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Introduction: Vertebral fractures in postictal patients with no prior acute or chronic trauma history are rare but can lead to severe neurological complications if missed during the initial evaluation., Research Question: What are the prevalence and risk factors associated with vertebral fractures? What are the characteristics of these fractures in terms of their location, severity, and clinical outcome?, Materials and Methods: A comprehensive literature search using MeSH terms was conducted. Data from previously published studies and three new cases from the authors' institution were collected. The variables included demographic information, seizure history, medical comorbidities, fracture characteristics, and treatment details. Descriptive statistics summarize the data. Inferential statistics ( t -test, Mann-Whitney U test, chi-squared test, Fisher's exact test, and logistic regression) were used to identify the risk factors for vertebral fractures., Results: The review included nine studies with a total of 19 patients, and three additional unpublished cases from the authors' institution. The median patient age was 50 years, with male predominance. No significant differences were found between the groups in osteoporosis, seizure history, antiepileptic drug use, or alcohol or drug abuse. The most common sites of fracture were the midthoracic spine for compression fractures and thoracolumbar junction for burst fractures. Risk factors for fractures include greater muscle mass, lower bone mineral density, longer convulsions, and recurrent convulsions., Discussion: The mechanism of injury involved violent muscle contractions during seizures., Conclusion: This review summarizes the current knowledge and provides evidence for best practices in the management of seizure-induced vertebral fractures., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purpose: This study aimed to adapt a Spanish translation of the Oswestry Disability Index (ODI) into a cross-cultural version for the Mexican population. The objectives were to verify the validity and reliability of the adapted ODI and to compare pain perception between patients with and without obesity., Material and Methods: We included 102 patients with low back pain from two neurosurgery departments in Mexico. The ODI questionnaire was translated and culturally adapted. Validity and construct were evaluated using exploratory factor analysis, and the external convergent validity was assessed by correlating ODI scores with pain intensity, age, and obesity. Test-retest reliability was calculated using the intraclass correlation coefficient, and confirmatory analysis was employed to validate the factorial structure., Results: Patients with obesity were older and had higher pain scores than patients without obesity. The exploratory analysis of the ODI in Mexican Spanish showed good reliability (Cronbach's alpha of 0.923) and validity (factorial loading range, 0.681 - 0.818). The confirmatory analysis showed almost null or very low discrepancy between the proposed model and the real data., Conclusions: A Spanish translation of ODI was cross-culturally adapted for the Mexican population. The Mexican version of the ODI showed good reliability and validity in Mexican culture.

Objective: Hydroelectrolytic disturbances are part of the complications of subarachnoid hemorrhage. Cerebral salt wasting syndrome (CSWS) must be considered when hyponatremia is associated with a decrease in circulating volume. We performed this study to determine the clinical characteristics and management paradigm of patients with serum sodium concentration abnormalities and aneurysmatic subarachnoid hemorrhage., Methods: We analyzed retrospectively clinical and laboratory data from eight patients with subarachnoid hemorrhage due to rupture of an intracranial saccular aneurysm and cerebral salt wasting syndrome. Their course, as well as their clinical findings and treatment, are described., Results: In eight patients, hyponatremia that lasted for more than 24 hours was detected (serum sodium under 135 mEq/l). The sodium disturbance occurred between day 3 and day 10 in all cases, in six of them in day 7 or day 8. The specific treatment for CSWS was to increase volume delivery according to the characteristics of the patient. Except for one case, none of the remaining patients required more than 72 hours of treatment to correct hyponatremia. No treatment-related complications were found, Conclusion: Cerebral salt wasting syndrome, occurring in some patients with subarachnoid hemorrhage, is more commonly related to certain specific anatomic locations of the ruptured aneurysm, responds to sodium replacement therapy and fluids and can be diagnosed and treated based on the clinical, hydroelectrolytic and hemodynamic course of the patient. Further studies are needed to define the underlying mechanism of this condition.