcMEP), and somatosensory evoked potentials (SSEP). All patients were submitted for full neurological examination and MRI of the spine both preoperatively and at the postoperative routine follow-up. Postoperative radiotherapy was conducted routinely by our radiotherapists. The secondary outcomes were the correlation between the warning criteria of IONM and postoperative neurological outcomes and their impact on the extent of tumor resection. Also, a recurrence rate during the follow-up period was reported.

Background and objective Encephaloceles are considered to be a spectrum of neural tube defects with a herniation of the brain and the meninges through a bony skull defect to the exterior. Methods This retrospective and prospective study was carried out on 30 patients with congenital encephaloceles either vault or basal. The risk factors and the prognostic factors were assessed. Results There was a statistically significant association between the content of the sac, outcome and seizures. There was a presence of neural tissue associated with worse outcome and seizures. There was a statistically significant association between the size of the sac and outcome with seizure. There was a statistically insignificant association between site of defect and parent consanguinity, folic acid intake, drug history, seizures, outcome, gender, family history and a statistically significant association between the site of the sac and hydrocephalus. There was a statistically significant association between the outcome and presence of Hydrocephalus, microcephaly and seizures. Conclusions There was statistically significant association between the worst outcome and presence of hydrocephalus, microcephaly and seizures, and there is correlation between site of the defect in occipitocervical region and development of hydrocephalus.

No abstract

Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles under the following conditions: Creative Commons Attribution-Share Alike 4.0 International Public License (CC BY-SA 4.0).

Background Data: Anterior cervical discectomy and fusion (ACDF) is a gold-standard option for treating cervical degenerative disc diseases (DDD). Anterior plating enhances stabilization with improved outcomes and reduced risk of pseudarthrosis yet with annoying morbidities. Fusion with stand-alone cages avoids such complications, although its use in multilevel disc arthrodesis is still controversial. Study Design: Retrospective multicenter comparative cohort study. Purpose: To evaluate clinical and radiological long-term outcomes after ACDF with stand-alone polyetheretherketone (PEEK) cages versus ACDF with cages and plating. Patients and Methods: Patients who underwent four-level stand-alone ACDF (Group 1) or ACDF with plating (Group 2) between July 2012 and May 2016 and followed up for at least two years were recruited for this study. In this study, the reported outcome parameters included operative time, operative blood loss, fusion rate, cervical curve, neck disability index (NDI), Visual Analogue Score (VAS) of neck pain, patient satisfaction, and perioperative morbidity. Results: Forty-seven patients, including 25 males and 22 females, were reported. The mean age was 50.8 and 50.1 years in Groups 1 and 2, respectively. Twenty-four patients underwent stand-alone ACDF and 23 underwent ACDF with plating. The baseline characteristics data of both groups were homogeneous between groups. The outcome parameters (NDI, cervical curve VAS scores, fusion rate, complications, reoperation rate, and patient satisfaction) showed no significant difference between the two groups at different time points of follow up. Pre-and postoperative NDI and VAS showed significant improvement in both groups. Dysphagia was reported more frequently in Group 2. Conclusion: Four-level ACDF with stand-alone PEEK cage is equally effective as ACDF with anterior plating in patients treated for four-level cervical DDD with less incidence of dysphagia. (2021ESJ233)

Objective: To assess the cognitive outcome of traumatic brain injury in elderly patients. Design: a prospective study. Methodsthis study was conducted on 50 elderly patients exposed to TBI in sohag university hospital and 50 patients exposed to TBI but less than 65 years used as a control. IntroductionTraumatic brain injury (TBI) is a significant problem in older adults,and is associated with changes in the brain that affect the cognition(Sapoznik et al 2006) ResultsDuring the study period, 50 elderly patients with TBI were followed up for cognitive outcome, 12 patients (24%) were associated with cognitive deficits. Conclusion: TBI in elderly patients is associated with cognitive deficits post injury.