Search

This article discusses a rare condition called complete posterior atlantoaxial dislocation (PAAD) with an unfractured odontoid process (UFOP), which is a traumatic injury to the craniocervical junction. The main objective of treatment is to preserve neurological function and restore spine stability. Traditional approaches for odontoidectomy, such as transnasal and transoral routes, are technically challenging and associated with complications. The article presents a case report of a patient with PAAD and describes a novel endoscopic surgical approach called Anterior Full-Endoscopic Transcervical (AFETA) Odontoidectomy, which provides a safer alternative for the treatment of this condition. [Extracted from the article]

This article discusses a case report of a patient who underwent a surgical procedure called transorbital neuroendoscopic surgery (TONES) to treat a frontal epidural hematoma. TONES is a minimally invasive approach that has been shown to have better cosmetic outcomes and shorter hospital stays compared to other skull base surgeries. The article highlights that there are no reported cases of managing epidural hematomas through TONES and no reports of the local experience and results in Latin America. The authors conclude that TONES is a safe and effective approach for treating skull base pathologies, including traumatic brain injuries, and should be encouraged in Latin America. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, discusses penetrating transorbital brain injuries (TOBIs), which are relatively rare and unique types of trauma. The diagnosis of TOBI requires a high degree of suspicion, thorough clinical examination, and appropriate imaging. Treatment options for TOBI include conservative and surgical approaches, but there is little evidence of their effectiveness and superiority. The article presents a case series of TOBI, describing the foreign body, surgical approach, outcomes, and complications, and also reviews the available literature. The authors conclude that prompt surgical management is crucial for TOBI, and they discuss the use of transorbital neuroendoscopic surgery as a viable and secure approach. [Extracted from the article]

Background and Importance: Complete posterior atlantoaxial dislocation (PAAD) with an unfractured odontoid process is a rare condition where a dislocated but intact odontoid process is positioned ventrally to the anterior arch of C1. This lesion is related to transverse and alar ligament rupture secondary to hyperextension and rotatory traumatic injury and is often associated with neurological deficit. The treatment strategy remains controversial, and in many cases, odontoidectomy is required. Traditional approaches for odontoidectomy (transnasal and transoral) are technically demanding and are related to several complications. This article describes a 360° reduction and stabilization technique through a navigated anterior full-endoscopic transcervical approach (nAFETA) as a novel technique for odontoidectomy and C1-C2 anterior transarticular fixation supplemented with posterior fusion., Clinical Presentation: A 21-year-old man presented to the emergency room by ambulance after a motorcycle accident. On evaluation, incomplete ASIA B spinal cord injury was documented. Imaging revealed a complete PAAD. We performed a two-staged procedure, a nAFETA odontoidectomy plus C1-C2 anterior transarticular fixation followed by posterior C1-C2 wired fusion. At a 2-year follow-up, the patient had a 10-point Oswestry Disability Index score and neurological improvement to ASIA E., Conclusion: PAAD can be successfully treated through minimally invasive nAFETA. Noteworthy, the risks of the transoral and endonasal routes were avoided through this approach. In addition, nAFETA allows anterior transarticular fixation during the same procedure providing spinal stability. Further studies are required to expand the use of nAFETA in this field., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Objective: The aim of this study was to determine an optimal waist circumference (WC) cutoff value for defining the metabolic syndrome (METS) in postmenopausal Latin American women., Methods: A total of 3,965 postmenopausal women (age, 45-64 y), with self-reported good health, attending routine consultation at 12 gynecological centers in major Latin American cities were included in this cross-sectional study. Modified guidelines of the US National Cholesterol Education Program, Adult Treatment Panel III were used to assess METS risk factors. Receiver operator characteristic curve analysis was used to obtain an optimal WC cutoff value best predicting at least two other METS components. Optimal cutoff values were calculated by plotting the true-positive rate (sensitivity) against the false-positive rate (1 - specificity). In addition, total accuracy, distance to receiver operator characteristic curve, and the Youden Index were calculated., Results: Of the participants, 51.6% (n = 2,047) were identified as having two or more nonadipose METS risk components (excluding a positive WC component). These women were older, had more years since menopause onset, used hormone therapy less frequently, and had higher body mass indices than women with fewer metabolic risk factors. The optimal WC cutoff value best predicting at least two other METS components was determined to be 88 cm, equal to that defined by the Adult Treatment Panel III., Conclusions: A WC cutoff value of 88 cm is optimal for defining METS in this postmenopausal Latin American series.